The psychological disorder and descriptive diagnosis of PTSD has undergone a gradual evolutionary change of labels over time but it is still essentially the same disorder; it’s still the same disease.
Variously named, PTSD was called:
Shell Shock (in World War I) →
Battle Fatigue (in World War II) →
Operational Exhaustion (in the Korean War) →
Post Vietnam Syndrome PVS (early in the Vietnam War) →
Post Traumatic Stress Disorder (without the hyphen) →
Post-Traumatic Stress Disorder (with the hyphen) →
Posttraumatic Stress Disorder (conjoined) (Vietnam War and later).
In elementary school we were sometimes tasked to “diagram a sentence” or break it down into its grammatical components of nouns, verbs, pronouns, adverbs and subject/predicate and so forth; although PTSD is not a whole sentence – it is a phrase that can be clearly understood in those terms.
To be clear: PTSD is not Post Trauma Stress Disorder but rather Post Traumatic Stress Disorder – a subtle yet very important difference.
Post – (as a stand-alone word without a hyphen) means after in time or sequence; following; subsequent (antonym of pre)
Post – (as a prefix with or without a hyphen) again means after in time or sequence; following; subsequent (antonym of pre)
Trauma – noun; wound, injury, physical or emotional (psychiatric)
Whereas, in the phrase “post traumatic stress disorder”
Traumatic – an adjective; modifies the noun “stress”
Stress – noun; the state of mental, emotional, suspense or physical strain or tension
Disorder – adjective; descriptive of something inappropriate or abnormal; chaotic
Understood grammatically no hyphen is necessary in PTSD. But there are those who would insist upon adding it and thereby change the very meaning of the phrase to their own purposes.
Adding a hyphen is misleading as it tends to emphasize trauma instead of traumatic stress. While trauma may run the full gamut of hurt from a mere paper cut to fatal injuries and recovery from such may be only partial, lengthy, or involve a degree of stress, it is still not injury caused purely by stress.
Remembering that the term and acronym PTSD was originally coined to describe a condition borne solely by combat veterans, reinterpretation by any means is like stretching a blanket over the civilian population and dilutes what it means to be a combat veteran. The soldier in combat is both hunter and hunted and no civilian activity comes near that level of psychological stress.
The late George Carlin had somewhat to say in this regard; he derided it as soft language:
George Carlin – On Soft Language
“You can’t be afraid of words that speak the truth. I don’t like words that hide the truth. I don’t like words that conceal reality. I don’t like euphemisms or euphemistic language. And American english is loaded with euphemisms. Because Americans have a lot of trouble dealing with reality. Americans have trouble facing the truth, so they invent a kind of a soft language to protect themselves from it. And it gets worse with every generation. For some reason it just keeps getting worse.
I’ll give you an example of that. There’s a condition in combat. Most people know about it. It’s when a fighting person’s nervous system has been stressed to it’s absolute peak and maximum, can’t take any more input. The nervous system has either snapped or is about to snap. In the first world war that condition was called shell shock. Simple, honest, direct language. Two syllables. Shell shock. Almost sounds like the guns themselves. That was 70 years ago. Then a whole generation went by. And the Second World War came along and the very same combat condition was called battle fatigue. Four syllables now. Takes a little longer to say. Doesn’t seem to be as hard to say. Fatigue is a nicer word than shock. Shell Shock…Battle Fatigue. Then we had the war in Korea in 1950. Madison Avenue was riding high by that time. And the very same combat condition was called Operational Exhaustion. Hey we’re up to 8 syllables now! And the humanity has been squeezed completely out of the phrase now. It’s totally sterile now. Operational Exhaustion: sounds like something that might happen to your car. Then of course came the war in Vietnam, which has only been over for about 16 or 17 years. And thanks to the lies and deceit surrounding that war, I guess it’s no surprise that the very same condition was called Post-Traumatic Stress Disorder. Still 8 syllables, but we’ve added a hyphen. And the pain is completely buried under jargon. Post-Traumatic Stress Disorder. I bet you, if we’d still been calling it Shell Shock, some of those Vietnam veterans might have gotten the attention they needed at the time. I bet you that. But it didn’t happen. And one of the reasons is because we were using that soft language, that language that takes out the life out of life. And it is a function of time it does keep getting worse.
Give you another example. Sometime during my life toilet paper became bathroom tissue. I wasn’t notified of this. No one asked me if I agreed with it. It just happened. Toilet paper became bathroom tissue. Sneakers became running shoes. False teeth became dental appliances. Medicine became medication. Information became directory assistance. The dump became the land fill. Car crashes became automobile accidents. Partly cloudy became partly sunny. Motels became motor lodges. House trailers became mobile homes. Used cars became previously owned transportation. Room service became guest room dining. Constipation became occasional irregularity.
