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Comment by jogjayr | Hacker News Reader

The intent isn't to make it softer though. "PTSD" is more accurate than "shell shock". In WWI they thought that the accumulated shockwave exposure from constant shelling caused mental issues in soldiers. Today we know that all sorts of stressful situations can cause PTSD; it doesn't require being in the trenches taking howitzer fire day and night.

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The point Carlin was trying to make is that the human experience is removed from a term such as "post-traumatic stress disorder". Yes, it might be more medically accurate, but fighting for the rights of people who experienced "shell shock" might have been more impactful. When your experienced is buried underneath medical terms, you bury the humanity of it.

A plausible counterpoint is that renaming can also remove a lot of the social stigma, leading to more people getting treatment. As an example, I believe many prefer using the term "post-traumatic stress/PTS" now because it removes the "disorder" stigma. I.e., it better communicates that it's a natural reaction to such stress and nothing to be ashamed of

[1]https://www.therecoveryvillage.com/mental-health/ptsd/relate...

You might be right that this motivates the 'euphemism treadmill', but if so I think that's misguided. It's my personal belief that the stigma follows the condition itself (particularly when untreated), not the name given to the condition. When I was a kid my friends and I all knew that you had to step light around some people's fathers because they were Vietnam vets with hair triggers that would go ballistic for seemingly little reason. In retrospect these men obviously had PTSD, though as kids we knew it as 'He's an asshole because Nam fucked him up.'

To be clear, I don't think the nomenclature is the sole driver of social stigma, just a contributor.

As an analogy, I doubt anybody thinks the social stigma around trisomy-21 is solely attributable to previous politically incorrect terminology but continued use of those former terms doesn't help alleviate that stigma.

I am amazed how civil and illuminating this particular discussion thread is. Thank you all!

That's a good point, and your PTS sans-D reference exemplified it well IMO. I think at this point it would be justified to label every one of us with PTSD, after suriving the pandemic so far, and I for one would prefer just post-trauamtic stress, instead of tagging myself with a "disorder" as if I had done something wrong.

Shell Shock isn't a better description of the problem than Post Traumatic Stress Disorder; the problem is that not enough people care to make this a priority.

Not everyone who gets fucked up got fucked up due to being shocked with shells. Your mom didn't get shocked with shells; she got shocked with your dad's fists (maybe even after he got Shell Shock).

Bad things happen to people, and sometimes they cause lasting trauma. The direct cause might be different but the effect is similar enough that the words used to name it should change.

I don’t think your comment has any kind of negative intent, but I feel like the idea that grouping any consequence of civilian experience with those of military combat certainly cannot be a reasonable association.

I don’t think Carlin’s point was so much to comment on the accuracy of the description, but rather to say that these descriptions have become longer and longer as time has advanced and thereby lessons the guttural impact they “used” to command.

Do you think that’s fair?

> I don’t think your comment has any kind of negative intent, but I feel like the idea that grouping any consequence of civilian experience with those of military combat certainly cannot be a reasonable association.

... even if we've since established that said consequences exist along the same cognitive spectrum? From the perspective of a clinician (whose use of the term PTSD is scientifically driven), does it matter whether the conditions that caused the disorder were military or civilian?

Actually we're getting increasing evidence that there are two different disorders/diseases here.

1. is the low grade TBI(traumatic brain injury) that is fairly called "Shell shock" 2. is the psychological weight of traumatic experiences

The evidence is pretty strong that part of why soldiers PTSD is so hard to treat(not that PTSD is easy to treat in general) is that their neurons have been damaged so it's literally more difficult for them to learn new stress responses and make use of CBT(Cognitive Behavioral Therapy) to manage their inappropriate, for civilian life, stress responses.

It moves the blame to the victim.

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