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Medical Whistleblower Advocacy Network

Human Rights Defenders

“All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”

 Universal Declaration of Human Rights

Article 1

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Trauma And Post Traumatic Stress

PTSD Injury not disease



Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normal reaction to an abnormal situation. Any human being has the potential to develop PTSD. The cause is external not internal. It is a Psychiatric Injury not Mental Illness. It is not resulting from the individual’s personality. The Whistleblower who is the victim of the retaliation is not inherently weak or inferior. In fact, any human being has the potential to develop PTSD. Whistleblower retaliation is extremely stressful and may lead to burnout or stress break-down - which is not the same as nervous or mental break-down; as stated above, everyone breaks down under the stress of a life altering trauma that is deeply wounding.  Thus individuals suffering PTSD are injured, not mentally ill.  PTSD indicates severe trauma and stress which causes a weakness in the individual, and not the reverse. This is confusing for mental health practitioners and laypersons alike.  But the distinction is important if mental health practitioners desire to assist a traumatized victim.  Too often reactions which are normal under excessive or prolonged stress are assumed to be signs of abnormality or deficiency within the person affected, which may then be assumed to be the cause of the problem rather than a consequence of it (this is sometimes referred to as the "Mental Health Trap"). The diagnosis Complex PTSD comes from being exposed to multiple traumas, sometimes small but causing cumulative emotional damage over a long period of time.  PTSD changes the diagnosed individual’s life and greatly impacts the lives of those with whom they are close and regularly interact.  The explosive rage, depression, isolation, anxiety, cognitive difficulties, and lack of vitality combine to cause loved ones to leave.   But a strong support network is essential for healing.  Friends and families are an integral part of that network.  Trusting relationships are essential to combat the dehumanizing effect of trauma.   Many therapists practice narrative therapy believing this is essential to overcoming the trauma.  This however is not good for all who are suffering from PTSD because it forces them to relive the events of the trauma.  Some people do better never narrating the trauma and should instead focus on coping techniques to deal with triggers.  A trigger is something that causes memory flashbacks and intrusive thoughts of the previous trauma.  Under extreme or prolonged stress people of a previously very strong constitution may become unassertive, over-anxious, compliant and unable to cope with even the most trivial of stressors. A person's reactions under stress may resemble symptoms of mental illness - loss of emotional control, apparent over-reactions to seemingly trivial stimuli, hypervigilance (e.g. being on constant alert for further abuse) etc., may be mistaken for instability, irrational behavior and paranoia.  It is important for supporters to provide a safe physical environment, but also emotional safety and be willing to accept a wide range of emotions.  According to Maslow’s (1970) hierarchy of needs, the being needs, the three higher-order needs, cannot be met until the deficiency needs the four lower-order needs, are met.. This is critical to relationship building, which will help provide the strong support network that is essential for healing. Recovery requires a sense of power and control. All relationships should be respectful and empower the Whistleblower to make choices. The Whistleblower 's symptoms and behaviors are adaptations to trauma, so services should address all of the Whistle-blower’s needs rather than just symptoms.

Drs. Zoellner and Bryant talk about PTSD

Psychological disorders following exposure to trauma include personal suffering, decreased productivity, occupational and social dysfunction, medical disorders and demands on health services. In this talk, Drs. Zoellner and Bryant review current research associated with the persistence of Post-Traumatic Stress Disorder and the variety of viable options that exist for treatment. Speakers also explore treatment options and focus on the effectiveness of both therapies and medications.

"All that we are is the result of what we have thought. The mind is everything. What we think we become."

Buddha

"I define a survivor as one who has touched, witnessed, encountered or been immersed in death in a literal or symbolic way and has himself remained alive."

