Treatment of victims of trauma

The psychiatric sequelae of trauma have been most often discussed in relation to disasters, both natural and man-made, and military conflict. This may sometimes lead psychiatrists to think of posttraumatic stress disorder (PTSD) and other posttraumatic mental illnesses as being somewhat exotic and unusual in general psychiatric practice. In this paper, I propose that PTSD and related disorders are actually common psychiatric problems which require treatment. The history of the concept will not be reviewed here; interested readers are referred to reviews by Trimble (1985) and Gersons & Carlier (1992). The problems of adult survivors of childhood trauma will not be discussed in detail here, but there are reasons for thinking that therapeutic approaches based on a PTSD model may sometimes be inappropriate. Concerning the specific problems of war veterans or children, readers are referred to the relevant chapters in textbooks such as Wilson & Raphael (1993).