Showing posts with label bulimia. Show all posts
Showing posts with label bulimia. Show all posts
2013/11/01
Rape, Assault, and the Damage to Individuals and our Society
So, over the last few weeks, we have covered the basic ideas of what trauma and torture are, an understanding of how it affects the individual victims by causing PTSD and other medical problems, and how if affects and changes the actions of family members, friends, and caregivers. So it seems only fitting that this week we look at some of the most common trauma in our society as well as how it changes and impacts our society as well. Some of the most common forms of violence and trauma in American society is physical and sexual assault. Some studies show that the United States has the highest rate of homicide than any other first world nation (approximately 8.3 per 100,000 people) with the exception of the Bahamas and Ecuador. (Isn't that pretty interesting that our country holds itself up as a Superpower and the 'police' of the world, but we as a nation cause just as much harm to each other as we do to other countries... maybe even more. Something to think about when looking at American culture and what we like or want to change about it.) While homicide is at the extreme end of the spectrum of violence, physical assault is much more common place and studies show that a considerable percentage of our population have experienced physical assault at least once in their lives. Adolescents and adults are most likely to be assaulted and both African American and Hispanic populations have higher rates of assault/ homicide over other racial groups.
There are a few subtle and clear paths to see the effects of both physical and sexual assault of the individuals in our society... and therefore, the society as a whole. Studies show that people who have either been victims of crime or family members of the former tend to behave and think differently in a few aspects of their life. Some numbers mentioned in the text express this trend:
1. 36% of family members that have experienced criminal homicide become more careful about their personal safety.
2. 74.7% of people who have had experience with alcohol related vehicular death also admit to taking extra precautions to protect themselves from crime.
3. 11.7% of victims choose to begin carrying a gun
Another number mentioned was that 94% of emergency room visits in 1994 where the patient was seen for violence related injuries, the injuries were attained as part of an assault. In general, women tend to fear being a victim of crime more than men and so they restrict many aspects of their lives and their behavior based on that fear... but most members of our society have some fear of being a victim at some point in their lives and that is a tragic statement in and of itself. Victims of assault (whether physical or sexual) are more likely to develop and have problems with chronic health conditions such as pain, gastrointestinal disorders, headaches as well as other complaints. Other concerns are that these individuals receive more medical care overall, have non normal sexual function, and challenges with somatic symptoms that as twice as frequent as the general population.... as well as bulimia and low body weight. They are less likely to see their health in a favorable light, are more likely to engage in unhealthy behaviors such as smoking and substance abuse and see a future ahead of them that is bleak and devoid of good things. In fact, rape and physical assault victims as associated with the highest levels of PTSD among women when compared with other civilian traumas.
One paradox that I see in our society is that as a rule, the victims of crime are seen as a part of the crime and some blame is attached to them. If a women is raped, it is because of her clothing, her choice to have a drink, her choice of friends, whether she 'fought' hard enough, etc.... I think that we tend to perpetuate this ideal because it helps each of us to 'feel' safer- we don't wear those clothes, etc.... but it is also so embedded into our culture as a way of controlling people – mostly women and minorities- that we don’t even realize that we are doing it. One of the pharmacists that I worked with at one point said that a teenager who was killed was entirely to blame for her own death as she made the choice to go see someone she had only known online and she must have been stupid as well. I was horrified by the statement and nothing I could say to her would change her opinion. However, I think that the textbook worded the thoughts that I was feeling best:
“Predatory assailants, not victims, cause assaults, irrespective of any risk factors the victims might possess.”
“...Studies show that all victim's behaviors are of lesser significance than offender characteristics in determining the outcome of sexual assault...”
It feel pretty conflicting to realize not only how common rape and assault are in our communities, county and the world overall, but to also learn how much these acts cause such long term harm not only to the individuals affected but also to our society as a whole was pretty challenging for me. I hear the terms rape culture and see the way people of both genders react when talking about cases of rape or sexual assault. But to see a brief view of the ripples that these acts are causing across the society I live in is staggering. Even if all assaults both sexual and physical ended today and never happened again in America... it would be generations (if ever) before our society recovered because of the damage caused in the past. I wonder how many of my reactions are involuntary based on my past. I wonder how as people modify their actions and behaviors that we model for the future generations, if we can ever really lose those behaviors.
What are your thoughts?
