Did Trump give me PTSD?

by John Fawcett
Ground zero NYC

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?

Criteria D contains a list of ‘negative thoughts’ that have worsened following the trauma. Only 2 of these are required but I have to confess that all of these symptoms are increasingly making themselves at home. The list includes the following;
  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing positive affect

My problem with the first one is that I am finding it hard to recall the key features - are these real events or are they fake? Did the President really wrestle and punch CNN to the floor? Did the President actually invent the word ‘covfefe’? Were the inauguration day crowds really that small? 

Blame? Oh, I know who to blame alright! And, given that I live in New Zealand I am extremely pleased that I feel isolated. But, given that nuclear arsenal I continue to have difficulty experiencing positive affect.

Criteria E relates to trauma-related arousal and, once more, I have the whole list. Especially hypervigilance and increased startle reactions.

It’s like one of those slow motion massive crashes which seems to be, at first, far away, but then gets closer and closer. On the one hand many things no longer surprise me, but they do startle me. For example, how can a human male leader get away with continued public, overt, violent, vicious and brutal attacks on women?

I feel dissociation coming on.

I cannot turn away from the news, or the comedy. I have become increasingly hyper-vigilant. This is a spectacle that has all the potential to engulf my life. It’s like being stuck in a school playground with a rabid wolf. All the gates are locked and the teachers have abandoned the kids. At present the rabid creature is savaging kids on the other side of the field, but, you just know, that any minute now, he might turn his gaze this way. 

Down here, in New Zealand, we are laughing (very) uneasily. What does it mean that the Trump appointed US Ambassador to New Zealand is a former Cosmopolitan Magazine naked male centerfold?

Is that a good thing, or a bad thing? Should I laugh or cry?

Criteria F requires the symptoms to have lasted longer than 1 month. Mine have lasted for (at the time of writing) 126 days, 11 hours and 6 minutes. 

Criteria G requires the symptoms to cause distress or functional impairment. I cannot speak for the functional impairment but 'distress' hardly covers what I feel.

Criteria H requires the symptoms to have not been caused by medication, substance abuse or illness. The symptoms were not caused by these things but I am finding that medication and substance abuse might be the only way forward right now. 

The DSM-V description goes on to add the following;

In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:

  • Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).
  • Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").

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 

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