A well-known forensic psychiatrist, Dr. John Bradford, developed PTSD after years of exposure to gruesome images. It suddenly came to a head and he broke down crying uncontrollably one day driving home after performing an evaluation.
Dr. Bradford told his therapist that it wasn’t only the ghastly images that were replaying inside his head but also the sounds — the screams and the begging for mercy.
DSM-5 requires that Criterion A be satisfied before proceeding with the decision tree that has four symptom clusters, each with a threshold that must be reached. Lastly, duration (>1 month), a “requirement of clinically significant distress or impairment in social, occupational, or other important areas of functioning”, and that “the disturbance is not attributed to the direct physiological effects of a substance (e.g., medication, drugs, or alcohol) or another medical condition (e.g. traumatic brain injury)” must be satisfied.
A close look at Criterion A reveals that in Dr. Bradford’s case, the repeated and extreme exposure to aversive details of traumatic events in the line of work (A. 4) satisfied the exposure threshold:
A. Exposure to actual or threatened a) death, b) serious injury, or c) sexual violation, in one or more of the following ways:
1. directly experiencing the traumatic event(s)
2. witnessing, in person, the traumatic event(s) as they occurred to others
3. learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental
4. experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related.
Dr. Bradford was unaware of this possible exposure path and believed that PTSD could only come about via direct personal experience.
Also, something I believe many professionals do: he engaged in denial.
I imagine that many professionals have disorders that satisfy diagnostic criteria, but these are kept under the wraps. And, undoubtedly, a number have subsyndromal disorders.
Employee Assistance Programs are geared to provide confidential referrals, as do many professions.
Dr. Bradford’s PTSD took a while to fester before he sought professional help.
It’s a good read.