Growing up, we laughed about the neighbor kid’s dad waking up in the middle of the night thinking he was in Vietnam, but while it was a little scary, it never really went beyond the level of a joke. I’ve now met a few veterans in my life affected by trauma, always taking medication, always steadily sweating, sometimes unable to hold a job, and I’ve realized that PTSD is a terrifying and debilitating condition.
There has been a debate this week about whether Donald Trump said those who have PTSD are weak or whether his words were taken out of context. Regardless of context, the issue goes beyond veterans and the sacrifices they have made. While these are important issues, Trump’s recent speech and the subsequent fallout illustrate a social stigma about mental health that obscures our understanding and impedes treatment.
Since this has become a controversial topic, the context of Trump’s words is that he was at a Retired American Warrior’s PAC in Virginia, and when asked about a more holistic approach involving community institutions to reduce veteran suicides, he responded:
When you talk about the mental health problems, when people come back from war and combat and they see things that maybe a lot of folks in this room have seen many times over and you’re strong and you can handle it but a lot of people can’t handle it. They see horror stories, they see events you couldn’t see in a movie, nobody would believe it …
He went on to confirm that veterans’ affairs will be a top priority for his presidency and that the problems veterans face are tragic.
Clearly he intended to support the idea of more holistic assistance for veterans, but the way he said it reveals our social consciousness surrounding PTSD and other mental illnesses. From the video of his response, it is clear he was trying to make his audience feel good because they are “strong” and they “can handle it.” He wasn’t slamming those who can’t handle it, but there is clearly an unconscious sentiment to that effect.
One major problem with our thinking is revealed by the fact that many people in that room with Trump likely have PTSD. Their strength, therefore, lies not in willing PTSD away, but in acting strong in the face of mental illness. Unfortunately, this kind of strength is the cost of internalizing our society’s stigmas. A debilitating mental illness should not be something we should feel compelled to conceal. We should not need to be strong enough to pretend nothing is wrong, because in cases of PTSD, something has gone very wrong and the resulting trauma should not be a mark of shame or weakness.
According to the National Institute of Mental Health (NIMH), “Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.” In other words, PTSD is by definition a condition that interferes with daily life over an extended period of time. It can include flashbacks, bad dreams, frightening thoughts, difficulty sleeping, outbursts, and more.
Most importantly, there are cognition and mood symptoms used to diagnose PTSD, and these illustrate how damaging it is to imply weakness in a sufferer’s condition. NIMH says these include “Negative thoughts about oneself or the world,” and “Distorted feelings like guilt or blame.”
PTSD has nothing to do with strength. It can unexpectedly strike anyone who has experienced trauma, even years after the event. It brings on unavoidable and devastating symptoms, and since these include guilt and self-blame, we need to be extra careful in the way we talk about and treat it as a society.
Furthermore, it is not only veterans who suffer from PTSD but also people who have been in a traumatic situation like a car accident, mugging, rape, or even loss of a loved one. As we know, there is no shortage of victim blaming in incidents of rape, and the underlying belief that any of these people are simply not strong enough is destructive and clearly exacerbates their condition. Imagine telling someone who had lost their wife to just be strong. Imagine telling a rape victim that he or she can “handle it.” Such responses would be equivalent to saying, “stop complaining,” and of course not talking about trauma makes PTSD even worse.
The National Center for PTSD has three therapies for treatment: cognitive therapy, exposure therapy, and EMDR, and they all involve talking through the trauma. “In cognitive therapy, your therapist helps you understand and change how you think about your trauma and its aftermath.” In exposure therapy, “By talking about your trauma repeatedly with a therapist, you’ll learn to get control of your thoughts and feelings about the trauma.” Talking about the problem is the best cure we have, and we need to be willing to help our veterans by listening to them.
That is what the questioner was alluding to when he asked Donald Trump if he would increase governmental cooperation with community groups like churches. These institutions have been providing help to veterans by providing a community to understand their trauma, and the government and society at large have failed to engage them.
We should not think PTSD sufferers can man up, keep their feelings to themselves, and “deal with it.” Furthermore, our view should not be obscured by thinking strong soldiers are the only ones with PTSD. Nor should we think that experiencing the horrors of war is any more the fault of a veteran than a rape or car accident is the fault of the victim. These horrors should be part of our social dialogue to mitigate their occurrence and effects, but they simply aren’t. Rape, war, death, and mental illness are all suppressed because they are uncomfortable topics. That is the reason for Trumps words, not some intentional slight against veterans.
Photo: Gage Skidmore/Creative Commons