Thread by @kateneuropsych

@KemtrupTweets @Roland_SKS I think arguing or disagreeing with how a patient describes or defines an experience is wholly unproductive and sinks therapy because now you're getting into your clinical philosophy vs their lived experience. Therapy and healing are ultimately subjective processes sometimes
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@KemtrupTweets @Roland_SKS predicated upon relatively objective events and sometimes intrapsychic ones. If you've ever sunk deep into depression, had your body & mind hyjacked by Bi-polar mania/depression decompensated into schizophrenia type episodes, been homeless that's truamatic tho many therapists
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@KemtrupTweets @Roland_SKS would not regard those events alone as truamatic; BUT THEY ATE and the fear of loosing the ground you later
gained equally real in terms of aviodence change in world view etc. Further if you are a White man or woman you should really reconsider what you think qualifies as
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@KemtrupTweets @Roland_SKS truama because your world view of what that is will never match my lived experience as a WOC and I couldn't even begin to communicate all that that is or what goes into it on a DAILY basis. I'd be beyond my bank account to do so and beyond your patience and time. That right
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@KemtrupTweets @Roland_SKS there should tell you alot. I may not even wrap that whole thing into what I talk about most of the time because the whole disconnect IS JUST TOO PROFOUND. And the insult contained in some therapist invalidating my last last nerve snapping as the result of the weight of truama
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@KemtrupTweets @Roland_SKS that I can't verbalize to your satisfaction only retrenches the truama that IS PRESENT that YOU CANT SEE. Also many traumas occur to folks who aren't very verbal or who are more concrete in expression. Psych never really thinks about this because we go for the verbal Patients
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@KemtrupTweets @Roland_SKS already which implies a required level of functionality right out the gate. Then too people's experiences are too easily dismissed on cultural grounds if they don't say it "right" or describe it in the prescribed manner. The level of arrogance in even thinking to argue
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@KemtrupTweets @Roland_SKS "that's not a truama or some people wouldn't consider that truamatic (lots of folks won't consider or think XYZ but that makes it nonetheless true for you) is stunning. More, often the "truama" itself is the last in a string of small daily assualts that aren't all that
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@KemtrupTweets @Roland_SKS truamatic as a singular event but the cumulative weight of the constant repitition of that event is what eventually causes overwhelm and collapse. That said most patients and therapists focus on the last thing recallrd or what "truggeted" overwhelm & collapse to identify
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@KemtrupTweets @Roland_SKS causality however causality not easily accessible to the naked (sometimes White) eye and is often embedded in the lived experiences. These are things we don't much consider when deciding trauma/not trauma and or if... PTSD. I'm not for looking at patients with a jaundiced
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@KemtrupTweets @Roland_SKS eye or correcting their language or how they define experiences. I definitely deal with contradiction and cognitive dissonance but I'm primarily looking for what those experiences mean to and for my patients, what are/were the consequences experienced and working to identify
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@KemtrupTweets @Roland_SKS the corrective experiential mechanism. To my way of thinking those levers (if you will) absolutely dont reside within the realm of redefining for patients what is and isn't truamatic based on my understanding of what that should be what event should quality as, justify
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@KemtrupTweets @Roland_SKS or elicit truama from another human being based on the POV of my life, my abilities, my research, my reserve, my temperament or from the level of security and comfort I enjoy, my personal or clinical philosophy or criteria. DX in this case is more to justify INS coverage for
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@KemtrupTweets @Roland_SKS treatment more so than anything else. In fact that's what the DSM is really for at this point and as such it is nothing if not a political document that via a round robin of stakeholders allows us to get paid if we're taking INS at all.
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@KemtrupTweets @Roland_SKS As for truama PTSD and DX, I tend to be generous by most standards but I can also tell you that as a Neuropsychologist I could back it up if needed in court any day of the week.
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