by Casey Fulkerson
What exactly PTSD is, how it develops from trauma, and how to diagnose and treat it are all topics hotly contested by experts. The “Authoritative understanding” of PTSD, as Finely refers to it on page 267, is that post-traumatic stress disease is a mental illness caused by the exposure to a traumatic event and that its symptoms are hyperarousal, reexperiencing, and avoidance / numbing. For an individual experiencing these symptoms to be clinically diagnosed with PTSD, their symptoms must prevent them from function normally. This “Authoritative understanding” provides a very rigid understanding of PTSD and suggests that exposure to a traumatic event solely dictates if an individual will develop PTSD. Finley takes a dramatically different multidisciplinary approach, drawing from anthropology, psychology, psychiatry, neuroscience and epidemiology to identify 6 variables that contribute to the development of PTSD: cultural environment, stress, horror, dislocation, grief, and cultural mediation. She combines these factors and their relationships with other another into one helpful figure, 10.1, on page 282. Ultimately these factors work together and influence each other to elicit a post-traumatic response. One advantage of Finley’s holistic model is that it opens more avenues for treatment (including things such as rituals and storytelling) rather than solely being limited to clinical intervention. Finley does not criticize the current diagnosis and treatment protocols used for PTSD. Instead, she acknowledges how many veterans have been helped using such protocols and uses her models to suggest that perhaps there is more to the story of PTSD and its treatment.
One thing that I appreciated about Finley’s chapter is that she admits that she is only telling half of the story. By purposefully interviewing male veterans about their experiences with PTSD, she misses the perspectives and experiences of female veterans because women perceive and interact with their environments in different ways them men and so will have different trauma responses. For the purpose of what Finley is trying to accomplish, this one-sided view is not an issue. She is trying to show that there is more to PTSD than trauma, not assert that those 6 variables are the absolute causes of PTSD.
How would the inclusion of women into Finley’s study provide a more complete picture of the effects of the 6 variables mentioned in the chapter on the development of post-traumatic responses?
How did our culture get to the point where post-traumatic responses are viewed as negative and unacceptable? How would a more positive and de-stigmatized viewpoint of them change the process of healing?