To Newsweek. What we now call posttraumatic stress disorder was known in World War II as “battle fatigue” or “combat fatigue.” Before that, in World War I, the condition was known as “shell shock.” Regardless of the name, however, the same symptoms were present, and from the 1940s on they were treated by helping victims relive the stress and trauma and decompressing the tension over a period of time, thereby enabling patients to regain a measure of mastery in place of the sheer helplessness that underlay the symptoms.
Drugs alone are not sufficient for the treatment of PTSD. It requires a trained, sympathetic other person, helping over a period of time. In “Reliving the Painful Past” (Newsweek, June 13), we see the evidence of pain and suffering inflicted on “some 210,000” veterans because of the stigma implied in their need to turn to someone else for help with their mental distress.
In the context of the debate on health care, we go on blithely asserting that treating such painful and debilitating symptoms by the most economical means—drugs or the briefest contact—will be sufficient. In this way we think we reduce the stigma, as well as the cost, of such treatment. But where, in the proposed health care reform, is there room for serious use of the training and capability of mental health care professionals? Why is that field looked upon as unnecessary, almost bordering on the illegitimate, when articles such as yours demonstrate that so many are being deprived of available help that is effective, if only it is administered by well-trained hands? As with many problems in our society, we have come to accept the more simplistic “solutions,” which time after time turn out to be no solution at all. Allowing monetary values to be the chief guide to decisions has regularly led us down the road to ruin. Money, competing with quality rather than buying it, becomes “bad currency,” and will drive quality out of the marketplace every time.
Remember the old adage (I paraphrase): for every complex problem, there is a solution that is simple, directly applicable, economical, and wrong.
Mel Mandel, M.D.
Pacific Palisades, CA