When I was a little kid if I got sick they wanted me to go to a hospital and see the doctor. Now they want me to go to a health maintenance organization. Or a wellness center to consult a health care delivery professional.
Poor people used to live in slums. Now the economically disadvantaged occupy sub-standard housing in the inner cities. And they’re broke! They’re broke. They don’t have a negative cash flow position. They’re f–kin’ broke! Because a lot of them were fired. You know, fired. Management wanted to curtail redundancies in the human resources area. So many people are no longer viable members of the work force.
Smug, greedy, well-fed white people have invented a language to conceal their sins. It’s as simple as that. The CIA doesn’t kill people anymore, they neutralize people, or they depopulate the area. The government doesn’t lie, it engages in disinformation. The Pentagon actually measures radiation in something they call sunshine units. Israeli murderers are called commandos. Arab commandos are called terrorists. Contra killers are called freedom fighters. Well if crime fighters fight crime and fire fighters fight fire what do freedom fighters fight? They never mention that part of it to us, do they?
And some of this stuff is just silly. We know that. Like when the airlines tell us to pre-board. What the hell is pre-board? What does that mean? To get on before you get on? They say they’re going to pre-board those passengers in need of special assistance…cripples!
Simple honest direct language. There’s no shame attached to the word cripple I can find in any dictionary. In fact it’s a word used in Bible translations. “Jesus healed the cripples.” Doesn’t take seven words to describe that condition. But we don’t have cripples in this country anymore. We have the physically challenged. Is that a grotesque enough evasion for you? How about differently-abled? I’ve heard them called that. Differently-abled! You can’t even call these people handicapped anymore. They say: “We’re not handicapped, we’re handy capable!” These poor people have been bullshitted by the system into believing that if you change the name of the condition somehow you’ll change the condition. Well hey cousin … doesn’t happen!
We have no more deaf people in this country. Hearing impaired. No more blind people. Partially sighted or visually impaired. No more stupid people, everyone has a learning disorder. Or he’s minimally exceptional. How would you like to told that about your child? ‘He’s minimally exceptional.’ Psychologists have actually started calling ugly people those with severe appearance deficits. It’s getting so bad that any day now I expect to hear a rape victim referred to as an unwilling sperm recipient!
And we have no more old people in this country. No more old people. We shipped them all away and we brought in these senior citizens. Isn’t that a typically American twentieth century phrase? Bloodless. Lifeless. No pulse in one of them. A senior citizen. But I’ve accepted that one. I’ve come to terms with it. I know it’s here to stay. We’ll never get rid of it.
But the one I do resist, the one I keep resisting, is when they look at an old guy and say, “Look at him Dan, he’s ninety years young.”
Imagine the fear of aging that reveals. To not even be able to use the word old to describe someone. To have to use an antonym. And fear of aging is natural. It’s universal, isn’t it? We all have that. No one wants to get old. No one wants to die. But we do. So we con ourselves.
I started conning myself when I got in my forties. I’d look in the mirror and say, “Well…I guess I’m getting …older.” Older sounds a little better than old, doesn’t it? Sounds like it might even last a little longer.
I’m getting old. And it’s okay. Because thanks to our fear of death in this country I won’t have to die. I’ll pass away. Or I’ll expire, like a magazine subscription. If it happens in the hospital they’ll call it a terminal episode. The insurance company will refer to it as negative patient care outcome. And if it’s the result of malpractice they’ll say it was a therapeutic misadventure.
I’m telling ya, some of this language makes me want to vomit. Well, maybe not vomit . . . makes me want to engage in an involuntary personal protein spill.”
George Carlin, 1937 – 2008
Strictly speaking, one ought not blame America for this gradual softening of language. Experience shows that it is the British who are the true Masters of Understatement: viz.,
On March 15, 1989, the Veterans Administration became the Department of Veterans Affairs. A careful examination of history both ancient and recent shows that loyal veterans routinely receive short shrift for their service. In the aftermath of the Vietnam War millions of veterans were essentially screwed by the VA. But to couch that in terms of some kind of an affair depends largely on one’s point of view. (POV)
In the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) the APA somehow managed to create an umbrella term by insistently gluing post to traumatic so as to be inclusive of practically everyone who suffered trauma. Of course this belies both the origin of the term and its acronym. PTSD would now be known simply as PSD.
In order to persuade future generations to go marching off to war, the true horror and terror must be down-played and minimized. It is like the powers that be saying “Contrary to anything General Sherman had to say about it, War isn’t really Hell.”