THE UNSPEAKABLE MIND

Comprehensive survey of the state of knowledge concerning PTSD, woven into the author’s experiences as a therapist and the child of survivors.

Family memories of the partition of India and Pakistan fueled psychiatrist and PTSD researcher Jain’s initial explorations of a condition marked by what she deems “five quintessential intrusive features”—namely, distress caused by memories of trauma, flashbacks, nightmares, unshakable waking thoughts, and physiological responses such as the feeling that one can’t breathe or that death is imminent. The trauma that produces PTSD is life-transforming. The author writes that recent therapies have improved the outlook for some of those who suffer from PTSD, and she suggests, in a footnote to the ongoing nature vs. nurture controversy, that someone raised in a supportive family may well weather trauma better than someone in a conflict-ridden environment. Moreover, she adds, “the resilience of the wider community to which you belong has a knock-on effect of your own capacity, as an individual, to be resilient.” When someone is not resilient, however, then trouble can lie ahead: PTSD sufferers tend to self-medicate, for instance, and their conditions are often misdiagnosed, so that when they are medicated pharmaceutically, it may well be with the wrong thing (benzodiazepines, in particular). Domestic violence, trouble with the law, suicide, and other negative consequences of PTSD are also commonplace. Jain carefully lays out what can be said with confidence about the syndrome—the fact, for instance, that “children with PTSD have altered neurobiology”—and what is more speculative, all with an eye to potential cures or at least effective therapies for managing the condition, such as recent British experiments with intensive residential treatments and the application of methods “with an emphasis on the fear and horror associated with the traumatic event."

Given epidemic anxiety and stress disorders, this is a timely book that will greatly interest those who suffer from them as well as family members and medical practitioners.