Beyond the Schoolyard: Workplace Bullying

This infographic on workplace bullying was created by International Business Degree Guide to convey the message that workplace bullies not only hurt people, they can also hurt business–driving away good employees in their quest for control.

Adept at dissimulation, those in authority often see what the bully expressly feigns and pretends to be. Under observation by authority the bully hides his true self and often cultivates an image designed to please and impress.  Veiling truth to those in power protects the bully.  Reports of abuse are disbelieved or ignored; dismissed or minimized as exaggeration; deemed a product of bellyachers and whiners.

In addition to hiding his true self the bully will often tell superiors what they want to hear. The workplace bully promotes an image of loyalty, dedication and hard work to superiors and may even feign common ideals and goals.   This  impression management often works.

When bullying ends in tragedy it is often revealed that those who could and should have done something about it knew about it and did nothing.  This failure to act may be the result of blinkered apathy, willful ignorance and even malicious complicity.  This is especially true when the  political and ideological views of the bully align closely with those in charge and the victim of bullying is remotely aligned.

Moral superiority, bigotry, racism and other biases all too often factor into the equation.

Perhaps those without sufficient empathy of others to take action when reports of abuse and harassment are reported to them will do their jobs if they realize workplace bullying might harm them personally or what they value most.

via Beyond the Schoolyard: Workplace Bullying.

Source: Beyond the Schoolyard: Workplace Bullying

Beyond the Schoolyard: Workplace Bullying

WorkplaceBullies

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Beyond the Schoolyard: Workplace Bullying

Not only do workplace bullies hurt people, they can also hurt business – driving away good employees in their quest for control. What can you do if you find yourself having to face a bully every day?

Share this infographic on your site!

Beyond the Schoolyard: Workplace Bullying

Not only do workplace bullies hurt people, they can also hurt business – driving away good employees in their quest for control. What can you do if you find yourself having to face a bully every day?

Not All That Different …

Schoolyard bullies vs. workplace bullies
Both share a need for control – exercising power through humiliation of a target. If reinforced by cheering kids, fearful teachers or ignoring administrators, there is no reason to change and it often continues into adulthood. (1)

What Is a Workplace Bully?

Characteristics of a workplace bully: (2)

  • Tormenters
  • Tattlers
  • Finger pointers
  • Publicly pick on people
  • CC the whole world in emails
  • Point out your mistakes and tell everyone

Narcissism and self-orientation

What workplace bullies usually score high on in personality tests (3)

Bullying Victims

How many workers are dealing with bullies?
50%
Workers who say they’re treated rudely at least once a week (in 2011); up from 25% in 1998 (4)
66%

Bullying victims who had to lose or give up their jobs to make the bullying stop (1)
40% of workplace bullies are women, picking on other women more than 70% of the time. (5)

How Bullying Can Hurt Your Business

Work is stressful enough on its own, but adding a bully to the mix can make it unbearable.
9% of people say they’re happy at the office. (3)
Less than 1/3
Employees who say they’re engaged at work (3)

Workplace bullying can have serious negative effects on employees, such as: (6)

  • Stress
  • Absenteeism and low productivity
  • Lowered self-esteem and depression
  • Anxiety
  • Digestive upset
  • High blood pressure
  • Insomnia
  • Trouble with relationships due to stress over work

All of this can hit the company’s bottom line, causing: (6)

  • High turnover
  • Low productivity
  • Lost innovations
  • Difficulty hiring quality employees due a “hostile work environment” reputation

Got a Bully? Here’s How to Deal

Avoid the workplace in the first place (1)

  • Ask why the job is open and how long the predecessor was there (turnover is a bullying sign)
  • Ask about the attitude toward “workaholics.” If it’s expected, then you can know what you’re getting into
  • Ask about policies and codes that help ensure a respectful workplace

Once you encounter a bully (5)

  • Don’t get emotional (bullies like that)
  • Don’t blame yourself (the problem is the bully, not you)
  • Do your best work
  • Build a support network
  • Document everything
  • Seek help
  • Get counseling
  • Stay healthy
  • Educate yourself about policies
  • Don’t expect to change the bully
  • Start a new job search

25% of workplace bullying deals with discrimination. If that’s the case, you can talk to an attorney. (7)

Don’t hire a bully
Recognize certain traits in an interview process: They usually interview well due to a desire to control the situation. Invite them to an informal lunch and see if they’re empathetic (good) or brag about “cracking the whip” (bad). (8)

Sources:

1. http://www.workplacebullying.org
2. http://www.forbes.com
3. http://www.usatoday.com
4. http://hbr.org
5. http://www.huffingtonpost.com
6. http://www.bullyingstatistics.org
7. http://www.ivillage.com
8. http://www.ere.net

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Symptoms of Post Traumatic Stress Disorder (PTSD)

 Screen Shot 2015-10-20 at 12.26.54 PM

From Bullyonline.org  read this

Symptoms of Post Traumatic Stress Disorder (PTSD)
Complex Post Traumatic Stress Disorder, PTSD symptoms, survivor guilt and trauma caused by bullying, harassment, abuse and abusive life experiences
What is Post Traumatic Stress Disorder?
How do I recognise the symptoms of PTSD? How do I recover from PTSD?

Updated 4 November 2005

Please link to this page: stress/ptsd.htm

On this page
Definition of Post Traumatic Stress Disorder – what is PTSD?
DSM-IV diagnostic criteria for Post Traumatic Stress Disorder
Causes of Post Traumatic Stress Disorder
Complex PTSD, PDSD and bullying
Mapping the health effects of bullying onto the diagnostic criteria for PTSD
Common symptoms of Post Traumatic Stress Disorder (PTSD)
Associated symptoms of PTSD – survivor guilt etc
New!Transformation
The difference between mental breakdown and stress breakdown
Differences between mental illness and psychiatric injury
Features of Complex PTSD specific to bullying, especially feelings of guilt
Post Traumatic Stress Disorder and fatigue
Incidence of PTSD and Complex PTSD in the general population
Legal aspects of Post Traumatic Stress Disorder
Bullying causes PTSD: the legal case
Complex PTSD and stress, especially stress at work
David Kinchin’s book Post Traumatic Stress Disorder: the invisible injury
Tim Field’s book Bully in sight validates the experience of psychological violence
Recommended reading on PTSD | Bookshops | Articles on PTSD
Seminars on Post Traumatic Stress Disorder and recovery
Links to PTSD, Complex PTSD and trauma sites

“When the trauma is inflicted by another person, is especially intense, or the traumatized person is extremely close to the trauma, the severity of traumatization may be especially profound”
Robert C Scaer, MD, Author, The Body bears the Burden: Trauma, Dissociation and Disease

Definition

Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normal reaction to an abnormal situation.

Post Traumatic Stress Disorder (PTSD) is defined in DSM-IV, the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual. For a doctor or mental health professional to be able to make a diagnosis, the condition must be defined in DSM-IV or its international equivalent, the World Health Organization’s ICD-10.

In the previous version of DSM (DSM-III) a criterion of Post Traumatic Stress Disorder was for the sufferer to have faced a single major life-threatening event; this criterion was present because a) it was thought that PTSD could not be a result of “normal” events such as bereavement, business failure, interpersonal conflict, bullying, harassment, stalking, marital disharmony, working for the emergency services, etc, and b) most of the research on PTSD had been undertaken with people who had suffered a threat to life (eg combat veterans, especially from Vietnam, victims of accident, disaster, and acts of violence).

In DSM-IV the requirement was eased although most mental health practitioners continue to interpret diagnostic criterion A1 as applying only to a single major life-threatening event. There is growing recognition that Post Traumatic Stress Disorder can result from many types of emotionally shocking experience including an accumulation of small, individually non-life-threatening events in which case the resultant PTSD is referred to as Complex PTSD.

DSM-IV diagnostic criteria for Post Traumatic Stress Disorder (PTSD)

The diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are defined in DSM-IV as follows:

A. The person experiences a traumatic event in which both of the following were present:

1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;
2. the person’s response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in any of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions;
2. recurrent distressing dreams of the event;
3. acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated);
4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event;
5. physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:

1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
2. efforts to avoid activities, places or people that arouse recollections of this trauma;
3. inability to recall an important aspect of the trauma;
4. markedly diminished interest or participation in significant activities;
5. feeling of detachment or estrangement from others;
6. restricted range of affect (eg unable to have loving feelings);
7. sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:

1. difficulty falling or staying asleep;
2. irritability or outbursts of anger;
3. difficulty concentrating;
4. hypervigilance;
5. exaggerated startle response.

E. The symptoms on Criteria B, C and D last for more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

The focus of the DSM-IV definition of Post Traumatic Stress Disorder is a single life-threatening event or threat to integrity. However, the symptoms of traumatic stress also arise from an accumulation of small incidents rather than one major incident. Examples include:

  • repeated exposure to horrific scenes at accidents or fires, such as those endured by members of the emergency services (eg bodies mutilated in car crashes, or horribly burnt or disfigured by fire, or dismembered or disembowelled in aeroplane disasters, etc)
  • repeated involvement in dealing with serious crime, eg where violence has been used and especially where children are hurt
  • breaking news of bereavement caused by accident or violence, especially if children are involved
  • repeated violations such as in verbal abuse, physical abuse, emotional abuse and sexual abuse
  • regular intrusion and violation, both physical and psychological, as in bullying, stalking, harassment, domestic violence, etc

Where the symptoms are the result of a series of events, the term Complex PTSD (formerly referred to unofficially as Prolonged Duress Stress Disorder or PDSD) may be more appropriate. Whilst Complex PTSD is not yet an official diagnosis in DSM-IV or ICD-10, it is often used in preference to other terms such as “rolling PTSD”, “PDSD”, and “cumulative stress”. See the National Center for PTSD fact page on Complex PTSD.

Causes of PTSD

PTSD resulting from accident, disaster, war, terrorism, torture, kidnap, etc has been extensively studied and literature is available elsewhere. The first written reference to PTSD symptoms comes from the sixth century BC; Post Traumatic Stress Disorder is nothing new – and neither is the willingness of some people to discredit and deny the existence of the disorder.

This section of Bully OnLine focuses on PTSD and Complex PTSD resulting from bullying, primarily in the workplace, however anyone suffering PTSD (however caused) will find this page enlightening.

Most of the information on this page and web site is relevant to other types of bullying, eg at school, in relationships (including domestic violence), by families, by neighbours or landlords, in the care of the elderly, in the armed services, etc. Bullying is behind harassment, discrimination, prejudice and persecution, therefore targets of repeated sexual harassment or racial discrimination or religious or ethnic persecution will also identify with the symptoms. The insight about bullying on this web site is therefore also relevant to more serious issues including physical abuse, repeated verbal abuse, sexual abuse, violent crime, kidnap, abduction, rape, war, terrorism, torture, and denial and abuse of human rights. Those exploring Contact Experience may also find this page helpful.

PTSD, Complex PTSD and bullying

It’s widely accepted that PTSD can result from a single, major, life-threatening event, as defined in DSM-IV. Now there is growing awareness that PTSD can also result from an accumulation of many small, individually non-life-threatening incidents. To differentiate the cause, the term “Complex PTSD” is used. The reason that Complex PTSD is not in DSM-IV is that the definition of PTSD in DSM-IV was derived using only people who had suffered a single major life-threatening incident such as Vietnam veterans and survivors of disasters.

Note: there has recently been a trend amongst some psychiatric professionals to label people suffering Complex PTSD as a exhibiting a personality disorder, especially Borderline Personality Disorder. This is not the case – PTSD, Complex or otherwise, is apsychiatric injury and nothing to do with personality disorders. If there is an overlap, thenBorderline Personality Disorder should be regarded as a psychiatric injury, not a personality disorder. If you encounter a psychiatrist, psychologist or other mental health professional who wants to label your Complex PTSD as a personality disorder, change to another, more competent professional.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of captivity, lack of means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and – crucially – lack of control, loss of control and disempowerment. It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD. Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc. Those working in regular traumatic situations, eg the emergency services, are also prone to developing Complex PTSD.

A key feature of Complex PTSD is the aspect of captivity. The individual experiencing trauma by degree is unable to escape the situation. Despite some people’s assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you’re a single parent or main breadwinner – the rate of marital breakdown is approaching 50% in the UK), unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference – the bully will go to great lengths to blacken the person’s name, often for years, and it is this lack of reference more than anything else which prevents people escaping.

Until recently, little (or no) attention was paid to the psychological harm caused by bullying and harassment. Misperceptions (usually as a result of the observer’s lack of knowledge or lack of empathy) still abound: “It’s something you have to put up with” (like rape or repeated sexual abuse?) and “Bullying toughens you up” (ditto). Armed forces personnel faced threats of being labelled with “cowardice” and “lack of moral fibre” (LMF) if they gave in to the symptoms of PTSD. In World War I, 306 British and Commonwealth soldiers were shot as “cowards” and “deserters” on the orders of General Haig in an act which today would be treated as a war crime – seeseparate page on this injustice.

In the UK at least 16 children kill themselves each year because they are being bullied at school. This figure is established in the book Bullycide: death at playtime. Each of these deaths is unnecessary, foreseeable, and preventable. The UK has one of the highest adult suicide rates in Europe: around 5000 a year. The number of adults in the UK committing suicide because of bullying is unknown. Each year 19,000 children attempt suicide in the UK – one every half hour. in the UK, suicide is the number one cause of death for 18-24-year-old males. Females also attempt suicide in large numbers but tend to use less successful means.

