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Wise Counsel Interview Transcript: An Interview with Frank Ochberg, MD on Post-Traumatic Stress Disorder (PTSD)

David Van Nuys, Ph.D.

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David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC, covering topics in mental health, wellness, and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.

[music]

On today's show, we'll be talking with Dr. Frank Ochberg about his fascinating work in the area of post-traumatic stress syndrome. He's a graduate of Harvard University and Johns Hopkins Medical School, Dr. Ochberg has dedicated his life and work to the prevention of the psychological consequences of violence.

Following the assassinations of Robert Kennedy and Martin Luther King in the late sixties, Dr. Ochberg, then a resident at the department of psychiatry at Stanford University, helped form a group of students and faculty to study dimensions of aggression. Shortly afterward, he co-edited the book, "Violence and the Struggle for Existence".

That was only the beginning, however, because he directed his professional life into what would become a lifelong career of service, research, education, treatment, and international leadership in the interrelated fields of trauma, crisis, and coping with violence and cruelty.

Dr. Ochberg has worked with the National Institute for Mental Health, the U.S. Department of Justice, and the National Security Council. Though he was responsible for community mental health primarily in the United States, he was an advisor and instructor for numerous government and international organizations. Now, here's the interview.

Dr. Frank Ochberg, welcome to Wise Counsel!

Frank Ochberg: Thank you.

David: Well, why don't we start out with having you share with our listeners a bit about your very fascinating background, your education, training, and so on.

Frank: Well, I'm glad to start back at the beginning. I went to public schools in Manhattan, near the George Washington Bridge. I was lucky to get into the Bronx High School in Science, which gave a terrific education for public school boys and girls back in that era, and I got a scholarship to Harvard.

At Science, we studied science and placed that very high on the agenda. At Harvard, I just fell in love with history and literature. I read every Shakespeare play. I thought I might become, actually, a Shakespeare professor, but that path didn't turn out to be the right one.

And I got another scholarship, this time to Johns Hopkins Medical School. And, between the science and the liberal arts, what happened? I ended up in psychiatry, which is where you go when you're a little bit confused.

David: Yes, and you had kind of a rocket career in psychiatry as well.

Frank: Well, you know, it was the Kennedy era, and one of the things in psychiatry that John Kennedy stood for was community mental health.

I thought the idea of revising the asylum system, making mental health care affordable and community-based was what I wanted to do, and I was able to meet a mentor, Bert Brown, who knew Kennedy, was in the Kennedy White House, and moved up to be the director of the National Institute of Mental Health.

Eventually, I became his assistant, and then his associate director, and he was very encouraging. Something else happened early in my life - I was a resident at Stanford.

It was 1968, Bobby Kennedy was killed, Martin Luther King was killed, the shadow of President Kennedy's assassination was hanging over all of us, and we formed a group that studied violence, wrote a book together, and I became very, very interested in the impact of cruelty.

Let me move forward a few years. I went to Washington; I became that assistant in the federal mental health program. Eventually, I was responsible for mental health services in the United States.

But along the way, because of the background and interest in violence and victimization, I landed a position - part time - I was still with the National Institute of Mental Health. But, I was the psychiatrist on the national task force on terrorism and disorder.

I became the liaison to the National Security Council. I studied what it was like for people to be held hostage, and how we should negotiate with hostage holders.

They sent me to work with ScotlandYard, and I ended up in the command center when a terrorist group called the Moluccans held an elementary school and a train with its passenger's hostage. I was in a position to observe this remarkable, ironic situation when you fall in love with the person who holds you hostage.

David: Yes, you were the person who originated the concept. You kind of defined that phenomenon, and it came to be called the Stockholm syndrome.

Frank: Well, that's true. Now, someone else came up with the term Stockholm syndrome, but I was the one who defined the term and who helped - at that point, it was the FBI hostage negotiators - learn how to develop the syndrome if it wasn't already there, because that syndrome can save lives.

You know, it isn't just that as a hostage you are, so grateful to the person who doesn't kill you, and you are so infantile in your responses, because they don't let you eat, they don't let you use a toilet, and they don't let you speak.

And suddenly, little by little, someone gives you permission to survive, and you have powerful, uncontrollable positive feelings. Not everybody, but many. And the remarkable thing is the hostage holder can feel those feelings back in return.

David: That's interesting.

