Faces and Manifestations of Psycho-trauma<br />Emilio Ovuga<br />GuluUniversity<br />
Objectives<br />Share my experience, thoughts<br />Post-traumatic stress disorder is not a psychiatric entity?!<br />Leave...
Introduction<br />Traumatic stress is classified as natural or manmade<br />Natural disasters occur outside the control of...
Forms of Traumatic Stress<br />Several forms of traumatic stress<br />Some dramatized more so than others<br />Emphasis is...
Manmade Disasters<br />Manmade disasters are inflicted on humans by fellow-humans<br />Pervasive, carefully planned; execu...
Racism as Mental Disorder 1<br />Black psychiatrists in America suggested that racism be classified as a mental disorder a...
Racism as a Mental Disorder 2<br />My lone response then was: “If racism is classified as a mental disorder, what about th...
Manmade Trauma<br />Despicable<br />Beyond the understanding of the sane<br />Destroys victim’s attachments<br />Victims a...
Examples 1: Powerful Parent Tortures own Child<br />8/19/2011<br />9<br />Global Health Center Symposium, MGH, Lake View H...
Example 2: Rape Leads to Phobia<br />A successful graduate and career woman sought professional help for lack of sleep, ne...
Example 3: Rape by Paternal Uncle<br />A student reported to a female confidant the experience of repeated rape that she a...
Example 4: Hate Turned Unto the Self<br />A four-year-old boy was brought to a mental hospital with each hand securely cre...
Example 4 Continued: Hate Turned Unto the Self<br />In one of his several attempts to push the sibling neonate from the mo...
Example 5: Former Child Soldiers<br />In December 2007 a group of former child soldiers were admitted to Gulu Regional Ref...
Nature of Traumatic Stress<br />Traumatic stress is defined as being beyond the tolerance of the average person<br />Howev...
Example 6: Battered Woman Relives Domestic Violence Through Own Little Son<br />The little son of a couple who saw his mot...
What Is Post-traumatic Disorder?<br />A diagnostic entity?<br />A variant of a major psychiatric disorder, e.g. Anxiety Di...
Traumatic Stress<br />Ordinary Stress<br />Traumatic Stress<br />Trust and confidence in social support system<br />Stress...
Post Traumatic Stress Disorder<br />Other Mental Disorders<br />Post Traumatic Stress Disorder<br />No evidence of flight ...
Conclusion<br />Traumatic stress is extremely common in daily life<br />Post traumatic stress disorder is perhaps more com...
Upcoming SlideShare
Loading in …5
×

Ovuga manifestations of psychotrauma

721 views

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
721
On SlideShare
0
From Embeds
0
Number of Embeds
6
Actions
Shares
0
Downloads
10
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Ovuga manifestations of psychotrauma

