Piers Morgan is wrong

I know the words “Piers Morgan is wrong” are about as remarkable as “The sky is blue” or “Winter is cold” but this time he’s excelled himself.

In brief, Lady Gaga told an interviewer that she suffered PTSD as the result of being raped when she was 19. Morgan managed a double dose of wrongness, first by casting doubt on whether she’d been raped, and then by stating that PTSD was something suffered by “soldiers returning from battlefields” (and by implication, not by people who have experienced other forms of trauma).

We should all of us, even talentless self-publicists, be aware by now that victims of sexual assault don’t tend to report it – largely because they fear not being believed. In that, they are right. Of the hundreds of children and women assaulted by Jimmy Savile, most kept the attack private. The few who did report it found themselves either ignored or accused of lying. If their reports had been taken seriously, Savile would have ended up in prison years ago, and many of his victims would have been spared. The fact that Morgan refuses to believe Lady Gaga now pretty much proves the point.

And if he knows anything at all about PTSD, he should know that soldiers are only one of the groups who suffer from it. Victims of sexual assault, people who have been in a car crash, people who have been attacked by a partner or a stranger, refugees fleeing terror, paramedics who have witnessed a violent death and, of course, women who have been through a traumatic birth can and do suffer from PTSD.

So which are the biggest groups of sufferers? Not soldiers. Rape Crisis reports that 97,000 people in England and Wales (85,000 women and 12,000 men) are raped each year. We know that about 50% of rape victims experience PTSD – that translates into nearly 50,000 people a year, so they may well represent the biggest group. But then there are also victims of domestic violence, asylum seekers and children being sexually abused. A rough estimate suggests that 2% of women giving birth experience postnatal PTSD, equivalent to about 20,000 people a year in England and Wales.

Whichever way you look at it, that’s a lot of PTSD sufferers. A huge number of people experiencing a major mental health problem that is under-diagnosed and under-treated. And what they don’t need, what they really don’t need, is an irresponsible idiot with a high media profile telling them that they’re lying about their experience and lying about their illness.

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How common is PTSD?

The National Post, a Canadian publication, has an interesting though frustratingly superficial article about how PTSD is more common than most of us think. Dr James Aw, who has a regular column in the paper, talks about a patient of his who suffered PTSD after being taken hostage by an armed robber.

He goes on to discuss the topic with Colonel Rakesh Jetly, chief psychiatrist for the Canadian Forces, who says that PTSD is more common among the civilian population than we realise – apparently between 6% and 9% of people who undergo a traumatic event will experience PTSD afterward. (He doesn’t define a traumatic event, however.) This is welcome: one of the problems with discussing PTSD is a general unwillingness to accept that it happens to people other than those who have returned from combat.

When it comes to treatment, rather than mentioning established methods such as cognitive behaviour therapy (CBT) or eye movement desensitation and reprocessing (EMDR) Dr Jetly mentions a relatively new approach of using “virtual-reality computer software to place the PTSD-affected subject in an environment similar to what caused the trauma in the first place.”

It’s true that there has been some success with this method, though it’s difficult to see how it would work in every case of PTSD – giving birth being one of those situations that would be hard to simulate through virtual reality software. And, as Dr Aw points out, it’s difficult to prepare for something you don’t know is going to happen (such as being taken hostage by a bank robber).

The article concludes with Dr Jetly’s advice to seek help “early following a traumatic event” – a curious piece of advice, given that the standard advice is to wait a month after a traumatic event before seeking help for PTSD symptoms. This is because a lot of people find that symptoms disappear of their own accord within a month, while early counselling can exacerbate symptoms by making people focus on the traumatic event. (While the causes of PTSD aren’t completely understood, it seems that it’s a result of the traumatic event remaining in short-term memory without being moved safely into long-term memory, which is what happens in the normal course of events.)

What the article reveals is how little we still know of a relatively common mental health condition: what causes it, who is most at risk, how it can be prevented and how treated. Forty or so years after it was first given a name, we’ve still got a very long way to go.