-- Robert Jay Lifton, American psychiatrist and pioneer

Complex Post Traumatic Stress Disorder

 

The diagnosis Complex PTSD comes from being exposed to multiple traumas, sometimes small but causing cumulative emotional damage over a long period of time.  PTSD changes the diagnosed individual’s life and greatly impacts the lives of those with whom they are close and regularly interact.  The explosive rage, depression, isolation, anxiety, cognitive difficulties, and lack of vitality combine to cause loved ones to leave.   But a strong support network is essential for healing.  Friends and families are an integral part of that network.  Trusting relationships are essential to combat the dehumanizing effect of trauma.  

 

References:

A.H. Maslov, A Theory of Human Motivation, Psychological Review 50 (1943):370-96.

Maslow, Abraham (1954). Motivation and Personality.


Wahba, A; Bridgewell, L (1976). "Maslow reconsidered: A review of research on the need hierarchy theory". Organizational Behavior and Human Performance (15): 212-240.


 

Talking Post Trauma Blues

Differences between mental illness and psychiatric injury

Thanks to Tim Field see his website:   http://www.bullyonline.org/stress/ptsd.htm)

The person who is being bullied will eventually say something like "I think I'm being paranoid..."; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury.

Paranoia

Hypervigilance

  • paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry
  • is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury
  • paranoia tends to endure and to not get better of its own accord
  • wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause
  • the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia
  • the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word "paranoia"
  • sometimes responds to drug treatment
  • drugs are not viewed favorably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process
  • the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia
  • the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so
  • the paranoiac is convinced of their self-importance
  • the hypervigilant person is often convinced of their worthlessness and will often deny their value to others
  • paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD
  • hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness
  • the paranoiac is convinced of their plausibility
  • the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)
  • the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")
  • the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury
  • sense of persecution
  • heightened sense of vulnerability to victimization
  • the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them
  • the hypervigilant person's sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them
  • the paranoiac is on constant alert because they know someone is out to get them
  • the hypervigilant person is on alert in case there is danger
  • the paranoiac is certain of their belief and their behavior and expects others to share that certainty
  • the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behavior is having; they cling naively to the mistaken belief that the bully will recognize their wrongdoing and apologize

Other differences between mental illness and psychiatric injury include:

Mental illness

Psychiatric injury

  • the cause often cannot be identified
  • the cause is easily identifiable and verifiable, but denied by those who are accountable
  • the person may be incoherent or what they say doesn't make sense
  • the person is often articulate but prevented from articulation by being traumatized
  • the person may appear to be obsessed
  • the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery
  • the person is oblivious to their behavior and the effect it has on others
  • the person is in a state of acute self-awareness and aware of their state, but often unable to explain it
  • the depression is a clinical or endogenous depression
  • the depression is reactive; the chemistry is different to endogenous depression
  • there may be a history of depression in the family
  • there is very often no history of depression in the individual or their family
  • the person has usually exhibited mental health problems before
  • often there is no history of mental health problems
  • may respond inappropriately to the needs and concerns of others
  • responds emphatically to the needs and concerns of others, despite their own injury
  • displays a certitude about themselves, their circumstances and their actions
  • is often highly skeptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?" - click here for the answer)
  • may suffer a persecution complex
  • may experience an unusually heightened sense of vulnerability to possible victimization (ie hypervigilance)
  • suicidal thoughts are the result of despair, dejection and hopelessness
  • suicidal thoughts are often a logical and carefully thought-out solution or conclusion
  • exhibits despair
  • is driven by the anger of injustice
  • often doesn't look forward to each new day
  • looks forward to each new day as an opportunity to fight for justice
  • is often ready to give in or admit defeat
  • refuses to be beaten, refuses to give up

 

Let Be - Joan Baez


"The psychology of the mature human being is an unfolding, emergent, oscillating, spiraling process marked by progressive subordination of older, lower-order behavior systems to newer, higher-order systems as man's existential problems change."

