We will soon be dealing with two terrorism trials. The defense team for KSM, et al, have already announced their intention to put the Bush administration on trial. It will not be pretty. The second terrorism trial is going to take a different tack. This morning, I heard a report on NPR that Major Hasan's lawyer plans for a plea of not guilty, followed by an insanity defense. As a Psychiatrist I find this appalling. A trial is a poor locale to develop a new Psychiatric diagnosis, either "Pre-Traumatic Stress Disorder" or "Post-Traumatic Stress Disorder by Proxy".
J.R. Salzman is a soldier who was severely injured by an Iranian shaped charge in Iraq, spent months at Walter Reed Army Hospital and has had to deal with terrible physical wounds compounded by symptoms of PTSD (Post-Traumatic Stress Disorder) and TBI (Traumatic Brain Injury.) He is angry, deservedly so, at the mis-use of Psychiatric jargon to ameliorate treasonous terrorism: [HT: Rich Lowry]
I’m more than a little angry right now. Yes, I’m irate that some sh-tbag Major (“sh-tbag” is often used as a technical term in the Army) opened fire on a group of his fellow Soldiers killing 12 and wounding 30. But that’s not even what is under my skin right now. What is bothering me is the general reaction of our media and those stupid enough to think this was not an act of terrorism, but was caused by supposed PTSD caused at Walter Reed Army Medical Center.
You want to know what PTSD is like? I'll tell you. You have nightmares that go on for weeks. Mine would always be the same. Wherever the window was in the room in which I was sleeping I would see a bright white flash. I would wake up screaming to my wife “Get up! Get the f-ck up! An IED just went off!” Sometimes I would just wake up screaming in agony as I relived the moment where my right arm was ripped from my body by an Iranian shape charge. (I may not know what childbirth feels like, but I know what it's like to go an hour with my arm ripped off without painkillers (I'm allergic to morphine).) PTSD makes you paranoid as hell. “Why is that person staring at me? Are they a threat? Where is the nearest exit? Why are these people so close to me? Why is no one pulling security? What was that noise? Where is the nearest cover? I need to get out of here.” You lie wide awake in bed at night wondering if it's safe to go to sleep or if you should get up and start pulling security. When I got home from Walter Reed and started college (a week later, stupid idea) I would often stay up for days at a time without sleeping. Eventually my body would completely shut down from exhaustion and I would sleep for 12 hours or more only to complete the cycle all over again. (I still cannot believe I got all As and Bs.) Since I was injured in a humvee I am especially susceptible on the road to the effects of my PTSD. I still get nervous and hold my breath every time I drive by a piece of trash or tire debris on the shoulder or median. I avoid guardrails and broken down cars on the side of the road. On a couple different occasions I yelled out “tire!” to warn my wife (who was driving) of a potential IED in the road. There was nothing there (no tire, no nothing). One late night while driving home completely exhausted on our small two lane country roads at slow speed I locked up all four tires on my car to keep from hitting a cardboard box in the middle of the road. At that moment I would have bet the contents of my bank account it was an IED. That's what PTSD is like. At no point in time have I ever felt the desire or need to grab a weapon and go shoot someone or something up. At no point in time have I ever grabbed a weapon and broken a law because I felt the need to protect myself. PTSD urges you mitigate the risk of events that happened in your life. But if you've never had anything traumatic happen in your life, you can't have PTSD. [Emphasis mine-SW]
Do yourself a favor andread J. R.'s entire post. My comments can wait.
To diagnose Major Hasan with some variation of PTSD is a travesty. There may well be some Psychiatrist willing to testify in Major Hasan's court martial that there exists some heretofore hidden variant of PTSD that can befall those who merely hear about actual trauma or observe and treat the victims of such trauma, or may someday see trauma close up; there are people willing to lend their credentials to all kinds of nonsense these days. I would like to state quite unequivocally, from the vantage point of a Board Certified Psychiatrist with more than 30 years of experience, and having treated hundreds of people who have been traumatized and have had all sorts of reactions to their trauma ranging from mild psychosomatic symptooms to full blown PTSD to overt psychosis, there is no such thing as PTSD by osmosis or by proxy or via time inversion (where one develops Pre-Traumatic Stress Disorder.) The single most salient feature of Major Hasan's case is that he took whatever psychopathology he had (and I believe he had a fair amount, none of it dispositive) and subsumed it into subservience (submission) to Allah whereupon he took it upon himself to perform his religious duty and murder infidels who he believed were part of an army attacking his people. Everything else is BS.
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