Sunday, September 21, 2008

Posttraumatic Stress Disorder: Issues and Controversies Paperback

Rating: (2 reviews)
Author: Gerald Rosen
ISBN : 9780470862858
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Review

“Gerald Rosen has assembled a talented group of contributors, many of whom are psychiatrists and psychologists.” (British Medical Journal, Vol.330, No.1215, 2005 and online at bmj.com)

From the Back Cover

Is Posttraumatic Stress Disorder (PTSD) an illness that arises after horrific and life-threatening events? Or is it a label that medicalizes human suffering, and brings with it more problems than it solves?

Still a relatively new diagnosis, PTSD has changed our vocabulary and shaped our views on human coping and resilience. Yet almost every assumption upon which the diagnosis rests has come under question. In this volume, Gerald Rosen brings together leading international scholars in posttraumatic studies to consider the most contentious debates. Each chapter offers an analysis of the issues, reviews current research, and clarifies implications for the practicing clinician.

Posttraumatic Stress Disorder: Issues and Controversies is essential reading for all practitioners, researchers, and students who work in the field of trauma. Professionals in related health fields and the law will also find this book useful.

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  • Paperback: 268 pages
  • Publisher: Wiley; 1 edition (September 24, 2004)
  • Language: English
  • ISBN-10: 0470862858
  • ISBN-13: 978-0470862858
  • Product Dimensions: 0.6 x 6.5 x 9.2 inches
  • Shipping Weight: 1.1 pounds (View shipping rates and policies)

Posttraumatic Stress Disorder: Issues and Controversies

Paperback

About the Editor.


Contributors.


Preface.


Acknowledgments.


1. Conceptual Problems with the DSM-IV Criteria for Posttraumatic Stress Disorder (Richard J. McNally).


2. Risk Factors and the Adversity-Stress Model (Marilyn L. Bowman and Rachel Yehuda).


3. Risk Factors and PTSD: A Historian’s Perspective (Ben Shephard).


4. Unresolved Issues in the Assessment of Trauma Exposure and Posttraumatic Reactions (B. Christopher Frueh, Jon D. Elhai, and Danny G. Kaloupek).


5. Malingering and the PTSD Data Base (Gerald M. Rosen).


6. Psychophysiologic Reactivity: Implications for Conceptualizing PTSD (Scott P. Orr, Richard J. McNally, Gerald M. Rosen, and Arieh Y. Shalev).


7. When Traumatic Memory Was a Problem: On the Historical Antecedents of PTSD (Allan Young).


8. On the Uniqueness of Trauma Memories in PTSD (Lori A. Zoellner and Joyce N. Bittenger).


9. Memory, Trauma, and Dissociation (Steven J. Lynn, Joshua A. Knox, Oliver Fassler, Scott O. Lilienfeld, and Elizabeth F. Loftus).


10. In the Aftermath of Trauma: Normative Reactions and Early Interventions (Richard A. Bryant).


11. “First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions (James D. Herbert and Marc Sageman).


12. Cross-cultural Perspectives on the Medicalization of Human Suffering (Derek Summerfield).


Index.

I'm a clinician with several decades' experience treating "complex" & "high-risk" clients, often with hospitalizations & prior treatment failures, most of whom have lived through "traumas". PTSD is the most common diagnosis on my caseload. Furthermore, I grew up with a father who was the last Marine of his platoon to be wounded or killed on Iwo Jima, and I was more-or-less raised by a next-door neighbor grandmother whose brothers were gassed in WWI, and whose father fought at Shiloh in the Civil War and was later multiply-wounded charging a Confederate battery. "PTSD" not only runs in my caseload, but also in my family.

This book, covering "issues and controversies" about PTSD, was written mostly by academic psychologists & psychiatrists - researchers & theorists, not clinicians. (Three authors are primarily clinical, one author is an historian, another an anthropologist.) Unsurprisingly, this book is not written mainly for clinicians.

Yet as a clinician, I call "PTSD: Issues & Controversies" "needed" for psychotherapists of all stripes. Why?

Here many PTSD controversies & issues highlight serious concerns I've had, as a practicing clinician, with the PTSD (and the DSM) "concept" or way of understanding . And other issues discussed make sense to me as a clinician, including those where I disagree with some interpretations.

Reviewing any book with a dozen chapters on diverse topics by different authors is difficult & dissatisfying. My approach will concentrate on only a few chapters, and touch on others.

McNally, a Harvard psychology professor and a member of DSM-IV's PTSD committee, writes a solid, experienced & thoughtful opening overview, "Conceptual Problems with the DSM-IV Criteria for Posttraumatic Stress Disorder".
As a person who suffers from combat related ptsd and who has been around the veteran's mental health system for 20 years trying to deal with it this book has been a window onto the complex and convoluted world of medical and psychiatric opinion and practice when it comes to this very difficult problem. It explains a hell of a lot, most importantly for me why the treatment/help I have been offered has been relatively useless. It has pointed up to me the incredible ignorance that most of the so called professionals I have encountered. I have no ideas what people are taught in their training but it is certainly clear that this has become a political issue co opted by all sorts of people to their own ends, yes including the women's movement!.

The sense of fraudulent claim that has been rising among veterans with a combat background when confronted in treatment with people whose trauma was sustained when they saw a news broadcast or heard about some event from someone else, or who happened to be i the vicinity.... or classically, as in one case cited, where the victim was subjected to having to overhear sexist comments by colleagues in the workplace. This is a perpetuation of the "counterfeit universe" that became so damaging to combat veterans returning from Vietnam, it does not serve them and it certainly will not serve the masses of service personnel who have, are now and will be returning from Irag and Afghanistan. They too will become familiar with the corrosive substance of the "counterfeit universe".

The "bracket creep" that has become such a part of the ptsd diagnostic and treatment debate will, if anything deter these people from seeking treatment or once they get a taste will have them run as fast and as far as they can, as so many of my generation did.
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