Clare W. Graves 1914-1986, American clinical psychologist and originator of the "Theory of levels of human existence" in the Futurist (1974)

Retraumatization

Retraumatization

Psychological violence can eventually lead to Post -Traumatic Stress Disorder (PTSD) which is a normal reaction to abnormal circumstances.  PTSD is not usually an indication of long term or underlying problems in those who suffer from it.  Whistleblowers who are being bullied should be encouraged to seek support sooner, rather than later, and should be able to do so with the assurance that they will be believed and effectively supported,  rather than be treated as if they themselves were the problem.  These competent whistleblowers under the effects of workplace bullying and  whistleblower retaliation may become unassertive, overanxious, compliant and even unable to cope with even the most trivial of stressors.  The symptoms of stress breakdown and PTSD are frequently misunderstood (by family, friends, co-workers and employers) as those of inadequacy or inefficiency.  There is a danger that stressed and/or bullied Whistleblower could find themselves facing disciplinary proceedings when what they really need is rest and support.  Some typical human reactions to severe and persistent stress are the loss of emotional control, apparent over-reactions to seemingly trivial stimuli, showing hyper-vigilance, and being on constant alert for further abuse.  Being targeted for Whistleblower Retaliation almost always leads to feelings of powerlessness in those targeted.  Those who are being retaliated against usually feel ashamed of what is happening to them, and by the time they seek help are likely to be already showing signs of stress breakdown.  At the point these competent Whistleblowers finally admit they need help, they are likely to present as over -emotional.  In these circumstances it is all too easy believe the person's account of workplace psychological violence or bullying as over-reacting when in fact the symptoms of emotional stress should be recognized as actually corroborating what they are saying.

 

Secondary Traumatization

Secondary Traumatization

The persons whose misdeeds the Whistleblower is reporting, often retaliate by fabricating complaints against the Whistleblower.  These fabricated complaints do not need to even have the appearance of truth in order for the bully to be protected by the Good Samaritan Laws and their false allegations protected by governmental immunity under Peer Review standards.  People may also disbelieve the Whistleblower, and side instead with those in power or authority.  Coworkers may ridicule him/her, abandon, blame, ostracize, sabotage, threaten, and betray him/her.  These painful and dangerous reactions can come from family, friends, and authorities as well as from people associated with the  perpetrator.  Co-workers may fault the Whistleblower for the hostility in the workplace.  The Whistleblower may be unable to recover until they leave the stressful position, but may be unable to find a new position until they have recovered.  Employers, therefore, need to be aware of the potential for compounding the problems of stressed/bullied Whistleblowers by unjustly disciplining them.  Where the stress has been caused by workplace bullying,  it also allows the perpetrators to switch the focus of attention away from their own abusive behavior by inferring, (usually under the guise of sympathy and support), that the person they are targeting is mentally ill, and that it is their "mental illness" which is responsible for the current problems.  Whistleblowers need ongoing reassurance that they are not to blame for what has happened. Referring stressed people for work-based counseling helps perpetuate the myth that it is the person who is the problem, rather than the working environment.  It is important that employers and service providers take stress reaction seriously and remove the Whistleblower from the stress before the damage becomes more serious or permanent.  Medical professionals, who are generally highly committed people, are particularly likely to ignore their own symptoms and struggle on,  since seeking help is too often regarded as an admission of weakness or professional inadequacy.  It is crucially important that those providing help and support to the Medical Whistleblower, do not mimic the effects of the trauma and inadvertently cause secondary trauma to the victim of retaliation.  If the support offered is too directive and/or controlling, however well-intentioned, there is a danger that it will be perceived as replicating the whistleblower retaliation or bullying, so reinforcing feelings of powerlessness and causing further stress and distress.   Do not put stressed/bullied whistleblowerback into the same stressful/bullying situation and expect them to "prove" themselves.   Long term solutions require the full involvement of the stressed person, but should wait until he/she is first rested and reassured.

