Kudler Harold
Mental Health Service Line, Veterans Integrated Service Network, VA Medical Center, Durham, NC 27705, USA.
J Am Acad Psychoanal Dyn Psychiatry. 2007 Spring;35(1):39-50. doi: 10.1521/jaap.2007.35.1.39.
Although Posttraumatic Stress Disorder (PTSD) has come to be understood in primarily biological terms, the problems of returning combat veterans from Iraq and Afghanistan (and indeed, of their families) are best understood in psychodynamic terms. Their needs would be better met through a public health model that incorporates progressive outreach and engagement of all new veterans rather than a traditional medical model which focuses only on those with a biological disorder. Work with new veterans and their families requires facilitation of their own adaptive processes (psychological, social, and biological). This approach carries with it the potential to reorient and revitalize the theory and practice of psychiatry.
尽管创伤后应激障碍(PTSD)主要从生物学角度得到理解,但从心理动力学角度理解伊拉克和阿富汗退伍军人(以及他们的家人)回国后出现的问题最为恰当。通过一种公共卫生模式能更好地满足他们的需求,该模式包括对所有退伍军人进行渐进式的外展和参与,而不是传统的医疗模式,后者只关注患有生物学疾病的人。与退伍军人及其家人合作需要促进他们自身的适应过程(心理、社会和生物学方面)。这种方法有可能使精神病学的理论和实践重新定位并焕发生机。