Traumatic Stress Disorders

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Question and consider how people adapt, how families/communities cope, and how physicians should engage with trauma.

As psychiatrists, we practice holistic medicine. Our traumatized patients depend on us to uncover their emotional pain delicately, to understand its effects on their minds and bodies, and to recognize and draw on their unique strengths and vulnerabilities as we promote recovery.

The first half of the 20th century saw 2 world wars, indiscriminate aerial bombing of civilians, the dropping of the atomic bomb, and the Holocaust-all of which created intense trauma for soldiers and civilians.Yet it was not until the American intervention in a post-colonial civil war in Southeast Asia that the psychiatric community in the 1970s formally described what we now call PTSD.

In preparing DSM-IV, we worked hard to avoid causing confusion in forensic settings. Realizing that lawyers read documents in their own special way, we had a panel of forensic psychiatrists go over every word to reduce the risks that DSM IV could be misused in the courts.

When counseling trauma victims and patients with PTSD, do you ask them to retell the trauma or do you think this prolongs it?

Colonel David M. Benedek, MD-a psychiatrist-takes a brief look at the emotional fallout of war in veterans returning from Iraq and Afghanistan and points you to the "The Clinical Manual for Management of PTSD."

David Osser, MD, and his colleagues from Harvard Medical School summarize key aspects of the Psychopharmacology Algorithm for PTSD.