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Why Am I Still so Afraid? Mass Market Paperback – Aug 10 1999


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Product Details

  • Mass Market Paperback: 240 pages
  • Publisher: Dell (Aug. 10 1999)
  • Language: English
  • ISBN-10: 0440234646
  • ISBN-13: 978-0440234647
  • Product Dimensions: 1.9 x 10.2 x 16.5 cm
  • Shipping Weight: 118 g
  • Average Customer Review: 3.2 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Bestsellers Rank: #1,577,121 in Books (See Top 100 in Books)

Product Description

About the Author

John Barnhill, M.D., is a psychiatrist and psychoanalyst who specializes in depressive and anxiety disorders. He is a clinical instructor of psychiatry at Cornell University Medical College and a lecturer in psychoanalysis at the Columbia University Center for Psychoanalytic Training and Research. He is also a clinical affiliate at the New York Hospital-Cornell Medical Center and Columbia Presbyterian Hospital. Dr. Barnhill graduated from Duke University and received his medical degrees from the Baylor College of Medicine. He has written articles and book chapters on a variety of subjects for medical journals and textbooks. He maintains a private practice in New York City.

R.K. Rosen is a medical writer and poet living in New York City. With a background in psychology, English, and medical technology, she has spent the past fifteen years working in human services. She specializes in education, mental retardation, and mental health.

Roger Granet, M.D., F.A.P.A., series editor for the Dell Mental Health Guides, has practiced psychiatry for twenty years. He is clinical professor of psychiatry at Weill Medical College of Cornell University, lecturer in psychiatry at Columbia University College of Physicians and Surgeons, consulting psychiatrist at Memorial Sloan-Kettering Cancer Center, attending psychiatrist at New York Presbyterian Hospital-Cornell Division, and director of consultation-liaison psychiatry at Morristown Memorial Hospital. He also maintains a private practice in Morristown, New Jersey.

Excerpt. © Reprinted by permission. All rights reserved.

WHAT IS POST-TRAUMATIC STRESS DISORDER?

Post-traumatic stress disorder (PTSD) is the name for an illness that has been present since the beginning of recorded history. At the same time, its symptoms have been complex and confusing and have frustrated the countless people who have suffered from it as well as all those who have tried to help the afflicted. The goal of this book is to help you get a handle on just what this diagnosis means and to offer some suggestions on ways it can be treated.

What makes it so complicated?

Post-traumatic stress disorder is a relatively recent term for a constellation of symptoms that can be hard to organize neatly. PTSD must begin after a trauma, but the trauma might be a train wreck that happened last month or sexual abuse that occurred in early childhood. At the time of occurrence, the trauma must have immediately caused intense fear, helplessness, or horror, but these feelings might not even be remembered by the time the person seeks treatment; and, in children, the immediate response might be disorganized or agitated behavior rather than a feeling. Although the trauma must be "reexperienced," the recollections may take place in several ways. They might be in the form of clear memories, nightmares, physical feelings, reenactments, or distress when exposed to something that reminds them of the traumatic event (like a war veteran hearing the backfire of a car). In addition to reexperiencing the event in some fashion, people with PTSD must also avoid reminders of the trauma and numb their general responsiveness, and they must present symptoms of increased arousal. Each of these terms and the general categories of "avoidance" and "arousal" are simplified expressions that reflect wide-ranging symptoms in human beings.

As can be seen, there are lots of ways that this disorder can present itself. In addition, most people experiencing PTSD have another disorder as well, such as depression, severe anxiety, or substance abuse, which can sometimes mask the diagnosis of PTSD.

I think I might have PTSD, but I don't really understand what you're saying. If it's so complicated, how am I going to recognize it?

The goal of this book is to allow everyone to understand the basic concepts of the disorder and to consider treatment options.

