Most people would consider an abuse victim as a person who experienced “trauma.” However people often don’t view them as potentially experiencing “post-traumatic stress disorder.” PTSD is more commonly thought of as a condition affecting combat veterans, but the number of civilians suffering from PTSD is 13 times more than military personnel, according to a release from Drexel University. So what gives? According to researchers at Drexel, the media plays a large role in what the general population and lawmakers associate with PTSD.
The Drexel study reviewed 35 years worth of articles on PTSD published in the New York Times — from 1980, the year PTSD was added to the Diagnostic and Statistical Manual of Mental Disorders, to 2015. Of 871 articles a little over 50 percent focused on military cases of PTSD. The occurrence of PTSD in veterans of Iraq and Afghanistan is 20 percent. But research shows the condition is far more likely to affect civilians who suffer sexual assault (30-80 percent of survivors), nonsexual assault (23–39 percent), survivors of disasters (30–40 percent), and car crashes (25–33 percent).
About a third of the articles focused on symptoms that aren’t common: nightmares (13.1 percent of the time), flashbacks (11.7 percent), depression (12.3 percent). Over time articles focused less and less on treatment — from 19.4 percent in 1980-1995 to just 5.7 percent in 2005-2015. Articles rarely told stories of survival or prevention.
“These negative themes could create misconceptions that people who have PTSD are dangerous and discourage employers from hiring prospective employees with the disorder,” said Jonathan Purtle, DrPH, assistant professor in Drexel’s Dornsife School of Public Health and the study’s lead investigator.
Of legislative proposals on PTSD from 1989 to 2009, 91.4 percent focused only on military populations and 81.7 percent focused on combat experience as the cause.
“This narrow focus could inhibit awareness about PTSD resilience and recovery and constrain discourse about the social determinants of traumatic stress, which is needed to garner political support for policy interventions,” wrote the Drexel team.
The portrayal of PTSD in the media definitely shaped my inability to see it in myself.
I lived in denial of the sexual abuse I experienced as a child. I saw therapists throughout my life and was treated for anxiety and depression. Because I didn’t recognize what happened to me as sexual abuse — I was too young when it occurred to understand what was happening — I never brought it up in therapy. It was a blind spot in my personal narrative.
I never considered that my anxiety and hypervigilance could be related to PTSD. I felt that the absence of flashbacks meant it couldn’t be relevant. But re-experiencing a traumatic event doesn’t mean solely through flashbacks. The DSM-5 also recognizes (1) recurrent, involuntary, and intrusive memories, (2) traumatic nightmares, (3) intense or prolonged distress after exposure to traumatic reminders, and (4) marked physiologic reactivity after exposure to trauma-related stimuli. All of which I did experience throughout childhood and adulthood, although only one is necessary for diagnosis.
I often described my anxiety as living each day like a cat on an electrified plate, waiting for it to intermittently zap her. I had other symptoms that could easily masquerade as a mood or anxiety disorder when trauma isn’t being recognized.
- Feeling alienated from others (e.g., detachment or estrangement).
- Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame).
- Constricted affect: persistent inability to experience positive emotions.
- Persistent (and often distorted) negative beliefs and expectations about oneself or the world.
- Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.
- Irritable or aggressive behavior
- Self-destructive or reckless behavior
- Exaggerated startle response
- Problems in concentration
But those things just didn’t seem as relevant as flashbacks. Isn’t that what we see in movies? Isn’t that what happens to Eric Bana in “Munich”? I had trouble finding stories about trauma that looked like mine. It’s like I was waiting for someone else to come along and define my own experience. The problem is that a therapist only knows what you disclose. They can’t fill in the blanks for you.
Even after the fog of denial lifted and I started talking about the abuse in therapy, I still had trouble seeing myself as someone with PTSD. I began comparing my trauma to the trauma of others. I was imagining some hierarchy where I didn’t have a right to be so traumatized. I mean, what could be more traumatic that seeing someone die? Those people need more help than me, right? That kind of thinking wasn’t helpful.
What was helpful was journaling and blogging about my story. I felt that if there were more stories out there about child sexual abuse, people struggling like me would be able to relate, stop feeling helpless, and seek treatment. I agree with the Drexel researchers; the discourse on PTSD needs to be broadened. A total of 7.7 million Americans age 18 and older have PTSD, according to the Anxiety and Depression Association of America.
Trauma therapy has helped me to find my voice, define my boundaries, recognize my strength, reduce shame, and rebuild my fragile self esteem. It helped me let go of resentment and feelings of being defective.
Some of the strongest people I ever met are trauma survivors. They show remarkable resilience in the face of extreme adversity. My trauma made me feel like anything (bad) could happen at any moment. Survivors have shown me that tremendous positive growth and healing is possible.
The military doesn’t have a monopoly on PTSD. Neither does abuse. In fact, every earthquake or volcano, each hurricane or tornado has the potential to traumatize tens of thousands at a time. We need those stories — we need to show that healing is possible.
Jonathan Purtle, Katherine Lynn, Mashal Malik. ‘Calculating the Toll of Trauma’ in the Headlines: Portrayals of Posttraumatic Stress Disorder in the New York Times (1980–2015). American Journal of Orthopsychiatry, 2016; DOI: 10.1037/ort0000187
Understand the Facts Posttraumatic Stress Disorder (PTSD) from the Anxiety and Depression Association of America.