Summary:
A psychiatrist and PTSD (post-traumatic stress disorder)
specialist, Dr. Shaili Jain has written a book on PTSD and its many angles,
from diagnosis to treatment to a larger perspective on cultural and historic
influences on the development of traumatic stress. She weaves the story of her
own family’s experience with the Partition of India and Pakistan in 1947, particularly its effect on
her father and grandparents, as a way to consider the effect of trauma on
family, but also how those traumas become ‘unspeakable.’
A brief but effective introduction outlines the seven parts
of the book:
1. Discovering Traumatic Stress: historical perspective and the
changing language to describe the effects of trauma.
2. The Brain: the physiologic
and psychological underpinnings of PTSD, including effects on memory formation
and retrieval.
3. The Body: such as addiction, cardiac effects and concerns at
different stages of life.
4. Quality of Life: domestic and sexual violence,
socioeconomic factors.
5. Treating Traumatic Stress: programs, treatment
strategies and psychopharmacology.
6. Our World on Trauma: global health,
large scale tragedy, terror and war.
7. A New Era: An Ounce of Prevention: resilience, accessibility of care including early and preventative care.
Additionally, almost 100 pages of notes, glossary,
resources and an index provide an easy way to further explore, to use the book
to look up specific topics, and underscore the heavily researched nature of the
text.
The book is eminently readable, with numerous,
well-placed stories of patient encounters and particular experiences and
manifestations of PTSD. These stories are illustrative of the concepts Jain ably
explains. However, they also provide an insider’s view of what happens in the
consulting room. In the prologue, Jain describes a young Afghanistan War
veteran, who has been hospitalized after a violent outbreak at a birthday party:
“Josh’s PTSD was fresh, florid, and untreated…. His earlier poise caves in to
reality, and his face falls to anguish.” (p. xvi) We are in the room, listening
to the patient, witnessing the tears of the medical student, glimpsing the
attending psychiatrist’s response, and relating to Jain, as a psychiatry chief
resident, as she understands that the individual before her, even as he shows
classic signs of traumatic stress, remains an individual, a person in need of
care.
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