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More PsychNotes: Policies and Issues in Mental Health

When Everyone is “Traumatized” What Happens to Those Who Are Truly Suffering?
by Monica A. Frank, PhD

I've written before about how the words used to diagnose mental illness are confused with everyday emotions. There's a difference between depression as a disorder and “I'm feeling depressed today.” Everyday anxiety about an upcoming event and an anxiety disorder cannot be equated.

When everyone is depressed or everyone is anxious it diminishes the suffering of those who have an anxiety or depressive disorder. People equate their momentary angst with the ongoing suffering of those with mental illness and then offer “solutions” that worked for them: “just smile”, “snap out of it”, “look at the bright side.”

Now the same thing seems to be occurring with trauma. When everything is “offensive” and a person can be traumatized by words and college campuses provide safe spaces and counseling when controversial speakers are present on campus, doesn't that diminish the concept of trauma?

For awhile I thought this was overblown hype by certain news outlets until I received an email asking me to change one of my relaxation audios because it had a word that the writer found offensive to urban children. The word “dingy” was used in describing a part of a city (not specifying whether it was a residential area or manufacturing area) so that later in the audio a person could mindfully reflect on the beauty of all areas of the city.

Even the most recent diagnostic criteria for trauma has been loosened. In the past the criteria indicated that a person experienced or witnessed an event that involved death, serious injury, or a physical threat. Now, however, the criteria indicate that learning about a relative or close friend who was exposed to trauma can be traumatic. In addition, “indirect exposure to aversive details” of a trauma could be considered traumatic. That would mean that all the explicit details of traumas I've been exposed to as a psychologist could be regarded as trauma to me.

Of course, the criteria for Post-traumatic Stress Disorder (PTSD) also indicates that a person must suffer from certain recurring symptoms which cause distress or impairment. But how can those self-reported symptoms be reliably determined as seriously impacting a person's ability to function? Long before I retired from my practice I quit scheduling clients who sought treatment for the purpose of getting a diagnosis for disability. Having worked with numerous trauma victims I knew the difference between those who were in severe pain and those who were giving lip service to the symptoms but how could I accuse someone of duplicity when symptoms are based on self-report?

How does this diminish those who are truly suffering?

1) Stigmatizes. It seems counter-intuitive that more people reporting being traumatized would stigmatize those who are suffering severe trauma but I believe that it does. When others equate their less intense experience of exposure to everyday events or certain words or ideas with those who have suffered or witnessed life-threatening attacks, sexual abuse, or serious injuries, it diminishes these truly traumatic experiences. As a result, those who are severely impacted by trauma are stigmatized as “weaker” or “unable to cope.”

2) Use of resources. More people claim trauma in order to access resources such as disability income, housing, or other benefits for those who are disabled by trauma. As more people obtain these limited resources, those who are in need may have less available to them. Those who are truly in need often are less likely to speak out to get help. As limited resources are over-utilized, their less forceful cries for help may go unnoticed by the overwhelmed health professionals and educators.

3) Backlash. When more people claim trauma, others begin to ignore such claims. As a result, those who are truly in need may not get the compassion, understanding, and help they need. I've noticed this type of backlash with emotional support animals. I've had several clients who truly benefited from support dogs. However, now as more and more people are claiming the need for an emotional support animal so as to take their pets everywhere with them, others are more skeptical of this practice and have less compassion for those in need of emotional support animals.

What can be done?

I'm not sure of the solution. As the mental health profession tries to make diagnoses more inclusive for those who are suffering, it seems that more people take advantage of it. I am concerned about those who truly need compassion and assistance. If we had unlimited resources and those with serious mental illness weren't further stigmatized I wouldn't care if some folks took advantage of the system. But how can we make sure that those who truly need help are getting it?