Since Andrea Adams first identified workplace bullying and gave it its name in 1988, recognition of adult bullying has grown steadily. Tim Field’s UK National Workplace Bullying Advice Line has logged over 8000 cases in seven years; in the majority of cases (over 80%), the caller is a white-collar worker who has become the prey of a serial bully whosebehaviour profile suggests a disordered personality. Callers refer to predecessors who have had stress breakdowns, taken early or ill-health retirement, or been dismissed on grounds of ill-health – all caused by the same individual. Sometimes callers refer to suicides of fellow employees.

Mapping the health effects of bullying onto PTSD and Complex PTSD
Repeated bullying, often over a period of years, results in symptoms of Complex Post Traumatic Stress Disorder. How do the PTSD symptoms resulting from bullying meet the criteria in DSM-IV?

A. The prolonged (chronic) negative stress resulting from bullying has lead to threat of loss of job, career, health, livelihood, often also resulting in threat to marriage and family life. The family are the unseen victims of bullying.
A.1.One of the key symptoms of prolonged negative stress is reactive depression; this causes the balance of the mind to be disturbed, leading first to thoughts of, then attempts at, and ultimately, suicide.
A.2.The target of bullying may be unaware that they are being bullied, and even when they do realise (there’s usually a moment of enlightenment as the person realises that the criticisms and tactics of control etc are invalid), they often cannot bring themselves to believe they are dealing with a disordered personality who lacks a conscience and does not share the same moral values as themselves. Naivety is the great enemy. The target of bullying is bewildered, confused, frightened, angry – and after enlightenment, very angry. For an answer to the question Why me? click here.

B.1. The target of bullying experiences regular intrusive violent visualisations and replays of events and conversations; often, the endings of these replays are altered in favour of the target.
B.2. Sleeplessness, nightmares and replays are a common feature of being bullied.
B.3. The events are constantly relived; night-time and sleep do not bring relief as it becomes impossible to switch the brain off. Such sleep as is achieved is non-restorative and people wake up as tired, and often more tired, than when they went to bed.
B.4. Fear, horror, chronic anxiety, and panic attacks are triggered by any reminder of the experience, eg receiving threatening letters from the bully, the employer, or personnel about disciplinary hearings etc.
B.5. Panic attacks, palpitations, sweating, trembling, ditto.
Criteria B4 and B5 manifest themselves as immediate physical and mental paralysis in response to any reminder of the bullying or prospect of having to take action against the bully.

C. Physical numbness (toes, fingertips, lips) is common, as is emotional numbness (especially inability to feel joy). Sufferers report that their spark has gone out and, even years later, find they just cannot get motivated about anything.
C.1. The target of bullying tries harder and harder to avoid saying or doing anything which reminds them of the horror of the bullying.
C.2. Work, especially in the person’s chosen field becomes difficult, often impossible, to undertake; the place of work holds such horrific memories that it becomes impossible to set foot on the premises; many targets of bullying avoid the street where the workplace is located.
C.3. Almost all callers to the UK National Workplace Bullying Advice Line report impaired memory; this may be partly due to suppressing horrific memories, and partly due to damage to the hippocampus, an area of the brain linked to learning and memory (see John O’Brien’s paper below)
C.4. the person becomes obsessed with resolving the bullying experience which takes over their life, eclipsing and excluding almost every other interest.
C.5. Feelings of withdrawal and isolation are common; the person just wants to be on their own and solitude is sought.
C.6. Emotional numbness, including inability to feel joy (anhedonia) and deadening of loving feelings towards others are commonly reported. One fears never being able to feel love again.
C.7. The target of bullying becomes very gloomy and senses a foreshortened career – usually with justification. Many targets of bullying ultimately give up their career; in the professions, severe psychiatric injury, severely impaired health, refusal by the bully and the employer to give a satisfactory reference, and many other reasons, conspire to bar the person from continuance in their chosen career.

D.1. Sleep becomes almost impossible, despite the constant fatigue; such sleep as is obtained tends to be unsatisfying, unrefreshing and non-restorative. On waking, the person often feels more tired than when they went to bed. Depressive feelings are worst early in the morning. Feelings of vulnerability may be heightened overnight.
D.2. The person has an extremely short fuse and is often permanently irritated, especially by small insignificant events. The person frequently visualises a violent solution, eg arranging an accident for, or murdering the bully; the resultant feelings of guilt tend to hinder progress in recovery.
D.3. Concentration is impaired to the point of precluding preparation for legal action, study, work, or search for work.
D.4. The person is on constant alert because their fight or flight mechanism has become permanently activated.
D.5. The person has become hypersensitized and now unwittingly and inappropriately perceives almost any remark as critical.

E. Recovery from a bullying experience is measured in years. Some people never fully recover.

F. For many, social life ceases and work becomes impossible; the overwhelming need to earn a living combined with the inability to work deepens the trauma.

Common symptoms of PTSD and Complex PTSD that sufferers report experiencing

  • hypervigilance (may feel like paranoia, but see HERE for key differences between paranoia and hypervigilance)
  • exaggerated startle response
  • irritability
  • sudden angry or violent outbursts
  • flashbacks, nightmares, intrusive recollections, replays, violent visualisations
  • triggers
  • sleep disturbance
  • exhaustion and chronic fatigue
  • reactive depression
  • guilt
  • feelings of detachment
  • avoidance behaviours
  • nervousness, anxiety
  • phobias about specific daily routines, events or objects
  • irrational or impulsive behaviour
  • loss of interest
  • loss of ambition
  • anhedonia (inability to feel joy and pleasure)
  • poor concentration
  • impaired memory
  • joint pains, muscle pains
  • emotional numbness
  • physical numbness
  • low self-esteem
  • an overwhelming sense of injustice and a strong desire to do something about it

Associated symptoms of Complex PTSD

Survivor guilt: survivors of disasters often experience abnormally high levels of guilt for having survived, especially when others – including family, friends or fellow passengers – have died. Survivor guilt manifests itself in a feeling of “I should have died too”. In bullying, levels of guilt are also abnormally raised. The survivor of workplace bullying may have develop an intense albeit unrealistic desire to work with their employer (or, by now, their former employer) to eliminate bullying from their workplace. Many survivors of bullying cannot gain further employment and are thus forced into self-employment; excessive guilt may then preclude the individual from negotiating fair rates of remuneration, or asking for money for services rendered. The person may also find themselves being abnormally and inappropriately generous and giving in business and other situations.

Shame, embarrassment, guilt, and fear are encouraged by the bully, for this is how all abusers – including child sex abusers – control and silence their victims.

Marital disharmony: the target of bullying becomes obsessed with understanding and resolving what is happening and the experience takes over their life; partners become confused, irritated, bewildered, frightened and angry; separation and divorce are common outcomes.

Breakdown

The word “breakdown” is often used to describe the mental collapse of someone who has been under intolerable strain. There is usually an (inappropriate) inference of “mental illness”. All these are lay terms and mean different things to different people. I define two types of breakdown:

Nervous breakdown or mental breakdown is a consequence of mental illness

Stress breakdown is a psychiatric injury, which is a normal reaction to an abnormal situation

The two types of breakdown are distinct and should not be confused. A stress breakdown is a natural and normal conclusion to a period of prolonged negative stress; the body is saying “I’m not designed to operate under these conditions of prolonged negative stress so I am going to do something dramatic to ensure that you reduce or eliminate the stress otherwise your body may suffer irreparable damage; you must take action now”. A stress breakdown is often predictable days – sometimes weeks – in advance as the person’s fear, fragility, obsessiveness, hypervigilance and hypersensitivity combine to evolve into paranoia (as evidenced by increasingly bizarre talk of conspiracy or MI6). If this happens, a stress breakdown is only days or even hours away and the person needs urgent medical help. The risk of suicide at this point is heightened.

Often the cause of negative stress in an organisation can be traced to the behaviour of one individual. The profile of this individual is on the serial bully page. I believe bullying is the main – but least recognised – cause of negative stress in the workplace today. To see the effects of prolonged negative stress on the body click here.

The person who suffers a stress breakdown is often treated as if they have had a mental breakdown; they are sent to a psychiatrist, prescribed drugs used to treat mental illness, and may be encouraged – sometimes coerced or sectioned – into becoming a patient in a psychiatric hospital. The sudden transition from professional working environment to a ward containing schizophrenics, drug addicts and other people with genuine long-term mental health problems adds to rather than alleviates the trauma. Words like “psychiatrist”, “psychiatric unit” etc are often translated by work colleagues, friends, and sometimes family into “nutcase”, “shrink”, “funny farm”, “loony” and other inappropriate epithets. The bully encourages this, often ensuring that the employee’s personnel record contains a reference to the person’s “mental health problems”. Sometimes, the bully produces their own amateur diagnosis of mental illness – but this is more likely to be a projection of the bully’s own state of mind and should be regarded as such.

During the First World War, British soldiers suffering PTSD and stress breakdown were labelled as “cowards” and “deserters”. During the Second World War, soldiers suffering PTSD and stress breakdowns were again vilified with these labels; Royal Air Force personnel were labelled as “lacking moral fibre” and their papers stamped “LMF”. For further commentary on this issue, click here. It’s noticeable that those administrators and top brass enforcing this labelling were themselves always situated a safe distance from the fighting; see the section on projection.

The person who is being bullied often thinks they are going mad, and may be encouraged in this belief by those who do not have that person’s best interests at heart. They are not going mad; PTSD is an injury, not an illness.

Sometimes, the term “psychosis” is applied to mental illness, and the term “neurosis” to psychiatric injury. The main difference is that a psychotic person is unaware they have a mental problem, whereas the neurotic person is aware – often acutely. The serial bully’s lack of insight into their behaviour and its effect on others has the hallmarks of a psychosis, although this obliviousness would appear to be a choice rather than a condition. With targets of bullying, I prefer to avoid the words “neurosis” and “neurotic”, which for non-medical people have derogatory connotations. Hypersensitivity and hypervigilance are likely to cause the person suffering PTSD to react unfavourably to the use of these words, possibly perceiving that they, the target, are being blamed for their circumstances.

A frequent diagnosis of stress breakdown is “brief reactive psychosis”, especially if paranoia and suicidal thoughts predominate. However, a key difference between mental breakdown and stress breakdown is that a person undergoing a stress breakdown will be intermittently lucid, often alternating seamlessly between paranoia and seeking information about their paranoia and other symptoms. The person is also likely to be talking about resolving their work situation (which is the cause of their problems), planning legal action against the bully and the employer, wanting to talk to their union rep and solicitor, etc.

Transformation

A stress breakdown is a transformational experience which, with the right support, can ultimately enrich the experiencer’s life. However, completing the transformation can be a long and sometimes painful process. The Western response – to hospitalise and medicalize the experience, thus hindering the process – may be well-intentioned, but may lessen the value and effectiveness of the transformation. How would you feel if, rather than a breakdown, you viewed it as a breakthrough? How would you feel if it was suggested to you that the reason for a stress breakdown is to awaken you to your mission in life and to enable you to discover the reason why you have incarnated on this planet? How would it change your view of things if it was also suggested to you that a stress breakdown reconfigures your brain to enable you to embark on the path that will culminate in the achievement of your mission? [More | More]

Differences between mental illness and psychiatric injury

The person who is being bullied will eventually say something like “I think I’m being paranoid…“; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury.

Our new page on Organised Gang Stalking and Mind Control explains the difference between “gang stalking”, a conspiracy theory, and bullying and other forms of abuse. The differences are analogous to the differences between paranoia and hypervigilance.

