Thanks to Dr. Bessel VanDerKolk and others, Post Traumatic Stress Disorder has been given more attention in terms of its neurological roots and impact on the nervous system.

The current thinking is that the brain is very affected by trauma, therefore creating long-lasting symptoms of PTSD.

A question arises as to what happens if trauma is chronic, that is to say, a person’s early

living environment has many traumatic situations over a sustained period of time?

Some theories have come up that suggest that chronic trauma is the foundation for the development of Borderline Personality Disorders.

Persons that come from severely abusive, violent, frightening, and unsafe environments have a high incidence of Borderline-like traits. This is easy to

understand, considering that the environment, through the eyes of a very young child, is interrelated with his/her caretakers. The sense of stability  and autonomy then are threatened, as the child is out of control of his/her fate. This sets up the potential for abandonment issues, splitting, oscillating moods, and desire to recreate drama (trauma). -K-

So they ingenuously came up with the idea of using easy-to-read numbers to represent entire concepts. Thus the Diagnostic Code System was birthed in the year 1000 A.D. and has remained in use to this day. Why reinvent the wheel?

Unfortunately the psychiatrists in the field had a problem. They wanted to get paid just like real doctors, but how did one go about categorizing mental problems into defined groups and subgroups...and make it as fat as a PDR?

It was decided that the mentally retarded and narcissists had something in common (you be the judge),, so they put them in one category (called Axis I due to the circular nature of mental illness).

The  rest of the book was fairly straightforward to create after Axis I was established. A simple scheme to come up  with  multitudes of codes was to label a set of symptoms, and when a patient had those symptoms for more than a week, it was called something completely different.

When drug addictions hit the scene, the writers of the DSM IV jumped for joy. Here was their chance to include things like Caffeine Dependency Disorder.

 

 

 

They debated whether to include Movie Popcorn Dependency Disorder and it was dropped since the majority of the writing committee suffered from this malady.

Does the DSM IV help in any way in the treatment of our patients?

The only mental illness the DSM IV attempts to treat and does so successfully is insomnia.

In fact, I believe the DSM IV can cause mental illness. It is the perfect handbook for those desiring to get out of work or marriage. It is useful for hypochondriacs as well.

Since it is getting late in the evening and I need to get up early tomorrow, I will use the DSM IV as directed. Good night.

–K-

 

The Bible for Mental Health Practitioners, the DSM IV, seems to be loved and hated simultaneously by both professionals in the health field and the general public.

Much like any other medical book, if one should browse through its contents long enough, one might easily start wondering if they have an illness.

 Could they be bipolar, do they have ADHD, are they possibly paranoid, do they have OCD?

In other words, the symptoms presented in the DSM IV are human traits we all may exhibit at different moments in our lives but do not necessary mean (but please don’t rule out the possibility!) that they are in full bloom mental illness.

What is the use of the DSM IV besides being a handy doorstop in disguise?

Well, we all know and love insurance claim forms, and that the only way to get reimbursed

for medical treatment is to, well, get medical treatment.

Since no one at Fiasco Insurance Company could read the handwriting of physicians (and therapists), they had to come up with a system that made the whole process of translating medical scribble easier.

 

 

What is the Result of Repeated Trauma?

DSM IV Commentary: History Lesson

Professional’s Corner: PSTD Revisited                      Page 2