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The premise which views post-traumatic stress as a disorder rests on the false belief that people are normally capable of enduring severe trauma or stress without lasting, deep, and impairing mental and behavioral struggles. Yet, as a holocaust survivor and psychiatrist Viktor Frankl once wrote,
An abnormal reaction to an abnormal situation is normal behavior.
In fact, the label of PTSD itself is redundant and undermines the suggestion that ongoing distress is an abnormality; by definition, trauma is an event(s) or experience that produces ongoing distress.
Merriam-Webster’s dictionary defines trauma as “a very difficult or unpleasant experience that causes someone to have mental or emotional problems usually for a long time.”
It should be expected, then, that when people experience horrific events or survive painful wrong-doing against them, they will experience ongoing mental struggles—even potentially throughout the rest of their lives. When a person’s trauma is the result of another’s depraved or evil actions, the ongoing stress and impairment are often greater, the pain deeper, and the negative physical effects more pronounced.
The construct of PTSD highlights the sharp contrast between humanistic and biblical anthropologies. Humanists see people as normally strong and able to survive, whereas the Bible teaches human fragility and depravity.
The American Psychiatric Association (APA) asserts in its construct of PTSD that post-traumatic stress is a medical abnormality/syndrome, but Scripture does not present this human tendency as a disorder or an abnormality.
Instead, the Bible reveals post-traumatic stress to be a normal and expected human response or reaction to a tragedy. In Ecclesiastes 7:7, for example, King Solomon states, “Surely oppression drives the wise (those who possess knowledge or are intellectual) into madness (turning to false beliefs).”
When people experience trauma that rests outside of their ability to handle the enormity of the stress mentally, it should be expected (“surely”) that they will struggle mentally to resolve these horrific realities and will be prone to turn to false beliefs to explain and mentally shoulder their experience.
Rather than being able to rely on faith or changing beliefs to enable endurance, the human tendency is to turn to falsehood and suppress or deny reality. The disposition of turning to false beliefs to deal with or reject reality represents the biblical definition of madness and is represented in the DSM-5 in part as “distorted cognition” and false guilt:
Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. Persistent negative emotional state (e.g., guilt or shame).
In Deuteronomy 28:33-34ff, as another Biblical illustration of PTS, the Word of God states,
A nation that you have not known shall eat up the fruit of your ground and of all your labors, and you shall be only oppressed and crushed continually so that you are driven mad by the sights that your eyes see.
This text not only helps to define the biblical concept of madness, it specifically explains what drives people to it: “by the sights that your eyes see.” Unlike the secular construct of mental illness today, madness in Scripture was not a concept that described abnormality; rather, madness meant that someone had turned to deceit or was overcome by it.
When people are oppressed and crushed, they naturally turn to deceit. In Deuteronomy 28:28, God warned his people that if they rejected His truth they would be given over to deceit (madness):
The LORD will strike you with madness and blindness and confusion of mind, and you shall grope at noonday, as the blind grope in darkness, and you shall not prosper in your ways. And you shall be only oppressed and robbed continually, and there shall be no one to help you.
Without proper faith, the realities that our eyes see (trauma) and the experiences of being oppressed and crushed will invariably lead us into spiritual blindness and deeper false beliefs.
There is overwhelming evidence now available to conclude that the majority of people diagnosed with what secularists believe to be severe mental illnesses are in fact responding to traumatic life events that they are unable to mentally shoulder. For example, neurologist Oliver Sacks comments on the secular concept of “dissociation”—the turning to deceit in order to deal with trauma:
The concept of dissociation would seem crucial not only to understanding conditions like hysteria or multiple personality disorder (now called dissociative identity disorder) but also to the understanding of post-traumatic-syndromes.
This realization is precisely what Dr. Charles Whitfield concludes:
I have found post-traumatic stress disorder (PTSD) to be the most accurate, inclusive and potentially useful of all the DSM diagnostic categories. Its accuracy begins with the fact that many of the common mental disorders are strongly associated with, and in some cases possibly caused by, repeated childhood and other trauma.
For example, one recent article in the Psychiatric Times remarks on the empirical evidence across numerous studies that consistently correlates traumatic life experiences with today’s psychiatric concepts of depression and mania (e.g., bipolar disorders):
Bipolar disorder has been linked to traumatic childhood experience and to the potential for violence.
Psychiatrist Petteri Pietikäinen concurs,
Nobody is born insane. The mad, the mentally ill, the insane were, in most cases, not destined to lose their minds. If their lives had taken different paths, most of them might not have been burdened with mental illness.