Paranoia

Hypervigilance

  • paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry
  • is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury
  • paranoia tends to endure and to not get better of its own accord
  • wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause
  • the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia.
  • the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word “paranoia”
  • sometimes responds to drug treatment
  • drugs are not viewed favourably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body’s own healing process
  • the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia
  • the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so
  • the paranoiac is convinced of their self-importance
  • the hypervigilant person is often convinced of their worthlessness and will often deny their value to others
  • paranoia is often seen in conjunction with other symptoms of mental illness, butnot in conjunction with symptoms of PTSD
  • hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness
  • the paranoiac is convinced of their plausibility
  • the hypervigilant person is aware of how implausible their experience sounds and often doesn’t want to believe it themselves (disbelief and denial)
  • the paranoiac feels persecuted by a person or persons unknown (eg “they’re out to get me”)
  • the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury
  • sense of persecution
  • heightened sense of vulnerability to victimisation
  • the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them
  • the hypervigilant person’s sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them
  • the paranoiac is on constant alert because they know someone is out to get them
  • the hypervigilant person is on alert in case there is danger
  • the paranoiac is certain of their belief and their behaviour and expects others to share that certainty
  • the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behaviour is having; they cling naively to the mistaken belief that the bully will recognise their wrongdoing and apologise

Other differences between mental illness and psychiatric injury include:

Mental illness

Psychiatric injury

  • the cause often cannot be identified
  • the cause is easily identifiable and verifiable, but denied by those who are accountable
  • the person may be incoherent or what they say doesn’t make sense
  • the person is often articulate but prevented from articulation by being traumatised
  • the person may appear to be obsessed
  • the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery
  • the person is oblivious to their behaviour and the effect it has on others
  • the person is in a state of acute self-awareness and aware of their state, but often unable to explain it
  • the depression is a clinical or endogenous depression
  • the depression is reactive; the chemistry is different to endogenous depression
  • there may be a history of depression in the family
  • there is very often no history of depression in the individual or their family
  • the person has usually exhibited mental health problems before
  • often there is no history of mental health problems
  • may respond inappropriately to the needs and concerns of others
  • responds empathically to the needs and concerns of others, despite their own injury
  • displays a certitude about themselves, their circumstances and their actions
  • is often highly sceptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate (“I can’t believe this is happening to me” and “Why me?” – click here for the answer)
  • may suffer a persecution complex
  • may experience an unusually heightened sense of vulnerability to possible victimisation (ie hypervigilance)
  • suicidal thoughts are the result of despair, dejection and hopelessness
  • suicidal thoughts are often a logical and carefully thought-out solution or conclusion
  • exhibits despair
  • is driven by the anger of injustice
  • often doesn’t look forward to each new day
  • looks forward to each new day as an opportunity to fight for justice
  • is often ready to give in or admit defeat
  • refuses to be beaten, refuses to give up

Common features of Complex PTSD from bullying

People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterise psychiatric injury and differentiate it from mental illness. These include:

Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)
An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words “manic” instead of motivated, “obsessive” instead of focused, and “angry” instead of “passionate”, especially from those with something to fear)
An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience
A simultaneous and paradoxical unwillingness to talk about the bullying (clickhere to see why) or abuse (click here to see why)
A lack of desire for revenge, but a strong motivation for justice
A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty
Extreme fragility, where formerly the person was of a strong, stable character
Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)
Clumsiness
Forgetfulness
Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled
An enhanced environmental awareness, often on a planetary scale
An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat – especially red meat
Willingness to try complementary medicine and alternative, holistic therapies, etc
A constant feeling that one has to justify everything one says and does
A constant need to prove oneself, even when surrounded by good, positive people
An unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as “persecution”
Occasional violent intrusive visualisations
Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable
A feeling of being small, insignificant, and invisible
An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you
In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of “I’m better!”, only to be followed by a full resurgence of symptoms a day or two later
Excessive guilt – when the cause of PTSD is bullying, the guilt expresses itself in forms distinct from “survivor guilt”; it comes out as:

  • an initial reluctance to take action against the bully and report him/her knowing that he/she could lose his/her job
  • later, this reluctance gives way to a strong urge to take action against the bully so that others, especially successors, don’t have to suffer a similar fate
  • reluctance to feel happiness and joy because one’s sense of other people’s suffering throughout the world is heightened
  • a proneness to identifying with other people’s suffering
  • a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)
  • a heightened sense of indebtedness, beholdenness and undue obligation
  • a reluctance to earn or accept money because one’s sense of poverty and injustice throughout the world is heightened
  • an unwillingness to take ill-health retirement because the person doesn’t want to believe they are sufficiently unwell to merit it
  • an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled
  • an unusually strong desire to educate the employer and help the employer introduce an anti-bullying ethos, usually proportional to the employer’s lack of interest in anti-bullying measures
  • a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself
  • an unusually high inclination to feel sorry for other people who are under stress, including those in a position of authority, even those who are not fulfilling the duties and obligations of their position (which may include the bully) but who are continuing to enjoy salary for remaining in post [hint: to overcome this tendency, every time you start to feel sorry for someone, say to yourself “sometimes, when you jump in and rescue someone, you deny them the opportunity to learn and grow”]

Fatigue

The fatigue is understandable when you realise that in bullying, the target’s fight or flight mechanism eventually becomes activated from Sunday evening (at the thought of facing the bully at work on Monday morning) through to the following Saturday morning (phew – weekend at last!). The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes semi-permanent, the body’s physical, mental and emotional batteries are drained dry. Whilst the weekend theoretically is a time for the batteries to recharge, this doesn’t happen, because:

  • the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;
  • sleep is non-restorative and unrefreshing – one goes to sleep tired and wakes up tired
  • this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends each weekend with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body’s batteries never have an opportunity to recharge.

When activated, the body’s fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It’s no coincidence that people experiencing constant abuse, harassment and bullying report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc). The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired.

Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome – seehealth page for details.

Legal

In law, gaining compensation for psychiatric injury is a long arduous process which can take five years of more. The areas most commonly quoted are breach of duty of care under the Health and Safety at Work Act (1974), and personal injury. There is little case law for personal injury caused by bullying (although there have been settlements which are subject to gagging clauses).

The most frequently quoted case is Walker v. Northumberland County Council [1995] IRLR35 (High Court). John Walker was a social worker dealing with child abuse cases. He suffered a stress breakdown caused by work overload, recovered and went back to work; his employer, having been informed of the cause of his stress breakdown, took no steps to reduce his workload and Mr Walker subsequently suffered a second stress breakdown. The award was made by the courts on the basis of the second stress breakdown.

In May 2001 the case of Long v. Mercury Mobile Communications Services resulted in Mr Long (the target of bullying, in this case in the form of a vendetta) winning his case on the basis of a first stress breakdown. This has become the new precedent. The House of Lords judgment in Barber v. Somerset County Council has also set a new precedent.

In July 1999 Beverley Lancaster won her case for stress against Birmingham City Council, and in September 2000 in the case of Waters v. London Metropolitan Police the UK House of Lords judged that an employee (or in this case an office holder) has the right in law to sue for negligence if bullying and harassment which the employer knew about but failed to deal with resulted in psychiatric injury.

However, the law at present is clearly inadequate:

the better a person qualifies to pursue a claim for personal injury by satisfying PTSD DSM-IV diagnostic criteria B4, B5, C1, C2, C3, D3, E and F, the more they are, ipso facto, frustrated from pursuing the claim

B4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event;
B5. physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness:
C1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
C2. efforts to avoid activities, places or people that arouse recollections of this trauma;
C3. inability to recall an important aspect of the trauma;
D3. difficulty concentrating;
E. The symptoms on Criteria B, C and D last for more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

The Diagnostic Criteria are exacerbated by the abusive and aggressive behaviour of the bully, the employer, and the employer’s legal representatives in their defence and rejection of the claim.

In its Consultation Paper on Liability for Psychiatric Illness (No 137) the Law Commission recommended, among other things, that

6.2 There should continue to be liability for negligently inflicted psychiatric illness that does not arise from a physical injury to the plaintiff;
6.15 Damages for psychiatric illness should continue to be recoverable irrespective of whether the psychiatric illness is of a particular severity;
6.20 Subject to standard defences, there should be liability where an employer has negligently overburdened its employee with work thereby foreseeably causing him or her to suffer a psychiatric illness.

There are a growing number of personal injury cases (for psychiatric injury caused by bullying) in the pipeline, with the first settled out of court in February 1998. See the case law page for recent cases and settlements.

New! Bullying causes PTSD: the legal case

Many people, especially guilty parties and their accomplices and lawyers, reject the notion that PTSD can arise from bullying. However, this research proves otherwise:

  • European Journal of Work and Organizational Psychology (EJWOP), 1996, 5(2), whole issue devoted to bullying and its effects, including PTSD. Published by Psychology Press, 27 Church Road, Hove, East Sussex BN3 2FA, UK.
  • The late Professor Heinz Leymann was one of the first people to identify the symptoms of injury to health caused by bullying as PTSD.
  • Research from Warwick University, England, identifies bullying as a cause of PTSD
  • Bullied workers suffer ‘battle stress’ and show the same symptoms of armed forces personnel who have been engaged in war

It is common practice for employers to order targets of bullying to see a psychiatrist of the employers’ choosing and to have the employee diagnosed as being “mentally ill” in order to provide grounds for dismissal whilst thwarting a personal injury claim. See BMA: ethics advice and the articles Abuse of Medical Assessments to Dismiss Whistleblowers andBattered Plaintiffs – injuries from hired guns and compliant courts and Giving Workers the Treatment: if you raise a stink, you go to a shrink!

Incidence of PTSD and Complex PTSD

The number of people suffering PTSD is unknown but David Kinchin estimates in his book Post Traumatic Stress Disorder: the invisible injury that at any time around 1% of the population are experiencing PTSD. This figure is only for PTSD resulting from traditional causes such as accident, violence or disaster.

The incidence of Complex PTSD is unknown; with estimates of the number of people being bullied at work in the UK ranging from 1 in 8 (IPD, November 1996) to 1 in 2 (Staffordshire University Business School, 1994), the figure could be as high as 14 million – or more. The silent suffering is considerable; symptoms prevent sufferers from realising their potential and contributing fully to society. Many sufferers are claiming benefit, often reluctantly, as people who suffer Complex PTSD are often hard working and industrious prior to their injury. Anyone who is on benefit and unable to work is also not paying tax and national insurance.

Within some groups of society, the incidence of PTSD must be expected to be much higher than one per cent. Within the emergency services (fire, police and ambulance) and the armed forces (army, navy and air force) the incidence of PTSD can be as high as 15 per cent. It is a disturbing probability that out of every hundred police officers currently engaged in uniformed patrol duties in our towns and cities, fifteen will be suffering from symptoms in accord with PTSD.
David Kinchin, Author, Post Traumatic Stress Disorder

Stress

Stress is on everybody’s minds these days. However, whilst almost everyone seems to feel “stressed”, most people are unaware that stress comes in two forms: positive and negative.

Positive stress (what Abraham Maslow calls eustress) is the result of good management and excellent leadership where everyone works hard, is kept informed and involved, and – importantly – is valued and supported. People feel in control.

Negative stress (what Maslow calls distress) is the result of a bullying climate where threat and coercion substitute for non-existent management skills. When people use the word “stress” on its own, they usually mean “negative stress”.

I define stress as “the degree to which one feels, perceives or believes one is not in control of one’s circumstances”. Control – or people’s perception of being in control – seems to be key to susceptibility to experiencing PTSD.

The UK, and much of the Western world, adopts a blame-the-victim mentality as a way of avoiding having to deal with difficult issues. When dealing with stress it is essential to identify the cause of stress and work to reduce or eliminate the cause. Sending employees on stress management courses may sound good on paper but coercing people to endure more stress without addressing the cause is going to result in further psychiatric injury.

Stress is not the employee’s inability to cope with excessive workload and excessive demands but a consequence of the employer’s failure to provide a safe system of work as required by the Health and Safety at Work Act 1974.

Stress is known to cause brain damage. Dr John T O’Brien, consultant in old-age psychiatry at Newcastle General Hospital, published a paper in March 1997 entitled “The glucocorticoid cascade hypothesis in man” (and presumably woman), helpfully subtitled “Prolonged stress may cause permanent brain damage”.
If Dr O’Brien’s research proves correct, then employers who encourage stressful regimes comprising long hours, threat and coercion might soon find themselves on the wrong end of a string of expensive personal injury lawsuits.

Further discussion of stress is on the health page.


Understanding and recovering from Post Traumatic Stress Disorder (PTSD)

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Post Traumatic Stress Disorder
The invisible injury, 2005 edition

by
David Kinchin

ISBN 0952912147
Published by Success Unlimited 2004
Paperback, 16 chapters, 224 pages, resources, index
Click book cover (left) for more information

“This is the book I so badly wanted when I was traumatised.”
David Kinchin, Author

Few people realise that trauma and psychiatric injury can be more devastating and long-lasting than physical injury. Traumatic events strike unexpectedly turning everyday experiences upside-down and destroying the belief that ‘it could never happen to me’.

PTSD is a natural emotional reaction to a deeply shocking and disturbing experience after which it can be difficult to believe that life will ever be the same again. The symptoms are surprisingly common and include sleep problems, nightmares and waking early, flashbacks and replays, impaired memory, inability to concentrate, hypervigilance (feels like but isnot paranoia), jumpiness and an exaggerated startle response, fragility and hypersensitivity, detachment and avoidance behaviours, depression, irritability, violent outbursts, joint and muscle pains, panic attacks, fatigue, low self-esteem, feelings of nervousness and undue anxiety. Survivors endure abnormal feelings of guilt, perhaps for having survived when those around them didn’t.

Untreated, PTSD symptoms can last a lifetime, impairing health, damaging relationships and preventing people achieving their potential. Sufferers often find that knowledge and treatment of PTSD (and especially Complex PTSD) is difficult to obtain. However, prospects for recovery are good when you have the right counsel and are in the company of fellow survivors and those with genuine insight, empathy and experience.

Now in its fourth edition, Post Traumatic Stress Disorder: the invisible injury furnishes PTSD sufferers (and their carers, families and professionals) with knowledge, belief and advice to hasten recovery, re-establish relationships and enable people to once more find meaning, purpose and pleasure in life.

Post Traumatic Stress Disorder: the invisible injury is a reassuring and sensitively-written book which validates, explains and relieves the silent unseen psychological suffering of trauma and is essential reading for survivors of accident, disaster, violence, rape, bullying, physical abuse, sexual abuse, crime, abduction, kidnap, terrorism, war, torture, bereavement, trauma, and those witnessing such events. Their rescuers, relatives, families, carers, counsellors and therapists will also gain insight into the suffering endured by their loved ones or clients.

This book provides a unique insight for anyone working in the areas of healthcare, social work, employment, personnel and HR, legal services, research and victim support as well as those in the emergency services, uniformed services, rescue services, critical incident debriefing and traumatic incident reduction.

