Guest Post: Why do PTSD diagnostics favour soldiers over survivors of sexual abuse?

This is post is written by Emily Scott, whose name has been changed for privacy.


Recently, I was referred to see a psychologist. I had been sexually abused from the age of nine – a total of twenty-one years, and I had just begun a new relationship. My new boyfriend was (and still is) lovely. And I couldn’t cope.

My first visit consisted of an assessment. To my surprise, this was made up of a series of basic yes and no questions from the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM V). As I remember, they included questions as mundane as “Do you like to make lists?” and as wonderful as “Do you believe you have supernatural powers?”

According the the survey I did not have a problem. Which puzzled me, since I would imagine that twenty-one years of sexual abuse might lead to some kind of problem a psychologist would pick up on.

I was transferred to a different organisation where I had to do the same survey. Again, I did not come out in any category. However, this time I made sure that I told the psychologist my story. At first, she tried to say that we were “dealing with behaviour” I exhibited, and that my story was irrelevant. But I insisted that she put down the survey and listen.

She was puzzled. My story fitted the profile of a chronic post-traumatic stress disorder (PTSD) sufferer, yet according to the survey I showed no signs of this. The psychologist could not understand this, so we had another look at the questions.

The primary question the survey asks to check for PTSD is “Have you ever been in a life-threatening situation?” The authors have assumed that a person experiences sexual assault as life-threatening.

I beg to differ. I have experienced quite some sexual assault. I have only once wondered if it would also be life threatening. Once, in twenty one years.

A Google search on PTSD brings up soldiers. Lots and lots of male soldiers. Male soldiers and cute PTSD help dogs.

So what about PTSD and women?

On average, one in three women are abused. Presumably, then, one in three women may at some point in her life experience PTSD. They may have nightmares, feel paralysed, be too afraid to leave home, be constantly scanning for danger, be fearing imaginary scenarios in which they meet their abuser, and not know who to trust.

However, these women may not have considered their abuse to be life threatening. So the wording of the survey needs to be changed. “Have you ever been sexually or physically violated, or have you ever experienced or witnessed a life-threatening situation?” would be my suggestion.

Then tackle the public perceptions of PTSD. It is not only soldiers who have PTSD. Train drivers hitting someone on the tracks, firefighters, police officers, ambulance workers, anyone witnessing an accident; and one in three women may develop it. While military veterans undoubtedly require support for PTSD, I think society emphasises soldiers’ need for support and neglects other groups, perhaps because we feel more guilty towards people who have been traumatised by fighting in conflicts that allegedly protect our freedom. On the other hand, conversations about epidemic sexual abuse tend to be kept under wraps – let’s have some acknowledgement.

PTSD dogs are generally only provided for men, generally ex-army men. The dogs are trained to recognise and comfort a person who is distressed, and, if necessary, to stand between the person and the object that the person responds to as threatening. Three years ago, I would have really valued such a dog. I would have felt safer and therefore freer to go about my daily life. However, the vast majority of charities target only soldiers.

Whilst I do not wish in any way to belittle the severity of PTSD that soldiers may experience, this does seem to be unfair. An abused woman could really benefit from a PTSD dog. I have had times when I have considered most adult males as potentially threatening. A dog would have given me extra protection and confidence. Plus, I am fairly sure there are more sexual predators on our streets than snipers. I even think a PTSD dog with an abused woman would have more cause to growl and protect her than a veterans’ dog.

As it is, women are neglected in PTSD, from the very first diagnostics, to the support they can claim as compared to men, and in the seriousness attached to their condition.

I do not like the approach of categorising psychological problems and assigning people to a category. But, since we seem to be stuck with this system, we should try to make it supportive of women.

So: give us recognition, give us the same right to the same support – including trained dogs – as men have, and give us a break from your petty surveys. Listen, please.

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4 thoughts on “Guest Post: Why do PTSD diagnostics favour soldiers over survivors of sexual abuse?”

  1. Another thing, and this is bound to alienate some, if you voluntarily shoot strangers for money (regardless of whether or not you whitewash it with a layer of patriotism) you have, in a sense, earned PTSD. It isn’t so much a diagnosis as evidence that you have yet to kill your conscience as effectively as you have killed other people. This is supported by the fact that those soldiers who suffer the most severe PTSD are those who have committed the worst atrocities.

    This is not the case for the victims of violence. They are suffering PTSD because of what was done to them not because of what they did to others and as such they deserve more of our compassion and resources. I think we need to make a diferentiation between PTSD suffered by victims and PVCEC (post violence-commission existential crisis) suffered by soldiers.

  2. Great post. As someone who has been abused multiple times by different men, this resonates with me.

    Would also like to add to the other great comment, that psychiatrists when making the assessment for PTSD don’t take into account childhood trauma. I wasn’t even believed by them, or did they bother to take my history as it didn’t matter because they only prescribe to treat symptoms, not resolve issues.

    Therapists, however, have the responsibility to take into account all the person’s history. I went through multiple traumas, emotional, physical, sexual abuse all the way during childhood until I was in my late 20’s. I saw countless therapists, only two took my history into account and tried to help. The first one didn’t go very far and after 4 years and I quit. The second one is great and I’m making good progress with him.

    I know other fellow PTSD sufferers that have all kinds of abuses in their belts, of all genders. All of them never had a true assessment to know the effects of trauma in their lifes, only after they specifically sought it and demanded it. This leads to misdiagnosis of mental and physical health issues.

    Another issue is the lack of specification of trauma in the diagnosis manuals, as childhood trauma is not included. It is only taken into account one traumatic inccident. If a person has several, it’s chronic and therefor impossible to treat according to most professionals. Luckily, I found one that doesn’t believe in that non-sense. But the vast majority of mental health professionals still live under the illusion that childhood or even adult abuse rarely happens.

    In the case of women, there is a lot of talk about how to deal with narcissists and abusers, but not how to deal with the aftermath of having abusive relationships with said abusers. If it’s a form of PTSD we don’t know, because we are told to live now that we’re free, when sometimes that is barely impossible.

  3. psychiatrists are prone to over ascribing personality factors to women’s presentations.. psychologists vary in how they approach problems.. some are trauma specialists others just try to tell you to get on with things and be positive.. I don’t know how qualified female professionals got sucked into that second way of doing it.

  4. Women don’t exist in the medical world -didn’t you know /s
    The military have the money. The people in power there, in medicine and Big Pharm are men. Say no more – women are disappeared….

    Great article – I didn’t know about PTSD dogs – I would love one.

    The good news is Medical MDMA is having astounding results in clinical trials for curing PTSD, especially in the women with complex trauma(85% cured). But of course who is getting the focus and attention – ex vets. In Australia the men still won’t consider a trial -ignorant fools.

    Let’s hope there’s a Goddess somewhere …..

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