Frank: And, that's what it's all about, David. That is what you want to achieve as a skilled negotiator. Get that relationship going, and get your adversary, someone with a gun who threatens to kill people, to feel at a very deep level that they are mother and father to these people, and they're responsible for keeping them alive.

David: Boy, you really have been on the front lines of this new world, this sort of unfortunate new world that has been unfolding in modern times, you know, what with terrorism and hostages, and just the escalation of that sort of violence.

And you've also been on the forefront of PTSD, post traumatic stress syndrome, and I understand that you helped get that term into the DSM, the Diagnostic and Statistics Manual of the American Psychiatric Association. Do I have that right?

Frank: Well, let's give the credit to the others who invented the term. I didn't invent that term, but I was responsible for policy at that stage, at the National Institute of Mental Health.

And, there were a group of us who were active in the American Psychiatric Association and the NIMH, and I was part of that. I had a lot to do with the politics of getting PTSD to become a legitimate diagnosis.

And then, I serve on the committee that rewrote the definition and, ever since that time, I've been very, very active among the scholars and the policy people who are concerned with PTSD.

You know, we, a lot of us, were dissidents in the Viet Nam era, and a lot of us came to realize that the soldier was not responsible for the policy of the war and the soldier was suffering.

And, we saw the same kind of suffering among women who had been raped and battered and had survived incest. So from my perspective, the PTSD diagnosis arrived when the genders came together.

And we saw, my goodness, there's a universal human response when an otherwise normal person suffers extreme stress and they can't shake the image of that which they suffered. It wakes them up at night. It comes back to them in the day with the intensity of a nightmare.

And, you know, we had no idea in the late '70s and early '80s, that a decade later, we would have brain scans that could show that a trauma memory is different from a normal memory. And now, we're seeing that. So...

David Van Nuys: Yes.

Frank: ...it's such an exciting field.

Let me go back to something you said earlier. You talked about how tragic and how difficult all of this is. Sometimes, you can get carried away as a scientist or as a teacher dealing with the drama. I mean it is dramatic.

It's the stuff of movies and television shows. But, you know, it takes a toll on all of us. And, we who choose to help people who have suffered traumatic and tragic loss, we end up carrying a burden and, every once in a while, it catches up to you and you just think, "my goodness, we really aren't civilized as a species, are we?"

David: Yeah, I'll bet that's true. And, you know, as I was poking around on your website, it really brought home what you're saying that I tend to... the first place I go when I hear PTSD, is I think of soldiers.

But, as I was poking around on your website, it really brought to my awareness, as you point out, it's rape victims, and it's the victims of crime, generally, of all sorts of crime and, particularly violent crime.

It's people who've been in terrible automobile accidents and, you know, earthquakes and floods and storms and so on. So, really there are quite a broad range of life circumstances that can lead to PTSD.

Frank: That's right, David. It tends to be women a little more than men. And, if it, let's say two of us, you and I, are with a third person and that third person is killed in front of us.

We never expected it; we knew the person. You know, he could have been struck by a car or it could be in combat. You know, a lot of violence happens in families.

And, one of us, who's right there, can get PTSD and the other won't. It doesn't mean that the other one who doesn't get PTSD is unaffected; it's just that their pattern of response is different.

David: And that could be biological or psychological or both, I would imagine.

Frank: Exactly, exactly, exactly. In fact, when you mentioned my website and I, there's not, I think there's a Frank Ochberg website that doesn't say much, but the website that most people go to is GiftFromWithin.

David: Yes.

Frank: That's Joyce Boaz's website. She's just wonderful. She's the executive director of the organization that is created for people with PTSD.

And they correspond with one another and a lot of us donate our articles or videotapes or just conversation to that website. And that's where... that's where a lot of people are learning about what we're saying today. And, a lot of them are women.

David: Yes and that is the website I was poking around on. [laughter]

Frank: That's a good one, Dave, [laughter] that's a good one.

David: I thought it was your website personally but... so I stand corrected.

Frank: Well, I'm... I'm the patron saint of the website.

David: Yes.

Frank: I helped get the funding for it and I talk very, very often with Joyce who, of course, is hearing from a lot of people and she is not a therapist or a mental health professional. So, she carries a lot of the burden of the people who contact her.