Anyone suffering unusual levels of stress and anxiety will also find relief in this clear and enlightening text, as will those with an interest in stress, psychiatric injury, and the Disability Discrimination Act.

David Kinchin’s Post Traumatic Stress Disorder: the invisible injury, 2004 edition is a revised and updated edition of Post Traumatic Stress Disorder: a practical guide to recoverypublished by Thorsons in 1994 and the republished edition Post Traumatic Stress Disorder: the invisible injury, published by Success Unlimited in 1998 and 2001.

Order a copy:
Online with secure credit card ordering
By fax or letter with printed order form


How bullying and harassment at school cause psychiatric injury, trauma, PTSD, and suicide

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Death at playtime

An exposé of child suicide caused by bullying
by
Neil Marr and Tim Field
Introduction by Jo Brand
ISBN 0952912120
Published by Success Unlimited in January 2001
Paperback, 18 chapters, 320 pages, 30 b/w pictures, resources, index
Click book cover (left) for more details

“An excellent book.”
Times Education Supplement, May 2001
“Require reading in every LEA [Local Education Authority] in the UK.”
Yorkshire Evening Post, March 2001

Using a blend of powerful testimony, moving narrative, insightful analysis and practical advice, Bullycide: death at playtime reveals the full and long-lasting extent of the psychiatric injury caused by bullying at school and in childhood. Contains new interviews with bereaved families, survivors and people who have overcome the trauma of bullying at school to succeed in life – sometimes spectacularly. Includes initiatives to combat bullying, helplines, organisations, suggested reading and web sites.

More reviews and reader feedback

Order a copy:
Online with secure credit card ordering
By fax or letter with printed order form


Identifying and dealing with workplace bullying, harassment and injury to health

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Bully in sight
How to predict, resist, challenge and combat workplace bullying
Overcoming the silence and denial by which abuse thrives

by Tim Field
Foreword by Diana Lamplugh OBE
ISBN 0952912104
Published by Success Unlimited 1996, reprinted 1998, 1999 and 2001
Paperback, 16 chapters, 384 pages, resources, index
Click book cover (left) for more details

“Thank you for writing Bully in sight … it’s like a torch in the darkness.”

“I have been through a horrendous 6 years, and for the last 2 years your website and book have been my lifeline. Your insight into the bully’s behaviour is incredible. You deserve all the praise you get and more! I am still battling but I know now that I am right and the bullies are wrong.”

More readers’ feedback and comments.

Bully in sight identifies bullying as the common denominator of harassment, discrimination, prejudice, abuse, conflict and violence, and describes the principal perpetrator of psychological violence, the serial bully.Bully in sight is one of the first books to describe psychiatric injury and Post Traumatic Stress Disorder resulting from long-term bullying.

Written with the experience and insight only a fellow experiencer can impart, Bully in sight validates the experience of bullying when everyone else is trying to ignore or deny it.

Packed with insight, ideas, guidance and direction, plus sources of help and suggested reading.

Order a signed copy:
Online with secure credit card ordering
By fax or letter with printed order form


Further reading on psychiatric injury

Post Traumatic Stress Disorder: the invisible injury, 2005 edition, David Kinchin, Success Unlimited, 2004, ISBN 0952912147

Supporting Children with Post-traumatic Stress Disorder: a practical guide for teachers and professionals, David Kinchin and Erica Brown, David Fulton Publishers, £12.00, ISBN 1853467278

Stress and employer liability, Earnshaw & Cooper, IPD, 1996, £16.95, ISBN 0852926154 (updated edition in preparation)

Why zebras don’t get ulcers: an updated guide to stress, stress-related diseases, and coping, Robert M Sapolsky, Freeman, 1998, ISBN 0716732106

The Body Bears the Burden: Trauma, Dissociation and Disease, Robert C Scaer, MD, The Haworth Medical Press, NY, ISBN 0789012464

Recovering damages for psychiatric injury, M Napier & K Wheat, Blackstone Press, £19.95, ISBN 1854313525

Understanding stress breakdown, Dr William Wilkie, Millennium Books, 1995

Understanding stress, V Sutherland & C Cooper, Chapman and Hall

Trauma and transformation: growing in the aftermath of suffering, R Tedeschi & L Calhoun, Sage, 1996

The Railway Man, Eric Lomax, Vintage, 1996, ISBN 0099582317 (a poignant story of undiagnosed PTSD from World War II)


Bookshops and services

The Oxford Stress and Trauma Centre bookshop

The Inner Bookshop, 111 Magdalen Road, Oxford OX4 1RQ: mind, body, spirit, esoteric, holistic, paranormal, contact experience etc.


Articles

European Journal of Work and Organizational Psychology (EJWOP), 1996, 5(2), whole issue devoted to bullying and its effects, including PTSD. Published by Psychology Press, 27 Church Road, Hove, East Sussex BN3 2FA, UK.

British Journal of Psychiatry, (1997), 170, 199-201, The ‘glucocorticoid cascade’ hypothesis in man: prolonged stress may cause permanent brain damage, Dr John T O’Brien MRCPsych, Department of Psychiatry and Institute for the Health of the Elderly, University of Newcastle.

Cortisol – keeping a dangerous hormone in check, David Tuttle, LE Magazine July 2004

T cells divide and rule in Gulf War syndrome (and asthma, TB, cancer, ME), Jenny Bryan, Immunology section in The Biologist, (1997) 44 (5)

Traumatic stress under-recognised
5% of males and 10% of females will develop PTSD in their lifetime says the National Institute for Clinical Excellence (NICE): http://news.bbc.co.uk/1/hi/health/4373367.stm


Seminars and workshops

David Kinchin’s own web page and PTSD workshops


Links

The late Professor Heinz Leymann was one of the world’s pioneers and foremost authorities on mobbing (bullying) and PTSD, with over a decade of experience. His web site is essential reading for anyone studying the effects of bullying on health.

David Kinchin, author of Post traumatic Stress Disorder: the invisible injury, 2004 edition

BBC News Online: bullying at school causes PTSD, name calling and verbal abuse worse than physical bullying

Ex-soldier Michael New wins £620,000 damages for PTSD: http://news.bbc.co.uk/1/hi/wales/4725455.stm

US soldiers return from Iraq with PTSD: http://news.bbc.co.uk/1/hi/world/americas/4474715.stm

Untreated PTSD may mean a lifetime of impoverished physical health including heart disease and cancer: http://news.bbc.co.uk/1/hi/health/4179602.stm

Bullied workers suffer ‘battle stress’ and show the same symptoms of armed forces personnel who have been engaged in war: http://news.bbc.co.uk/1/hi/business/3563450.stm

National Center for PTSD factsheets:

Complex PTSD – recommended.

Coping with PTSD and Recommended Lifestyle Changes for PTSD Patients: http://www.ncptsd.org/facts/treatment/fs_coping.html

Anger and trauma: http://www.ncptsd.org/facts/specific/fs_anger.html

You can join the NCPTSD mailing list to be alerted to updates on PTSD information at their site.

Post Traumatic Stress Disorder diagnostic criteria and self-diagnosis at Internet Mental Health.

Helpguide for Post-traumatic Stress Disorder (PTSD): Symptoms, Types and Treatment

High percentage of youth in the USA report symptoms of Post Traumatic Stress and other disorders; study involving 4,023 adolescents finds that exposure to interpersonal violence (including bullying) increases the risk for PTSD.

PTSD Public Service Announcement Website

Patience Press aims to ensure that other people never have to be alone with the pain of PTSD, struggling to heal without help or support.

The Traumatic Stress Clinic in London has good online information about PTSD.

UK Trauma Group web site.

Contact information about local specialist resources in the UK offering advice about the assessment or treatment of people with psychological reactions to major traumatic events.

NICE guidelines for PTSD: http://www.nice.org.uk/page.aspx?o=248505

Traumatic Incident Reduction – the web site of Gerald D French.

Hospital Anxiety and Depression Scale (HADS): a simple, standardised self-assessment questionnaire for measuring the severity of anxiety and depression.

CODT – Cooperative Online Dictionary of Trauma, a dictionary of trauma terms:

The National Institute for Clinical Excellence (NICE) page on Post Traumatic Stress Disorder (PTSD).

For some time the American Psychological Association (APA) has been looking at the traumatic effects of psychological violence

American Psychiatric Association (APA) public information on Posttraumatic Stress Disorder

Dave Baldwin’s site at http://www.trauma-pages.com/ contains comprehensive links.

A Valuable Stress Information Resource Website

Stress Spot is a stress information resource with links to Post Traumatic Stress Disorder web sites.

The Panic Center.

Brain Injury Resource Center page on Post Traumatic Stress Disorder

The Trauma Center in Alston, Massachusetts. The Medical Director of the Trauma Center is Dr Bessel van der Kolk.

Trauma in the Family by Family Trauma Group Centre.

Partners with PTSD by Frank Ochberg, M.D.

The trauma of betrayal

Why a broken heart hurts so much; social rejection may affect your brain as much as physical pain

Legal Abuse Syndrome: how the courts and legal system may cause Post Traumatic Stress Disorder

Essentials for litigating Post Traumatic Stress Disorder (PTSD) claims: http://www.lawandpsychiatry.com/html/Litigating%20PTSD%20Claims%20-%20Final.pdf

Pre-action protocol for disease/illness claims: http://www.apil.com/pdf/publicdocs/DISEASE_PROTOCOL_approved_version.pdf

Descriptions of Post Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD).

Gift From Within is a private, non-profit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals.

TACT is the UK Trauma After Care Trust.

Regular verbal abuse more damaging than physical assault: research from Warwick University, England.

Articles from Psychology Today: When Disaster Strikes by Hara Estroff Marano, Recovering From Trauma andLife Lessons by Ellen McGrath Ph.D., plus Trauma Do’s and Don’ts

“A Guide to Anxiety Disorders” – http://www.datehookup.com/content-a-guide-to-anxiety-disorders.htm has a concise compilation of information on a variety of common anxiety disorders

Trauma is covered on the Mental Health Network at http://www.mhnet.org/guide/trauma.htm

The Healing Centre Online is at http://www.healing-arts.org/

Ask the Internet Therapist

Institute of Psychiatry library listing on traumatic stress.

The International Society for Traumatic Stress Studies (ISTSS) has a comprehensive web site on various aspects of trauma and its causes.

The European Society for Traumatic Stress Studies (ESTSS) web site.

The Invisible Epidemic: Post-Traumatic Stress Disorder, Memory and the Brain by J. Douglas Bremner, M.D.

Information for for ex-servicemen & servicewomen who think they are suffering from PTSD.

A glossary of trauma terms

PTSD and dissociation

Information on Falsification of Type (Dr Carl Gustav Jung’s description for an individual whose most developed and/or used skills were outside one’s area of greatest natural preference) and PASS (Prolonged Adaption Stress Syndrome) is at http://www.benziger.org/pass.html

Rebecca Coffey’s PTSD bibliography at http://www.sover.net/~schwcof/ptsd.html

Canadian Traumatic Stress Network page at http://play.psych.mun.ca/~dhart/trauma_net/index.html and the useful web connections page athttp://play.psych.mun.ca/~dhart/trauma_net/useful.html

Australian Trauma Web is at http://www.psy.uq.edu.au/PTSD

Links to PTSD and PTSD-related sites are at http://www.ptsd.com/

Gillian Kelly, barrister at law, looks at the development of Post Traumatic Stress Disorder and the legal recognition thereof on her web site athttp://www.telecoms.net/law/index.html

Hope E. Morrow’s Trauma Central contains a large collection of links to online articles on trauma and related subjects.

Risk Factors in PTSD and Related Disorders: Theoretical, Treatment, and Research Implications, Anne M Dietrich MA, Doctoral Candidate, University of British Columbia, Canada

See the ability, not the disability list of PTSD links

If your health has suffered but those around you cannot or will not see your hurt, see Why Seeing Is Not Believing When Dealing With A Chronic Illness

PTSD may be a flaw in the way the brain is designed: http://www.mhsanctuary.com/ptsd/ineng.htm

The Highly Sensitive Person (HSP): http://www.artdsm.com/hsp/


Copyright © Tim Field 1996-2005. Information on this site may be reproduced freely for non-commercial purposes – please acknowledge the source by quoting the web site address ptsd.htm

The views on this web site are those of Tim Field and result from personal experience of being bullied out of his job and experiencing a stress breakdown caused by the bullying, thereafter setting up and running theUK National Workplace Bullying Advice Line since January 1996 and Bully OnLine since 1997, and liaising with over 10,000 cases of bullying. I believe this to be the largest number of targets of workplace bullying that any one person has ever dealt with. I am not a mental health professional. Whilst every effort has been made to ensure accuracy, no responsibility can be accepted. In all matters, consult a qualified competent professional.

