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Resilience: Chapter II

May 14

G’day all! I am recently returned from the Lower Mainland. Good to be back on Vancouver Island. I read where the idea of “PTSD” has been introduced in the Ft. McMurray context. Riddle me this? How do you think a person SHOULD respond after being exposed to the big fire; if they have not had experience dealing with such a natural disaster on such a personal level? If they become symptomatic would that be a “normal” response or an “abnormal” one? And if someone tells them they are suffering a “disorder”, how do you suppose they would respond? And if the “patient” begins to struggle against those symptoms, what path do you suppose those symptoms will follow? (Do you practice a martial art? What does your opponent do if you push against him?) And if the government offers the residents compensation for being “sick”, rather than treating them as if they were having a normal human response to a highly unusual circumstance, what do you suppose the near universal, and human, response will be?

On with our review of the literature. As several authors have documented, following the Viet Nam war, the US Military (and Veterans’ Associations) began to lobby the American Psychiatric Association (APA) to craft a diagnosis that would recognize the “long term” psychological effects incurred in combat; and would pave the way for therapeutic services. The group proposed the diagnostic category of Catastrophic Stress Disorder (CSD). The key aspect of CSD was the precipitating (or causal) factor. The deliberating psychiatrists were uncomfortable having an external causal factor included. (Less need for prescription drugs to ameliorate the problem?) The compromise solution was the introduction of the new disease “PTSD” into the DSM III (1980). The criteria specified for the new diagnosis included an initial stressor (e.g. exposure to the horrors of battle) that would evoke stress in nearly anyone, a time frame, and a list of symptoms.

Prior to the start of the systematic investigation of “PTSD” (1980), the research tended to focus on children exposed to brutal developmental experiences and how they coped psychologically (i.e. resilience vs. psychopathology) during their formative and adult years. Evidence derived from research suggests that competent coping is related to psycho-social resources. It, of course, makes sense that these resources would be less available to children growing up in adversity. Some of these psycho-social resources include: effective parenting, IQ (as a predictor of social competence and intellectual functioning), adequate economic well being, a good self image, and the ability to solve problems.

On the other side of the coin, the literature offered a wide range of stressors that put children “at risk” for maladaptive behaviours including “PTSD”. These included: early psychological trauma, abuse, mentally ill parents, physical disability, life threatening birth defects, personal injuries, asylum seeking, refugee status, war, disasters, life threatening illness, poor maternal nutrition, and domestic violence.

I would like to conclude this offering by referring to a classic study. This was a Hawaiian study where fully one third of the sample chosen from a population at risk due to chronic poverty, low maternal education, and moderate to severe peri- (during) natal stress did not develop problems and were psychologically healthy at ages 10, 18, and 30. They were considered “resilient” and when compared with children considered “less resilient” (i.e. high risk) it was discovered that as infants they received more attention, were more active and socially responsive. These children were characterized by their mothers as “active, affectionate, cuddly, good natured, and easy to deal with”.

Next time I would like to introduce research in the area of the appraisal process, (remember…..”Beauty is in the eye of the beholder”?) Well, it just might be that stress is in the eye of the beholder as well. Could “appraisal” act as a moderating factor in the development of posttraumatic stess and other psychological concerns?

I’ve noticed that our numbers dropped off after we stopped beating up on “Bobbles” and began to discuss the “diagnosis du jour”………”PTSD”. I encourage you to be open minded and read what is offered. You are always entitled to your own opinion. And don’t be afraid to send in arguments or questions. (I am in no way suggesting that current treatment you are taking is in error. I am not your therapist. I would like you to be informed.) The blog is at its’ best when you engage each other. Here is something to ponder until we meet again……….”TAKING PERSONAL ACCOUNTABILITY IS A BEAUTIFUL THING, BECAUSE IT GIVES US COMPLETE CONTROL OF OUR DESTINIES”

Dr. Mike Webster
Registered Psychologist

One Comment
  1. One reader of Re-sergeance asked another, “How can you tell whether what Dr. Webster says is true or false?” The other replied, “You’ll get burned if you stick your hand in the fire”. “Do you mean that good teaching is always hot?”, asked the first. “Blistering”, replied the second.


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