Finding Myself in the DSM Criteria
It is Thursday morning. I am standing in front of my computer.
Matthew, my therapist, appears on the Zoom screen. He is an Asian American man with neatly combed dark hair, glasses, and a gentle smile. Over the past few months, I have come to trust him. I can speak openly with him. I don’t feel particularly guarded.
I had asked him for help.
As part of my clinical psychology studies, I wanted to understand CBT and DBT more deeply—not only through books and lectures, but from the patient’s side of the therapy room.
Somehow, our conversation moved toward symptoms I have lived with for many years.
PTSD was not a foreign idea to me. I had used the term before. I had wondered about it. At times, I had even used it to describe myself.
But I had never really stopped.
Never sat with the DSM-5-TR criteria in front of me and asked, one by one:
Does this describe me?
I had never taken the diagnosis apart and examined my own life against it.
Matthew began with the first criterion: exposure to actual or threatened death, serious injury, or sexual violence. It could mean experiencing it yourself, witnessing it, or learning that it had happened to someone close to you.
Yes.
I know this territory.
He continued. Now he was reading about the ways a traumatic event can return.
Unwanted memories of what happened.
Yes.
Distressing dreams.
Yes.
Feeling as though it is happening again.
I paused at that one.
Intense distress when something brings it back.
Yes.
The body reacting to a reminder, even before the mind has caught up.
Again, yes.
Something was beginning to shift.
Not surprise exactly.
More like recognition.
A slow, uncomfortable recognition.
Matthew continued.
Avoidance.
Yes.
Negative thoughts. Blame. Isolation. Difficulty experiencing positive feelings.
Some more than others. Some in ways I would have described differently.
But I recognized myself.
Then came arousal and reactivity.
Irritability or aggression.
I knew that one.
Hypervigilance.
That one too, very well.
Heightened startle response.
Yes.
Difficulty concentrating.
Sometimes.
Difficulty sleeping.
Sometimes.
Matthew kept reading.
And with each line came the same quiet recognition.
That’s me.
Another line.
That’s me too.
It wasn’t a dramatic revelation. No sudden discovery that I had never considered before.
It was more unsettling than that.
Now, line by line, experiences that had lived separately in my mind were gathering together under one heading.
My temper.
My vigilance.
My need to anticipate.
My tendency to withdraw.
The speed with which my body can go from calm to alarm.
My difficulty letting go when something feels threatening.
I had explanations for all of them.
Personality.
Temperament.
Childhood.
Israel.
The army.
My father.
My mother.
Survival.
Just the way I am.
But standing there on that Thursday morning, listening to Matthew move down the page, those separate pieces began to form a picture.
PTSD.
I stood in front of the screen and let that settle.
There was something sobering about seeing experiences I had carried for decades organized so plainly in front of me.
And something sad.
Not because the diagnosis suddenly defined me.
It didn’t.
Perhaps the sadness came from recognizing how long these patterns had been with me. How much energy I had spent adapting to them. How naturally I had incorporated them into the person I understood myself to be.
I had known the term PTSD for years.
That morning, I began to understand what it meant when applied to me.
And for a moment, the DSM stopped being a textbook.
It became a mirror.
Tim O’Brien once said that “wars do not end when you sign a peace treaty.” He was speaking about the lives that continue after the fighting stops.
I understand what he means.
I left the army more than four decades ago, but parts of it may never have entirely left me. And I carried something older into the army. My parents survived the Holocaust. They spoke little about it, but I knew enough to wonder about what they had lived through. I read, I listened, and I imagined the rest. At times, their war felt almost like a memory of my own.
Standing in front of my computer that Thursday morning, listening to Matthew read the criteria, I began to see how much I had been carrying. Some of it came from what I had experienced. Some came from the silences I grew up with.
The danger passes. Years pass. The body can still be waiting for what might happen next.
Throughout my third quarter at Antioch, I had been studying trauma. That Thursday morning, I saw familiar pieces of my own life gathered together on a single page.
➡️ For a brief overview of PTSD, see: The psychology of post-traumatic stress disorder
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