David: Yeah. I want to go back to your example of the two people who witness something traumatic and react differently. And, I'm just wondering if the concept of resiliency is applicable there?

Frank: Absolutely. You can define vulnerability and the other side of the coin is resiliency. And we've known about attributes of resilient people for a long, long time.

There was a fabulous woman, Elise Boulding, who was in my mother-in-law's era, and I'm 68 so that goes back a way. And I know Elise Boulding studied the indestructible child.

She was so interested in these kids who are raised in horrible circumstances and come out normal. What is it that they have?

Well, you know, they have a certain genetic predisposition that keeps them optimistic, cheerful. They have good genes and they would stand some terrible experiences.

But, there are also people who've had the benefit of good parenting and, we say it takes a village, they grew up in a good village, not a village that was destroyed by others or where warfare, the urban equivalent of warfare is rampant, and they escape the debilitating diseases.

I went to a residency program that taught us all about coping and the coping mechanisms are the ones that allow you to meet your challenges, keep your anxiety within tolerable limits, maintain your self esteem and keep up the relationships which significant others. If you do that, you're a coper.

David: Yes.

Frank: And the mechanisms that the copers have, seems to include a certain amount of imagination, a willingness to project yourself forward in the future and think about failing and deal with the prospect of failure without letting it humiliate you or knock you completely off balance.

I don't know about you, David, but, you know, we're obviously able to talk in public like this. Public speaking can be a great challenge for a lot of people...

David: Oh, yes.

Frank: ...makes people nervous.

David: Oh, yes. [laughter] It's funny.

Frank: You too?

David: Yeah, yeah, me too. You know we get thrust into these roles or we thrust ourselves into them and that's certainly been the case for me. And, yet, there's always been a little bit of anticipatory anxiety, I would say, before and once I'm in it, it's OK.

Frank: Right. Right. I feel the same way, the same way. Most people do have those normal anxieties. It doesn't mean that the good coper is free of apprehension.

In fact, fear is a blessing. There is a book written called, "The Gift of Fear." So, having a healthy amount of fear that keeps you from ignoring danger means, that you can tell when someone who is seeking your company is a dangerous person.

David: Yeah.

Frank: That's part of resilience also.

David: Yes.

Frank: Resilience has a lot to do with danger avoidance.

David: I want to go back to discussing veterans a bit, because the Vietnam area, I think helped to catapult interest in PTSD and now we've got a whole new wave of veterans from places like Iraq and Afghanistan.

And I am wondering, are we any better able to treat this new wave. Have more effective approaches been developed?

Frank: Yes. Yes. We are better. Let's start with something that isn't the first line of treatment, but it's so clear and it's boring and that's medication. We do have some better medication for the range of symptoms that you see in PTSD and look we have gotten this far without defining PTSD.

Let me very quickly say that for PTSD, first of all, you need to have something occur to you. You need to experience something that causes you great fear or horror or feeling completely helpless at the time that it happens.

And, it has to be the kind of thing that effects or it threatens your life or you see someone killed or you see someone badly hurt or your integrity, your bodily integrity is threatened.

It's not something like losing all of your earnings. As we are speaking now, there is a tremendous disruption in economy going on and people are frightened.

Frank: Yes.

David: That's not what we meant by the diagnosis of PTSD. We meant something much more biological and threatens who you are in a very clear and Oh, I can say biological again. It might kill you. It might pull you apart or it might invade you like a rapist. Anyway, that's the thought of the first part.

And the second part of PTSD is for at least a month you have trauma memories and a trauma memory is a nightmare, a flashback, an unwanted memory. You didn't ask for it and it comes over you. It's not as though your mind is voluntarily taking you there. It is involuntarily taking your mind there.

There are more subtle forms of that. That's the memory problem. And, the other completely different part of PTSD, David, you feel numb. You aren't who you used to be. You don't have a full range of human emotion and you don't have a full range of the kind of behaviors you used to have, doing what you loved to do.

And the last part of PTSD, you are very nervous. Things get to you easily. You get angry. You can't sleep. You can't concentrate. You are jumpy. You have to put those three different sets of problems together and that's when it adds up to PTSD.

David: Well, that's very useful to have that ground set of definitions there. So, you started to say a bit about medications. What would they do? How would they be helpful?

Frank: Well, the antidepressant medication is not only good for depression, it seems to help prevent forms of anxiety and at a high dose, and it seems to help with forms of obsessive thinking and in a way.