DSM-IV diagnostic criteria for Post Traumatic Stress Disorder (PTSD)

DSM-IV diagnostic criteria for Post Traumatic Stress Disorder (PTSD)

The diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are defined in DSM-IV as follows:

A. The person experiences a traumatic event in which both of the following were present:

1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;
2. the person's response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in any of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions;
2. recurrent distressing dreams of the event;
3. acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated);
4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event;
5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:

1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
2. efforts to avoid activities, places or people that arouse recollections of this trauma;
3. inability to recall an important aspect of the trauma;
4. markedly diminished interest or participation in significant activities;
5. feeling of detachment or estrangement from others;
6. restricted range of affect (eg unable to have loving feelings);
7. sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:

1. difficulty falling or staying asleep;
2. irritability or outbursts of anger;
3. difficulty concentrating;
4. hypervigilance;
5. exaggerated startle response.

E. The symptoms on Criteria B, C and D last for more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

The focus of the DSM-IV definition of Post Traumatic Stress Disorder is a single life-threatening event or threat to integrity. However, the symptoms of traumatic stress also arise from an accumulation of small incidents rather than one major incident. Examples include:

  • repeated exposure to horrific scenes at accidents or fires, such as those endured by members of the emergency services (eg bodies mutilated in car crashes, or horribly burnt or disfigured by fire, or dismembered or disembowelled in aeroplane disasters, etc)
  • repeated involvement in dealing with serious crime, eg where violence has been used and especially where children are hurt
  • breaking news of bereavement caused by accident or violence, especially if children are involved
  • repeated violations such as in verbal abuse, physical abuse, emotional abuse and sexual abuse
  • regular intrusion and violation, both physical and psychological, as in bullying, stalking, harassment, domestic violence, etc

Where the symptoms are the result of a series of events, the term Complex PTSD may be more appropriate. Whilst Complex PTSD is not yet an official diagnosis in DSM-IV or ICD-10, it is often used in preference to other terms such as "rolling PTSD", and "cumulative stress". See the National Center for PTSD fact page on Complex PTSD.

PTSD and Complex PTSD sufferers report experiencing the following symptoms:

  • hypervigilance (feels like but is not paranoia)
  • exaggerated startle response
  • irritability
  • sudden angry or violent outbursts
  • flashbacks, nightmares, intrusive recollections, replays, violent visualizations
  • triggers
  • sleep disturbance
  • exhaustion and chronic fatigue
  • reactive depression
  • guilt
  • feelings of detachment
  • avoidance behaviors
  • nervousness, anxiety
  • phobias about specific daily routines, events or objects
  • irrational or impulsive behavior
  • loss of interest
  • loss of ambition
  • anhedonia (inability to feel joy and pleasure)
  • poor concentration
  • impaired memory
  • joint pains, muscle pains
  • emotional numbness
  • physical numbness
  • low self-esteem
  • an overwhelming sense of injustice and a strong desire to do something about it.

Associated Symptoms of Complex PTSD

Survivor guilt: survivors of disasters often experience abnormally high levels of guilt for having survived, especially when others - including family, friends or fellow passengers - have died. Survivor guilt manifests itself in a feeling of "I should have died too".

Shame, embarrassment, guilt, and fear are encouraged by the bully and those retaliating against the whistleblower, for this is how all abusers - including child sex abusers - control and silence their victims.

Marital disharmony: the target of whistleblower retaliation and workplace bullying becomes obsessed with understanding and resolving what is happening and the experience takes over their life; partners become confused, irritated, bewildered, frightened and angry; separation and divorce are common outcomes.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of captivity, lack of means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and - crucially - lack of control, loss of control and disempowerment. It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD.  Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc. Those working in regular traumatic situations, for example the emergency services, are also prone to developing Complex PTSD.

A key feature of Complex PTSD is the aspect of captivity. The individual experiencing trauma by degree is unable to escape the situation. Despite some people's assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you're a single parent or main breadwinner)  unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference - the workplace bully will go to great lengths to blacken the person's name, often for years, and it is this lack of reference more than anything else which prevents people escaping.

