[derefr]

Words don’t just have textual meaning (where a term can be “inaccurate” or “imprecise”); they also have emotive force.

Carlin’s point was that “shell shock” is more visceral and evocative than “PTSD”, in a way that would be helpful as a rhetorical shield in the hands of its sufferers.

Saying that a rape or accident survivor has “shell shock” communicates by analogy the problem they’re facing, even to laymen who have never experienced such trauma—everyone has seen a war movie where artillery shells are landing all around someone, and most can (if prompted) easily picture what chronic exposure to such a traumatic stressor would do to them. This creates empathy in the minds of laymen who may not understand what was so traumatic about the particular trauma the PTSD suffered encountered.

Whereas saying “they have PTSD” does the opposite—it communicates the symptom without painting a picture of the cause, inviting a layman to minimize the imagined cause.

It’s like saying that someone is a “battered spouse”, vs. “a victim of domestic violence.” The former could have been taken to just mean the latter—non-physical forms of violence and all—but instead, in pursuit of accuracy and precision, an umbrella term that does not evoke a central example is used, and has settled into, more often than not, being mentally interpreted by the listener as implying the least-bad thing that still merits the name.

To put this another way: this is the reason that security vulnerabilities have started getting names like “Heartbleed.” That is an evocative name. CVE-2014-0160? Not so much. More useful to researchers! But less useful as a rhetorical device to communicate the impact of the problem. It’s a PR campaign in support of solving the problem!

Going from “shell shock” to “PTSD” is like going from the named vulnerability to the numerical designation. You’re doing anti-PR, making a buzzword on the tongues of the public into something that’s too much effort to buzz about at all.

Sure, the term might have more diagnostic “clarity.” When in medicine has that ever mattered? Do we name bones or tendons for what they do? No, we just give them ridiculous “legacy” names inherited from some conversation someone had once in 400BCE. Because those names are catchy, in a way that systematic names wouldn’t be.

[dvlsg]

I completely agree, but I would also point out that being manipulative by using an evocative name isn't always great by default. Personally, I think it would be beneficial in those cases (shell shock, battered spouse), since dehumanizing suffering is awful at best.

But then names like the "patriot act" also come to mind. Or for something a little closer to home, "anemic domain models".

I suppose appreciating emotive language would depend on whether or not you agree with the purpose behind it.

[derefr]

Definitely.

In this case, I imagine that psychiatrists, as a kind of medical doctors, would generally want to do whatever gets their patients the help and consideration they need. Thus, when they consider naming (or re-naming) a diagnosis, they should probably have that purpose in mind.

PR in general is neither good nor evil. But when people are seeking to do good, they should really make sure that their usage of PR (accidental or otherwise) aligns with their goals.