Consider the following scenarios:

Jim is a Vietnam vet. He has difficulty falling asleep. When he does doze off, he is tormented by nightmares that are sometimes so vivid that he shakes and pushes his wife, terrified that he is back in Vietnam and that she is the enemy. He has complained about sleep problems for years, but his family doctor has quit giving him sleeping pills, saying that sleeping pills and alcohol don't mix. Jim knows this is true, but he also believes that beer helps him in several ways. According to Jim, a few cans of beer stop him from exploding at all the daily frustrations of life, help him get to sleep, and help squash the nightmares. People say he should just get over it, that it's been thirty years since he was in the war, but he is just feeling worse and worse. And now his wife says she can't stand the physical abuse at night (he has been known to assault her in his sleep, mistaking her for the enemy hidden in the jungles of Vietnam) and his irritability all day. His relatives think he's an alcoholic, and he is afraid that his wife may want a divorce. Jim wants to change, but he doesn't know where to begin.

While Lilly was walking home from work one night, she was wrestled into the woods and raped. She felt like a wreck afterwards, unable to sleep or relax. It's been six months, but she keeps thinking of the man's face. She never walks home anymore, but takes the bus, even though it's slow and out of her way. In fact, she gets very anxious at the thought of going anywhere near the woods. She quit her softball team, because all the games were held at a park, and the park reminded her of the woods. Her whole body shakes when she sees a stranger who reminds her of the man who raped her. She now has great difficulty going out on dates or being alone with men. She obsesses about what she should have done to prevent the rape.

Fred, a paramedic in a small town, was called to the scene of a terrible traffic accident during a blizzard. A school bus carrying nine children had skidded off a cliff and crashed into the rocks below. The children and the driver were killed. Fred felt his whole body go numb at the scene of the accident, but he was able to help remove the bodies from the wreckage. While he seemed to be doing okay immediately after the accident, images of the school bus preoccupied him for months. His whole body seemed to alternate between being numb and being sensitive to any little stress. He decided to quit working as a paramedic. This helped a little, but almost anything reminded him of the accident: children, buses, snow, the cliffs. He convinced his wife to move to Florida, to get a fresh start. This helped, but he knows he's still not the same.

Beverly started seeing a therapist last year because of persistent depression. She knew she should have seen the therapist sooner, but she'd never liked talking about herself. She'd finally relented because another of her boyfriends was complaining that she was uptight, spacey, and moody. As she and the therapist started talking about her difficulties with intimacy, a vague, nauseating sensation came over her, which then stuck with her for days. She'd never really enjoyed foreplay, but now she began to feel creepy whenever her boyfriend even touched her. She started to have terrifying dreams in which a giant rat was eating her. After a few weeks of these dreams and creepy feelings, Beverly had just about decided to stop therapy. She'd been depressed before, but now she was worse. Suddenly she began to have images of her first stepfather doing sexual things to her when she was a young child. The images seemed very clear, and there were lots of them, but they also seemed unreal, as if they'd happened to someone else. Could she possibly have forgotten something so major? That stepfather had disappeared when she was five. She'd never given him a second thought. How could he have done this? She began to feel dirty and contaminated and more depressed. She had lots of thoughts of hurting herself and a few, dim feelings of intense rage. She certainly wanted nothing to do with her boyfriend. And she wasn't so sure she wanted to continue with her therapy.

In many ways, Jim, Lilly, Fred, and Beverly may have little in common, yet each is suffering from PTSD. I've started hearing and reading a lot about PTSD. Is this condition something new?

While doctors have been studying and treating victims of trauma for centuries, the diagnosis of PTSD wasn't included in the psychiatric diagnostic manual until 1980. Prior to that time, people with PTSD symptoms were diagnosed and treated in a variety of ways; often their situation simply went unrecognized. How did PTSD get recognized in 1980?

Apparently the efforts of three separate groups forced a review of the diagnosis. Vietnam veterans, women, and therapists began to challenge the status quo.

What Is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder (PTSD) is the name for an illness that has been present since the beginning of recorded history. At the same time, its symptoms have been complex and confusing and have frustrated the countless people who have suffered from it as well as all those who have tried to help the afflicted. The goal of this book is to help you get a handle on just what this diagnosis means and to offer some suggestions on ways it can be treated.

What makes it so complicated?

