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Ask the Mental Health Expert Archives 2001-2004

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Trauma Condition?

Q. There is an addiction that I don't know the name of. The first time I had heard of such an addiction was in reading accounts of POW's returning from the Korean War. Many of them stated that they actually missed the torture, both the physical and emotional.

Some World War 2 survivors of death camps reported the same phenomenon. Since that time, I have seen or heard of it in association with other illnesses and mentioned by survivors of political torture/incarceration scenarios in many third world countries. What is this condition called? How common is it and how is it treated? Do you have any other resources for further information on it?

A. I am dubious that what you are describing constitutes a specific condition. More likely, it represents a pathological response to trauma--perhaps an atypical form of post-traumatic stress disorder (PTSD). There is, of course, a milder variant of what you describe, sometimes known as "The Stockholm Syndrome", in which in which hostages come to sympathize or identify with their captors. This could provoke paradoxical feelings of missing one's captors--or even one's torturers--upon release.

There is also the phenomenon of re-enactment, sometimes seen in trauma victims. As Dr. Jon Allen explains in his book, "Coping With Trauma", "?it is not uncommon for individuals who have undergone trauma to actively re-create it." Allen describes the case (Blank, 1985) of a surgeon who had shot a prisoner while stationed in Viet Nam. Years later, this doctor walked into a school classroom with a rifle and took a class hostage, resulting in his nearly being shot by the police SWAT team. Although the doctor eventually surrendered, Allen hypothesizes that he "?may have been staging his own punishment by exposing himself to the possibility of being killed by a sniper."

I suspect that many of the individuals you have in mind are coping with deep-seated feelings of shame and self-hatred, stemming from the feelings of helplessness and rage they felt while being held captive, tortured, etc. It is not really that they miss the torture--it is that they need to expose themselves to some form of punishment that allows them to atone for, or perhaps master, their feelings of shame and self-loathing.

Finally, there is a hypothesis that posits addiction to trauma. This holds that the intense adrenaline rush experienced, for example, in the heat of battle, permanently alters the individual's central nervous system. The result is that the individual compulsively tries, perhaps unconsciously, to recapture that intense hyper-aroused state in some fashion.

This hypothesis has been used to explain the apparently high percentage of Viet Nam veterans who eventually took jobs as EMTs, police, firemen, etc. For details on the treatment of PTSD and its many symptoms, I recommend getting hold of Dr. Allen's excellent book.

February 2003

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