Post-Traumatic Stress Injury: Why You Should Be Using PTSI To Describe Your Trauma (instead of PTSD)!

Most people are familiar with the psychological condition called Post-Traumatic Stress Disorder (PTSD).  As you may be aware from anything you have read or heard—or more unfortunately, from what you may personally suffer from—PTSD can be a quite debilitating psychological condition.  The main symptoms of PTSD typically include severe anxiety or panic attacks, flashbacks, depression, somatic symptoms (e.g., loss of appetite, sleep disturbance, or headaches), and loss of self-confidence and self-esteem.  Problems with addiction are also not uncommon when PTSD has taken hold. All of these symptoms ongoingly create and perpetuate marked distress in the person suffering from PTSD, and can continue to be present for many years or more, if not much of a lifetime.

When someone is formally diagnosed with PTSD, it is understood that by definition, the trauma triggering the PTSD involved a life or death event. War, a plane or car crash, or a natural disaster are all prime examples of life and death events that can of course traumatize someone involved in any of these events.  I should add that the formal diagnosis of PTSD can also include directly witnessing a life or death event, of the types just listed, without being a direct victim of it.

There is however another category of trauma that may not involve formally diagnosable events, but can trigger psychological trauma anyway. I’m referring here to psychological events which while not life and death, nevertheless in the extreme certainly can be traumatizing by themselves.  These especially include painful rejection, severe abuse, or a blind-siding major betrayal (e.g., an unsuspected infidelity). All of these psychologically devastating events have the potential to create most if not all of the same clinical symptoms listed above for traumas involving life and death events. Plus, need I add: unlike the first category of trauma which thankfully most people will never experience, chances are most people will go through their life experiencing at least one situation involving the second category of trauma.  

Now it’s time to tell you about Dr. Peter Levine’s work related to PTSD.  First we have his absolutely marvelous book, entitled In An Unspoken Voice: How The Body Releases Trauma and Restores Goodness (2010). Then we have the incredibly valuable conference of his I attended several years ago on the subject of his book and related writings.  Dr. Levine is clearly a brilliant man. But better yet, he is also a deeply compassionate man—especially when it comes to people plagued by the debilitating symptoms of PTSD.

Let me tell you what I mainly mean by that statement of compassion—by quoting something from his book.  On page 34, Dr. Levine writes:


 “Recently, a young Iraq veteran took issue with calling his combat anguish PTSD.  Instead, he poignantly referred to his pain and suffering as PTSI. With the “I” designating “injury.”  What he wisely discerned is that trauma is an injury, and not a disorder like diabetes, which can be managed but not healed.  In contrast, post-traumatic stress INJURY is an emotional wound, amenable to healing attention and transformation.”


In An Unspoken Voice: How The Body Releases Trauma and Restores Goodness
Peter A. Levine
North Atlantic Books, 2010

To say I am indebted to Dr. Levine for introducing the term “injury” into the mix is putting it mildly.  That’s because virtually all of my current and past patients whom I have treated have found the term post-traumatic stress injury (PTSI) a term that strips the stigmatizing judgment out of the diagnosis of a disorder or mental illness.  Knowing that in this framework someone who has been traumatized will instead be seen as having a painful deep-seated injury can provide a badly needed sense of “normalcy” for that traumatized person. After all, who doesn’t sooner or later have to contend with a painful PHYSICAL injury, which can—as with a painful psychological injury—last a long time, take quite a while to treat, and quite possibly never fully go away?  No one in good conscience could possibly think of suffering from a painful physical injury as having anything but normalcy to it under the circumstances, right?

So to me the overall moral of the story is this.  If you are an individual who suffers from PTSD, strongly consider from now on calling it PTSI (and leave the PTSD thing to, say, professional diagnosing for insurance purposes).  Same recommendation I want to give to psychotherapists, counselors, coaches, and healers working with people diagnosed with PTSD: tell your patients/clients you will be using the term PTSI for their condition.  Then, as so sensitively encouraged by Dr. Levine, let’s help these suffering souls attempt to heal from their deep, complicated injury. And let’s make sure they get plenty of doses of healing-oriented kindness and compassion along the way—from people around them and of course from us—and not just in-office, diagnosis-based treatment options.

PTSI rather than PTSD—thank you Dr. Levine!


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