Why a PTSD Diagnosis Matters—and Why It Doesn’t Define You Pt 1.

As a Licensed Psychologist who has worked with military and law enforcement trauma for close to 30 years, I’d like to share my understanding around concerns which are coming up for many about a diagnosis of PTSD. I hope this information may bring some context and perspective to a challenging issue and keep the conversation going.

The mental health field has a long history of working to establish itself as a legitimate scientific field. As such, it has adopted a medical model which uses terminology which sounds…. well, pathological. That is unfortunate to the degree it can create an image of sick or “crazy,” though fortunate, in that being able to name something is the starting place for a common language which allows us to organize, research, and develop

approaches for assistance or “treatment.”

Through decades of training mental health professionals, including in the art of

diagnosis, I continue to trip over a language which does not match my own sensibilitiesor training about the work of facilitating and supporting fellow human beings throughtheir profound and meaningful challenges. I have found that those inclined to diminishothers based on their struggles and symptoms will do this, with or without a diagnosis.Likewise, those who recognize and respect the body and mind’s way ofexpressing/manifesting human suffering, and with it, a potential roadmap to well-beingand even flourishing, will not diminish any human being or reduce her/him to a“diagnosis.”

The term “disorder” reflects a set of symptoms that result in significant distress or

difficulty in living fully. One thing that sets apart some traditional medical diagnoses

from mental health diagnoses is that many medical diagnoses are categorical, meaning you have a condition or you don’t. Think of a bone fracture…or being pregnant. There is no “kind of broken” or “a little pregnant.” In the world of our mental health, symptoms are more often on a continuum. Think of a sad mood. At one end of the continuum, we all will experience sadness over a situation or loss…which is not a disorder. It is life and life is not an illness. When a sad mood is considered a disorder, it is due to its intensity, duration, and frequency. It is the point on a continuum where symptoms make the person’s existence significantly compromised.

Around the concerns of a PTSD diagnosis (and sometimes other diagnoses), I‘d like to mention a common tendency people have to thinking if the symptoms someone is experiencing “make sense,” under the circumstances, it isn’t a “disorder.” I can honestly assure you nearly all of what I see in my work “makes sense”, and it is my responsibility to uncover that sense, as it can hold clues to the paths to wellness. I also refer you back to the idea of intensity, duration, and frequency and the degree to which someone is suffering and intervention is called for. If that intervention is within the mental health community, it is called treatment or therapy but what is “therapeutic” goes far beyond the confines of a consulting room. There is so much that can be done to support our veterans…. More on that in Part II.

Finally, I want to mention another concern voiced around a diagnosis of PTSD, that

being a belief it is a lifetime diagnosis. Once again, I would return to the concepts of

intensity, duration and frequency. After any trauma, what begins as a natural reaction and may evolve into PTSD will initially deeply color the experience of the traumatized individual. With time, support, and a potentially wide range of healing/therapeutic experiences, those colors become woven into a much larger fabric of one’s life. Resilience and growth are the possible offerings.

In the system we work within, however imperfect and flawed, at the point of diagnosis, what is opened is accessibility to assistance, insurance payment and, in the case of our veterans with PTSD, the possibility of the profound bond, skills, and healing support of a service dog trained through New Life K9s.

While I have barely touched the surface here and there is more to come, I welcome any and all comments, concerns or questions to rlewis@calpoly.edu.

Robin Lewis, Ph.D.

Licensed Psychologist

New Life K9s Advisory Board