I recognize that many believe that physical abuse only can lead to PTSD. I disagree, certainly after having lived through what I have. Physical wounds can heal (mostly), but psychological abuse - in my opinion - is a soul crusher.
I just have an inkling that psychological stuff will one day be proven to be PTSD worthy. Just an opinion.
It already is. There's not a required physical component to these:
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, and/or witnessing the trauma, and/or learning that a relative or close friend was exposed to a trauma, and/or indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)
What
is distinct (and this is why infidelity just doesn't fit), is:
- death or threat of death
- serious injury or threat of serious injury
- sexual violence or threat of sexual violence
"Threat of" is where people sometimes miss the mark, because they equate discovering their partner was cheating with "feeling like they were going to die". But "death" as a metaphor is not the same as actual or threatened death. Whereas, many domestic violence situations invoke threat of death or serious injury or sexual violence. Sometimes there will be a single incident of actual serious injury or sexual violence, but not always.
Trying to categorize "psychological abuse" as a type of serious injury (that's where it would live, I think, in the criteria) is another kind of metaphor-making. That's probably another reason why I think it's useful to stay narrow with these things. A threat is, in essence, an example of a psychological abuse. But threatening oh, say, blackmail - as opposed to threatening to shoot someone - is the threat of blackmail
by itself - absent
any kind of threat of serious injury or violence - enough to create PTSD?
I can see it instigating PTSD, in someone who has more to their history. But all by itself...no, I'm not sure it would. Extreme stress, yes. Fear, yes. Blackmail involving a kidnapped loved one who is being harmed, that can get us into PTSD. Blackmail as in, "do this thing, or I'll break your legs" - that could be plausible threat, depending, and it could be believed enough to cause PTSD - you don't have to be laying on the asphalt with a hammer being held over your kneecaps for a threat to be viable. But blackmail, as in, "pay me the money or I'll release the compromising pictures..." - no, blackmail really isn't enough.
"Threat of" is also where we invoke the concept of "I thought I was going to die/I thought I was going to be seriously injured/thought I was going to be raped". It's up to the diagnostician to evaluate - was the threat enough to plausibly cause that fear, when considering the whole of the circumstance, and the age of the patient?
From there, we get into how children believe things differently from adults; however, a child's concepts of death and injury vary greatly from an adult's, and they are tied to where they are in their development, and their learned/observed experience.
A person who says, "I was severely bullied, and thought I was going to get really hurt, maybe even killed" - it's up to the diagnostician to ascertain whether that belief was what the individual had at the time, or whether they've introduced it later in life. A child can be terrified of breaking a limb - or, a child can think they can jump off the roof and be fine.
Specifics of the narrative, how the narrative is delivered, context for the trauma event, age, prior exposure to elements that relate...and then how the symptoms have manifest, all that stuff - ultimately, that's
all necessary info. The buzzwords (bullying for example) get in the way of communicating clear information about the narrative, and can lead to mis-perception and misinformation, generally.
That, to me, means that psychologically I was 'broken' by somebody and that could very well have taken on the form of emotional abuse only.
I'm curious - and you can link me to anything you've posted elsewhere, no need to re-type painful things - would you say that at least some of the psychological breaking that you endured came in the form of threat of death, serious injury, or sexual violence, or threat of same to an intimate loved one?