Psychiatrist Lawrie Reznek explains further why people turn to false beliefs when faced with trauma,
We also cling to beliefs if they provide comfort and protect us from the terror we experience when we think of our place in the universe. As one group of psychologists put it, we need “a protective shield designed to control the potential for terror that results from awareness of the horrifying possibility that we humans are merely transient animals groping to survive in a meaningless universe, destined only to die and decay.”
Though we are not soulless animals as Reznek asserts, our human nature is to turn to our belief system when life is too difficult to bear. PTS is not a disorder or an abnormality; it simply describes our normal human condition in a fallen world full of trouble. Job 14:1-2 states it as such:
Man who is born of a woman is few of days and full of trouble.
If we genuinely want to help people through their traumatic experiences and ongoing mental struggles, we must first stop stigmatizing and labeling them as disordered and, instead, help them to embrace a faith that encourages them toward truth rather than further into deceit. One truth that is vital for both counselors and counselees to understand is that it is not the individual’s reaction or struggle with a traumatic life event that is itself a disorder; rather, it is the horrific experience that is disordered—the result of the fall in the Garden of Eden.
This reality takes the starting point of proper faith back to Genesis 3. Of course, some trauma (e.g., drug use, attempted suicide, and sexual deviant behavior) is self-inflicted and produces justified guilt and mental struggles. But post-traumatic stress mostly describes survivors of traumatic events outside their own control or capability.
Unless we start with this reality, then survivors’ ongoing distress and pain will not make sense. Insisting that soldiers who have endured the greatest stress known to mankind (the threat of being killed), have seen and smelled things God never intended to be experienced, and have had to take others’ lives against their own wishes should not have ongoing struggles is not realistic nor is it helpful. It is the result, however, of framing human mindsets, emotions, and behaviors within evolutionary thinking.
In the same manner, labeling people as psychotic who persistently struggle with turning to falsehood and denying reality due to their enduring repeated childhood rapes or other abuse does not help these individuals to heal.
In fact, if people did not struggle after returning from war or enduring abuse, we might consider that something is wrong with them. People who are struggling with PTS must be understood, not as physically ill or abnormal, but as normal individuals reacting to life’s horrific experiences in a typical but impairing manner.
Assuredly, such mental struggle will also produce physical impairment and measurable brain variances, but these are symptoms and not causes. Clinical psychologist Richard Bentall explains,
Plainly, these findings do not imply that post-traumatic stress can be adequately understood as a disorder of the brain. It is better thought of as a psychological reaction to adverse events that manifests itself, at the biological level, as changes in brain structure.
In his book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, professor of psychiatry Bessel van der Kolk writes specifically on how the body reacts to and bears the condition of our mental states. Chair of the DSM-IV task force and former head of psychiatry at Duke University, Allen Frances, also remarks on the normalcy of reacting to trauma,
Almost everyone has at least some intrusive imagery and emotional reactivity to cues after a shocking event—this is part of the human condition and until recently was not defined as illness. For most people, the intrusive images gradually become less intrusive, and the triggers become less terrifying. The mental disorder PTSD should be diagnosed only when the symptoms persist and cause significant disability.
Frances attempts to distinguish between normal and abnormal by imposing a time qualifier onto mental struggles. Those people who have ongoing struggles past an imprecise and subjectively established time frame are in his view abnormal.
But as regarded neurologist Norman Sacks notes, PTS is regularly a reaction which persists throughout life:
Much deeper trauma and consequent PTSD may affect anyone who has lived through a violent crash, a natural cataclysm, war, rape, abuse, torture, or abandonment—any experience that produces a terrifying fear for one’s own safety or that of others.
All of these situations can produce immediate reactions, but there may also be, sometimes years later, post-traumatic syndromes of a malignant and often persistent sort.
Simply because people have ongoing struggles with past trauma does not make them abnormal or disordered, and such a belief does not take into consideration that people deal with trauma and sorrow differently.
The remedy to PTS does not come in denying the past, suppressing memories, or by diminishing awareness and feelings through psychotropic drugs. Instead, the answer to PTS is to change one’s faith in accordance with God’s truth which alone can explain this broken world and enable endurance through its many horrific experiences. James 1, among other passages, gives us this solution for mental endurance through all types of trauma or trials:
Count it all joy, my brothers, when you meet trials (evil experiences, traumas, or hardships) of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing. If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him.
After enduring trauma, people should expect to have a crisis or testing of faith. If their faith is lacking the ability to explain the most horrific circumstances and to provide comfort and hope, then they face choosing between two options: they can pursue God’s truth to explain their experience and ongoing mental struggles, or they can turn to natural deceit and attempt to reject the reality of their experience.