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Stress, injury to health, trauma and PTSD
How bullying, harassment and abuse damage health and cause trauma
Stress, trauma and PTSD Home Page
The cause of stress revealed
Stress at work, injury to health, fatigue, depression, suicide
PTSD (Post Traumatic Stress Disorder) and Complex PTSD
Bullying, stress and self-harm |Stress and debility
Bullying and suicide | Cases of suicide caused by bullying
Bullying shame | Bullying fear | Bullying embarrassment |Bullying guilt
Bullying and denial |Trauma | Shell shock: PTSD in WW1
David Kinchin’s book Post Traumatic Stress Disorder: the invisible injury
validates and relieves the silent unseen suffering of trauma

Profile of David Kinchin |PTSD workshops by David Kinchin
Neil Marr and Tim Field’s book Bullycide: death at playtime reveals the
secret toll of children who attempt or commit suicide because of bullying

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Beyond the Schoolyard: Workplace Bullying

quote-to-be-able-to-destroy-with-good-conscience-to-be-able-to-behave-badly-and-call-your-bad-behavior-aldous-huxley-314332This infographic on workplace bullying was created by International Business Degree Guide to convey the message that workplace bullies not only hurt people, they can also hurt business–driving away good employees in their quest for control.

Adept at dissimulation, those in authority often see what the bully expressly feigns and pretends to be. Under observation by authority the bully hides his true self and often cultivates an image designed to please and impress.

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Veiling truth to those in power protects the bully.  Reports of abuse are disbelieved or ignored; dismissed or minimized as exaggeration; deemed a product of bellyachers and whiners.  In addition to hiding his true self the bully will often tell superiors what they want to hear. The workplace bully promotes an image of loyalty, dedication and hard work to superiors and may even feign common ideals and goals.   This  impression management often works.

When bullying ends in tragedy it is often revealed that those who could and should have done something about it knew about it and did nothing.  This failure to act may be the result of blinkered apathy, willful ignorance and even malicious complicity.  This is especially true when the  political and ideological views of the bully align closely with  those in charge and the victim of bullying is remotely aligned.   Moral superiority, bigotry, racism,  and other biases all too often factor into the equation.

Perhaps those without sufficient empathy of others to take action when reports of abuse and harassment are reported to them will do their jobs if they realize workplace bullying might harm them personally or what they value most.

via Beyond the Schoolyard: Workplace Bullying.

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An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

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—There is no place in science for consensus or opinion, only evidence.-Claude Bernard

Dear Senator Warren,

Thank you for your reply regarding laboratory developed tests (LDTs) and the need for regulatory oversight.   As you mention, LDTs are developed without FDA approval—a pathway in which is not even necessary to prove validity of a test (that it is actually testing what it claims to be testing for) to bring it to market. With no FDA oversight or regulation a commercial lab can claim any validity they want in marketing these tests. The regulation debate has focused on the reliability and validity of a number of clinical tests marketed with unverified claims of accuracy such as prenatal screening and Lyme disease and this lack of oversight is a direct threat to patient safety.

I am sure you would agree with me that the importance of tests diagnostic accuracy is directly proportional to that tests potential to cause patient harm if reported inaccurately.

Sensitivity and specificity are important components of any diagnostic test because there are consequences associated with both false-positive and false negative results.

A test falsely indicating the absence of a condition in someone who truly has it can delay or prevent needed treatment wile a test falsely indicating the presence of a condition in someone who does not truly have it can result in unnecessary testing and treatment.

Incorrect treatment and false labeling of patients can also occur. Therefore diagnostic accuracy is paramount if a test is being used as the basis for further tests and treatment. Any test being used as a basis for further tests or treatment needs to be accurate. It needs to be reliable and valid. Moreover, if the consequences of a test can result in significant patient harm (such as unneeded chemotherapy) it needs to be either 100% accurate or be combined with other tests to confirm the true diagnosis.

 “Forensic” vs. “Clinical” Laboratory Testing

“Forensic” testing differs from “clinical” testing because of the consequences and the process is tightly controlled because false-positive results are unacceptable as the consequences can be grave, far-reaching and even permanent.

Forensic testing demands special handling and safeguards to protect the donor such as validated tests, certified labs, strict chain-of-custody procedures and MRO (Medical Review Officer) review. These safeguards of quality control assure the validity and integrity of the specimen.   The LDT pathway was not designed for forensic tests.

Forensic Laboratory Developed Tests (LDTs)

 Paradoxically, laboratory developed tests with the potential to cause  life-changing and possibly irreparable harm have been absent from the regulatory debate; LDT drug and alcohol tests used for “forensic” monitoring purposes.

A panoply of tests using urine, blood, hair, fingernails breath and saliva have been developed and brought to market since 2003 when the first one was introduced by Gregory Skipper, then Medical Director of the Alabama Physicians Health Program, who “convinced the initial lab in the USA, NMS near Philadelphia to start performing EtG testing.” 1

Developed as an LDT, Skipper and NMS then claimed the alcohol biomarker (which was discovered in the 1950s) “appeared to be 100 percent specific” in detecting covert use of alcohol based on a study he coauthored that involved a mere 35 forensic psychiatric inpatients in Germany, all male. 2   With this “evidence-base” and a not yet published paper in the pipeline,3   Skipper then pitched the test to the Federation of State Medical Boards (FSMB) as an accurate and reliable tool detect covert alcohol use in health care professionals.

Policy Entrepreneurship

In  “Agendas, Alternatives, and Public Policies,”4 John W. Kingdon describes the problem, policy and political streams involved in public policy making.   When these three streams come together a specific problem becomes important on the agenda, policies matching the problem get attention, and then policy change becomes possible.

Kingdon also describes “policy entrepreneurs’ who use their knowledge of the process to further their own policy ends. They ‘lie in wait… with their solutions at hand, waiting for problems to float by to which they can attach their solutions, waiting for a development in the political stream they can use to their advantage.”4

And due to a perfect confluence of streams ( Institute of Medicine report that 44,000 people die each year due to medical error,5 media reports of “impaired physicians,”  the the war-on-drugs, etc.)  the FSMB was swayed into accepting not just the validity but the necessity of using an alcohol biomarker of unknown reliability and validity on doctors referred to or monitored by state Physician Health Programs (PHPs) .

As the national organization that gives guidance to state medical boards through public policy development and recommendations, the individual state medical boards adopted use of the test without critical appraisal and no meaningful opposition.

Shortly after its founding in 1912, the FSMB began publishing a  journal called the Quarterly of the Federation of State Boards of the United States. Now known as the Journal of Medical Regulation, the publication has archived all issues with full articles dating back to 1967 and, as the official journal of the national organization involved in  medical licensing and regulation this facilitates an unskewed and impartial examination of how and when specific issues and problems were presented and who presented them and, in doing so, the “policy entrepreneurship” Kingdon describes can be seen quite clearly. For example a 1995 issue containing articles written by the program directors of PHPs in 8 different states contains an FSMB editorial acknowledging the reported 90% success rate claimed of these programs (in part attributed to the 90-day inpatient treatment programs) that concludes:

“Cooperation and communication between the medical boards and the physician health programs must occur in an effort to protect the public while assisting impaired physicians in their recovery.” 6

No one bothered to examine the methodology of these reports to discern the validity of the claims and it is this acceptance of faith without objective assessment that has allowed the passage of flawed public policy in medical regulation.

Nowhere  is “policy entrepreneurship” more glaringly displayed as it is in a 2004 issue promoting the use of EtG in monitoring doctors as under the same cover is an article identifying both the need7 for such a test and an article providing the solution.8  

“Detection of Alcohol Use in Monitored Aftercare Programs: A National Survey of State Physician Health Programs,” a survey of state Physician Health Programs (PHPs) concludes that “surreptitious alcohol use” is a significant concern” for PHPs, there is no current  “best method” for detection,  but a promising new test  with “exceptional specificity (100 percent) and sensitivity” in detecting small amounts of alcohol for up to 18 hours has recently become available.7

This same issue contains an article authored by Skipper about a new marker “not detectable unless alcohol has been consumed” recently introduced in the United States and now commercially available.”8

Notably absent from both of these articles is Skipper’s role in the commercial availability of the test. This conflict-of-interest is nowhere mentioned in this display of “creating a market then filling it.”

This “regulatory sanctification” of the test implied its tacit approval by the medical profession  (i.e. “if they are using it on doctors it must be valid”) and facilitated its marketing  to other monitoring agencies (nurses, airline pilots) as well as  Courts and Probation Departments where those doing the monitoring had absolute power while those being monitored had no voice.

Bent Science

In Bending Science: How Special Interests Corrupt Public Health Research9, Thomas McGarity and Wendy Wagner describe how special interest groups scheme to advance their own economic or ideological goals by using carefully crafted distorted or “bent” science to influence legal, regulatory and public health policy.  The authors describe how those making these decisions often assume the information that reaches them has been sufficiently vetted by the scientific community as it flows through a pipeline of rigorous peer-review and professional oversight and that the final product that exits the pipeline is unbiased and produced in accordance with the norms and procedures of science.

McGarity and Wagner note the serious and sometimes horrific consequences of bent science and provide examples involving Tobacco and Big Pharma . The authors call for:

“..immediate action to reduce the role that bent science plays in regulatory and judicial decision making” and the need for the scientific community to be involved in “designing and implementing reform.”

“Shedding even a little light on how advocates bend policy -relevant science could go a long way toward remedying these problems.  Indeed, precisely because the advocates have overtaken the law in this area, heightened attention to the social costs of bending science could itself precipitate significant change.”

In the case of EtG this shedding of light is not very hard as no “carefully crafted” studies bending science were used to sway opinion.   None existed. The only items in the pipeline were directly related to Skipper.  If anyone dare to look, the Emperor has no clothes.

Lack of Answerability and Accountability

There are difficulties in challenging bent science including a general lack of recognition of the problem and an absence of counter-studies to oppose deliberately manufactured ends-oriented research.   This has proven true with the myriad LDTs introduced into the marketplace as no counter-forces or competing economic interests producing counter-studies exist.

Multiple lawsuits, including a class-action, have been decided in favor of the labs who have taken a stand-your-ground approach supported by a body of industry-related “research” they or their affiliates produced to support the validity and reliability of the tests.

Those affected by these tests either have no power or have had their power removed. Most do not have the resources to mount a defense let alone produce counter-studies questioning the reliability and validity of the tests.

Most employee drug testing follows Department of Health and Human Services (DHHS) guidelines using FDA-approved tests that have specific cutoff levels defining a positive-result in an effort to eliminate false-positive results.10  Procedural safeguards are in place in these programs to protect the donor.  Forensic testing programs using LDTs provide no such safeguards as the testing is unregulated and there is no oversight from outside actors.

Unlike clinical LDTs “forensic” LDTs are even exempt from CLIA oversight.   The only avenue for complaint is through the College of American Pathologists (CAP) and, as an accrediting agency, they can only address problems by ensuring compliance with CAP guidelines.   If an investigation concludes lab error or misconduct CAP can mandate the lab correct the test result and come into compliance with their guidelines under threat of loss of accreditation but no other consequences exist.  Accountability has been removed yet the  consequences to those harmed by these are significant and without remedy.

State Physician Health Programs

As is the case with the LDTs  they introduced, Physician Health Programs have no oversight or regulation.   A 2013 Audit of the North Carolina PHP 11 prompted by complaints from doctors and performed by State Auditor Beth Woods found absolutely no oversight of the program by either the state medical board or medical society and that “abuse could occur without being detected.”

The Audit also found that doctors were predominantly referred to the same “PHP-approved” out-of-state facilities to which they in part attribute their high success rates in treatment. Interestingly the PHP could not identify what quality indicators or quantitative measurements were used by the PHP to “approve” the “PHP-approved” facilities.

In January of 2015 a Federal class action lawsuit was filed in the Eastern District of Michigan against the state PHP program and found health care providers were subject to the same referral system using these out-of-state facilities. The suit alleges constitutional violations related to the forced medical treatment of health care professionals and the “callous and reckless termination of professional licenses without due process.” 12

As with North Carolina, the Michigan PHP will be unable to provide what quality indicators and quantitative measurements are being used to “qualify” and “approve these facilities.    None exist. The sole indicators for approving these assessment centers are ideological and economic. In fact, the medical directors of most, if not all, of these facilities can be seen on this list of “like-minded docs.” 

Institutional Injustice

You once said “People feel like the system is rigged against them. And here’s the painful part: they’re right. The system is rigged.”

So too is this system.

As the Michigan lawsuit notes: “Unfortunately, a once well-meaning program has turned into a highly punitive and involuntary program where health professionals are forced into extensive and unnecessary substance abuse/dependence treatment under the threat of the arbitrary application of pre-hearing deprivations.”

This has become the rule not the exception. The Federation of State Physician Health Programs (FSPHP), the same group to which Dr. Skipper belongs, has systematically taken over these programs state by state by removing competent and caring doctors not agreeing with the groupthink and silenced them under threat of litigation if they violate their confidentiality agreements and “peer review” statutes.

The same system of coercion, control and abuse exists in Massachusetts.  In the past week alone I have heard from a medical student, a resident and two doctors who complained of misconduct  misconduct involving fraudulent testing and falsified diagnoses.

In “Ethical and Managerial Considerations Regarding State Physician Health Programs,” published in the Journal of Addiction Medicine in 2012, Drs. John Knight, M.D. and J. Wesley Boyd, M.D., PhD who collectively have more than 20 years experience with the Massachusetts Physician Health Program (PHP) state that:

“Because PHP practices are unknown to most physicians before becoming a client of the PHP, many PHPs operate out- side the scrutiny of the medical community at large. Physicians referred to PHPs are often compromised to some degree, have very little power, and are, therefore, not in a position to voice what might be legitimate objections to a PHP’s practices.”13

Noting that “for most physicians, participation in a PHP evaluation is coercive, and once a PHP recommends monitoring, physicians have little choice but to cooperate with any and all recommendations if they wish to continue practicing medicine,” Knight and Boyd raise serious ethical and managerial questions about current PHP policies and practice including conflicts of interest in referrals for evaluation and treatment, lack of adherence to standards of care for forensic testing of substances of abuse, violations of ethical guidelines in PHP research, and conflicts of interest with state licensing boards.

