Saturday, February 19, 2011

Is "disorder" the best term to use?

I am increasingly uncomfortable with using the term “disorder” with the post traumatic. Bear with me – better still, walk along with me while we talk – and try to make sense of what knocks the sense out of the strongest of us. This comes to me best when I contrast it with another condition with which I am familiar, the obsessive-compulsive disorder. Let it be said at the outset, however, that my desire is not in anyway related to my wife’s being able to pronounce posttraumatische Belastungsstorung! You can balance that with my raising a related question to her cousin (who had the misfortune to be commissioned in 1938). Of the next few years he did say – reflectively – “Well, I have had some officers say that the mind can play some strange tricks.” Like so many survivors, he is a master of understatement. 

There are similarities, of course, between OCD and PTSD. Both are characterized as “anxiety disorders.” Both have unwanted thoughts intruding on the mind; both heavily reflect biological processes. Each sufferer may be described as “frozen in time” in some way, the obsessions more than being “ preoccupied.” Each condition has some characteristics in common, but endless in their individual manifestations.

Each condition, as it occurs, is a seizure by fearfulness. With OCD, however, it is more generalized, as in its varieties of contamination fears - the person may be panicked by having to use a public restroom. On the other hand, with PTSD, the person may be overwhelmed with fear after a horrendous accident at having to drive down a specific road. OCD has its roots in the individual’s genetic system; PTSD is grounded in the self awareness of an event of life-threatening violence.

In some ways, my discomfort with the implications of a mental health illness and the post traumatic did come out of my thoughts about the Apostle Paul. I am not uncomfortable with him being overwhelmed by violence, including presumably his own, nor with his having to work himself out of some very disruptive behaviors. It is the notion of a condition from which there is no salvation. If it is anything, the post traumatic condition is an inclusively human experience. I think we have to find a more descriptive word for this “inclusively human” process than “disorder.” OCD has a large religious component because it finds expression in ritual; the post traumatic, in its very humanness, as often incorporates a need that can best be described as “spiritual.” It is in this context that Paul stands out as a role model.

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