The Deficiency of the Concept of Posttraumatic Stress Disorder When Dealing with Victims of Human Rights Violations

Abstract

The classification and diagnosis of an illness is a noble task that, at first sight, seems to be a value-free activity, carried out in the best interest of scientific development and the health care necessities of a given patient. Unfortunately, science is never value free, and since Werner Heisenberg defined his principle of uncertainty, we definitely learned that, even in the so-called hard sciences, the way we look at things changes not only what we see but also what happens. Posttraumatic stress disorder (PTSD), as defined by the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987), was probably never meant to be a concept, a theory of the aftereffects of traumatic experiences, but it ended up being just that. The PTSD concept defines the existence of the illness based on the appearance of certain symptoms within a certain time span. Without symptoms, there is no illness. PTSD is a form of diagnosis applicable to individuals. If the illness in question were to exist between individuals and not only in them, PTSD not only would be incapable of understanding the phenomenon but would also influence the appearance of the illness. In short, PTSD is, necessarily, a concept that shapes our way of understanding trauma, that determines treatment strategies, and, last not least, that possibly influences how persons suffering from trauma will deal with their problem.

Revised version of a paper presented at the ISTSS Conference “Trauma and Tragedy,” Amsterdam, The Netherlands, June 1992.