Irritable Hearts: A PTSD Love Story (41 page)

at least 4 billion trauma survivors in the world: Estimates in the U.S. range from 60 percent to 89.7 percent. The world population is 7.1 billion. Extrapolating from the lowest U.S. estimate, at least 4.26 billion people have experienced trauma—and some experts argue that many other countries present more traumatizing conditions. Norris 1992; Kilpatrick et al. 2013; Acierno.

89.7 percent of Americans exposed to trauma by
DSM-5
’s standard: Kilpatrick et al. 2013.

9 percent develop PTSD: The best estimate of conditional risk for PTSD in Americans. Breslau et al; Brunet 2.

violence against women more common cause of PTSD than war: Kessler et al. 1995; Herman 2. A study looking at the epidemiology of PTSD from the National Comorbidity Survey in 1995 found that of a nationally representative sample with PTSD, 49 percent of women reported rape and molestation as their most upsetting traumas, as did 7.2 percent of men. Combat ranked high for 28.8 percent of men. Additional sources: Acierno; Black et al;
NIH Medline Plus
. Additional math: There are nearly 125 million women over the age of 18 in the United States. In 2011, the National Intimate Partner and Sexual Violence Survey estimated that nearly one in five, or 18.3 percent, of women over 18 in the U.S. had been raped—42.2 percent of which had first occurred before the age of 18. Of those, 45.9 percent are likely to develop PTSD—10.3 million. There are 21.2 million veterans in the United States. Going by the highest estimate of PTSD using the highest rate from any of the recent wars (Vietnam’s), 31 percent of those veterans may have had PTSD—6.6 million. See Black et al; Kulka et al. The NISVS also estimated that 4.3 million women had suffered physical violence perpetrated by an intimate partner in the year prior to taking the survey alone. Between 45 and 84 percent of women who have been battered are estimated to develop PTSD, and nearly 33 percent of women in the United States will suffer physical violence at the hands of a partner in their lifetime. Black et al; DeJonghe et al. Note that the alarming numbers discussed here do not even include such crimes against men and boys, who are also far too often victims of sexual and domestic violence. For statistics see Black et al.

car accidents a leading cause of PTSD: Coffey et al; Norris 1992.

National Urban Search and Rescue left codes on Katrina houses: FEMA; Moye.

hazards in the spray paint quadrant: Moye.

“two dead cats”: West End Animal Hospital; Animal Legal Defense Fund; Perlstein.

PTSD one of the most common and debilitating psychological disorders following natural disasters: Galea, Nandi, and Vlahov; Norris et al. 2002.

tens of thousands of New Orleans homes destroyed: Plyer.

Katrina death toll: Graumman et al.

Haiti earthquake causes upswing in mental health calls in New Orleans: McClelland 5.

quarter of the post-Katrina population had PTSD: Kessler et al. 2008.

if PTSD were measles, public health crisis: Hassig.

post-Katrina PTSD hardly better in New Orleans after nearly two years, worse in Gulf Coast overall: Kessler et al. 2008.

6.4 percent of population thinking about suicide, 2.5 percent had a plan: Kessler et al. 2008.

suicide rates 56 percent higher, 85 percent higher in 2008 and 2009, respectively: Barrow; Louisiana Department of Health and Hospitals; Moving Forward Gulf Coast Inc.

need to establish safety before treatment/recovery: Herman 1, p. 3.

one- and two-year PTSD window where majority of population recovers/doubling of prevalence of PTSD in most affected Katrina area: Spiegel.

Twenty percent PTSD in New Yorkers near Ground Zero: Galea et al. 2002.

Thirty percent (28.9) of New Yorkers in general recovered six months later: From two or more PTSD symptoms. Out of a representative NYC sample: Bonanno et al.

65.1 percent of New Yorkers showed resilience; 30 percent to 50 percent recovery and 20 percent to 40 percent resilience in most exposed PTSD population: Bonanno et al, table 3.

New Yorkers still susceptible to symptoms later (as of 2011): Brackbill et al; Hartocollis; Galea interview.

resilience as triumph of human spirit: Bloomberg; Bush 1, 2.

more than 40,000 crisis counseling sessions after 9/11: Felton; Lewin.

fire department sextupled number of full-time counselors: New York City Fire Department 1, 2; Lachmann.

employers and community centers offered therapy: Felton; Lewin.

no food and water for some Katrina survivors for up to five days:
Frontline
; Clarice B.; American Civil Liberties Union; U.S. Department of Homeland Security, p. 36.

