study: psychiatry, medical illness misdiagnosed as mental illness

painting inspired by migraine

Sarah Raphael, Strip Page 8 (Detail), 1998, acrylic on can­vas with papier maché collage

Med­ical dis­or­ders among patients admit­ted to a public-​sector psy­chi­atric inpa­tient unit. at

Active and impor­tant phys­i­cal dis­or­ders are com­mon among patients admit­ted to psy­chi­atric inpa­tient units. Some patients’ men­tal symp­toms are caused or exac­er­bated by undi­ag­nosed med­ical con­di­tions. Addi­tional research is needed to define cost-​effective med­ical eval­u­a­tion meth­ods for patients in this set­ting and to devise ways to con­vince pro­gram admin­is­tra­tors and staff to imple­ment them.

Understanding the Victims of Spousal Abuse” by Frank M. Ochberg, M.D.

battered women

Under­stand­ing the Vic­tims of Spousal Abuse by Frank M. Ochberg, M.D. at Gift from Within

Spouse abuse has his­toric roots. Females have been bought and sold and bartered, rit­u­ally branded and muti­lated, denied edu­ca­tion, land own­er­ship, means of travel, and are not yet full part­ners in own­ing and con­trol­ling the major insti­tu­tions of this world. In a polit­i­cal sense, the female gen­der is engaged in a long march from slav­ery, still eclipsed in the shadow of patri­ar­chal dom­i­nance. When par­ity in power is sought, too often the seeker is pun­ished. Behind closed doors the pun­ish­ment may be swift, explo­sive and brutal…

… not every ther­a­pist is equipped to help the woman who wants to change the habits that helped her endure abuse. In fact, many ther­a­pists make mat­ters worse. They do this by announc­ing their skep­ti­cism. They do this by with­hold­ing support…

There­fore three caveats are offered for those seek­ing counseling:

1. Shop Around. The first or sec­ond coun­selor may not be right for you. This rela­tion­ship will be very impor­tant. You should feel com­fort­able and you should be sure your coun­selor is com­fort­able with you.

2. Change Coun­selors If You Must. Early in a ther­a­peu­tic rela­tion­ship you may feel betrayed or insulted. Since sen­si­tiv­ity to rejec­tion is often a prob­lem for per­sons deal­ing with inter­per­sonal issues in ther­apy, you deserve a coun­selor who you can trust. If a coun­selor can­not deal with your anger, you might be bet­ter off elsewhere .

3. Endure Once You Find the Right Coun­selor. Those who are out of an abu­sive rela­tion­ship, but strug­gling to find a sense of per­sonal worth, con­sis­tency and secu­rity, will often have stormy times in ther­apy. Your job is not to please your ther­a­pist, but your ther­a­pist will be pleased if you reach your goal of independence.

In sum, spouse abuse hap­pens because our so called civ­i­liza­tion is not that civ­i­lized and men get away with beat­ing women. Women stay with these men for sev­eral rea­sons, includ­ing fear, iso­la­tion and unusual forms of love. Leav­ing is dan­ger­ous for many, dif­fi­cult for most. A com­mon long term con­se­quence of abuse is an inter­per­sonal and intrap­er­sonal con­di­tion that includes depres­sion, rejec­tion sen­si­tiv­ity, anger and dif­fi­culty with trust. Coun­sel­ing for vic­tims should be prac­ti­cal, mul­ti­dis­ci­pli­nary and geared to secu­rity needs. Ther­apy for those who are safe but not fully “whole” is a longer, more demand­ing process.

Ther­apy is not the answer; we must do more than treat the wounded. Spouse abuse is a long stand­ing, entrenched prob­lem. For­tu­nately, there are expe­ri­enced, effec­tive sur­vivors com­mit­ted to chang­ing this cruel aspect of human his­tory. We who treat and teach can do no bet­ter than to join hands with them.

For more on women and the Stock­holm Syn­drome see the free online book Lov­ing to Sur­vive: Sex­ual Ter­ror, Men’s vio­lence, and Women’s Lives by Dee L. R. Graham