#167 PTSD as a Family Crisis
Section 1
The DSM-5 lists eight different diagnostic criteria for Post Traumatic Stress Disorder. They range from exposure to death or violence, intrusion symptoms, avoidance of stimuli related to trauma, negative changes in cognitive behaviour, mood changes, long duration of symptoms, clinical distress, and affects not being attributed to a substance (American Psychiatric Association 2013). These diagnostic requirements separate actual PTSD from what popular culture describes as PTSD. I recently heard a young adult call their encounter with an angry man as traumatizing because the encounter upset them. But while an unfortunate experience no lasting harm was done. The experience was actually just upsetting rather than PTSD. It may be observed from her experience that it does not fit the requirements for PTSD. Her being upsetted by the experience did not last more than a month, her behaviour did not change, and her mood did not change either; even though their day was somewhat ruined.
Section 2
All suicidal gestures should be taken seriously as we may not know how serious someone is about committing suicide. Suicide clues may be verbal, behavioural, situational, and Syndromatic, “All of these clues may be considered as cries for help, no matter how subtle or camouflaged they are.” Regardless of how serious someone may be about committing suicide all of these clues are cries for help and we ought to give that help. When a teenage girl in my church community recently committed suicide, the parents of her friends discovered that the entire group were trying to decide if life was worth living. They were attempting to process the trauma of their friends death and in their grief finding the positives in her choice to commit suicide. The experience of that friend group does rise to the level of trauma and is presently being treated as such.
Section 3c
Medical crises destabilize family systems by changing the roles that all family members fill. When a husband/father is in the hospital the support system of the wife/mother is disrupted causing her to take on more responsibilities that may not have previously existed, such as having to be the disciplinarian (James & Gilliland, 2017). A biblical example of this sort of crisis is that of Job. When Job loses his children, servants, flocks, and becomes ill, his wife says to him, “Do you still hold fast your integrity? Curse God and die!” Job 2:9 (NASB). Their relationship in that moment shifted from one of love and mutual respect to one of derision. While Job’s crisis manifested itself in many forms the end result was a disruption of his marital relationship, and his friendships. Instead of being cared for he was being blamed and rejected. Crisis interventionists need to be aware that the support network of someone in crisis may be perpetuating the crisis and need to be shown how to care well for the person in crisis.
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013.
New American Standard Bible: 1995 Update (La Habra, CA: The Lockman Foundation, 1995).
Richard K. James and Burl E. Gilliland, Crisis Intervention Strategies, 8th ed. (Boston: Cengage Learning, 2017).