New Orleans eliminated nearly a quarter of in-patient psych beds: Rudowitz, Rowland, and Shartzer.

Van der Kolk comparing aftermath of 9/11 and Katrina: Harryman; Babbel.

New Yorkers represented as heroes: Anker; Bush 1; Office of the White House Press Secretary.

New Orleans crime-rate spike: In 2007. Evans et al, p. 34.

levees remain compromised for years: Even after $22 million in repairs, a repaired levee was leaking in 2008. Burdeau; Goodman.

CHAPTER FIVE

people sometimes driven to reenactments: Survivors of incest, rape, and combat trauma, specifically, in Herman 1, p. 40.

Janet and controversy: Interlandi, for one.

reenactments restore agency/“efficacy and power”: Janet, p. 603.

“flooding”: Herman 1, p. 181.

CHAPTER SIX

progress in Haiti in early 2011 was a joke: McClelland 13.

rebuilding happening only for the rich: McClelland 14.

reported rapes increased: McClelland 18.

female reporters and sexual harassment/assault: Matloff; Ann Friedman.

female oil wrestling night: McClelland 7.

The Doctor’s demonstrative rape tips: McClelland 13.

Bill Clinton, tent-city movie house: McClelland 15.

chasing Baby Doc: McClelland 16.

orphanages: McClelland 17.

spending a Saturday with The Robber Baron: McClelland 19.

“whiskey”: KERA, at 38:30.

freezing: The lateral nucleus of the amygdala takes in sensory input, and sends it to the central nucleus, which then activates instinctual response. The process lights up the autonomic nervous system (brain stem), while connections from the amygdala to other parts of the brain control freezing, immobility, and adrenaline. Van der Kolk 1; Wilensky et al.

people not taught to set their own boundaries: Herman 1, p. 69. “Traditional socialization virtually ensures that women will be poorly prepared for danger, surprised by attack, and ill equipped to protect themselves.”

women who respond with physical aggression to violent physical attack more likely to avoid rape: Ullman. Kleck and Tark say that according to data from the National Crime Victimization Survey, self-protection actions (including forceful and non-forceful actions) “significantly reduce the risk of rape completions” and do not significantly increase risk of serious injury. Self-defense interventions for teenage girls in Nigeria and college women in the United States also showed decreased sexual assaults: Sarnquist et al; Hollander.

worse off if your rapist is a sadist: Kilpatrick interview.

female victims of intimate-partner assaults twice as likely to sustain injury if they used physical or verbal self-protective behavior: Bachman and Carmody.

victims are revictimized: Two of three sexual assault victims; women sexually assaulted in childhood are twice as likely to be sexually assaulted in adulthood. Sarkar and Sarkar; Campbell, Dworkin, and Cabral.

mountain lions prey on wasted mule deer: Krumm et al.

pleading makes it worse: Kleck and Tark, pp. 6, 18, and 19.

victims should look at own behavior only after it’s clear that perpetrator is responsible for the crime: Herman 1, p. 199.

“thus did I take it upon myself…”: Full self-defense stories in McClelland 20, 22.

full-force self-defense backstory and philosophy: Wagner.

women can be triggered into paralysis with words: Marx et al; Marx interview; Bovin; Gallup; Forsyth.

angry town hall meetings in New Orleans: McClelland 23.

CHAPTER SEVEN

International Criminal Court trial of Congolese politician: McClelland 24.

unveiling of Qaddafi’s arrest warrant: McClelland 25, 26.

“rapid and dramatic return to the appearance of normal functioning…”: Herman 1, p. 165. See also 173, 183.

scenes and details from the reported Congo feature: McClelland 29.

Bosco Ntaganda’s fighters integrated into Congolese army in 2009: Human Rights Watch 1.

Ntaganda’s outstanding warrant for arrest: International Criminal Court.

800 civilians killed in Mongbwalu and neighboring villages in 2002; 150 in North Kivu in 2008; recruiting children: Human Rights Watch 2.

UN peacekeeper allegedly killed by M23 troops led by Ntaganda: United Nations 1.

“Private Eyes”: McClelland 30.

Scenes and details from the Uganda feature: McClelland 33.

213 survivors of antigay violence in San Francisco in 2010: National Coalition of Anti-Violence Programs.

Alec Baldwin movie:
Heaven’s Prisoners
!

emotional anesthesia: Constriction of affect/numbing of general responsiveness. European Society for Traumatic Stress.

CHAPTER EIGHT

“Equally as powerful…”: Herman 1, p 1.

