The complex nature of post traumatic stress disorder (PTSD) often requires long-term therapy. PTSD is a syndrome that produces behavioral abnormalities which affect not only the patient, but his or her family and community. Whereas PTSD was once thought to afflict only survivors of war, psychoanalytical research indicates that this syndrome is experienced by victims of violence and natural disasters as well.
The term post traumatic stress disorder was initially defined in 1980 in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III). DSM-III-R, the revised 1987 edition, lists five criteria for diagnosing this disorder. First, the person must have experienced a life-altering event capable of causing extreme distress to almost anyone. Typical events include serious bodily trauma to oneself or to one's family and close friends, witnessing the catastrophic destruction of one's home or community, or having contact with the victim of an accident or incidence of physical violence. Second, the traumatic event is re-experienced through recurring dreams, flashbacks, feelings of deja vu, etc. Third, the person struggles to avoid thoughts, feelings, activities or situations associated with the initial trauma, all of which avoidance may lead to repression, numbness, or even psychogenic amnesia. Fourth, specific symptoms such as insomnia, increased anger, or hyperalertness are present. Fifth, the post traumatic difficulties must persist for at least one month (Figley, 1989, pp. 6-7).
Ulman and Brothers (1988) broaden the DSM-III-R definition of PTSD by claiming that trauma shatters a person's concept of self (p. 5). The authors view self as a "central organizing fantasy" and quote research that "places the self at the center of mental activity that organizes experience" (Ulman and Brothers, 1988, pp. 6-7). Trauma inhibits the ability of the self to function. Therefore, PTSD may...