  1. 1. Faces and Manifestations of Psycho-trauma<br />Emilio Ovuga<br />GuluUniversity<br />
  2. 2. Objectives<br />Share my experience, thoughts<br />Post-traumatic stress disorder is not a psychiatric entity?!<br />Leave the audience in suspense<br />8/19/2011<br />2<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  3. 3. Introduction<br />Traumatic stress is classified as natural or manmade<br />Natural disasters occur outside the control of humans<br />8/19/2011<br />3<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  4. 4. Forms of Traumatic Stress<br />Several forms of traumatic stress<br />Some dramatized more so than others<br />Emphasis is mainly on war, organized violence, rape, childhood sexual abuse, and natural disasters<br />Trauma in the hands of powerful members of households in the equally powerful and secretive environments of homes are more common<br />These are perhaps the most destructive, most crippling, and most painful of all traumas<br />Physicians often manage traumatic stress in the context of households at their own peril<br />8/19/2011<br />4<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  5. 5. Manmade Disasters<br />Manmade disasters are inflicted on humans by fellow-humans<br />Pervasive, carefully planned; executed in cold blood, without emotion/feeling<br />Victims cannot usually escape however hard they try, only thing in their power is to surrender to the will of their aggressors<br />Accounts of manmade traumatic stress leave one wondering whether perpetrators have human hearts and souls<br />8/19/2011<br />5<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  6. 6. Racism as Mental Disorder 1<br />Black psychiatrists in America suggested that racism be classified as a mental disorder at an Inaugural Meeting of African Psychiatrists in the Diaspora at Massachusetts General Hospital, November 2001<br />The suggestion was understandable given the degrading and traumatic experiences that African slaves and their descendants went through in the hands of their white slave masters/owners<br />8/19/2011<br />6<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  7. 7. Racism as a Mental Disorder 2<br />My lone response then was: “If racism is classified as a mental disorder, what about the ethnic violence that is currently going on in Northern Uganda?” I received no answer.<br />The lack of an answer then was perhaps equally understandable given the commonplace experience of traumatic stress in public and domestic domains<br />8/19/2011<br />7<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  8. 8. Manmade Trauma<br />Despicable<br />Beyond the understanding of the sane<br />Destroys victim’s attachments<br />Victims are left helpless and without foundation<br />Erodes victims’ confidence and sense of security; shakes the foundations of trust in the social order<br />Alienates victims beyond words; victims left feeling abandoned<br />8/19/2011<br />8<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  9. 9. Examples 1: Powerful Parent Tortures own Child<br />8/19/2011<br />9<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  10. 10. Example 2: Rape Leads to Phobia<br />A successful graduate and career woman sought professional help for lack of sleep, nervousness, and inability to perform her usual work. The primary problem was fear of closed spaces that generalized to fear of flying; she felt her fear would prevent her from travels abroad.<br />The woman gave history of repeated rape in her room in the house of her married sister by a brother-in-law at night. She feared to raise the alarm in order to save her sister’s marriage. In her anguish she asked during therapy: “Why should someone rape you when you had all along protected and kept yourself intact waiting for the man you would marry?”<br />8/19/2011<br />10<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  11. 11. Example 3: Rape by Paternal Uncle<br />A student reported to a female confidant the experience of repeated rape that she and her younger sisters were subjected to by a paternal uncle. The girls had lost both parents to AIDS and they depended on their paternal uncle for education and general survival. Despite their anguish and wish to escape from their paternal uncle, the girls declined a suggestion for therapy and professional advice.<br />8/19/2011<br />11<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  12. 12. Example 4: Hate Turned Unto the Self<br />A four-year-old boy was brought to a mental hospital with each hand securely crepe-banded into a fist.<br />The boy presented to hospital with severe recent and old scars in both temporo-frontal areas of his face; worse on the right.<br />At the age of 2½ years the child had reacted to the birth of a rival sibling with apparent jealousy, rage and perhaps, hate<br />8/19/2011<br />12<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  13. 13. Example 4 Continued: Hate Turned Unto the Self<br />In one of his several attempts to push the sibling neonate from the mother’s lap the boy brutally hit and scratched at his follower and attempted to sit on it.<br />The mother with maternal instinct to save the newborn hit the boy with such force that the boy apparently instantly turned his hate onto himself<br />The boy began slapping and scratching himself almost without rest; whenever he got tired, he walked to the mother or other adult and silently tried to use the hand of the adult to hit him in the side of the head<br />8/19/2011<br />13<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  14. 14. Example 5: Former Child Soldiers<br />In December 2007 a group of former child soldiers were admitted to Gulu Regional Referral Hospital with what appeared to be mass hysterical behavior. Assessment indicated that the children presented with mass psychotic or dissociative disorder following a noisy prayer session in the evening. (Ovuga et al 2008)<br />8/19/2011<br />14<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  15. 15. Nature of Traumatic Stress<br />Traumatic stress is defined as being beyond the tolerance of the average person<br />However:<br />What is tolerable to one average person may not be so to the next average person<br />Definition in primary care does not often take account of the lived experience of victims<br />The meaning attributed to traumatic experience may influence the symptom patterns of emotional/mental disorders<br />Parental experience of traumatic stress predisposes offspring to similar experience<br />8/19/2011<br />15<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  16. 16. Example 6: Battered Woman Relives Domestic Violence Through Own Little Son<br />The little son of a couple who saw his mother battered by his irate father apparently internalized the suffering, fear, helplessness of his mother. Whenever the mother was angry at the little boy for minor mistakes she would yell and swear at him just like her husband did. In response the little boy looked apprehensively at his mother. Unfortunately the boy’s eyes resembled the eyes of his irate father, and this reminded his mother of her traumatic experiences (de Zulueta, 2011)<br />8/19/2011<br />16<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  17. 17. What Is Post-traumatic Disorder?<br />A diagnostic entity?<br />A variant of a major psychiatric disorder, e.g. Anxiety Disorder as currently recognized?<br />How does traumatic stress that leads to other mental disorders qualitatively differ from the one that leads to PTSD? How does traumatic stress that leads to PTSD qualitatively differ from the common place experience of stressors in daily life?<br />8/19/2011<br />17<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  18. 18. Traumatic Stress<br />Ordinary Stress<br />Traumatic Stress<br />Trust and confidence in social support system<br />Stressor understandable to the victim<br />Victim recalls all aspects of the stressor at will<br />Victim feels safe in recall of events of stressor<br />Loss of trust and confidence in social order<br />Stressor alien and not understandable<br />Victim cannot freely recall aspects of stressor<br />Victim feels insecure in recall of events of stressor<br />8/19/2011<br />18<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  19. 19. Post Traumatic Stress Disorder<br />Other Mental Disorders<br />Post Traumatic Stress Disorder<br />No evidence of flight or fight reaction<br />Hyperarousal, reexperience or avoidance of situations or reminders not usually evident<br />Evidence of degrading, humiliating traumatic stress usually not available<br />Traumatic stress leads to flight or fight reaction<br />Reaction characterized by hyperarousal, reexperience of traumatic event and avoidance of reminders or situations<br />Fragments of traumatic stress available to history unlike in most anxiety disorders<br />8/19/2011<br />19<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />
  20. 20. Conclusion<br />Traumatic stress is extremely common in daily life<br />Post traumatic stress disorder is perhaps more common than recognized<br />PTSD may present with unusual symptoms<br />However culture specific definitions are required to recognize victims and clients<br />8/19/2011<br />20<br />Global Health Center Symposium, MGH, Lake View Hotel, Mbarara<br />

×