Lara Logan garners jokes: McClelland 21.

—dismissals: Schechner; Hallett.

—blame: Mary Elizabeth Williams.

“abatement of many of my symptoms”: See Herman 1, p. 183, about flooding and intensive treatments helping with intrusive symptoms but not constrictive ones, such as numbing and withdrawal. Reconstruction “is a necessary part of the recovery process,” she says, “but it is not sufficient.”

Ohio union rights recently demolished: links to this and other Ohio dispatches in McClelland 28. Scenes and details from the reported feature in McClelland 32.

oscillation between extreme and opposite symptoms: Herman 1, p. 162.

rape survivors with PTSD 26 times more likely to have serious drug abuse problems: National Crime Victim Center. For a great volume on the relationship between trauma and addiction, check out Gabor Maté’s
In the Realm of Hungry Ghosts.

75 percent to 85 percent of veterans with PTSD turn to booze: Herman 1, p. 44; Kulka et al.

probably wasn’t the first person in history to experience PTSD-related sex dysfunction: Herman 1 discusses it on p. 48. See also Haines.

essay I wrote about my PTSD: McClelland 27.

“What’s Happening in Haiti Is Not About You”: Valbrun.

“She makes use of stereotypes about Haiti…”: Open Letter.

UN prostitute: Cave.

other side of article war (examples): Filipovic; Friedersdorf; Gay.

about 30 percent of Vietnam vets have had PTSD:
NIH Medline Plus
; Kulka et al.

Herman on PTSD deniability, sharing burden with victims, discrediting victims and their therapists: Herman 1, pp. 2, 7, 8, 115, 246.

people love stories about murderers: For an excellent article on this see Schlosser. Also discussion in Howard, specifically p. 136.

1964 study of battered women, 1998 study of ER doctors, “masochistic personality disorder”: Herman 1, p. 117.

people think they would have done a better job in traumatizing situations than victims did: Herman 1, p. 115.

“denial, repression…”: Herman 1, p. 2.

trauma specialists harassed for taking victims’ sides: Herman 1, p. 246. There’s a famous case where daughter accused father of rape, then father sued daughter’s therapist. Butler.

“In spite of a vast literature…”: Herman 1, p. 8. See also footnote 7 on Herman 1, p. 279.

Haitian rape victim’s published note: Danticat.

“I am bad,” etc.: American Psychiatric Association.

persistent negative beliefs about the self being characteristic of PTSD: Dyer et al; American Psychiatric Association.

“geisha to the NGO republic”: Cave.

concern between me and other traumatized people mutual: E-mails used with permission.

“healing does not always mean that we will feel better”: Donald Epstein, p. 99.

PART TWO

“You do not have to be good…”: Oliver, p. 110.

CHAPTER NINE

all information about sessions with and methodology of Denise Benson: Benson.

“person is a composite functioning…”: Strozzi-Heckler 1, p. ix.

Special Forces to professional athletes: Strozzi-Heckler 1, back-page bio.

Levine’s Somatic Experiencing: Levine.

Van der Kolk’s treatment of a car accident victim with EMDR: Van der Kolk 2.

visual, tactile, and auditory stimuli while thinking about trauma: Roger Solomon.

Van der Kolk used neuroimaging to discover that frontal lobes went off-line during the re-creation of traumatic experiences: Korn; Van der Kolk 5.

importance of getting the body to feel safe: Korn. Says Van der Kolk, “I think medications are necessary if therapists have exhausted other techniques of calming people’s bodies down.”

can’t treat trauma just by talking about it: Wylie 1. Also: “… fundamentally, words can’t integrate the disorganized sensations and action patterns that form the core imprint of the trauma,” according to Van der Kolk.

Van der Kolk training legions of practitioners to treat PTSD through body: His organization, the Trauma Center at Justice Resource Institute, has trained 20,000 according to the 2011 brochure. Trauma Center at Justice Resource Institute.

mind tells an anorexic he’s fat: Park.

“just because our feet and legs are on the ground…”: Strozzi-Heckler 1, p. 119.

“like I wasn’t a victim of my own system”: Van der Kolk 3, p. 8. “The core idea [with calming practices] is that I am not a victim of what happens. I can do things to change my own thoughts…”

“hatred never ceases by hatred”: Chodron, p. 7.

dissociating is the opposite of processing: Van der Kolk 3, p. 6. “[T]he work with traumatized people consists of helping them to field the present as it is and to tolerate whatever goes on.”