Knight and Boyd recommend “the broader medical community begin to reassess PHP’s as a whole” and that “consideration be given toward the implementation of independent ethical oversight and establish and appeals process for PHP clients who feel they are being treated unfairly.” 13

They recommend the relationship between PHP’s and the evaluation and treatment centers and licensing boards be transparent and that national standards be developed “that can be debated by all physicians, not just those who work within PHPs.”13

Accountability, or answerability, is necessary to prevent corruption.  This requires both the provision of information and justification for actions.    What was done and why? Accountability also requires that consequences be imposed on those who engage in misconduct.

In discussing the financial conflicts-of-interest between PHPs and “PHP-approved” assessment centers Knight and Boyd state:

“..if a PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwisetailor its diagnosis and recommendations in a way that will support the PHP’s impression of that physician.”  

To “consciously tailor a diagnosis” is fraud. It is political abuse of psychiatry. And it is not only the assessment and treatment centers willing to “tailor” a diagnosis; so too are the labs involved.

Physician Suicide

I can think of nothing more institutionally unjust than an unregulated zero-tolerance monitoring program with no oversight using unregulated drug and alcohol testing of unknown validity.   But that is what is occurring.   Some of us are trying to expose this corrupt system but barriers exist. As with the Laboratory Developed Tests (LDTs), those involved have intentionally taken steps to remove both answerability and accountability.  Both the tests and the body of individuals administering these tests are notable for their lack of transparency, oversight and regulation.  This renders them a power unto themselves.

Doctors (and others coerced into Professional Health Programs) across the country have reported going to law enforcement and state agencies only to be turned away.   The Federation of State Physician Health Programs (FSPHP)  has convinced these outside agencies that this is a “parochial” issue best handled by the medical profession..   Those reporting crimes are turned back over to the very people committing the crimes.

The Massachusetts Medical Society and Massachusetts DPH claim no oversight of the Massachusetts PHP, PHS.inc. The Massachusetts Board of Registration in Medicine (BORM) will not address ethical or even criminal complaints about the doctors involved in the PHP and there is good evidence that some members of the BORM are in fact complicit in unethical and even criminal behavior. As the Massachusetts AGO represents the BORM they defer issues back to them and dig no deeper.

Drs. Knight and Boyd have suggested State Audits and we are hoping that MA State Auditor Suzanne Bump will investigate the MA PHP and the Board of Registration in Medicine’s Physician Health and Compliance Unit shortly.

One major problem is that barriers have been put in place to prevent information from getting to the right people.

The majority of people at medical societies, boards, departments of public health and other organizations are individuals of integrity and honesty but the system has been erected so that valid complaints are deflected, delayed, dismissed or otherwise tabled by sympathizers, apologists and those complicity.   The criminal activity the Massachusetts PHP is engaging in is undeniable and indefensible but who is going to hold them to account?

It is going to take a while to reform this system of institutional abuse and it has to be done state by state. Please take a look at the facts and documentary evidence and help me hold them accountable. This needs to be exposed, acknowledged and addressed.   Doctors are dying from this system of institutional abuse. It is a public health emergency no one is talking about.  Yet those behind the PHP programs are claiming this system of coercion, abuse and control is the “gold standard” of addiction treatment and, using another loophole, they want to expand this system to mainstream healthcare.

Sincerely,

Michael L. Langan, M.D.

  1. Skipper G. Exploring the Reliability, Frequency, and Methods of Drug Testing: What is Enough to Ensure Compliance?:   Alcohol Markers and Devices. 2013; http://www.fsphp.org/Skipper, Exploring the Reliability Frequency and Methods 2 Presentation.pdf.
  2. Wurst FM, Vogel R, Jachau K, et al. Ethyl glucuronide discloses recent covert alcohol use not detected by standard testing in forensic psychiatric inpatients. Alcoholism, clinical and experimental research. Mar 2003;27(3):471-476.
  3. Skipper GE, Weinmann W, Thierauf A, et al. Ethyl glucuronide: a biomarker to identify alcohol use by health professionals recovering from substance use disorders. Alcohol Alcohol. Sep-Oct 2004;39(5):445-449.
  4. Kingdon JW. Agendas, alternatives, and public policies. Updated 2nd ed. Boston: Longman; 2011.
  5. Leape LL. Institute of Medicine medical error figures are not exaggerated. JAMA : the journal of the American Medical Association. Jul 5 2000;284(1):95-97.
  6. Schneidman B. The Philosophy of Rehabilitation for Impaired Physicians. The Federal Bulletin: The Journal of Medical Licensure and Discipline. 1995;82(3):125-127.
  7. Jansen M, Bell LB, Sucher MA, Stoehr JD. Detection of Alcohol Use in Monitored Aftercare Programs: A National Survey of State Physician Health Programs. Journal of Medical Licensure and Discipline. 2004;90(2):8-13
  8. Skipper G, Weinmann W, Wurst F. Ethylglucuronide (EtG): A New Marker to Detect Alcohol Use in Recovering Physicians. Journal of Medical Licensure and Discipline. 2004;90(2):14-17.
  9. McGarity TO, Wagner WE. Bending Science: How Special Interests Corrupt Public Health Research. Cambridge, MA: Harvard University Press; 2008.
  10. US Department of Health and Human Services. Mandatory guidelines and proposed revisions to mandatory guidelines for federal workplace drug testing programs: notices. Federal Register. April 13, 2004;69(71):19659-19660.
  11. Wood B. State of North Carolina Performance Audit North Carolina Physicians Health Program. . http://www.ncauditor.net/EPSWeb/Reports/Performance/PER-2013-8141.pdf. Accessed March 17, 2015.
  12. U.S. District Court Eastern District of Michigan, Case No: 2:15-cv-10337-AJT-RSW (2015). Carole Lucas, R.N., Tara Vialpandno, R.N., Scott Sanders, R.N., Kelly Schultz, P.A., and all other similarly situated health professionals v. Michigan Department of Licensing and Regulatory Affairs, Carole Engel, J.D.Former Director of Michigan Bureau of Health Professions, Ulliance, Inc. (State Contractor), Carolyn Batchelor (HPRP Contract Administrator), Stephen Batchelor (HPRP Contract Administrator), and Nikki Jones, LMSW.   Filed January 30, 2015.
  13. Boyd JW, Knight JR. Ethical and managerial considerations regarding state physician health programs. Journal of addiction medicine. Dec 2012;6(4):243-246.

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Letters From Those Abused and Afraid

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Letters From Those Abused and Afraid.

Please sign Petition.

I get many e-mails, letters and phone calls from doctors, nurses and others who have been abused by  “professional health programs” (PHPs).  Most do not want their letters published for fear of being identified and punished by the PHP.   They are reluctant to do so even with their names and states removed as they feel their complaints alone could reveal their identity to they prying eyes of the PHP.   A few have allowed their letters to be posted and I am doing so here:    Letters From Those Abused and Afraid

I am posting Dr. Roop’s  letter below at his request.  He specifically stated his name and contact information be included. I applaud his courage.   As was the case with the Inquisition, this is system  that relies, above all else,  on secrecy and silence.

Effective “Impression management” requires both promoting positive information and suppressing negative information.

The “PHP-blueprint” has been effectively propagandized via a back-slapping parade of congratulatory misinformation; a promotional campaign that includes exaggeration of the existence and dangers of the doctors they target as well as their inflated abilities and success in “helping” these doctors and protecting the public.   Aimed at the legal, regulatory, and administrative arenas of medicine as well as the the general public, the PHP moral crusade has flourished without any meaningful opposition.

 Suppression of negative information is necessary and  involves both removal  ( comments critical of PHPs are rapidly removed as spam) and prevention.   One way of preventing negative information is by silencing critics.  Those enrolled in PHP programs who speak out often suffer “swift and certain consequences” and this effectively silences the rest.

 In reality  If more people like Dr. Roop spoke up this abusive system of coercion, control and corruption could easily be identified, exposed and reformed.

Sunshine is the best disinfectant.

The stories are the same and these patterns must be recognized.

Doctors  are vulnerable to medical abuse, just like any other patient.  Their knowledge of medicine and the medical system, means that they question, as they should, the validity and appropriateness of any treatment.   It has long been proven that patients that question their doctor’s decisions and the quality of the care provided to them, fare better and have better outcomes and are less subject to medical error or medical fraud.

The Physicians Health Program is based on a flawed philosophy that Doctors must be beaten down, forced to be submissive and obedient to PHP authority who intimidate and control, deny access to services, impose punishments, and even create criminal records with impunity and immunity.

This not quality care for anyone. It is abuse.  The PHP paradigm is just another  example of how false constructs come to to be regarded as irrefutable truth.

Once in the clutches of a  PHP a doctor is told – obey us, or lose your license, your hospital privileges, your credit rating, your good reputation – obey us no matter what we tell you to do.

 If you stand up to them, they take you down, very publicly and humiliate you, and destroy your career and good name.  Then no other doctor who saw the retaliation that happened to you is willing to buck the PHP system.  It is essentially extortion.

Dr. Janet Parker, a a human rights and disability advocate has  personal knowledge of doctors forced into the Washington PHP program Dr. Roop speaks of below.

These doctors told her that they had a plan to kill themselves if a PHP  “peer counselor” came anywhere near them –  they meant it.

3 doctors in the Washington PHP did commit suicide during the period of time when she was interviewing the WPHP referred doctors.   Last year a doctor I went to high school with and have known since childhood hanged himself due to the abuses of the Washington PHP.  HIs crime?  He was pulled over for speeding five years prior after having a few drinks at a social function.  He was given a breathalyzer and blew just over the legal limit–his entry ticket into the system Dr. Roop describes below.   As is often the case, he was given a positive alcohol biomarker just as he was about to complete the five-year PHP contract  This results in re-assessment at a “PHP-approved” facility, a new contract with the PHP and another five-years of drug and alcohol testing  all paid for out of-pocket.

And this is a national problem–three doctors being monitored by the Oklahoma state PHP killed themselves during a one month period (August 2014).

There is no evidential standard used and false accusations and even forged documents are routinely used against the targeted doctor.   Physicians are ill prepared for such criminal tactics used against them,  by the time they realize it is happening, it is too late to stop the inevitable process that threatens their medical license.  This is very emotionally traumatic to doctors who have always excelled in their schooling, worked hard to get where they are, and are facing the loss of not only their professional careers but also financial security, their self esteem and self concept.


Name: Jonathan Crane Roop MD

Email: jonathanroop@hotmail.com

Comment: I am Board Certified in Internal medicine. I have endured years of emotional, psychological and spiritual abuse at the hands of the Washington Physician’s Health Program. I have suffered through a long list of injustices without recourse. They include, but are not limited to discrimination, abuse of power, breach of contract and repeated and WILLFUL medical negligence. 

Because the actions of the WPHP have been SO egregious, I assumed what was happening to me must be extraordinarily rare.

I have nothing to hide. And I have shared my story with any and all who would listen. To date, my voice, my rights and now my life have been dismissed as unimportant. MY LIFE!! It’s apparently better that I die than my tormentors be questioned and compelled to defend their indefensible and evil behavior. 

I am meeting with one last attorney tomorrow. I fully expect him to ignore the basic, indisputable and well documented facts of my case. Namely, there is massive and systematic malfeasance being committed by a tax payer funded agency in the State of Washington who act with omnipotence and without oversight. I have no reason to believe he will respond any differently than the others with whom I have met. HE WON’T CARE! HE WILL NOT BE MOVED. He will make statements that suggest I DESERVE this treatment. And that my life, as well as my imminent death, is unworthy of his time or efforts.

Once my assumptions about this last meeting are officially confirmed, I am committed to the only course of action available to me. The only thing which will put an end to this nightmare.

Today I stumbled upon your website. And today, for the first time, I have learned that my case is not rare. I suspect the other physician victims in this matter have occasionally allowed themselves to dream wistfully of justice. Justice which they have seen thwarted at every turn. Perhaps they, like me, have dreamily imagined the relief and joy and LIFE they would experience if the truth were simply presented and the perpetrators held accountable. I have imagined standing up in court and triumphantly affecting justice for myself as well as all of the other current and future victims. I deliver a powerful defense of justice. My ‘dream speech’. I have imagined that I might still live. And then I wake up. 

And so today, imagine my shock, when I found my ‘dream speech’ here. My speech. Reasonable. Honest. Consistent. And based firmly in truth, justice and defense of the powerless against the (arbitrarily) powerful. My speech, it seemed, but authored by another.

Thank you, Dr. Langan.  You have given a voice to my struggles. Please never stop speaking for me, and people like me, many of whom, I fear, will not survive to see justice. 

Despite my intention to die, I actually WANT TO LIVE! And I will live and fight on if I ever believe that there is even a small chance of justice for me and the other innocent victims of PHP’s and the ‘treatment’ centers with whom they contract (Talbott in my case. Purely evil and loathsome human beings, for the record).

So, because I do WANT to live…PLEASE HELP ME, SIR!

