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Summary
Summary
From a physician and post-traumatic stress disorder specialist comes a nuanced cartography of PTSD, a widely misunderstood yet crushing condition that afflicts millions of Americans.
"Dr. Jain's beautiful prose illuminates this widely misunderstood condition and makes for fascinating reading. It is a must for anyone who has a survived trauma, their loved ones and the healthcare professionals who care for them." --Irvin Yalom, bestselling author of When Nietzsche Wept
The Unspeakable Mind is the definitive guide for a trauma-burdened age. With profound empathy and meticulous research, Shaili Jain, M.D.--a practicing psychiatrist and PTSD specialist at one of America's top VA hospitals, trauma scientist at the National Center for PTSD, and a Stanford Professor--shines a long-overdue light on the PTSD epidemic affecting today's fractured world.
Post-Traumatic Stress Disorder goes far beyond the horrors of war and is an inescapable part of all our lives. At any given moment, more than six million Americans are suffering with PTSD. Dr. Jain's groundbreaking work demonstrates the ways this disorder cuts to the heart of life, interfering with one's capacity to love, create, and work--incapacity brought on by a complex interplay between biology, genetics, and environment. Beyond the struggles of individuals, PTSD has a tangible imprint on our cultures and societies around the world.
Since 9/11 and the wars in Iraq and Afghanistan, there has been a huge growth in the science of PTSD, a body of evidence that continues to grow exponentially. With this new knowledge have come dramatic advances in the effective treatment of this condition. Jain draws on a decade of her own clinical innovation and research and argues for a paradigm shift in how PTSD should be approached in the new millennium. She highlights the myriads of ways PTSD care is being transformed to make it more accessible, acceptable, and available to sufferers via integrated care models, use of peer support programs, and technology. By identifying those among us who are most vulnerable to developing PTSD, cutting edge medical interventions that hold the promise of preventing the onset of PTSD are becoming more of a reality than ever before.
Combining vividly recounted patient stories, interviews with some of the world's top trauma scientists, and her professional expertise from working on the frontlines of PTSD, The Unspeakable Mind offers a textured portrait of this invisible illness that is unrivaled in scope and lays bare PTSD's roots, inner workings, and paths to healing. This book is essential reading for understanding how humans can recover from unspeakable trauma. The Unspeakable Mind stands as the definitive guide to PTSD and offers lasting hope to sufferers, their loved ones, and health care providers everywhere.
Reviews (3)
Publisher's Weekly Review
Jain, a psychiatrist who specializes in PTSD, draws on her experiences working with sufferers of the disorder to outline a commonly misunderstood problem and its possible solutions. At a time when millions of Americans have suffered from trauma, this work sheds light on the symptoms of PTSD as well as the different types of treatment currently available, among which the "gold standard," in her view, is cognitive behavioral therapy. Describing symptoms such as flashbacks and increased anxiety, Jain argues that "the goal of treatment should be to help survivors thrive in their new normal." She also explores the diverse types of trauma that can lead to PTSD and related disorders, through stories from people she has treated. These include a woman traumatized by both her infant's death from sudden infant death syndrome and by being blamed by her parents and ex-husband for the death, and a man whose memory of witnessing, over five decades before, a racially motivated assault suddenly manifests itself in late-onset stress symptomatology. This instructive resource can be recommended not only for those who have personal experiences with PTSD and trauma, but for anyone interested in learning more about the disorder and how it affects society. (May) © Copyright PWxyz, LLC. All rights reserved.
Kirkus Review
Comprehensive survey of the state of knowledge concerning PTSD, woven into the author's experiences as a therapist and the child of survivors.Family memories of the partition of India and Pakistan fueled psychiatrist and PTSD researcher Jain's initial explorations of a condition marked by what she deems "five quintessential intrusive features"namely, distress caused by memories of trauma, flashbacks, nightmares, unshakable waking thoughts, and physiological responses such as the feeling that one can't breathe or that death is imminent. The trauma that produces PTSD is life-transforming. The author writes that recent therapies have improved the outlook for some of those who suffer from PTSD, and she suggests, in a footnote to the ongoing nature vs. nurture controversy, that someone raised in a supportive family may well weather trauma better than someone in a conflict-ridden environment. Moreover, she adds, "the resilience of the wider community to which you belong has a knock-on effect of your own capacity, as an individual, to be resilient." When someone is not resilient, however, then trouble can lie ahead: PTSD sufferers tend to self-medicate, for instance, and their conditions are often misdiagnosed, so that when they are medicated pharmaceutically, it may well be with the wrong thing (benzodiazepines, in particular). Domestic violence, trouble with the law, suicide, and other negative consequences of PTSD are also commonplace. Jain carefully lays out what can be said with confidence about the syndromethe fact, for instance, that "children with PTSD have altered neurobiology"and what is more speculative, all with an eye to potential cures or at least effective therapies for managing the condition, such as recent British experiments with intensive residential treatments and the application of methods "with an emphasis on the fear and horror associated with the traumatic event."Given epidemic anxiety and stress disorders, this is a timely book that will greatly interest those who suffer from them as well as family members and medical practitioners. Copyright Kirkus Reviews, used with permission.