 The law is inadequate because the better a person qualifies to pursue a claim for personal injury by satisfying PTSD DSM-IV diagnostic criteria B4, B5, C1, C2, C3, D3, E and F, the more they are, ipso facto, frustrated from pursuing the claim.

B4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event;
B5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness:
C1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
C2. efforts to avoid activities, places or people that arouse recollections of this trauma;
C3. inability to recall an important aspect of the trauma;
D3. difficulty concentrating;
E. The symptoms on Criteria B, C and D last for more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning

 

Medical Whistleblower acknowledges Tim Fields, an English advocate for persons who experienced workplace bullying, as the pioneer of this work on the effects of psychological violence in the workplace. Much of this material came from the wonderful research he did on the topic.  There is additional information on his website  Stress Injury to Health and Trauma

Victim’s Rights and Needs: Requirements for a Victim’s Rights System

Victim’s Rights and Needs: Requirements for a Victim’s Rights System

  • Compensation
  • Redress
  • Testimony
  • Truth
  • Acknowledgment
  • Memory
  • Reparation
  • Justice
  • Prevention (Never Again!)

JUSTICE

Vicarious Trauma

Vicarious Trauma

A formula that we have found helpful comes from "The ABCs of self-care are Awareness, Balance and Connection" (Saakvitne & Pearlman, 1996 - see the reference below).

The ABCs are as follows:

Awareness: You must first be able to identify the signs and symptoms of unhealthy stress and the effects of trauma (whether experienced first- or second-hand). This requires awareness.

Balance: Seek balance among a number of different types of activities, including work, personal and family life, rest and leisure.

Connection: Build connections and supportive relationships with your coworkers, friends, family and community. All the work you do to create a better society will have little meaning if you don’t experience positive and healthy connections along the way to this better place.

The New Tactics in Human Rights: A Resource for Practitioners has a brief section on "Self-Care: Caring for your most valuable resource" on page 164-165 of the book. You will find some questions that can be used to open discussion in pairs, in small groups or within your organization to take time to discuss the ways in which you are coping — individually and collectively — with the stress of doing human rights work. 

 

In the tiger's mouth: an empowerment guide for social action, Katrina Shields, 1991, Millennium Books, Newtown, N.S.W ISBN: 0855748923 (pbk.) This book uides you through the big issues that show up in activism: how to avoid burn-out, network, create stable groups, as well as how to approach listeners with bad news that they may not want to hear. The guide includes exercises that encourage discovery and growth, both for individuals and groups.

Transforming the Pain: A Workbook on Vicarious Traumatization. Karen W. Saakvitne, Laurie Ann Pearlman, and the staff of the Traumatic Stress Institute. Published by W. W. Norton & Co., Inc.: New York, 1996. A practical, how-to guide on secondary traumatization designed for all levels of professionals, paraprofessionals, and volunteers who work with traumatized persons. Contains exercises for individuals and groups that come from the authors' experience giving workshops on this topic.

"Each time a person stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he or she sends forth a tiny ripple of hope...Those ripples build a current which can sweep down the mightiest walls of resistance."

     - Robert F. Kennedy,

South Africa, 1966

Further Reading - on psychiatric injury


 

Post Traumatic Stress Disorder: the invisible injury, 2005 edition, David Kinchin, Success Unlimited, 2004, ISBN 0952912147

Supporting Children with Post-traumatic Stress Disorder: a practical guide for teachers and professionals, David Kinchin and Erica Brown, David Fulton Publishers,  12.00, ISBN 1853467278

Stress and employer liability, Earnshaw & Cooper, IPD, 1996, 16.95, ISBN 0852926154 (updated edition in preparation)

Why zebras don't get ulcers: an updated guide to stress, stress-related diseases, and coping, Robert M Sapolsky, Freeman, 1998, ISBN 0716732106

