Shrink rap

Meet the panel

The abusive coworker  |  The procrastinator
The loner  |  The commitment phobe
The rejected gay son  |  The cutter
The crime victim  |  The serial dater
The fast and the furious  |  The coaster

{Dilemma 7}

The crime victim
I’m a 28-year-old man who got mugged nine months ago. I was coming home from a bar where I’d had a few drinks with friends after work. It was about 11:00pm, I was alone on a side street and two guys jumped out from behind a Dumpster. One got me in a choke hold, while the other took my wallet, my watch and my iPod. Then they threw me to the ground and kicked me a few times. I’ve had nightmares ever since, and I can’t walk down that same street again, and feel like I can’t relax. My friends are sympathetic, but I feel ashamed that I didn’t fight back and that I’m not over it yet.

Matt Lundquist: I would work to help him get out of the “emotional choke hold” he continues to be locked in as a result of being violated and brutalized. As with all crises, I would begin by looking at how this traumatic experience might be an opportunity to grow by discovering new ways of being close to people. The patient needs help to radically accept what happened, as a precondition for moving forward in his life and reconnecting with people. The trauma will always be there; he’s never going to forget it, but he can change his relationship to it and grow from it and with it. This patient doesn’t have to live his life devastated and afraid.

Richard Sugden: There is very good behavioral treatment for Post Traumatic Stress Disorder. I would refer the patient to the Center for the Study of Trauma and Resilience of Columbia University Medical Center at the New York State Psychiatric Institute (columbiatrauma.org/index.html). This is an intensive time-limited treatment that allows the victim to confront the fear of reliving the trauma as well as many of the thoughts and feelings about his involvement in the incident. This is particularly important for this man because of how ashamed he feels for not fighting back. However, this treatment is short-term with the goal of eliminating the traumatic symptom reactions, not about understanding how his negative feelings may be an expression of his characteristic way of interacting in the world. So if this is the case, I would recommend that he return to see me after the behavioral treatment to discuss what other lingering issues he might have.