PTSD

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The old guys were right.

Cover of The Maltese Falcon by Dashiell Hammett (1930)I mean the really old guys, the ones who wrote over one hundred years ago.  The guys like Freud and Janet who said that mostly everything that shapes people’s lives seems to be trauma — whether or not modern authors agree.

I have seen an anorectic whose trauma was a passer-by in a crowd who told her that she was too fat for anyone to have sex with, and then keep walking. I have seen a sufferer of OCD (obsessive-compulsive disorder) who was told she was filthy when she was a kid.  She later became so excited about cleanliness she missed nights of sleep to tidy the living room.

But although very real causes of pathology, these seem too trivial to be real traumas for most people.

Others are too horrible to be denied. Read more on PTSD From Sexual Trauma — Learning That Life Is Not Always Fair…

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When we talk about sending troops out to fight with numbers that have lots of zeros on them, chance are that nobody is thinking about how the lives of the survivors will never be the same.

PTSD SoldierRecently, ABC News made an attempt, a praiseworthy attempt, to help people see at least a little of what the human devastation means. “PTSD” stands for “post-traumatic stress disorder,” which leaves lives devastated.  People come out with devastated personal relationships, often unable to maintain marriages, unable to maintain jobs, with sometimes a high potential for violence.  The devastation all too frequently progresses to suicide.

Adding to this the fact that the bureaucratic institutions do not generally encourage or even permit the most efficient means of treatment, we have a domestic mess and a domestic mortality of veterans, the very people who put their lives on the line, that is nothing short of horror.

Read more on PTSD — Often Denied, Resistant To Mainstream Treatment…

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I was in my psychiatric training.  My supervisor and clinic director had booked me to see a patient.  I was often booked for some very difficult patients, because I am good at this sort of thing.  But he warned me about this particular patient.

“She is not a patient we want to follow in this clinic.  Just see if she needs medicines, and give her a little bit.  The psychologist will do the work.”

I thought he had to be kidding, as I prided myself on being an all-around psychiatrist, and I wanted to take care of everything psychiatric.  Especially while in training, under the malpractice coverage of the University, with their supervision.

Split Personality“They say she has multiple personality disorder.  We don’t believe in that diagnosis.  We leave it, as much as we can, to the psychologists that do.  This patient is a mess.  Lots of commitments, lots of suicide attempts, lots of restraining orders.  Let the psychologist do it.  Stabilize her quickly on medication, and get her out of here, with monthly checkups, then bimonthly.
Read more on Multiple-Personalities — Rare, but they happen…

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