The Body Bears the Burden: Trauma, Dissociation and Disease, Robert C Scaer, MD, The Haworth Medical Press, NY, ISBN 0789012464

Recovering damages for psychiatric injury, M Napier & K Wheat, Blackstone Press, 19.95, ISBN 1854313525

Understanding stress breakdown, Dr William Wilkie, Millennium Books, 1995

Understanding stress, V Sutherland & C Cooper, Chapman and Hall

Trauma and transformation: growing in the aftermath of suffering, R Tedeschi & L Calhoun, Sage, 1996

The Railway Man, Eric Lomax, Vintage, 1996, ISBN 0099582317 (a poignant story of undiagnosed PTSD from World War II)


Bookshops 

The Inner Bookshop, 111 Magdalen Road, Oxford OX4 1RQ: mind, body, spirit, esoteric, holistic, paranormal, contact experience etc.


Articles

European Journal of Work and Organizational Psychology (EJWOP), 1996, 5(2), whole issue devoted to bullying and its effects, including PTSD. Published by Psychology Press, 27 Church Road, Hove, East Sussex BN3 2FA, UK.

British Journal of Psychiatry, (1997), 170, 199-201, The 'glucocorticoid cascade' hypothesis in man: prolonged stress may cause permanent brain damage, Dr John T O'Brien MRCPsych, Department of Psychiatry and Institute for the Health of the Elderly, University of Newcastle.

Cortisol - keeping a dangerous hormone in check, David Tuttle, LE Magazine July 2004

T cells divide and rule in Gulf War syndrome (and asthma, TB, cancer, ME), Jenny Bryan, Immunology section in The Biologist, (1997) 44 (5)

  Traumatic stress under-recognised
5% of males and 10% of females will develop PTSD in their lifetime says the National Institute for Clinical Excellence (NICE): http://news.bbc.co.uk/1/hi/health/4373367.stm


Workshops

David Kinchin's own web page and PTSD workshops


Links

The late Professor Heinz Leymann was one of the world's pioneers and foremost authorities on mobbing (bullying) and PTSD, with over a decade of experience. His web site is essential reading for anyone studying the effects of bullying on health.

David Kinchin, author of Post traumatic Stress Disorder: the invisible injury, 2004 edition

BBC News Online: bullying at school causes PTSD, name calling and verbal abuse worse than physical bullying

Ex-soldier Michael New wins 620,000 damages for PTSD: http://news.bbc.co.uk/1/hi/wales/4725455.stm

US soldiers return from Iraq with PTSD: http://news.bbc.co.uk/1/hi/world/americas/4474715.stm

Untreated PTSD may mean a lifetime of impoverished physical health including heart disease and cancer: http://news.bbc.co.uk/1/hi/health/4179602.stm

Bullied workers suffer 'battle stress' and show the same symptoms of armed forces personnel who have been engaged in war: http://news.bbc.co.uk/1/hi/business/3563450.stm

National Center for PTSD factsheets  & their site.

 

Helpguide for Post-traumatic Stress Disorder (PTSD): Symptoms, Types and Treatment

High percentage of youth in the USA report symptoms of Post Traumatic Stress and other disorders; study involving 4,023 adolescents finds that exposure to interpersonal violence (including bullying) increases the risk for PTSD.

PTSD Public Service Announcement Website

Patience Press aims to ensure that other people never have to be alone with the pain of PTSD, struggling to heal without help or support.

The Traumatic Stress Clinic in London has good online information about PTSD.

UK Trauma Group web site.

Contact information about local specialist resources in the UK offering advice about the assessment or treatment of people with psychological reactions to major traumatic events.

NICE guidelines for PTSD: http://www.nice.org.uk/

CODT - Cooperative Online Dictionary of Trauma, a dictionary of trauma terms:

The National Institute for Clinical Excellence (NICE) page on Post Traumatic Stress Disorder (PTSD).

