PTSD (Post Traumatic Stress Disorder) is a relatively recent creature in the ongoing research of understanding stress and trauma, two conditions which, among others, are at the core of a currently raging mental epidemic that evolved in the past twenty years or so —and which is now billowing almost beyond control thanks to the Covid global catastrophe.
The precursors of modern PTSD research emerged after the end of WWII and mass demobilization, which returned millions of draftees back to their home countries after years of often indescribable combat privations, severe psychogenic stress due to loss of comrades, and the lasting effects of serious physical injuries.
It was though not until the Vietnam War that the basics of PTSD research began to gain speed as US involvement in SE Asia rapidly deteriorated into a pointless ugly slugfest fed by wrong politics, wrong strategies, and the vagaries of the Cold War.
Vietnam veterans were the first post-WWII young men to pay an enormous physical, social, and emotional price and become America’s own “lost generation” at a time of tectonic shifts, which deeply undermined US global leadership and standing.
Eventually, the US Department of Veteran Affairs accepted the recognition of PTSD by the American Psychiatric Association as a formal etiological concept affecting the support of physically and emotionally traumatized young Americans of the Vietnam era.
In 1980, the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme (2). Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of "trauma."
But PTSD isn’t an ailment exclusive to war veterans. It is a frequent corollary of social and family
abandonment
,
a nosologic concept that, in its embryonic form, was recognized as far back as the earlier days of modern psychiatry and the study of grief.
Abandonment is a catastrophic blow to one’s self esteem, which can (and frequently does) lead to severe depressive episodes, complete dislocation of “normal” daily life, a profound personal sense of worthlessness that can lead to suicide, and the onset of physical ailments that may evolve into major health crises.
Grief theories usually begin to associate PTSD of Abandonment with the very early stages of life when the child is separated from his/her mother. Freud, in particular, produced rims of observations about this particular stage of infancy, which include his Oedipus complex assumption, a theory that later became the subject of often severe criticism.
More recently, however, Freud’s tracing anxiety, fear, and stress back to the very early stages of life has been further challenged by complicated research findings related to brain functions and the manner and effects of neuron operation and activity.
Current psychiatric researchers and practitioners are thus beginning to question the efficacy of “traditional” psychoanalysis, piling up responsibility for anxiety and depression on those very early years of childhood, and, by extension, take a dimmer view of the pharmaceutical emphasis on treating panic disorders and depression.
These widely debated concerns have already raised serious questions of efficacy regarding the current massive antidepressant use for therapeutic purposes, especially in treating children, but also adult patients (see this and this).
PTSD of Abandonment , although similar to that affecting combat veterans, has its own host of symptoms and longer terms impacts.
My personal experience with this nightmare is as dire, and perhaps worse, as the examples offered in the literature.
Within months of the triggering incident, back in 2019, the world collapsed into a grey hue; the body weakened; the mind began to stubbornly dig into primordial fears; and personal tasks and routine behaviors, once instinctive, morphed into a daily struggle dominated by debilitating stubborn fatigue.
PTSD of Abandonment has the terrifying ability to often grotesquely magnify emotional responses which, in the past, were either easily dealt with or simply set aside as insignificant.
When taking a shower becomes a project, quite dissimilar to what you do almost unconsciously like brushing your teeth in the morning, it’s time to become concerned.
When you almost subconsciously begin the traumatic trudge of rehashing old feelings, earlier losses, hurtful separations, the promises of your once most significant other, which vanished into thin air in a matter of days, and the painful feelings of rejection by your own children, apparently without any rational cause, you know you’ve fallen into the ditch.
When you lie in bed, and suddenly feel the walls are closing in, you know you’re wide open to the (irrational) fear of “losing your mind.”
When you find yourself thirsting, every minute of the day and night, for the modest physical comfort that you enjoyed in your previous living environment, you’re open to desperate, damaging, and even dangerous thoughts of irreparable loss and abandonment.
When you feel intense “emotional hangover” over the slightest stimulus, like leafing through old family photos, there’s distress that can put you out for hours.
When an irregular, often anguish-filled, sleep briefly occurs at 3 o'clock in the morning, instead of your previous, almost lifelong, hitting the pillow around ten, and sleeping through to 6 a.m. without any dreams, you’re already in minefield territory.
When you wade deeper and deeper into self-judgement and despair concerning what you did, and/or didn’t do, in supporting, succoring, and trying to mend a traumatized child you adore, you’ve already reached a dead end.
And when, overall, you feel you’re cornered, without access to even a modest route of escape, it’s time to re-think your entire life philosophy and decide whether you have the stamina to restart your emotional connections— and cut out maladaptive practices that dominated most of your life.
It took me three decades to realize my chosen companion-for-life, who appeared emotionally, intellectually, and honorably rock-solid, did have a side that was terrifyingly “opaque” — and which manifested itself, within a matter of weeks, in creating the perfect surprise attack that devastated what I thought was a relationship immune to the vagaries of time.
What to do next is a question which, so far, has no answers. Perhaps irrationally, I still (want to) believe there’s hope…. and that hope dies last.
PS: I am truly grateful of having good friends and relatives who are doing their very best to help and remind me I’m still alive. I cannot thank them enough and will always cherish their genuine feelings and advice at this time of brutal trial.
A very moving piece, AT. I learned a lot about PTSD, about despair and about you.