In the early versions of the primary manual of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatrists used the word “trauma” only to describe a physical agent causing physical damage, as in the case of what we now call traumatic brain injury.
In the 1980 revision, however, the manual (DSM III) recognized “post-traumatic stress disorder” as a mental disorder—the first type of traumatic injury that isn’t physical. PTSD is caused by an extraordinary and terrifying experience, and the criteria for a traumatic event that warrants a diagnosis of PTSD were (and are) strict: to qualify, an event would have to “evoke significant symptoms of distress in almost everyone” and be “outside the range of usual human experience.” The DSM III emphasized that the event was not based on a subjective standard. It had to be something that would cause most people to have a severe reaction. War, rape, and torture were included in this category. Divorce and simple bereavement (as in the death of a spouse due to natural causes), on the other hand, were not, because they are normal parts of life, even if unexpected. These experiences are sad and painful, but pain is not the same thing as trauma. People in these situations that don’t fall into the “trauma” category might benefit from counseling, but they generally recover from such losses without any therapeutic interventions. In fact, even most people who do have traumatic experiences recover completely without intervention.
By the early 2000s, however, the concept of “trauma” within parts of the therapeutic community had crept down so far that it included anything “experienced by an individual as physically or emotionally harmful . . . with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” The subjective experience of “harm” became definitional in assessing trauma. As a result, the word “trauma” became much more widely used, not just by mental health professionals but by their clients and patients—including an increasing number of college students.
As with trauma, a key change for most of the concepts was the shift to a subjective standard. It was not for anyone else to decide what counted as trauma, bullying, or abuse; if it felt like that to you, trust your feelings. If a person reported that an event was traumatic (or bullying or abusive), his or her subjective assessment was increasingly taken as sufficient evidence. And if a rapidly growing number of students have been diagnosed with a mental disorder, then there is a rapidly growing need for the campus community to protect them.
In the 1980 revision, however, the manual (DSM III) recognized “post-traumatic stress disorder” as a mental disorder—the first type of traumatic injury that isn’t physical. PTSD is caused by an extraordinary and terrifying experience, and the criteria for a traumatic event that warrants a diagnosis of PTSD were (and are) strict: to qualify, an event would have to “evoke significant symptoms of distress in almost everyone” and be “outside the range of usual human experience.” The DSM III emphasized that the event was not based on a subjective standard. It had to be something that would cause most people to have a severe reaction. War, rape, and torture were included in this category. Divorce and simple bereavement (as in the death of a spouse due to natural causes), on the other hand, were not, because they are normal parts of life, even if unexpected. These experiences are sad and painful, but pain is not the same thing as trauma. People in these situations that don’t fall into the “trauma” category might benefit from counseling, but they generally recover from such losses without any therapeutic interventions. In fact, even most people who do have traumatic experiences recover completely without intervention.
By the early 2000s, however, the concept of “trauma” within parts of the therapeutic community had crept down so far that it included anything “experienced by an individual as physically or emotionally harmful . . . with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” The subjective experience of “harm” became definitional in assessing trauma. As a result, the word “trauma” became much more widely used, not just by mental health professionals but by their clients and patients—including an increasing number of college students.
As with trauma, a key change for most of the concepts was the shift to a subjective standard. It was not for anyone else to decide what counted as trauma, bullying, or abuse; if it felt like that to you, trust your feelings. If a person reported that an event was traumatic (or bullying or abusive), his or her subjective assessment was increasingly taken as sufficient evidence. And if a rapidly growing number of students have been diagnosed with a mental disorder, then there is a rapidly growing need for the campus community to protect them.
Concepts sometimes creep. Concepts like trauma and safety have expanded so far since the 1980s that they are often employed in ways that are no longer grounded in legitimate psychological research. Grossly expanded conceptions of trauma and safety are now used to justify the overprotection of children of all ages—even college students, who are sometimes said to need safe spaces and trigger warnings lest words and ideas put them in danger.
- Greg Lukianoff and Jonathan Haidt, The Coddling of the American Mind:
How Good Intentions and Bad Ideas Are Setting Up a Generation, 2018
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