American Psychiatric Association (APA) public information

Dave Baldwin's site at http://www.trauma-pages.com/ contains comprehensive links.

A Valuable Stress Information Resource Website

Stress Spot is a stress information resource with links to Post Traumatic Stress Disorder web sites.

The Panic Center.

Brain Injury Resource Center page on Post Traumatic Stress Disorder

The Trauma Center in Alston, Massachusetts. The Medical Director of the Trauma Center is Dr Bessel van der Kolk.

Partners with PTSD by Frank Ochberg, M.D.

Why a broken heart hurts so much; social rejection may affect your brain as much as physical pain

Legal Abuse Syndrome: how the courts and legal system may cause Post Traumatic Stress Disorder

Essentials for litigating Post Traumatic Stress Disorder (PTSD) claims: http://www.lawandpsychiatry.com/html/Litigating%20PTSD%20Claims%20-%20Final.pdf

Descriptions of Post Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD).

Gift From Within is a private, non-profit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals.

Articles from Psychology Today: When Disaster Strikes by Hara Estroff Marano, Recovering From Trauma and Life Lessons by Ellen McGrath Ph.D., plus Trauma Do's and Don'ts

The Healing Centre Online is at http://www.healing-arts.org/

Ask the Internet Therapist

The International Society for Traumatic Stress Studies (ISTSS) has a comprehensive web site on various aspects of trauma and its causes.

The European Society for Traumatic Stress Studies (ESTSS) web site.

The Invisible Epidemic: Post-Traumatic Stress Disorder, Memory and the Brain by J. Douglas Bremner, M.D.

Information for for ex-servicemen & servicewomen who think they are suffering from PTSD.

PTSD and dissociation

Information on Falsification of Type (Dr Carl Gustav Jung's description for an individual whose most developed and/or used skills were outside one’s area of greatest natural preference) and PASS (Prolonged Adaption Stress Syndrome) is at http://www.benziger.org/pass.html

Links to PTSD and PTSD-related sites are at http://www.ptsd.com/

Gillian Kelly, barrister at law, looks at the development of Post Traumatic Stress Disorder and the legal recognition thereof on her web site at http://www.telecoms.net/law/index.html

Hope E. Morrow's Trauma Central contains a large collection of links to online articles on trauma and related subjects.

Risk Factors in PTSD and Related Disorders: Theoretical, Treatment, and Research Implications, Anne M Dietrich MA, Doctoral Candidate, University of British Columbia, Canada

See the ability, not the disability list of PTSD links

Trauma And Post Traumatic Stress

Worry Free Rest Needed

Worry Free Rest Needed

Medical Whistleblowers are usually workers who have attained professional competence in their field.  Medical Whistleblowers have access to information at a high enough level to be able to detect medical fraud, abuse and neglect but also brave enough to alert others to the problem.  Because they often are in the healing profession, Medical Whistleblowers often provided comfort to others and were the strength that others rely on.  Most Medical Whistleblower’s are originally of a very strong constitution.  They are usually self confident adults who have good self esteem and were fully capable of handling difficulties in their own lives.  Therefore Medical Whistleblowers have many coping mechanisms to hide the emotional damage the retaliation has caused them and just try harder.  But under extreme or prolonged stress even very emotionally strong people often undergo an apparent personality change.  It is inappropriate and even dangerous to make long term assumptions about a person by observing their reactions under stress.  It is also important to remember that there needs to be intervention from outside to protect the whistleblower and prevent further retaliatory abuse.

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”
 
― Leo Buscaglia

Medical Whistleblower Advocacy Network

MEDICAL WHISTLEBLOWER ADVOCACY NETWORK

P.O. 42700 

Washington, DC 20015

MedicalWhistleblowers (at) gmail.com

CONTACT

"Never impose on others what you would not choose for yourself."  Confucius

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

Theodore Roosevelt- Excerpt from the speech "Citizenship In A Republic", delivered at the Sorbonne, in Paris, France on 23 April, 1910