Post-traumatic stress disorder is a relatively recent term for a constellation of symptoms that can be hard to organize neatly. PTSD must begin after a trauma, but the trauma might be a train wreck that happened last month or sexual abuse that occurred in early childhood. At the time of occurrence, the trauma must have immediately caused intense fear, helplessness, or horror, but these feelings might not even be remembered by the time the person seeks treatment; and, in children, the immediate response might be disorganized or agitated behavior rather than a feeling. Although the trauma must be "reexperienced," the recollections may take place in several ways. They might be in the form of clear memories, nightmares, physical feelings, reenactments, or distress when exposed to something that reminds them of the traumatic event (like a war veteran hearing the backfire of a car). In addition to reexperiencing the event in some fashion, people with PTSD must also avoid reminders of the trauma and numb their general responsiveness, and they must present symptoms of increased arousal. Each of these terms and the general categories of "avoidance" and "arousal" are simplified expressions that reflect wide-ranging symptoms in human beings.

As can be seen, there are lots of ways that this disorder can present itself. In addition, most people experiencing PTSD have another disorder as well, such as depression, severe anxiety, or substance abuse, which can sometimes mask the diagnosis of PTSD.

I think I might have PTSD, but I don't really understand what you're saying. If it's so complicated, how am I going to recognize it?

The goal of this book is to allow everyone to understand the basic concepts of the disorder and to consider treatment options.

Consider the following scenarios:

Jim is a Vietnam vet. He has difficulty falling asleep. When he does doze off, he is tormented by nightmares that are sometimes so vivid that he shakes and pushes his wife, terrified that he is back in Vietnam and that she is the enemy. He has complained about sleep problems for years, but his family doctor has quit giving him sleeping pills, saying that sleeping pills and alcohol don't mix. Jim knows this is true, but he also believes that beer helps him in several ways. According to Jim, ...

Customer Reviews

3.2 out of 5 stars
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Most helpful customer reviews

By A Customer on June 18 2001
Format: Mass Market Paperback
As has been stated, this is a basic book about a complicated subject. I guess I can see how some people would find it too simplistic or be disappointed that their ptsd wasn't cured by reading the book, but I found the concepts pretty sophisticated even if stated in a simple fashion. For example, one reviewer complained that the book shouldn't include the bit about the patient "falling in love". It seems to me that "erotic transference" is a pretty common experience in therapy, especially in people who have been traumatized, and I kind of liked the fact that it was discussed by the authors. I've read a bunch of books on the subject, and several gave very specific treatment suggestions that seemed--at least to me-- to reflect that the author had a specific ax to grind. While this author is a psychoanalyst, his suggestions seemed pretty commonsensical to me. The q and a format isn't my favorite, but it did make the text move along, and they covered the waterfront. I didn't expect my ptsd to get cured by reading the book, but I did want to understand it better, and I found it one of the clearer books on the subject. I'm not sure why there is so much of a mixed feeling about the book.
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Format: Mass Market Paperback
I was not at all impressed with this book. It was over simplistic and is in question and answer format. The book gives such advice as, you should see a councilor. Well, that is a bit obvious. One question was: I am in love with my therapist, but it is not appropriate for us to have a relationship while he is my doctor, should I get a new therapist so I can date my doctor? The answer was no, with obvious reasons supporting that view. Well if a person falls in love with their doctor, they have a few more issues than post traumatic stress disorder. I would hope a different councilor could help them with that problem as well.
The questions and answers described pretty well the fear and the inability to move on after a major trauma, but very little advice on what to do about it. It was as if they were trying to be as vague as possible. It really made me angry. I suffered a trauma a few years back, and was looking forward to releasing and letting go of it, but my hopes were dashed by this book because after reading it, I was no closer to that goal.
If anyone finds a great book on this subject I would be trilled to here about it. This one is not the one.
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By A Customer on Sept. 18 1999
Format: Mass Market Paperback
I've been struggling with depression, anxiety, and nightmares for most of my life, but I never really understood what it was. This book described my illness almost exactly. At times, it felt like the authors were reading my mind. At other times, they wrote about stuff that I'd never considered but which was still really helpful. It goes into some of the medical aspects of PTSD, but the book is always clear, even for us laypeople. I can't recommend this book highly enough.
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Format: Mass Market Paperback
For people who don't know much about PTSD this is a good book. I found it to be rather simplistic but it did cover a lot of material related to PTSD. Buy it if you're newly diagnosed, it will help. Don't buy it if you've moved on to books that help with treatment, this one won't.
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Most Helpful Customer Reviews on Amazon.com (beta)