King David provides one Scriptural example of someone who endured incredible trauma and stress. In fact, David expresses in Psalm 39:6a both the vanity and tumultuous nature of life: “Surely a man goes about as a shadow! Surely for nothing they are in turmoil.”
David himself lived under the constant threat of dying (e.g., 1 Samuel 19), he had to kill others at proximity (1 Samuel 17), he endured his daughter being raped (2 Samuel 13), he endured his own son’s killing another of his children (2 Samuel 13-14), and he lost his infant son (2 Samuel 2:12-18)—to name a few of his traumatic experiences.
Psalm 116 tells of the only faith/worldview able to remedy post-traumatic stress. It is this mindset which enabled David to deal with life’s distressful and impairing events supernaturally:
I love the Lord because he has heard my voice and my pleas for mercy. Because he inclined his ear to me. Therefore I will call on him as long as I live. The snares of death encompassed me; the pangs of Sheol laid hold on me; I suffered distress and anguish. Then I called on the name of the Lord.
In the passage, the psalmist explains how God delivered him from the snares of death (vs. 8), from affliction (vs. 10), from the evil and deception of humanity (vs. 11), and from distress and anguish. There was one specific hope that enabled his mind/soul to resolve the horrific reality (trauma) that he faced (6-13):
The Lord preserves the simple; when I was brought low, he saved me. Return, O my soul, to your rest; for the Lord has dealt bountifully with you. For you have delivered my soul from death, my eyes from tears, my feet from stumbling; I will walk before the Lord in the land of the living. I believed, even when I spoke: I am greatly afflicted . . . I will lift up the cup of salvation and call on the name of the Lord.
Believing in God’s gracious plan to deliver/save us from our low state, death, sorrow, our depraved nature, and our affliction is the only means to have rest in the midst and aftermath of trauma. That does not mean that we will not suffer great sorrow and pain or struggle with false beliefs (our normal human condition; Jeremiah 17:9). But having right faith allows us to both mentally explain and endure our most broken human experiences and heal our broken souls.
In Psalm 77:1-15 Asaph expresses how he endures during the day of trouble—when his soul refuses to be comforted and perceives that God has forgotten him:
I cry aloud to God, aloud to God, and he will hear me. In the day of my trouble I seek the Lord; in the night my hand is stretched out without wearying; my soul refuses to be comforted.
When I remember God, I moan; when I meditate, my spirit faints. Selah You hold my eyelids open; I am so troubled that I cannot speak. I consider the days of old, the years long ago. I said, “Let me remember my song in the night; let me meditate in my heart.”
Then my spirit made a diligent search: “Will the Lord spurn forever, and never again be favorable? Has his steadfast love forever ceased? Are his promises at an end for all time? Has God forgotten to be gracious? Has he in anger shut up his compassion?” Selah
Then I said, “I will appeal to this, to the years of the right hand of the Most High.”
I will remember the deeds of the LORD; yes, I will remember your wonders of old. I will ponder all your work, and meditate on your mighty deeds. Your way, O God, is holy. What god is great like our God? You are the God who works wonders; you have made known your might among the peoples.
You with your arm redeemed your people, the children of Jacob and Joseph. Selah
The greatest of God’s deeds toward humanity centers on His enduring the physical and mental trauma of the cross for the sake of redeeming His people. When we feel as though God has abandoned us, that our bodies are shutting down, and our souls cannot be comforted, we must remember that God has been through far more suffering and endured far greater trauma and that He offers us the same sustaining faith.
We must look unto Jesus, the author, and perfecter of our faith. Who by staying focused on the joy set before Him was able to endure the cross (Hebrews 12:2-5).
To learn more about the psychiatric construct of PTSD, see Daniel R. Berger II, Mental Illness: The Influence of Nurture (Taylors, SC: Alethia International Publications, 2016).
Dr. Daniel R. Berger II is the founder and director of Alethia International Ministries (AIM), where he continues to write and to speak around the country in various churches, organizations, medical communities, and at various counseling and teacher’s conferences. He is also an experienced pastor, counselor, school administrator, and the author of ten books on Biblical counseling, practical theology, education, and the history and philosophy of the current mental health construct. Daniel earned his B.S. in counseling, an M.S. in counseling/ psychology, an M.A. in pastoral studies, and a doctorate in pastoral theology. Daniel is also an adjunct professor at several Universities and seminaries-including serving as the director of a post-grad degree at SEBI (Brasilia, Brazil) in Biblical Counseling, which is specifically focused on understanding the various aspects of the construct of mental illness from a biblical worldview.