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Reflections on psychiatry.

Posttraumatic stress (PTSD) is a key-word in the context of new developments in contemporary society. In addition to confrontation or witnessing events that involved death or serious injuries, its defining elements are persisting re-experiencing, avoiding stimuli associated with trauma, along with lasting symptoms of hyperexcitability.

As a reference to the gravity of this condition, it is estimated that up to 35 % of the people directly exposed to the 9/11 attacks presented posttraumatic stress symptoms (Yehuda, 2002).

If we were to take only the tragic events that took place at the COLECTIV Club, the enormous shadow of mourning that swept the Romanian society covers both deep psychological wounds of the survivors, friends, family, and of the public consciousness as a whole. The brutal disruption from the illusory sense of security to the abyss of mass panic, mixed in the multidimensional blend of a long string of errors and negligence, all intimately affect the stratified social layers, sparking scattered but immeasurable moral outrage bouts, pain or delayed twinges of conscience.

In this somewhat paralogical framing, I adhere to the idea that professionals--be they psychiatrists, psychologists or psychotherapists --can immediately buffer the emotional haemorrhage, but this requires time and a great deal of mending for the scars of this inner combustion which frequently takes much longer to defuse after the exterior healing.

Inner pain, this refined and, at the same time, ferocious demon, prolongs the agony, at times testing to the extreme the limits of reason and projecting an imaginary and apparently distorted construct of the old temporal-spatial landmarks.

The reality is that there is no need for elevated language, psychological refinement or philosophical musings in order to help someone in the midst of painful labour. Instead, it takes infinite emotional openness, quality empathy, sincere and respectful reverence for the sufferer. Everything else fades and tunes out the delicate psycho-emotional mechanism, leading the doctor --patient alliance towards the swamps of the concrete, the formal structured dialogue, deprived of authenticity.

It is sad. Not just sad, but tragic. Humanitarian disaster. These are just words. Words that don't even begin to touch the essential significance of what has happened. A brutal and sudden crushing of personal reality.

What then causes a chain reaction--at the family level, but also in the group, in the community, and in the society as a whole. Maintained and augmented by the media, debated, broken, analysed, synthesized until it lacks any meaning. And all that remains is individual pain. The unique print of anguish in search for meaning or at least of a cure.

Nolens volens, we, the psychiatrists, are perceived as wizards of the soul, even if, at times, we lack all the ingredients to prepare the cure. Nevertheless, every time, we add a bit of emotion, a drop of empathy, a heartfelt word, and our humble expertise as seekers of Meaning.

Ovidiu-Eugen ALEXINSCHI--M. D., Ph. D., Senior Psychiatrist, "Socola" Institute of Psychiatry Iasi, Romania

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Author:Alexinschi, Ovidiu-Eugen
Publication:Bulletin of Integrative Psychiatry
Article Type:Editorial
Geographic Code:4EXRO
Date:Dec 1, 2015
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