PTSD is a combination of something wrong with mood regulation, something wrong with fear regulation and something wrong with the way your mind deals with thoughts and images.

Well, after you've had enough of this kind of trauma, it appears that your brain mechanisms for keeping you in balance, keeping your flight in trim, if you were an airplane, isn't working at a biological level. So the medication like Lexopro, Prozac, Zoloft, Paxil helps a lot of people.

I will tell you, for example, I worked with the administration of Columbine High School after kids were killed and believe me, the principal, the assistant principals, the teachers, the counselors, they were like parents of murdered children.

They were terribly, terribly upset and it took a long time for them to pull themselves together even though they labored on in a heroic way and they were wonderful for the kids, they suffered.

And, it took about a year for many of them to agree to take this kind of medication. I was not their doctor but I was their friend and their confidant and their consultant and I encouraged them. Don't be embarrassed.

It's like a diabetic who needs something to help with sugar regulation. You need something to help with this kind of regulation of your feelings and it did help and I think most of them don't need it anymore.

David: Yeah.

Frank: I just want to say that I don't think we knew all of that in the Vietnam era.

David: OK.

Frank: OK and we certainly did not know how to treat with reexposure. If you are having a flashback, twice a month, there you are, it's like you are in presence of your rapist, in the presence of an enemy who is killing the man next to you.

That's a very, very debilitating condition. You don't necessarily want to talk about it. After getting to work with a therapist who has a lot of experience, you might be ready to revisit your nightmare in the office of the therapist.

And that's what we learned how to do. How to conduct a session in which somebody has, a moderated flashback. You bring your flashback into the office. You turn it on. You turn it off with somebody helping you and then it doesn't turn itself on and scare the heck out of you when it comes at you when you are all alone.

David: OK. It's a little bit of the old saw of getting back on the horse that threw you.

Frank: It is, but I think we learned how to be more effective because the old saw was literally get back on the horse that threw you. Here you are having flashbacks, you are having nightmares and you have to go right back and be on duty all again.

Let's talk about Iraq. Here is what's so difficult for our current troops. They are being redeployed and re, redeployed and re, re, redeployed .So they don't just have post traumatic stress disorder, they have pre traumatic stress disorder, into traumatic stress disorder and this is very, very hard.

Back in Vietnam you did your 13 months and you were finished. You re-upped sometimes if you were a more invulnerable sort but now...

David: Yes, I saw that movie, I can't remember the term. There's this one word term for being forced to go back, do you know it?

Frank: I'm not sure I know the term.

David: OK. Well there was a movie that came out and it told the story of this young man who was getting out from Iraq and then he got the letter saying, "No, you're going back" and the rest of the movie explores that theme.

I had no idea, I didn't know that it was going on and according to the movie at the end they kind of told some of the story behind it, it's happened to a very large number of people.

Frank: Absolutely and you know some feel honor bound to go back because there's such a strong attachment to the unit, the band of brothers. The brothers and sisters.

David: Yes.

Frank: It's unit cohesion and that kind of loyalty is at odds with the loyalty to your wife and kids or your husband and kids, so there are these two families that are fighting for the soldier or the Marine and that's, it's a deadly struggle.

David: Yes.

Frank: It's a terrible struggle, and you know now we need to train a lot of general therapists to learn how to work with this returning population.

David: Definitely.

Frank: I just made a little DVD thanks to Joyce and [inaudible] and a wonderful journalist named Mike Walter, and we worked together to make an almost hour long DVD that will help the general therapist think through the challenge of providing therapy to this population.

David: Excellent, excellent. You know poking around some more on that website I saw that, a paper that you've written on the counting method in relation to treating PTSD. I've not heard of the counting method. What is that and how does it work?

Frank: It's so simple and there are people who are training others in it. I never tried to market it heavily, so it isn't anywhere near as popular as EMDR and some of the other methods that work in similar ways.

Here's how the counting method goes, David. If you were my patient, I would tell you, not right away but eventually after you're comfortable with me and I'm comfortable with you and you've made a little bit of progress with me we can do this.

It will be like elective surgery. We'll have a day when you'll come to the office and that horrible thing that happened to you, I'm going to give you an example from the first Iraq war, because I did this with Paul who was my patient.

