![]() At first these behaviors were attributed to noncombat-related neurosis or psychosis. veterans exhibited problematic and life-threatening behaviors. Not until the Vietnam War did the demand for a combat-related trauma diagnosis reach a tipping point. The new manual briefly acknowledged that combatants experienced short-lived psychological reactions to war but did not label the syndrome a psychiatric disorder. In the heat of battle in the Korean War, the American Psychiatric Association published the first edition of the DSM. Nevertheless, we should note that the first use of the term “posttraumatic” occurred in a follow-up study on veterans who had been diagnosed with combat fatigue. However, when psychiatrists found that the degree of relatedness in the military unit was a protective factor, they developed treatment strategies for what they termed “combat fatigue.” These treatment strategies emphasized emotional support and rapid return to active duty.Īgain, interest in trauma faded once World War II came to an end. Initially, those who developed posttraumatic reactions were discharged. With the beginning of World War II, many service members once again experienced the horrors of combat. ![]() Other mental health practitioners, influenced by Sigmund Freud’s theories, diagnosed the condition as “war neurosis.” In World War I, psychiatrists originated the term “shell shock” because they considered the symptoms to be physiological reactions to the intense shock waves that emanated from artillery explosions. In the past, however, the prior lessons learned were largely abandoned and ignored in the decades of peacetime that followed wars.įor example, many physicians who were followers of the somatic movement proposed that traumatized Civil War combat veterans were suffering from a cardiac injury, which they labeled “soldier’s heart.” At the same time, other health care providers relied on a psychological conceptualization of the condition, which they referred to as “nostalgia.” Civil War to the recent conflicts in Iraq and Afghanistan, researchers and practitioners have returned again and again to the impact of war-related violence on the psyches of military troops. During the past 150 years, wars have spurred health care providers to consider, to varying degrees, these contrasting perspectives in hopes of better understanding and treating the psychiatric casualties of combat.įrom the U.S. The somatic movement, which conceptualized a physiological basis for the syndrome, began in England during the 1860s, when researchers described “railway spine” as a consequence of the physical traumas of railroad accidents. The psychological movement began in the 1790s and considered the syndrome to be primarily a mental one involving altered consciousness and amnesia, which later became known as dissociation. The origins of the PTSD diagnosis stem from two dramatically different conceptualizations of its cause and symptoms. Now that counselors are playing an increasingly important role as service providers for both military and civilian survivors of trauma, it is vital that we become familiar with the historical context and current issues regarding PTSD. Only dissociative identity disorder has stirred up more debates among researchers and practitioners. Since then, the evolving diagnosis of PTSD has generated numerous and intense controversies. Despite powerful accounts over the millennia of the psychic impact of trauma, it was only 35 years ago that the Diagnostic and Statistical Manual of Mental Disorders ( DSM) introduced the condition known as posttraumatic stress disorder (PTSD). ![]() ![]() These “hidden wounds” of combat included overwhelming feelings of anxiety, horrific nightmares, heightened startle reactions, flashbacks of battle scenes and a profound sense of alienation years after the conflicts had ceased. In fact, for nearly 3,000 years, such epic poems as The Odyssey and The Iliad have given eloquent voice to the psychic scars of war. ![]()
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