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PTSD: Chapter II

Dec 20

Since I wrote the first article on this topic, “PTSD: Is That All There Is?”, the article has received quite a response from readers.  It seems that many of you found the information encouraging and liberating.  There was a small minority however, who were offended by what I wrote.  This group seemed to interpret what I was saying as, “c’mon suck it up, there really is no problem”.  I apologize to them, my purpose was to educate not upset.  It is to this group that I address the present article.

To begin, it is critical to consider that PTSD is an assortment of contextless symptoms removed from the complexities of people’s lives and the social systems (structures) that contribute to them.  As such, a diagnosis of PTSD does nothing more than to individualize social problems and to pathologize distressed people.

I will explain.  The phenomenon of trauma can be understood as a number of symptomatic responses to a concrete situation.  Therefore traumatic events and situations can be viewed as concrete events within contexts.  Particular traumatic events affect particular people in particular locations within particular contexts, and most often involve other people.  It stands to reason then, that trauma is inherently a socio-political phenomenon.  This assertion is most apparent in those situations comprised of obvious perpetrators or obviously oppressive systems (organizations, institutions, policies, etc).  As an example of the former, a woman is beaten and sexually assaulted by a man.  The man is the perpetrator, and the context is patriarchy/power/control.  As an example of an oppriessive organization, lets say a policeperson becomes distressed after being exposed to traumatic stimulii.  In a supportive context, the employer might offer ongoing caring and support (whatever was necessary), and in so far as it did the employee’s distress would be contained and his/her natural resilience encouraged to build.  On the other hand when our policeperson encounters antagonism, opposition, pressure, doubt, combativeness etc., from the employer, the traumatic exposure and the natural initial response (most often acute anxiety) take on a new dimension.

In other words, the reactions of others (including organizations) to victims of traumatic exposure can greatly compound the initial reaction and contribute to the lack of resilience, the development of post traumatic responses and other related adjustment concerns.  Moreover, these reactions can be determined, in the case of an RCMP victim, by the values and structures of the Federal government in power and Canadian society at large.  This is not to say that if the government of the day had the political will to care for the members of the national police service, and Canadian citizens would stand for nothing but the best for the RCMP, that there would be no post traumatic responses; only that they would not have the dimensions that they currently do.

The stifling of natural resilience (“ordinary magic”) and the magnification of trauma by the government, the RCMP, and society at large can occur in several ways including: the cancellation of programs; ignoring mental injuries; minimizing mental injuries; failing to accomodate; and emphasizing budgets over people.

In conclusion, while most of us are imbued with “ordinary magic” it seems to thrive in a particular environment.  That environment is one of inclusion, support, and caring.  If an employer can provide the foregoing, the chances of a normal adjustment to the traumatic exposure followed by post traumatic growth are increased.  Alternatively, if the employer creates an environment of exclusion, isolation, and stigma the policeperson is likely to be secondarily traumatized; and this secondary exposure often cuts deeper than the primary exposure to the traumatic event.  Sound familiar?

Dr. Mike Webster, R.Psych.

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