We'll go back to the day when the lieutenant ordered you at night to go into the bunker and using night vision goggles, kill the Iraqis who were in a bunker. You came out of that and we know that you haven't quite been the same and I'll count out loud to a 100 and you'll start the memory, without talking.

By the time at 50, 60 you'll be right at the parts that were most intense. By the time I'm in the 90's you will have been in your memory, back to the point where you felt safe and removed from the trauma scene. Then after that we'll talk.

So, the day comes and I do it. I count out loud and he remembers and while he's remembering and not talking, I'm taking, I'm looking at him. I'm counting and I'm watching him. He has his hands up to his face, his face gets contorted.

I can see that he is having a very, very intense memory and then when he's done we both take a breath and then he starts to talk. Sometimes I have to prompt, usually I don't. The person talks about what they just remembered.

In the case of Paul he said, "Oh my God, oh my God, I remembered for the first time stepping on a body as I walked out. I was stepping on the body of a man I killed." He hadn't remembered this part of it.

It's often in trauma memories, there's a piece missing and that piece could haunt you or it could pull you down.

David: Yes.

Frank: Without your knowing about it.

David: Yes.

Frank: And he never wanted to think about this day. With me he was able to do it, without telling me and then we went into the detail. Then the least part is I respond. I say, "Well look, Paul you did what you had to do then and now and now you're able to remember.

You're able to have the feelings that go with the memory and you're able to get to a 100. You're able to get to the end of it. Now, I don't want to say he never had that memory again but he never had the same kind of PTSD again.

David: That's really great. You mentioned and I can see relationships between that and some other approaches. For example you mentioned EMDR, Eye Movement Desensitization Deprogramming. I actually interviewed Francine Shapiro the originator of that technique.

Frank: And we're friends.

David: Oh really?

Frank: She and I, yes we are. She's encouraged me to learn her technique and I've encouraged her to learn mine and we did some research at Yale where we trained residents in both techniques. The both work.

David: Yes, that's great. There's another one that's even more controversial, I wonder if you've heard of it. It's called EFT, Emotional Freedom Technique.

Frank: Tell me about it.

David: Well it's not to dissimilar to what you described. The practitioner would have the person go into the memory while tapping on certain acupuncture points around their face and on their arms.

Frank: Oh yes, yes tapping sure.

David: Yes.

Frank: Sure and I've met several of the people through the International Society for Traumatic Stress Studies who do various tapping techniques, right.

David: And you know I thought it sounded kind of hokey when I was first exposed to it, but I have spoken to a number of practitioners through my podcasting and interviewed people and they just say that it really is very effective. That it works and that it works very quickly.

Frank: I think what these techniques have in common are several things. First you have a therapist who's comfortable with the technique, who believes in it.

David: Yes.

Frank: Then you have a client who believes in a therapist.

David: Yes.

Frank: Because the client has to voluntarily move into the frame of mind where they have their horrible recollection. They have to go there. Now most people avoid going there. Part of the diagnosis of PTSD is avoiding going to your trauma memory. You're aware of that.

David: Right, right yes, yes definitely.

Frank: So here, you take someone who has a diagnosis that says as part of this condition you don't move toward your traumatic memory. Then in the hands of a therapist you do, but you do it, because you're convinced that something in the way of mastery, in the way of desensitivization. In the way of recovery, is going to occur.

And I think my theory of what happens is, you end up placing in your mind the calming and soothing and more dignified partnership that you achieve with the therapist right there where the trauma memory lies. And you help reduce the sting of the trauma memory.

David: Yes, I totally agree that those kinds of factors are at work there. I'm wondering, just to bring up one more approach, I'm wondering if you're familiar with Dr. Edward Tick's work.

He wrote a book called "War and the Soul: Healing Our Nation's Veterans from Post-Traumatic Stress Disorder", and he's founder of something called the Soldier's Heart Foundation, at soldiersheart.net. Do you know his work at all?

Frank: You know, I know some of the phrases, but... Sounds like it's a book I should have read.

David: Yeah, well, if you get around to it...

Frank: Tell us more about it, David.

David: Well, I interviewed him, as I'm interviewing you, and I was very impressed - just as I am impressed by you, and what you've been doing - and like you, he's a guy who comes across with a lot of heart and a lot of soul. And he draws upon Native American and other indigenous traditions and believes that the role of community is very important.

