Re: ARTICLE: Fallout likely caused 15,000 deaths

Ruth Weiner, Ph. D wrote:

Okay, I will rephrase from "I worry when HPs practice psychiatry" to "I worry when other than those trained in psychiatry try to practice psychiatry or offer opinions on what is, what is not, what causes, what does not cause, what could cause, and what should not cause or result a psychiatric condition or what could appear to be a psychiatric condition as defined in the DSM."

Perhaps, but your posting "I just do not think one can compare having lived in Harrisburg, PA, or even in the Chernobyl fallout, AND HAVING SUFFERED NO PHYSICAL HEALTH EFFECT AT ALL, with shell-shock, or battle stress, or being a crime victim." seems to offer an opinion on a recognized psychiatric condition that is not (seemingly) in accordance with what is recognized (in the DSM and by the APA) as current.

It is the APA that makes such statements. I only quoted and paraphrased it. I also based it on how I have seen it applied to intentional infliction of emotional distress or negligent infliction of emotional distress with PTSD as the evidence indicative of an injury.

Objective - "Based on observable phenomena." I can not fake the symptoms of a heart attack (as observed by ECG and enzyme analysis); however, I could fake symptoms of PTSD. Hum, can anything that relates to the mind of another (such as is the red I see the same red as everyone else) be truly objective? Where is Spock and the Vulcan mind meld when we need him. Seriously, the APA lists the symptoms as:

PTSD usually appears within 3 months of the trauma, but sometimes the disorder appears later. PTSD's symptoms fall into three categories:

* Intrusion
* Avoidance

* Hyperarousal

Intrusion

In people with PTSD, memories of the trauma reoccur unexpectedly, and episodes called "flashbacks" intrude into their current lives. This happens in sudden, vivid memories that are accompanied by painful emotions that take over the victim's attention. This reexperience, or "flashback," of the trauma is a recollection. It may be so strong that individuals almost feel like they are actually experiencing the trauma again or seeing it unfold before their eyes and in nightmares.

Avoidance

Avoidance symptoms affect relationships with others: The person often avoids close emotional ties with family, colleagues, and friends. At first, the person feels numb, has diminished emotions, and can complete only routine, mechanical activities. Later, when reexperiencing the event, the individual may alternate between the flood of emotions caused by reexperiencing and the inability to feel or express emotions at all. The person with PTSD avoids situations or activities that are reminders of the original traumatic event because such exposure may cause symptoms to worsen.

The inability of people with PTSD to work out grief and anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it. Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others-particularly friends or family-did not.

Hyperarousal

PTSD can cause those who have it to act as if they are constantly threatened by the trauma that caused their illness. They can become suddenly irritable or explosive, even when they are not provoked. They may have trouble concentrating or remembering current information, and, because of their terrifying nightmares, they may develop insomnia. This constant feeling that danger is near causes exaggerated startle reactions.

Finally, many people with PTSD also attempt to rid themselves of their painful re-experiences, loneliness, and panic attacks by abusing alcohol or other drugs as a "selfmedication" that helps them to blunt their pain and forget the trauma temporarily. A person with PTSD may show poor control over his or her impulses and may be at risk for suicide.

I leave further research on this subject to the reader; however, one can start at: http://www.psych.org

I was responding to your post that:

I am not questioning that post-traumatic stress syndrome exists. However, actually being mugged and being in a battle in a war is far, far more frightening and stressful than hearing about TMI on the radio or reading it in the newspaper and never noticing any physical health consequence at all. Even if the person fears cancer, the FEAR is likely to fade with the passage of time. And what would trigger post-traumatic stress in someone who lived in Harrisburg when TMI happened? A radio program? A newspaper?

I just do not think one can compare having lived in Harrisburg, PA, or even in the Chernobyl fallout, AND HAVING SUFFERED NO PHYSICAL HEALTH EFFECT AT ALL, with shell-shock, or battle stress, or being a crime victim.

I can find only one questions that you posited in the post to which I was responding and it was not related to distinguishing between fear and the fear that can cause PTSD. Your question was "And what would trigger post-traumatic stress in someone who lived in Harrisburg when TMI happened? A radio program? A newspaper? " I believe that my first response and this one both address that question.

However, what could cause PTSD for someone living in Harrisburg PA (from TMI)? Well Harrisburg is further from TMI than is nearby Hershey, but how about these as causing stress:

Days/weeks of indecision by the utility, state and federal government, medical "authorities," and radiation safety "experts."

Days/weeks of receiving incorrect information and "facts" from the utility, state and federal government, medical "authorities," and radiation safety "experts."

The indecision by the NRC as to what the governor of PA should do.

The governor of PA calling for a partial evacuation.

The occurrence of an accident that had never before been envisioned.

Day after day of news coverage by local and national news organizations (at least some of which was intended to cause a concern).

Being faced with a hazard (radiation exposure) that you can not see, hear, smell and that some are telling you WILL cause cancer and birth defects.

Not being able to tell your exposure.

Not being knowledgeable of the real risks from radiation.

A kook (a technical term?) riding around on a bike, wrapped in tin foil, and taking radiation measurements with an old CDV meter. Last calibrated in 19??.

--- I saw or experienced many of the above first hand. I could go on, but why?

"I just do not think one can compare having lived in Harrisburg, PA, or even in the Chernobyl fallout, AND HAVING SUFFERED NO PHYSICAL HEALTH EFFECT AT ALL, with shell-shock, or battle stress, or being a crime victim." Do you have any evidence that NONE of the folks near TMI suffered NO PHYSICAL HEALTH EFFECT AT ALL? If you mean no effect from radiation, I agree. However, is loss of sleep, an increase in blood pressure, and other physical effects of PTSD to be ignored if they occurred?

In response to your current question "how does one distinguish between fear and the fear that can cause post-traumatic stress?" Who is the "one" doing the distinguishing? An individual who experienced the fear, an individual who did NOT experience the fear, a psychiatrist, a clinical psychologist, an HP, a news-person, a mechanical engineer, an artist, my mom . . .? I would not expect them to have similar opinions.

Paul Lavely (just an old HP living in an administrative law dominated world)

<lavelyp@uclink4.berkeley.edu>