Dr. Allan Botkin tells Sam's story, Vietnam Vet

Eyes forward in PTSD therapy

August 28, 2008

BY CAROL MUELLER The Graminator
When Dr. Allan Botkin talks about treating post traumatic stress disorder he tells Sam's story. Sam was an American soldier fighting in Vietnam who befriended an orphaned, 10-year-old Vietnamese girl named Lee. But the Army discouraged closeness with war orphans and arranged to ship Lee off to an orphanage.

A truck arrived and there were sad good-byes; then gunfire. The enemy attacked, suddenly and fiercely, and Sam covered Lee's body with his own. When the shooting stopped, Sam rose but Lee could not. The little girl lay in a pool of her own blood, mortally wounded despite Sam's efforts to shield her.

"That was the cause of Sam's psychological undoing," said Botkin, a clinical psychologist who for 20 years worked at the VA Hospital in North Chicago treating veterans with PTSD. He explained that after Sam's discharge and return to civilian life, the Vietnam vet began experiencing symptoms of post traumatic stress disorder: Nightmares, flashbacks, hypervigilance, anger, avoidance, depression.

"PTSD is a psychological disorder that results from a traumatic experience," Botkin said. "Memories of the event intrude at night through nightmares and daily through flashbacks, like it's happening all over again. They don't just remember the event, they relive it. There are physiological symptoms, too. Hyperarousal, the fight or flight response, is easily triggered.

"A secondary symptom is avoidance of reminders. At home Sam avoided his daughter and lived in the basement."

And there was anger. "Intense anger and rage are used to cover sadness and fear," said Botkin, who believes sadness and fear are the root of PTSD.
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