And so, he brings these veterans together to create a new kind of community among themselves, and one with rituals that honor them as warriors. The indigenous societies honored their warriors. We're in a situation where we're very ambivalent about the things that people that we send out to kill other people...

Frank: Right, that's right. And David, it's not just honoring the warrior, it's honoring the warrior who loses, it's honoring the disabled veteran whose disability is shameful to him.

Now let me tell you something else about more down-to-earth, original cultures. Very, very early in all of this, I met Dr. Lambo, who was from Nigeria, who was the head of the World Health Organization psychiatry division.

And we were talking about this at a conference in Italy, and he said when somebody is wounded, or when somebody is raped in my village, which is an open-air village, people will come from around and they will take this person and they will lift him up. They will lift her up.

And I thought, oh my goodness! When someone gets raped in one of our villages, we put her in the back room. When someone gets raped in certain parts of the world, they kill her for bringing shame to their family.

And here was a culture that embraced its psychiatrically wounded people and restored dignity and love and the embrace of the community. So let me hear the name of this...

David: Yes, Dr. Edward Tick, T-I-C-K.

Frank: ...Dr. Pick...

David: No, Tick, T as in Thomas.

Frank: Oh, Tick!

David: Yes.

Frank: OK, thank you. Dr. Tick, I just wanted to... bless you for bringing us back to our roots!

David: Yes.

Frank: I think very early on, before we became civilized in some of the ways that are not civilized, we had more natural affection and attention to one another, and we lived with one another for better or for worse, and yes, there were rituals of healing.

David: Yes.

Frank: One of the chapters in the text, which I edited back in the eighties on post traumatic therapy and victims of violence did speak of the sweat lodge ceremony.

There was John Wilson, who wrote about that and who developed some of his approaches from Native American rituals. So yeah, this isn't just about biology. This is about restoring a person to a niche in life. It's about heart and soul as well as brain.

David: Yeah, I'm so happy to hear you say that because it's so easy to have a stereotype about psychiatry, that psychiatry is obsessed solely with pharmaceutical concerns.

Frank: Well, it's true that psychiatry has moved too much in that direction in America. I mean, I will not see a patient to just give them medication.

But, a lot psychiatrists have lost the enjoyment of knowing somebody very, very deeply which happens when you spend an hour or two with them once a week for a year or so.

David: Yes.

Frank: It's a very, very privileged relationship and medication is a small part of it. Now it's the psychologists, the social workers, other therapists who have that kind of intimate relationship and the psychiatrist spends twenty minutes adjusting medication.

David: Yes, yes.

Frank: I would not go into the field if that was what I would be doing with my life. I think that is really missing the opportunity that you're privileged to have among doctors as a psychiatrist, where you can combine biology with the spirituality, the culture, the literature, the whole range of humanity.

David: Yes, well, I know that you're not alone in that feeling within psychiatry, and I hope that your voice continues to be heard and to have impact.

I know one of the things that's near and dear to your heart that we haven't had a chance to talk about is your work with trauma among the journalists who are on the scene in some of these hot spots around the world.

Frank: Well, thanks for raising that. It was - let's see, this is 2008 - so it's about twenty years ago that I first realized that journalists are first responders, and they have so much to do with opportunities to help us all acknowledge the impact of cruelty and violence.

They have a thorough understanding of people who suffer and endure, and it didn't take long to find the best of the journalists who were frustrated with some of the problems of journalism. You know, newspapers are losing staff, the entertainment industry is moving in.

It's harder and harder to be an old-fashioned seeker of truth, but I've gotten very, very close to journalists around the world.

I helped, with others, to develop the Dart Center for Journalism and Trauma, and now there's a Dart Society made up of those journalists who've received fellowships and awards in the field of journalism and trauma.

David: What does Dart stand for?

Frank: It stands for the William and Claire, and Bob and Ken Dart family...

David: Oh.

Frank: ...who made their fortune and who met me along the way. I helped with some issues that they faced, and they were philanthropic and kind enough to help me with some ideas that I had.

And so there is the Dart Family Foundation, and they support Gift from Within, they support this journalism project and others as well. The journalism project is now quite robust.

It has just been renewed for its second five-year program. More than a million dollars goes into it in a year. And there are now offices now in different part of the world.

