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In his recent guest editorial, Richard McNally voices skepticism about the National Vietnam Veteran’s Readjustment Study (NVVRS) data reporting that over one-half of those who served in the Vietnam War have posttraumatic stress disorder (PTSD) or subclinical PTSD. Dr McNally is particularly skeptical because only 15% of soldiers served in combat units (1). He writes, “the mystery behind the discrepancy in numbers of those with the disease and of those in combat remains unsolved today” (4, p 815). He talks about bizarre facts and implies many, if not most, cases of PTSD are malingered or iatrogenic. Dr McNally ignores the obvious reality that when people are deployed to a war zone, exposure to trauma is not limited to members of combat units (2,3). At the Operational Trauma and Stress Support Centre of the Canadian Forces in Ottawa, we have assessed over 100 Canadian soldiers, many of whom have never been in combat units, who have experienced a range of horrific traumas and threats in places like Rwanda, Somalia, Bosnia, and Afghanistan. We must inform Dr McNally that, in real world practice, even cooks and clerks are affected when faced with death, genocide, ethnic cleansing, bombs, landmines, snipers, and suicide bombers ...One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients." Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.
Colin Cameron
In 2006, there is no army of recovered memory therapists, and Dr McNally’s assumptions about patients with PTSD and those working in this field are troubling. Owing to past debates, those working in the PTSD field are perhaps more knowledgeable than others about malingered, factitious, and iatrogenic variants.Why, then, does Dr McNally attack PTSD as a valid diagnosis, demean those working in the field, and suggest that sufferers are mostly malingered or iatrogenic, while giving little or no consideration is given to such variants of other psychiatric conditions? Perhaps the trauma field has been “so often embroiled in serious controversy” (4, p 816) for the same reason Dr McNally and others have trouble imagining the traumatization of a Vietnam War cook or clerk. One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients."Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.
Colin Cameron
Every time you feel like mocking a person you disagree with politically by implying that they are mentally ill, I want you to instead imagine you are talking to every single person who actually is mentally ill and telling them they are worthless. That's how it makes mentally ill people feel. Doesn't seem very progressive now does it?
Ariel Howland
Richard J. McNally, a Harvard clinical research psychologist, considered the "politics of trauma" in Remembering Trauma (2003).[139] He argued that the definition of PTSD had been too broadly applied, and suggested narrowing it to include "only those stressors associated with serious injury or threat to life" —a suggestion that would drastically alter the public discussion of rape, incest, abuse by clergy, and the traumatic affect of racism and homophobia, to name just a few potentially trauma-inducing contexts and actions.[140] McNally presents his conclusion that most traumatic experience is remembered soon after the event, as if his view represents objective scientific research, when much evidence suggests that memories of traumatic events reoccur over time unpredictably. McNally’s bias is apparent in his strong support of Ian Hacking’s curiously fervent effort to discredit the diagnosis of multiple personality (dissociative identity disorder) and Hacking’s effort to blame clinicians attached to recovered memory therapy of the spurious "rewriting" of patients’ "souls."[141] While McNally accounts for those who do recall their traumas, he does not equally offer an explanation for those who do not remember them, and his extensive bibliography and research do not cite key publications that would challenge his results.[142] - Page 19
Kristine Stiles
I cut myself up really badly with the lid of a tin can. They took me to the emergency room, but I couldn’t tell the doctor what I had done to cut myself—I didn’t have any memory of it. The ER doctor was convinced that dissociative identity disorder didn’t exist. . . . A lot of people involved in mental health tell you it doesn’t exist. Not that you don’t have it, but that it doesn’t exist.
Bessel A. van der Kolk
Each of these patients counts on us to help them to the best of our abilities. We have an obligation to them. We shouldn’t turn our backs on them and give up. It’s not fair to them, nor is it fair to ourselves.
Jason Medina
Mental illness is not something you misunderstand in this era. Get educated because bias is no different than racism.
Shannon L. Alder
The fatal weakness of most psychiatric historiographies lies in the historians' failure to give sufficient weight to the role of coercion in psychiatry and to acknowledge that mad-doctoring had nothing to do with healing.
Thomas Szasz
A phenomenon that might seem only backwards or silly when expressed at a social level becomes madness at the individual level.
Caitlín R. Kiernan
Schizo. It didn't matter how many times Dr. Gill compared it to a disease or physical disability, it wasn't the same thing. It just wasn't. I had schizophrenia. If I saw two guys on the sidewalk, one in a wheelchair and one talking talking to himself, which would I rush to open a door for, and which would I cross the road to avoid?
Kelley Armstrong
There is something about being loved and protected by a parent (or guardian) knowing that I can be loved for who I am, not what I can do, or might one day become. Unfortunately it’s not usually like this in every single situation. From time to time, my parents made mistakes during my childhood. Possibly I was the mistake, or unwanted. But I don’t know. I had every material thing that I could have ever wanted, but there was still something missing, as if I felt distanced from my parents, or misunderstood, in the ways that they treated me. At times, I had felt completely loved and accepted by my parents, but for one reason or another, they were unable to care for me, provide for me, in some ways that would have been very important. Sometimes I feel like I am trying to make up for the experiences in life that were absent when I was a child.
Jonathan Harnisch
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