Booklist Review
Post-traumatic stress disorder (PTSD) is a challenging condition with a collection of possible symptoms nightmares, relentless harmful emotions (anger, fear, guilt), hypervigilance, flashbacks, and an amplified startle response. PTSD patients are at greater risk of suicide. About 80-percent of the afflicted also suffer from other psychiatric problems (depression, alcoholism, drug abuse). Some causes of PTSD are rape, combat exposure, child abuse, accidents, and fire. Psychiatrist Jain (the daughter of immigrants from India with a family history of trauma) incorporates anecdotes of her patients to help explain the etiologies, diagnoses, and treatments of PTSD. A sampling includes a woman who is sexually assaulted as a teenager and later endures her baby's SIDS death, a marine who served in Iraq and witnessed a street bombing that maimed or killed many civilians, and an individual badly injured in a car accident. The best treatment remains talk therapy (cognitive behavioral therapy), and medication (chiefly SSRI antidepressants) can be beneficial. Jain asserts that the importance of accessible treatment and early intervention for PTSD cannot be overstated, while also emphasizing the genuine healing value of empathy and simply listening.--Tony Miksanek Copyright 2019 Booklist
Table of Contents
| Prologue | p. xiii |
| Introduction | p. xvii |
| Part 1 Discovering Traumatic Stress | p. 1 |
| The Road Trip with My Father | p. 3 |
| A Pressing Public Health Concern | p. 10 |
| A Brief History of Trauma | p. 16 |
| Old Wine in a New Bottle? From Shell Shock to Battered Women to PTSD | p. 21 |
| Rocky Roads: Overdiagnosis and Underrecognition | p. 25 |
| Part 2 The Brain | p. 33 |
| A Disorder of Memory | p. 35 |
| Nightmares | p. 49 |
| Flashbacks | p. 55 |
| An Unlived Life: The Hidden Cost of Avoidance | p. 58 |
| Denial Land: When Trauma Memories Are Deeply Buried | p. 66 |
| Carrying Sorrows in the Blood: Cortisol, Epigenetics, and Generational Trauma | p. 70 |
| A Wildness in the Bones: Acute Awareness and Shady Moods | p. 76 |
| Dissociation: The Two-Thousand-Yard Stare | p. 83 |
| Part 3 The Body | p. 87 |
| Bodily Wounds | p. 89 |
| A Soldier's Heart: PTSD and Cardiac Disease | p. 96 |
| Russian Roulette: The Perilous Bond Between Traumatic Stress and Addiction | p. 101 |
| Broken Smiles: The Toxicity of Childhood Adversity | p. 110 |
| Senescence: Traumatic Stress in Late Life | p. 120 |
| Part 4 Quality of Life | p. 129 |
| Complex Trauma | p. 131 |
| Intimate Violence: A Secret Pandemic | p. 139 |
| A Danger to Others: Hurt People Hurt Other People | p. 149 |
| Angry Loving: The Stubborn Imprint of Inner-City Poverty | p. 155 |
| The Fairer Sex? Rape, Secondary Injuries, and Postpartum PTSD | p. 163 |
| Shame: The Cinderella Emotion | p. 171 |
| The Science of Suicide Prevention | p. 180 |
| Part 5 Treating Traumatic Stress | p. 187 |
| Talking Cures and Beyond | p. 189 |
| Psych Meds | p. 198 |
| Medication Management | p. 209 |
| The Allure of Magic Bullets | p. 216 |
| Part 6 Our World on Trauma | p. 223 |
| Trauma of the Masses: A Wicked Problem | p. 225 |
| The 1947 Partition | p. 229 |
| War, Disaster, and Terror: Hard-Earned Knowledge and Lessons for the Future | p. 239 |
| An Americanization of Human Suffering? | p. 250 |
| Part 7 A New Era: An Ounce of Prevention | p. 255 |
| Prevention with Precision | p. 257 |
| The Golden Hours | p. 262 |
| Reaching the Hard to Reach: Making PTSD Treatment More Accessible | p. 266 |
| The Power of Social Networks | p. 272 |
| The Science of Resilience | p. 275 |
| Afterword: A Precious Inheritance | p. 285 |
| How This Book Was Written | p. 291 |
| Acknowledgments | p. 295 |
| Notes | p. 301 |
| Glossary | p. 361 |
| Resources | p. 365 |
| Index | p. 371 |