But, let me go to the problem. There is one problem in the way journalists interview people who have been traumatized and tell their stories. They need help in doing that with accuracy and sensitivity.

David: Hmm.

Frank: There's a different problem, David, when the journalist, and more and more of them are coming to me now. And I say, you are certainly recording a lot of confidentiality.

But they say, "I have seen so much. I'm not the kind of person I want to be. I can't sustain a relationship with a loved one." I hear a lot of that. "I have nightmares and flashbacks. I have concentration problems." And think about what we do to our journalists.

David: Yes, I don't think that would have occurred to most of us.

Frank: No, no, it doesn't. It is easy to bash the media. They bring a lot of bad news and they look like they like doing it. Well, there are a few on television, who I think would be better off having a different job.

But, that's not journalism. Journalism is working for a local paper or a small media market and listening and looking up close. And before you know it, you've inherited a lot of the mental space of the people you are reporting on. You don't have the same opportunity that I have to feel good about helping.

Of course, a lot of time you are taking someone's story whether they want to give it to you or not. And they don't call you up and thank you.

It's a tough profession. And the first amendment of our constitution protects this. Our founding fathers realized how critical it is for a democracy to have people who do get in close, and tell us what they see.

David: hmm.

Frank: So, I find the people I deal with have a tremendous sense of honor and courage; and it's a lonely job. I want to quote Scott North. Scott is a fantastic guy. He writes for the Everett Herald, up north of Seattle. He is the president of this dark society of journalist who cover trauma.

So he does a fantastic series about a young Native American kid, who took some peyoty or some drug and he ripped off his clothes and went running through the streets; and the police tackled him and they could not quite hold him down and they held him down too hard, and they killed him.

David: Hmmm.

Frank: Scott ends up a year later telling the whole story, doing justice to the police, and doing justice to the native American tribe. He gets to go to a piece of the ceremony for the funeral. They usually don't let non-native Americans in. And he says, I stood near the circle close but apart, at the distance at which a journalist finds truth.

David: Hmmm.

Frank: You know, it just sends a shiver through me thinking of Scott being there, close but apart. Your allowed close but you are never really brought in. You don't get the feedback and the reward, and sometimes even the love that a lot of the rest of us who help are able to benefit from.

David: Well, I'm going to have a deeper appreciation of journalists as a result of this conversation.

Frank: Thank you.

David: Yeah. It might be that one or more of our listeners knows someone suffering from trauma. So as we wind down here, I'm wondering if you have any advice as to how one can best support a friend or family member suffering from PTSD.

Frank: Well, I wonder a piece about that. It is on the Gift from Within website. That's www.giftfromwithin.org, and I think its called PTSD and partners. Or if you just Google Ochberg and partners, you can find it.

Essentially it says, first of all learn about this; it's not that hard to learn about PTSD. If you really want to help someone who has PTSD, you make sure that you're the most informing person on your block about PTSD. It is fun to learn about - it's not hard.

Then you do not have to be teachy and preachy about it. But, it is an awful good thing to be there. And to get the message through to this person. I'm not going to push you or I'm not going to make them feel sorry for you.

But, when you're ready to talk I'm here. When you're ready to learn more about this yourself, I've already learned about it - let me show you some things.

You want to take away the stigma. PTSD is real. It is biological socialist, spiritual; it hurts you in a lot of different ways. The worst way is it makes you feel like you shouldn't be too close to people who could help you and love you. It separates you.

As the loved one, as the friend, as the one who cares, you want to help that person come back to the circle. But you don't want to smother them. They may not be ready for you to move in too close.

David: Right.

Frank: You move in carefully.

David: Yes. Well, Dr. Frank Ochberg, I want to thank you so much for being my guest today on Wise Counsel.

Frank: Well, it is really my privilege and pleasure and I think we reached a lot of people with some good things too here. So thanks a lot for being a wonderful questioner and listener.

David: Well, thank you.

[music]

David: As I am sure you could tell, I really enjoyed this conversation with Dr. Ochberg. And I hope you did too. He really comes across with a lot of warmth.

And it felt like we had real rapport going on between us. I love it when that happens. I encourage you to visit the website we referred to several times. You will find it at www.giftfromwithin.org.

You've been listening to Wise Counsel. A podcast interview series sponsored by www.mentalhelp.net. If you found today's show interesting, we encourage you to visit mentalheathe .NET.

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Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.