The question I asked myself the other day was, ‘Has Donald Trump given me PTSD?’. As the calendar ticks over towards the 4th of July and the celebration of all things American, this seems a timely idea to think on. Perhaps over a grilled steak.

The DSM-V criteria for this condition are intriguing, not the least because the diagnosis begins with something outside of the individual being assessed.

An event (Criteria A) is required for a diagnosis of PTSD. The event is not cognitive, behavioural, neurological, physiological or anatomical. The event is historical, in the sense that it can be documented by independent witnesses. This has lead some, like Derek Summerfield (2001) to describe PTSD as an invented condition, one that does not meet the usual standards of describing psychological conditions.

I thought I might try to apply the DSM-V criteria for PTSD to my condition and see how both I, and the diagnostic framework, aligns or matches.

Criteria A, the event, requires a time and place, and a perceived threat to life. Well, I can date this fairly precisely. About 10pm, Eastern Time, Tuesday November 7, 2017. Was there a threat to my life, or the life of others I know? Well, yes, there was (and still is). Personally, I wouldn’t put Trump in charge of a soda fountain at a county fair. Now he controls the largest nuclear arsenal in the world, and has a group of non-thinking hench-people operating under his direct control. I certainly feel threatened. I have family living in the USA. Living in the same country where this idiot is seriously considering making it legal for any person in the country to carry a concealed firearm without a permit.

Am I concerned for my family? Absolutely! People are being killed because of this man.

Criteria B, of which only one is required, includes intrusive thoughts and/or emotional distress occasioned by reminders and physical reactions. Well, I find intrusive Trump thoughts appearing quite often, and emotional distress ensues, often accompanied by a nauseous physical reaction.

Criteria C relates to avoidance behaviour, where an effort is made to avoid either the thoughts or actual reminders. I find this increasingly difficult. Everywhere I turn there are physical reminders and I am beginning to think I am being stalked. Is this paranoia?

All I can say to this is that, right now, this feels like a dream (make that nightmare) and completely distorted.

Surely this cannot be ‘real’? Can it?

So, all this to say, has Trump caused my PTSD? Or, in sympathy with Derek Summerfield, is PTSD a somewhat invented psychological condition? 

Or, maybe, it’s not the diagnosis that matters so much as the event. Has the event actually ended yet? We have over 3 years still to go!

One of the factors that really concerns me about the diagnosis of PTSD is it’s connection to ‘an event’. As if there is a single event. To me, this is a first world problem. For millions of people across the world, there is no single traumatic event. I have worked in environments and contexts where every day has the conditions that meet many of the criteria of PTSD.

What is the diagnosis for a Syrian refugee, fleeing the insanity of Assad?. What 'event' signals PTSD? For any living Syrian this 'event' is never going to end. Those that live will have lost family and friends to almost unspeakable horror. Many will never know what happened to those they lost. There is nothing "post" about this trauma. It is, for them, eternal. 

Under the DSM-V criteria PTSD may be a uniquely first world condition, reserved for those privileged to experience maybe one or two such events in their lives. Unfortunately, or perhaps, fortuitously, the first world is now facing daily imminent threat from a megalomaniac tweeter with a gun. 

Welcome to the real world.

And happy 4th of July!

John Fawcett 

Ref: D. Summerfield, "The Invention of Post-Traumatic Stress Disorder and the Social Usefulness of a Psychiatric Category", British Medical Journal, 322, pp. 95-98, 2001