Can you refer me to attorneys, individuals or groups who might advocate for me and the other victims? Do you have any specific words of hope or encouragement?

Please note my name. Please add me to the list of innocent victims of these power hungry, narcissistic BULLIES.

I don’t expect to live through this. And in a way, the PHP, Talbott and the addiction ‘experts’ with whom I have been tragically acquainted are correct…My life is worth very little. But this issue is so much larger than I. I can die with some serenity if I believe there will be meaningful justice for others like me. And that those responsible will be held to account. 

Thank you Dr. Langan. Thanks to all of those involved in the creation and maintenance of this website. Although your shining beacon is barely perceivable through the darkness of injustice which surrounds and seeks to extinguish it…it is the only glimmer of hope I have found during my slow death by PHP.

Jonathan Crane Roop MD

811 S Cowley St #48

Spokane WA 99202

509-710-4641

Beyond the Schoolyard: Workplace Bullying

Screen Shot 2015-06-08 at 1.47.25 PMThis infographic on workplace bullying was created by International Business Degree Guide to convey the message that workplace bullies not only hurt people, they can also hurt business–driving away good employees in their quest for control.

Adept at dissimulation, those in authority often see what the bully expressly feigns and pretends to be. Under observation by authority the bully hides his true self and often cultivates an image designed to please and impress.

Veiling truth to those in power protects the bully.  Reports of abuse are disbelieved or ignored; dismissed or minimized as exaggeration; deemed a product of bellyachers and whiners.  In addition to hiding his true self the bully will often tell superiors what they want to hear. The workplace bully promotes an image of loyalty, dedication and hard work to superiors and may even feign common ideals and goals.   This  impression management often works.

quote-to-be-able-to-destroy-with-good-conscience-to-be-able-to-behave-badly-and-call-your-bad-behavior-aldous-huxley-314332When bullying ends in tragedy it is often revealed that those who could and should have done something about it knew about it and did nothing.  This failure to act may be the result of blinkered apathy, willful ignorance and even malicious complicity.  This is especially true when the  political and ideological views of the bully align closely with  those in charge and the victim of bullying is remotely aligned.   Moral superiority, bigotry, racism,  and other biases all too often factor into the equation.

Perhaps those without sufficient empathy of others to take action when reports of abuse and harassment are reported to them will do their jobs if they realize workplace bullying might harm them personally or what they value most.

via Beyond the Schoolyard: Workplace Bullying.

Beyond the Schoolyard: Workplace Bullying

WorkplaceBullies

Share this infographic on your site!

Beyond the Schoolyard: Workplace Bullying

Not only do workplace bullies hurt people, they can also hurt business – driving away good employees in their quest for control. What can you do if you find yourself having to face a bully every day?

Not All That Different …

Schoolyard bullies vs. workplace bullies
Both share a need for control – exercising power through humiliation of a target. If reinforced by cheering kids, fearful teachers or ignoring administrators, there is no reason to change and it often continues into adulthood. (1)

What Is a Workplace Bully?

Characteristics of a workplace bully: (2)

  • Tormenters
  • Tattlers
  • Finger pointers
  • Publicly pick on people
  • CC the whole world in emails
  • Point out your mistakes and tell everyone

Narcissism and self-orientation

What workplace bullies usually score high on in personality tests (3)

Bullying Victims

How many workers are dealing with bullies?
50%
Workers who say they’re treated rudely at least once a week (in 2011); up from 25% in 1998 (4)
66%

Bullying victims who had to lose or give up their jobs to make the bullying stop (1)
40% of workplace bullies are women, picking on other women more than 70% of the time. (5)

How Bullying Can Hurt Your Business

Work is stressful enough on its own, but adding a bully to the mix can make it unbearable.
9% of people say they’re happy at the office. (3)
Less than 1/3
Employees who say they’re engaged at work (3)

Workplace bullying can have serious negative effects on employees, such as: (6)

  • Stress
  • Absenteeism and low productivity
  • Lowered self-esteem and depression
  • Anxiety
  • Digestive upset
  • High blood pressure
  • Insomnia
  • Trouble with relationships due to stress over work

All of this can hit the company’s bottom line, causing: (6)

  • High turnover
  • Low productivity
  • Lost innovations
  • Difficulty hiring quality employees due a “hostile work environment” reputation

Got a Bully? Here’s How to Deal

Avoid the workplace in the first place (1)

  • Ask why the job is open and how long the predecessor was there (turnover is a bullying sign)
  • Ask about the attitude toward “workaholics.” If it’s expected, then you can know what you’re getting into
  • Ask about policies and codes that help ensure a respectful workplace

Once you encounter a bully (5)

  • Don’t get emotional (bullies like that)
  • Don’t blame yourself (the problem is the bully, not you)
  • Do your best work
  • Build a support network
  • Document everything
  • Seek help
  • Get counseling
  • Stay healthy
  • Educate yourself about policies
  • Don’t expect to change the bully
  • Start a new job search

25% of workplace bullying deals with discrimination. If that’s the case, you can talk to an attorney. (7)

Don’t hire a bully
Recognize certain traits in an interview process: They usually interview well due to a desire to control the situation. Invite them to an informal lunch and see if they’re empathetic (good) or brag about “cracking the whip” (bad). (8)

Workplace Bullies

Sources:

1. http://www.workplacebullying.org
2. http://www.forbes.com
3. http://www.usatoday.com
4. http://hbr.org
5. http://www.huffingtonpost.com
6. http://www.bullyingstatistics.org
7. http://www.ivillage.com
8. http://www.ere.net

Rantings from the Bully Pulpit

 

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The three e-mails below were received within a twenty-four hour period from a physician supporting (and in all likelihood involved in) drug courts and physician health programs (PHPs).  E-mails such as this are invariably anonymous and I usually drag them right to the trash where they belong  but the trio below provides valuable insight into the mentality of those involved.  And for that reason I am posting them as they were received.

Under the nom de plume of “TT Wilson” the author presents non-sequitur and fallacious logic to promote drug courts, PHPs and the sanctification of an illegitimate  and irrational medical specialty.

He presents either/or logical fallacy and  false dichotomy.  You are either with us or against us!  He appeals to professionalism yet his words show he has no  inkling of the true definition, resorts to simple-minded cliches and meaningless platitudes and then sinks into ad hominem attacks on my blog and then me.

Ironically he accuses me me of ranting in a rant!

He is a prototypical example of the sham-artist physicians typically involved in these programs–an authoritarian paternalistic know-it-all who can only rant under the shield of gang-stalking power or a shroud of absolute anonymity.

As I have said time-and-time again if any factual errors exist in my blog I will not only remove them but remove my blog.

So I am going to make this offer to “TT Wilson”–if you wish to provide a rebuttal of any of the documentary evidence I provide in my blog herein then do so now.  If you can I will delete the whole kit and kaboodle.  Simple as that.

You Sir are an incompetent and a coward.  If not then prove me wrong. I challenge you to reveal your true identity. Let’s level the playing field a tad on this.  It is easy to present an opinion while cowardly hiding behind a veil of anonymity.  Let’s see if you have the courage to debate this publicly.

I won’t be holding my breath on this one.


 

February 7, 2015 7:45 PM

Comment:  It looks like it is too late already.  The ABAM is closer than ever to becoming a member of the ABMS, there is a big push from the Obama administration to fund addiction treatment and to greatly widen access.  As communities see how well run addiction programs save lives and force crime away from their homes the trend will be very hard to stop.  I agree, PHPs are draconian when they work with physicians thought to have SUDs, but I would rather have them too tough than too lax.  And a sober physician should be OK with that.

February 7, 2015  3:00 PM

Comment: Actually well run drug courts help patients who would have otherwise kept using substances of abuse.  Drug courts are quite dictatorial by design and clearly a defiant patient will defeat even the most caring and competent efforts to help them.  Of course we prefer that the patients be in a stage of change that leaves them open to treatment, but more than a few we’ve helped were not about to change without pressure from the court.

And I stipulated well run drug courts.  There are many incredibly poorly run drug courts.  When a judge doesn’t get it things are just as bad or worse than when the medical team doesn’t get it.  And the studies done are typically dismal.  Very short, small sample size, no standardization.  

As far as impaired physicians are concerned, it is not enough to just stop using and declare innocence.  If a cardinal event has attracted the attention of the medial (sic) board and that board requires participation in treatment to maintain licensure, well that goes with the license.  You can certainly choose not to participate, and the board can then choose to not let you practice.  They do the same thing with physicians with psychiatric issues.  And they encounter a huge amount of denial in this population, I would say more so than the lay population.  At least the denial is louder.

Dictatorial — sure.  Fair — well, no.  But life is not fair.  

As doctors we owe it to our patients to be held to a higher standard.  If someone of authority says I need to be screened, they are most welcome to any fluid or hair sample they require.  Is that fair?  Surely not.  Does that make it bad?  Not at all.

Do you have a better approach?  So far you haven’t demonstrated it in your myriad postings.

As far as ABAM is concerned, have you cried out about the ER boards, Pain Medicine boards, and all of the other boards that have been added to the charter members of the ABMS over the years?  Heck, back in the day a buddy of mine was grandfathered into the board of Plastic Surgery without even taking a test.  He sent them $500 and he was board certified.  Got a really nice certificate too, but it didn’t come with a frame.  Years later they started requiring fellowship training and actually taking a test.

I enjoy your site — clearly there are problems with the way care is being delivered by some individuals in some cases.  Of course that is true of every aspect of medicine.  No one is advocating that we shut down every other aspect of medicine.  Well some are, but that is for another discussion.  

My concern is that your ranting will deter some people away from meaningful treatment, very much like those who seethe against vaccinations lead the unknowing to not treat their children.  If I was cynical I could invoke Darwin here.  Thinning the herd.  

And you might want to get some help with wordpress.  This endless scrolling is distracting.  I was missing a good third of your content.

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February 7. 2015  9:45 PM

Comment: Finally made it to your last entry.  Please learn how to conduct a wordpress blog — your technique is very distracting.

You protesteth too much good sir.  Put aside your denial and get some treatment.  I am sure Harvard was glad to be rid of you.  They are very lucky you are out of there.

There might be some legitimate content in there somewhere, but by the time I reached the bottom of the page I was ready to hand you a mood disorder questionaire.  Not that we really need you to fill one out to make a diagnosis.

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johnnyLawrence

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Physician Suicide, the “Impaired Physician Movement” and ASAM: The Dead Doctors at Ridgeview Institute under G. Douglas Talbott

 

FullSizeRenderThe Elephant in the room is the state Physician Health Programs organized under the FSPHP.    Nothing has changed–they have only grown more powerful and opaque and removed themselves from accountability and culpability.  Moreover,  they are expanding to other fields. Just ask the airline pilots. They eventually want to expand to students and children.   Just take a look at the ASAM White Paper on Drug Testing or Dupont’s Keynote Speech before the Drug and Alcohol Testing Industry Association.

If this does not affect you yet it eventually will and by then it will probably be too late.

Illegitimate and irrational power is very dangerous.  But no one is really paying attention.   This is just a few public policy steps away from you. Speak now before the door closes for good!

 

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Disrupted Physician

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“It is easier to believe a lie one has heard a hundred times than a truth one has never heard before.” –American sociologist Robert S. Lynd

Ridgeview Institute was a drug and alcohol treatment program for “impaired physicians” in Georgia created by G. Douglas Talbott, a former cardiologist who lost control of his drinking and recovered through the 12-steps of Alcoholics Anonymous.

Up until his death on October 18, 2014 at the age of 90, Talbott  owned and directed a number of treatment facilities for impaired professionals, most recently the Talbott Recovery Campus in Atlanta, one of the preferred referrals for physicians ordered into evaluation and treatment by licensing boards today.

G. Douglas Talbott is a prototypical example of an “impaired physician movement” physician–in fact in many ways he may be considered the”godfather” of the current organization.  He helped organize and serve as past president of the American Society of Addiction Medicine (ASAM) and was a formative…

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Abuse Hidden Under a Veil of Benevolence: Bill Cosby, Physician Health Programs and Cognitive Dissonance

Fake ASAM ‘Doctors’ Push AA Cult For Profit.

The blue slides below are from a  presentation at the 2014 FSPHP spring meeting in Denver, Colorado and can be seen here.   The presentation was given by past FSPHP President Gary Carr, MD, Current FSPHP President Warren Prendergast, MD, West Virginia PHP Director Brad Hall, MD and Montana PHP Director Mike Ramirez, MS.

 

This needs to be seen as a "to-do" list.

This needs to be seen as a “to-do” list.

A.A. = ASAM = FSPHP 

The quote is from Alcoholics Anonymous and the full passage is as follows:

“We are convinced that a spiritual mode of living is a most powerful health restorative. We, who have recovered from serious drinking, are miracles of mental health. But we have seen remarkable transformations in our bodies. Hardly one of our crowd now shows any mark of dissipation.
      But this does not mean that we disregard human health measures. God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons. Most of them give freely of themselves, that their fellows may enjoy sound minds and bodies. Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward.”–Alcoholics Anonymous, 4th Edition,  The Family Afterward

Federation of State Physician Health Program (FSPHP) physicians often quote A.A. because they are defined by A.A. in both mechanics and mentality.  The “impaired physician” movement began with evangelical recovered addict and alcoholic physicians whose recovery was based on 12- step spirituality.  As this group molded into the American Society of Addiction Medicine (ASAM) many of them found employment at 12-step rehabilitation facilities and others joined their state Physician Health Programs and organized under the FSPHP.   Their ability to make authoritative pronouncements on physician impairment is  based on their own claim to insiders knowledge of recovery as brandished in this A.A. passage which I find condescending toward the medical profession and oddly narcissistic.

