THE VARIED PRESENTATIONS OF PTSD

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DISSOCIATIVE DISORDERS

What I was meeting in the seventies and eighties, was a variety of very severe dissociative disorders. There were mothers who were amnesic for the total experience of having a baby whilst living as a withdrawn inhibited machine complying with their relationships without initiative or good feelings. Sometimes over a decade later they would break though to their personality that existed before the trauma with sudden shock and dismay. Derealisation, numbness, negative schemata about themselves, pervasive experience of hopelessness, poor relationships chosen by others, and lack of positive affects was to be their lot. While such symptoms of these are very common among many of the mothers, when dissociation was a factor, these phenomena were ‘locked in’.

DREAMs

Mother’s dreams many decades later are still invaded by babies, nurses, hospital corridors and trolleys. Some are as vague as their drugging, others are graphic nightmares.

INTRUSIVE IMAGES

However the invasion of their everyday consciousness with intrusive images of the hospital equipment, or their legs caught in stirrups, feet in the air waiting for something to happen was very common. Many times it was scenarios where they were being confronted so sign the consent form, or being bullied in the mother’s home. These would intrude like short video-tapes. One mother who had to have her membranes ruptured to induce labour had these many years later after her dissociation lifted.

RUMINATIVE PREOCCUPATION

Another post-traumatic consequence was going over and over the circumstances that led her to labour ward. These might be the circumstances of becoming pregnant that was often a one off event - totally unexpected. For a minority it was a traumatic rape as was the case in a patient who was raped by a policeman in a tunnel leading to the university. Sometimes it was about whether or not to have an abortion with accompanying guilt about even thinking this. At other times it was how she came to be so easily brain-washed to accept their view of what she should do.

I write this view of post-traumatic disorder as I will about the various forms of related depression with a strong sense of dismay about those who propose simplistic and brief therapy of these women with not the vaguest idea other than words by some author in a book about the extent of treatment those with PTSD and severe Depression require. I protested to the previous NSW premier in a letter about this and received a form letter that a friend had also received – grossly glib about how they had this all under control. The irony was that the funds were to go through an organisation all the mothers knew as a modern evolvement of a Baby Takers organisation of the sixties and seventies.
These women mostly need Psychiatrists with special training about their needs and the funding to do this without shortcuts.

 

Dr Geoff Rickarby Consultant Psychiatrist
November 2014