If that isn't a cause for diagnosis
@HealingMama then what diagnosis is it? I don't understand why ongoing trauma doesn't count.
It depends what the actual experience and perception was at the time.
If you're taken into the woods by a group of white people as a person of color and brought over to a noose, or beaten, or they imply that they are going to beat/rape you, nobody would argue that counts as criterion A trauma because it does. If you're physically overpowered at all as a person of color by white people, that also counts.
But the kind of harassment, ostracism, nonverbal rejection that is a common component of racism? Unfortunately doesn't fit the technical definition of index trauma according to DSM.
So even with developmental trauma, there is some nuance there. Obviously for most children a perception of abandonment signals fear of death. So that's valid criterion A. I would argue that abuse and neglect count even if on a mild spectrum because again, you're totally dependent on caregivers for survival.
Some diagnosticians would rule out certain types of childhood experience as not criterion A. A lot of bullying isn't criterion A, even stuff as bad as girls ganging up on girls on social media in middle school telling someone she should kill herself. It isn't criterion A unless there's a perception of death or serious injury according to the strict interpretation of the criteria. Verbal harassment without fear of physical acting out doesn't technically count.
I tend to err on the side of events counting, because it's very hard for someone to hear and understand that the bad thing they experienced that seems to have created all these bad things in the present "doesn't count."
I've also heard clinicians say harassment that drove an adult to consider suicide doesn't count as criterion A. I am not sure that I agree but I understand why they think of it that way.
Here's the technical description of what can be considered criterion A trauma in the DSM 5:
The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):
- Direct exposure
- Witnessing the trauma
- Learning that a relative or close friend was exposed to a trauma
- Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)
So there's distressing experiences that feel traumatic, then there is index trauma according to DSM. A difficult divorce, a long complicated breakup, getting laid off, getting harassed unless threatened physically, seeing a parent decline in health and then die, none of that is criterion A, even though it is all very stressful.
I prefer the DSM IV for PTSD criteria myself. I think they made changes in a wrong direction.
