The Blind Spot (3)

Over nine months, Linda spent 51 days in the hospital for her stress-related illness but two mental health professionals (MHPs) failed to find the cause.  Joaquin, age 16,  was ill for three months, told his doctors he suspected his pain was caused by stress and was referred to three mental health counselors who failed to find the cause.  How can this happen when the issues underlying most cases of stress illness are well known to MHPs?

The problem is that not many patients who present themselves to the health care system with physical symptoms are evaluated by MHPs, so they often lack experience in linking a patient’s stresses to their illness.  With Linda and Joaquin, for example, just one question would have revealed the connection: “Did anything stressful happen to you shortly before your symptoms began?”  In Linda’s case, just before she became ill she found herself obligated to provide time-consuming support to her father who had neglected her since childhood and whom she usually tried to avoid.  On top of that, he was verbally critical if her efforts didn’t fully meet his needs.  For the teenage Joaquin, his pains began after an attempt to reconcile with his abusive, alcoholic father had ended in a shouting match.  (Joaquin was so angry he “borrowed” his father’s new truck and deliberately ruined the transmission).

Both of these patients improved significantly after the chronology of their life stresses was linked to that of their symptoms.  Uncovering the connections between stresses and symptoms is not difficult in most cases.  With just a little training and experience and a good working relationship with a primary clinician, MHPs could provide enormous benefit to hundreds of millions of stress illness patients.  They could, in fact, close the blind spot.

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