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Rapid response to:

Education And Debate

The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7278.95 (Published 13 January 2001) Cite this as: BMJ 2001;322:95

Rapid Response:

Re: History is not conspiracy heory

If PTSD was 'invented' by the APA, or the Vets, then why did no one
sue the organisations, or their presidents, for fraud? Surely insurance
companies have an interest in pursuing such a costly abuse of power? Did
they not read the reference offered as evidence? Or did they read it and
dismiss the claims as fanciful'?

And what did the people with all the symptoms of PTSD suffer from
prior to the 'invention' of PTSD? Was it just 'distress'?

I think anyone who has seen a genuine patient with PTSD knows it
exists, knows the term is useful and would not dream of trivialising these
people's experiences.

To lump everyone with distress together seems to me not only
unwarranted but also unhelpful. Science can do better than that!

Who will judge how much distress is normal? Imagine the following
scale:

Falling off your bike without major injury: 10 ml distress.

Surviving 3 years in a Nazi concentration camp, suffering hunger,
witness to atrocities: 100 ml distress.

Surviving 1 year in a Nazi concentration camp, have one's ovaries
removed without anaesthetic, never able to enjoy sex after that, losing
40% of your family including a husband and son: 150 ml distress.

Anyone reporting 'distress' exceeding the given figure is:

a. not coping well. Send for CBT\psychodynamic therapy plus
antidepressants if required,

b. deliberately exagerating for financial gain. Ignore.

c. Deluded for other reasons. Ignore.

I think I'll stick to DSM-IV-TR, faults and all.

Competing interests:  
None declared

Competing interests: No competing interests

08 September 2003
Ellen Goudsmit
Psychologist
London TW11 9QX