How a PTSD Diagnosis Can Help, and Harm

Psychological diagnoses can tell someone they are not alone. They can also be used to alienate even further.
How a PTSD Diagnosis Can Help, and Harm
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This June, CT drew attention to veterans’ experience in the cover story “Formed by War.” To continue the discourse sparked by that story, alongside the Centurions Guild, CT is hosting an online series called Ponder Christian Soldiers. (Read the Introduction to the series here.) The following essay is from Warren Kinghorn, associate professor of psychiatry and pastoral and moral theology at Duke Divinity School.

Ray sat in my examination room, tense and uncomfortable. A Vietnam combat veteran with a wiry build and a gray, frizzled beard, he was sitting in a Department of Veterans Affairs (VA) hospital for the first time in 38 years. He had visited once in the 1970s and had left angrily, vowing never to return. But his wife had recently told him that she was leaving for good if he didn't get help. So he was back, sitting in my office.

After hearing Ray’s story, I asked him a set of standard clinical questions:

Do you have trouble sleeping?

Yes—four or fewer hours per night, since Vietnam.

Frequent nightmares?

Yes—at least twice weekly, usually of experiences in Vietnam that he doesn’t want to talk about now.

Do you avoid situations that remind you of combat? Check.

Are you "triggered" by certain smells and sounds? Check.

Is being in crowds difficult? Do you startle easily at loud noises? Check. Check.

I asked if he had ever heard of post-traumatic stress disorder (PTSD). He hadn’t. I told him that PTSD names the experience of some veterans who witness hard things in war and then have difficulty moving past those memories. The memories return at unexpected times and places, sometimes as nightmares. People go to great lengths to avoid them, but still they ...

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How a PTSD Diagnosis Can Help, and Harm
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