This special knowledge, of course, was based on the chronic relapsing brain disease model with lifelong abstinence and participation in 12-step recovery.

These “miracles of mental health” joined their state PHPs and those who did not agree with their rigid inflexible views were removed.   Those with access to special secret knowledge were eventually able to outvote those with intelligence and open minds as this groupthink infested and eventually monopolized  PHPs.


 

It is important to understand that the ideology of  A.A. is the ideology of the ASAM is the ideology of the FSPHP 

Like all “front-groups” the ASAM purports to serve one agenda while in reality serving another.  The ASAM claims to be a “physician society with a focus on addiction and its treatment” According to their website their mission is to

  • increase access to and improve the quality of addiction treatment;
  • to educate physicians (including medical and osteopathic students), other health care providers and the public;
  • to support research and prevention;
  • to promote the appropriate role of the physician in the care of patients with addiction;
  • and to establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public

In order to accomplish this the  American Board of Addiction Medicine certifies doctors  to “provide assurance to the American public that Addiction Medicine physicians have the knowledge and skills to prevent, recognize and treat addiction.”

Ostensibly these are laudable goals that are almost universally endorsed.   The perceived organizational purpose and public persona are altruistic and humanitarian.  Treating addiction not only saves individual lives but improves the community.  It is for the common good.


 

Abuse Hidden Under Benevolence and Torture as Treatment

History reveals that all manner of abuse can lie underneath a patina of benevolence.   In the past few months alone we have both Bill Cosby and the  British Parliamentary pedophile ring as prototypical examples.  Both cases reveal a decades long coverup of allegations in which the abusers escaped little or no investigation into their alleged crimes. Abuse of power with a large gap between the power of the abuser and the powerlessness of the abused is a common denominator.  If the abuser endorses our own beliefs systems it creates a discord that promotes disbelief.  It does not fit.   Accusations are dismissed, deflected or otherwise suppressed.   Power effectively extinguishes the truth.  Disbelieved and delegitimized, information is suppressed, charges are not filed and law enforcement and the media turn a blinkered eye for decades. Indifference, disbelief, rationalization and cognitive dissonance prevent exposure and accountability. Hidden in plain site the truth was there and easy to find.  The problem was no one was looking. Most did not want to look.

It does not take much sleuthing to uncover what is beneath the veil of the American Society of Addiction Medicine.  The history, mentality and mechanics are well documented and reveal where they came from,  how they evolved and what they have planned.    It is a complicated web and hard to explain but once the pieces of the puzzle are fit together it is clear.  But it involves assembling a complex puzzle by finding the individual pieces scattered in disparate areas including the regulatory, clinical, administrative and professional niches of the medical profession,  Alcoholics Anonymous and 12-step related organization, public policy, all levels of the political arena and other areas. Once put together the portrait is clear.

In reality the ASAM is a political action group or special interest group that is designed to cement the chronic relapsing brain disease model with lifelong abstinence and spiritual recovery as the one and only treatment for addiction.   A.A. is used as the energy source of the operation.  By labeling addiction a “disease” requiring “treatment” in which someone is helpless they are able to dictate all aspects by coercion and control.  But in my opinion the A.A. ideology is just used as a ruse to support the multi-billion dollar drug and alcohol testing, assessment and treatment industry.  The zero-tolerance mindset of the “treaters” combined with the “helplessness” of the diseased enables them to erect a revolving door of testing, assessment and treatment that provides them with both control and a steady stream of money.

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The FSPHP mandates 12-step ideology on all doctors in a zero-tolerance system of abuse and control while at the same time putting out misinformation that the PHP programs are the “new paradigm.”  The page below is from the book Drug-Impaired Professionals by Robert Holman Coombs.

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This is they type of propaganda these groups have propagated.   What is described above is absurd and unrealistic but it is reported, reproduced and repeated to the point that it is accepted as the truth.

The majority of physicians referred to these programs are not even addicts. These programs of Zero-tolerance and 12-step indoctrination are based on coercion and control.  They are causing many doctors to die by suicide as they are feeling hopeless, helpless and defeated.    This portrayal of a group of blissful 12-stepping doctors over the moon because they found spirituality is nonsense.

But you will not find many doctors speaking out against them for fear of “contingency management.”  Disagreeing or even questioning PHP practices including the validity of 12-step can literally cost you your license.

I have spoken to multiple physicians and nurses and have encouraged them to tell their stories here but they are afraid of retribution and “unintended consequences.”  And who can blame them?

They can send you back to one of the “PHP-approved” facilities for “stinkin thinkin.”

Unfortunately the ASAM and FSPHP have successfully bamboozled others into believing they are true experts with noble intent.  They have bamboozled the Federation of State Medical Boards (FSMB) to the point where they have gained autonomy and unrestrained managerial prerogative.    They essentially use the state Boards to impose sanction on doctors who they report doctors for “noncompliance” which includes disagreeing with or questioning mandated A.A  or refusing to admit you have a chronic relapsing brain disease when you in fact do not.    They are in fact imposing A.A. on doctors and forcing them to accept their thinking under threat of loss of licensure.  This  violates the Establishment Clause and is a very serious problem that is being ignored.  It is a slippery slope we are on.

The FSMB House of Delegates adopted an updated Policy on Physician Impairment at their 2011 annual meeting distinguishing “impairment” and “illness”  stating that Regulatory Agencies should recognize the PHP as their expert in all matters relating to licensed professionals with “potentially impairing illness” that predates impairment often by many years.”  

It also defines “relapse without use” as “behavior without chemical use that is suggestive of impending relapse.”Screen shot 2013-05-13 at 1.30.29 PM

G. Douglas Talbott defines  “relapse without use”  as  “emotional behavioral abnormalities” that often precede relapse or “in A. A. language –stinking thinking.”

The ASAM has  monopolized addiction treatment in the United States.  But what the FSPHP arm has done is far more sinister.   A.A. has effectively taken over regulatory medicine and the private lives of doctors as a form of social control.  A doctor can be referred to a PHP for virtually anything and if the PHP believes he or she is in need of an assessment it will be done by a “PHP-approved” facility which means it will be done by a 12-step facility.  The PHP selects who will be monitored and dictates every aspect of what that entails and the entire process is done within the confines of A.A. ideology.  It is a, in fact, a  rigged game as the medical directors of the PHP approved facilities can all be seen on this list of like-minded docs who refer to theselves as “trusted servants” and “believe that evidence from extensive, well-designed studies demonstrates the great benefits of Twelve-Step recovery modalities including Twelve Step Facilitation in promoting long-term recovery.”

A.A. is imposed  on doctors through the FSPHP.  The FSPHP political apparatus exerts a monopoly of force.    And the bottom line is that A.A. has taken over all aspects of “physician health” and is forcing doctors to accept doctrine that is perhaps helpful to a few, useless or unneeded for many, and harmful and sometimes lethal to others.  This is unacceptable and it needs to be recognized.


 

“New Paradigm” of Zero-Tolerance and 12-step Spirituality Based on “success” of PHP to Move to Other Occupations and Kids.

To move this “new paradigm” to other populations they had to gain control of the doctors first.  They have not only created a monopoly but buffered themselves from physicians who may disagree with what they are doing to others.  This current system essentially stifles them.

The power, immunity and impunity this group yields over doctors was done silently and with no opposition. It was done by sequential public-policy steps.  This is why anyone interested in civil liberties and human rights should recognize the menace this presents to society.   The scaffold is in place and they are just adding more nooses.  Just ask the airline pilots.  They plan to impose similar systems on teachers, students and athletes.

And this is all spelled out in the ASAM White Paper on Drug Testing.   What people need to realized is what is described therein is just a few public policy steps away from them.  The only organization they have to convince is the organization that regulates any type of professional license, employment or benefit.

Gaining regulatory sway in the medical field and control over individual doctors was necessary to move this model to other populations.  It is merely a stepping stone for things to come.  It is only a few public policy steps from us to you.

This impacts us all.   It enables control of research, public policy and public health.   It is a system that suppresses dissent and shapes conformity.  The FSPHP  encourages the confidential referral of outliers.

The ASAM is pro-drug war and anti-medical marijuana.  This essentially silences most doctors for fear of being recognized and being brought in.  I know many doctors who will not even talk about it in public.

This is fixed doctrine and will not change.

That is why the ACLU and other groups who promote civil rights, those who are against the drug war and anyone involved in Medical Marijuana need to step in.    These  groups need to recognize the reality of who these people are, what they have planned and understand why they need to be stopped.   They are currently not even in the public eye and by outward appearances they appear to be benign.   In truth they are malignant and rapidly metastasizing without any symptoms.

In Order to Stop This the Following Must be Done

1) get a team of epidemiologists/statisticians to attack the “evidence-base” and “research” that the ASAM/FSPHP has used to support their claims (junk science, pseudoscience, success of 12-step, etc) and do a Cochrane type meta-analysis that will show there is little to no basis for it.

2) Demand accountability of the PHPs. Assign accountability to the Medical Societies and Departments of Public Health. Demand they be accountable for state-contractors with the Medical Boards (many of whom are complicit–in Massachusetts the Board of Registration in Medicine is simply an extension of the state PHP-i.e. Like-minds.

3) Demand that the criminal activity taking place within these PHPs be addressed by law enforcement.

4) Demand the Attorney General enforce the rampant Establishment Clause Violations occurring with mass 12-step coercion.

5) Identify and expose the  backgrounds of many of the individuals involved including felons and double felons who reinvented themselves as “addiction medicine” doctors. Many of these individuals are repeat offenders with a history of manipulating the system who should have never had their licenses returned.  In my opinion the ASAM/FSPHP/LMD rigged system is an example of corporate psychopathy.  While corporate level psychopathy is estimated at around 3% the numbers here appear to be much higher if one looks at the moral disengagement, unethical decision making, lack of empathy and externalization of blame evident in their personal histories.

6) Correctly identify that this system of institutional injustice is responsible for the astronomical suicide rate in physicians. This is due to the fact that doctors who need help are not getting it for fear of being ensnared by the state PHP and those already ensnared are being subject to coercion, abuse, institutional injustice, degradation, dehumanization, delegitimization and civil and human rights abuses and that this is a public health emergency that needs to be addressed.

7) reveal the scam set up between the PHPs, rogue labs, and “PHP-preferred” assessment and treatment gulags.

8) show how this is only a few public policy steps from Doctors to Pilots to Teachers to students to kids. etc. etc.

This necessitates that we get the conversation going before it is too late.

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Physician Suicide

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Physician Suicide 101: Secrets, Lies & Solutions by Dr. Pamela Wible, M.D.,  will hopefully serve as a stepping-stone to start discussing the elephant in the room; Physician Health Programs (PHPs) and their relationship to physician suicide.

The current state-of-affairs in these once benevolent programs that served a dual purpose of helping and protecting the public from “impaired” physicians is one of unrestrained managerial authority and absolute power with no meaningful oversight, regulation or accountability.

Moreover, the authority bestowed on this group is both illegitimate and irrational. The Federation of State Physician Health Programs is composed of American Society of Addiction Medicine “specialists” in “Addiction Medicine.”

The ASAM is not even recognized by the American Board of Medical Specialties as a bona fide specialty. It is a Self-Designated-Medical-Specialty; an AMA term used to keep track of what any group of doctors is calling themselves.

In fact, American Board of Addiction Medicine (ABMS) “board certification” is little more than a diploma mill.

Yet these “specialists” are now in charge of ALL things related to PHYSICIAN HEALTH.

Many of the physicians running these programs had their licenses revoked and got them back by claiming salvation through the good graces of Alcoholics Anonymous and other 12-step methodology. Many have felony convictions. Some have double felonies.

At best we have unqualified zealots. But one major problem I have heard over and over again from physicians forced into these programs is an absolute lack of justice, empathy and even civility by those in charge.

Misconduct, fraud, and even crimes are being reported.

Perhaps the 12-step salvation is just a ruse for some of them; a convenient cloak under which to hide all manner of abuse with impunity and immunity.

These individuals have been granted unrestrained managerial prerogative and absolute power over doctors. They decide not only who to monitor but how that monitoring proceeds in every last detail. Our fates, literally, lie in the hands of this group. No more physicians should die by this system of institutional injustice, bullying and pseudoscience. The conflicts-of-interest are abhorrent and would be incomprehensible in any other venue.

Isn’t it time we take charge? And the solution is fairly simple.

Oversight, regulation, and auditing by OUTSIDE groups. That is how it’s done everywhere else. Why do these guys get a pass?  Why would anyone be against procedural fairness and transparency in any situation? These are legitimate questions.

State Medical Societies, Departments of Public Health, the American Medical Association, the American Council on Graduate Medical Education, the Institute of Medicine and other Accreditation and Professional Organizations need to start addressing this.

It is a public heal emergency that is not going away.  It needs to be addressed directly and with urgency.

Accountability is without exception.   Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good.

Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

http://youtu.be/FNoLigQzp5M

Disrupted Physician

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