Amazon.com: 5 reviews
9 of 10 people found the following review helpful
A great book Sept. 18 1999
By A Customer - Published on Amazon.com
Format: Mass Market Paperback
I've been struggling with depression, anxiety, and nightmares for most of my life, but I never really understood what it was. This book described my illness almost exactly. At times, it felt like the authors were reading my mind. At other times, they wrote about stuff that I'd never considered but which was still really helpful. It goes into some of the medical aspects of PTSD, but the book is always clear, even for us laypeople. I can't recommend this book highly enough.
3 of 3 people found the following review helpful
A good one June 18 2001
By A Customer - Published on Amazon.com
Format: Mass Market Paperback Verified Purchase
As has been stated, this is a basic book about a complicated subject. I guess I can see how some people would find it too simplistic or be disappointed that their ptsd wasn't cured by reading the book, but I found the concepts pretty sophisticated even if stated in a simple fashion. For example, one reviewer complained that the book shouldn't include the bit about the patient "falling in love". It seems to me that "erotic transference" is a pretty common experience in therapy, especially in people who have been traumatized, and I kind of liked the fact that it was discussed by the authors. I've read a bunch of books on the subject, and several gave very specific treatment suggestions that seemed--at least to me-- to reflect that the author had a specific ax to grind. While this author is a psychoanalyst, his suggestions seemed pretty commonsensical to me. The q and a format isn't my favorite, but it did make the text move along, and they covered the waterfront. I didn't expect my ptsd to get cured by reading the book, but I did want to understand it better, and I found it one of the clearer books on the subject. I'm not sure why there is so much of a mixed feeling about the book.
Finallly An Answer! Jan. 11 2003
By A Customer - Published on Amazon.com
Format: Mass Market Paperback
I've been struggling with depression and fears that I haven't been able to overcome or understand since my childhood. I'm female, over 40 and still have trouble being comfortable around men. Now I understand why. This book is easy to understand. I really like the question and answer format. As the book explains, if a person is suffering from trauma and stress, there are many mixed up thoughts and feelings involved. The book goes into enough detail to explain fully the complicated issues involved in PTSD but simply enough for the lay person. It gave answers to questions I didn't know I had and even answered some questions that I found too embarrassing to ask my counselor. It was recommended to me by my Psychologist.
1 of 2 people found the following review helpful
A simplistic Q&A book about PTSD May 21 2001
By "balikris" - Published on Amazon.com
Format: Mass Market Paperback
For people who don't know much about PTSD this is a good book. I found it to be rather simplistic but it did cover a lot of material related to PTSD. Buy it if you're newly diagnosed, it will help. Don't buy it if you've moved on to books that help with treatment, this one won't.
0 of 3 people found the following review helpful
Why Am I Still So Afraid? : Understanding Post Traumatic Str April 28 2001
By "hugthecat" - Published on Amazon.com
Format: Mass Market Paperback
I was not at all impressed with this book. It was over simplistic and is in question and answer format. The book gives such advice as, you should see a councilor. Well, that is a bit obvious. One question was: I am in love with my therapist, but it is not appropriate for us to have a relationship while he is my doctor, should I get a new therapist so I can date my doctor? The answer was no, with obvious reasons supporting that view. Well if a person falls in love with their doctor, they have a few more issues than post traumatic stress disorder. I would hope a different councilor could help them with that problem as well.
The questions and answers described pretty well the fear and the inability to move on after a major trauma, but very little advice on what to do about it. It was as if they were trying to be as vague as possible. It really made me angry. I suffered a trauma a few years back, and was looking forward to releasing and letting go of it, but my hopes were dashed by this book because after reading it, I was no closer to that goal.
If anyone finds a great book on this subject I would be trilled to here about it. This one is not the one.


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