Labels:
blame,
bulimia,
choice,
Fear,
gender,
health,
homicide,
mental health,
physical assault,
PTSD (post traumatic stress syndrome),
rape,
rape culture,
risk,
sexual assault,
sexual health,
society,
somatic symptoms
2010/10/25
Thoughts on Somatoform Disorder... and a Lot of Questions!

1. Somatoform disorder is the name for a group of conditions in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can't be traced to a specific physical cause. In people who have a somatoform disorder, medical test results are either normal or don't explain the person's symptoms. This group of disorders includes: Conversion disorder, Dissociative disorder, Somatization disorder, Hypochondriasis, Factitious disorder, and Body Dysmorphic Disorder.
I will admit that after reading my texts twice- I am still not sure that I 'get' Somatoform disorder. Or at least I thought that I was starting to get it until I read a lot of the other posts from my other classmates. Everyone seemed to focus on hypochondriacs and while I do think that was part of being discussed... well, I guess I wasn't really convinced that was the whole idea... And the amount of backbiting/rudeness and judgement was quite impressive ('I know someone just like that and she does it for the attention...' or 'I know someone who definitely fits this disorder and they go to the doctor all the time but it's clear there's nothing wrong with them', etc...)
Am I wrong? Maybe I am so focused on the idea that I was so sick and nobody could find anything wrong for a year. I had x-rays, ultra sounds, a colonoscopy or two, and was poked and prodded by everyone imaginable in my local practice and was given huge antibiotic shots every few weeks, started Prozac and was then sent to a third specialist... who then gave me an upper-endoscopy and then told me that all of my symptoms made perfect sense for the problem that I was really having... which wasn't recognized by any of the other physicians that I had seen.... So how can you really be sure that someone is a hypochondriac and doesn't really have something physical wrong with them? Especially just by casual looking or conversation...? The textbook talked about how women are more likely to be diagnosed with this disorder... can this be because physicians as a rule are more likely to think women have something wrong with their mind (anxiety, etc) than a heart attack for instance... and so they do not look deep enough? Or am I just overly tolerant and not cynical enough?
I guess I also wonder if pain disorders have to be specifically 'pointed' at in the sense that I think that Fibromyalgia is a 'pain disorder' but there doesn't seem to be anything specific to 'point' at- they hurt, but no one seems to know for sure why? Are they hurting?... I have no doubt. Is it all in their mind? I can't believe that... Also if I look at the criteria, is it possible that someone with a bad relationship and stress problem be able to be 'diagnosed' with this disorder that with time and other changes could no longer qualify for this disorder? For instance, if my friend Pamela has belly pain and reflux from stress (she thinks), a sex symptom- because she has no interest in sex with her estranged husband right now, and she is also likely to complain of random chest pain, a twitching eye, headaches, and leg pain... could she be diagnosed with this disorder if her doctor can't find anything definitive? Even though a casual discussion and exam could probably show that this is most likely temporary and stress related? And once you are diagnosed, can you ever 'lose' the diagnostic label... or is it yours forever? I also wonder which came first- the label hypochondriac or somatoform disorder... although I suspect that the term hypochondriac came first. I guess I have more questions this week than answers- sorry :(
One thing that was really interesting to me was that Body Dsymorphic Disorder is one of the disorders under this diagnosis- known to us lay people usually as anorexia or bulemia. Because maybe that is my clue for understanding the idea of the disorder. If the idea behind BDD is than an individual for some reason is unable to accept who he/she is or what he/she looks like or can't be what he/she wants to be... is able to for unknown reasons in her mind attempt to force the body into what he/she cannot have (and I believe that is done unconsciously truly- I can't imagine that those thought processes are something that someone works on to develop... although I could be wrong.) Well, than maybe what the book is trying to say is that a person has so much 'stuff' in his/her life that is painful (whether it is abuse, stress, etc...) that they cannot control... then the unconscious mind tries to get out some of the strain through other various ways which the individual doesn't tend to recognize and then they go to the doctor thinking that they had another problem. But I guess I am again stuck on the idea that at some point the doctor can decide that the patient has nothing really wrong and diagnose them with this when it could be something else.
Does anyone out there know someone who has one of these disorders and can maybe give me a little more insight into it? I really am curious and want to have a real discussion on it. What do you think if you are someone who has it? Would you be willing to explain a little bit of your personal history so maybe I can understand a little better?
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