Causes of psychophysiologic disorder (PPD) symptoms are so diverse that even after assessing thousands of patients I still encounter new variations. Earlier this year a 65 year old retired nurse practitioner from Oregon whom I have worked with in the past contacted me because of months of abdominal pain. She suspected PPD because medical evaluation was unrevealing and her symptoms fluctuated for no obvious reason.
Archive for the ‘Patient Stories’ Category
The latest evidence of the woeful state of care for Psychophysiologic Disorders (Stress Illness) comes from my local newspaper. In a Health column, we find the following question from a reader:
A match for the Women’s World Chess Championship recently finished in Tirana, the capital of Albania. The winner was incumbent champion Hou Yifan, a 17 year old from China who won the title last December, the youngest ever. The pressure on her was enormous for several reasons. The weight of national pride was heightened by the fact that Ms Koneru, her 24 year old challenger, is a native of India, China’s geopolitical rival. Ms Koneru had also surpassed Hou (slightly) in the world rankings. In addition, prize money for the match winner was more than $50,000 greater than for the loser.
After my lecture on stress illness yesterday at the beautiful and innovative Kadlec Hospital in Richland, Washington, USA, a young specialist physician came to me with a question. (I will change a few details to preserve confidentiality). She described a patient with pain in his back, chest and the left lower corner of the abdomen but no abnormalities on diagnostic tests. She went on to explain several diagnoses she considered but acknowledged that none of them were a good fit for all the features of her patient’s condition. Her initial treatment suggestions had not been helpful and she felt the patient was about to conclude that “I’m just as bad as his other two doctors.”
David Seidler was pre-school age and living in London when the Nazis bombed his apartment and later killed his grandparents in the Holocaust. Understandably, the family decided to relocate to New York. David developed a stammer during the move that he believed was connected to the war-time traumas. He struggled with his voice for over a decade.
The article about the Chinese “Tiger Mother” (described in the last three posts) reminded me of another issue of key importance for the 55% of my stress illness patients who have survived dysfunctional childhood environments. Often they struggle to perceive accurately the long-term impact of this experience. There are a couple of reasons for this, most simply that they have no parallel life to contrast with their own experience. More subtly, part of surviving a difficult environment involves suppressing your emotional reaction to what is happening. When this is done repeatedly, in later years it becomes difficult to look back and accurately perceive what took place.
Continuing the comment from the last post about the article Why Chinese Mothers are Superior. Another concern I have about the author’s parenting choices is the absence of any perspective on the limitations it places on her own life. The approach to her daughters is tremendously demanding of time and emotional energy. Of course she has every right to allocate these resources as she thinks best, but giving a little more time to her career, husband or other interests is not considered.
Continuing the comment from the last post about Amy Chua’s article in the Wall Street Journal titled Why Chinese Mothers are Superior. To achieve goals the author has for her daughters, she imposes high levels of pressure and coercion. There is a significant risk that this will result in long term damage to their self-esteem. This damage is the common denominator in my patients whose symptoms are linked to their childhood experience.
An article making the rounds of my social network, titled Why Chinese Mothers Are Superior, was published January 8, 2011 in the Wall Street Journal. The subheading is “Can a regimen of no playdates, no TV, no computer games, and hours of music practice create happy kids? And what happens when they fight back?” The author, Amy Chua, was born soon after her Chinese parents arrived in the U.S. She is a professor at Yale Law School and the article is excerpted from her forthcoming book Battle Hymn of the Tiger Mother. The article has generated over 2500 comments in three days.