Tuesday, July 10, 2012

ONE of the problems with "vulnerability"

Lying somewhere on the cutting room floor of Psychotherapy Networker is nearly half of the original article I wrote.  That part dealt with the other half of Lao Tzu's statement (see previous post), the righteous error.

When faced with trying to understand why some (but not all) of those exposed to the horrors of war "get" PTSD, many of us choose the idea of "vulnerability" as the favored explanation.  The idea being that some event(s) in the person's past made him/her more susceptible to the "damaging" effects of combat (or other awful events.)  I will have more to say about what I believe are the deficiencies of this idea in later posts but want to illustrate its dangers but telling a story from my time at Walter Reed.

One day my administrator, a retired Army Sargent Major, came to me distressed after attending a lecture by a therapist, an author of a book on war and PTSD.  The author had described the research linking difficult upbringings (abuse, neglect, etc) with subsequent combat PTSD.  "He shouldn't have said that," my administrator said, "even if it's true.  In the Army that will come to mean those with symptoms will be seen as previously damaged, already broken, and that's why they're sick."

My administrator was pointing, I believe, to a fundamentally important dynamic about how we respond to those who don't "bounce back" after horrific events.  You and I don't really think we're likely to get schizophrenia or bi-polar disorder or some other serious mental illness after we've reached adulthood.  But PTSD is different.  All of us harbor some concern about our ability to handle the very worst that life has to offer.  Who among us would "guarantee" our ability to come back from, say, the brutal slaying of our loved ones, or worse?  Knowing how we judge others who "fail," we fear others' judgements and seek ways to reassure ourselves we'd do better.  "Vulnerability" provides just what we're looking for.  By seeing those with problems as having them because of pre-existing "deficiencies" we can tell ourselves what happened to them won't happen to us.  Useful if you're headed into combat.

I'll have much more to say about vulnerability in later posts, but for now can you smell the hints of contempt, the righteousness behind the concept?

Roy Clymer

For the background and context for these remarks, please read my article on PTSD published in the Psychotherapy Networker which can be found here http://www.psychotherapynetworker.org/recentissues/1151-the-puzzle-of-ptsd or see a copy of it found on this blog titled "The Puzzle of PTSD."

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