Academic journal article Ethical Human Psychology and Psychiatry

The Traumatic Flashback as One Basis of Misunderstanding between Patients and Law Enforcement Officers

Academic journal article Ethical Human Psychology and Psychiatry

The Traumatic Flashback as One Basis of Misunderstanding between Patients and Law Enforcement Officers

Article excerpt

A patient in psychoanalytic psychotherapy reported to the analyst that the patient recently had been forced by satanic cult members to commit a murder. After discussion, the patient and the analyst agreed to inform the police. The police could not find evidence for the occurrence of the crime. Continued psychoanalytic work revealed that it was not a contemporary murder but a flashback of a childhood horror. Because flashbacks of past traumatic experiences are not an uncommon phenomenon, they would account for some of the gruesome events reported by patients but which law enforcement officers cannot validate as having recently occurred.

Keywords: flashback; murder; police; psychoanalytic psychotherapy; trauma

The case material, observations, and conclusions discussed in this article come from an integration of 30 years of clinical study and work by Waiess and more than 50 years by Karon. Both authors are psychoanalysts, which means that four concepts discovered and described by Freud will inform their work: the unconscious, resistance (defense mechanisms), repression, and transference.

All of us are opposed to murder. Psychoanalysts and psychoanalytic psychotherapists are very good at getting to the truth by listening and studying what patients say, even though reaching the truth might take a long time. They help patients to remember even what is repressed and to discover the distortions in their memory. Some patients remember witnessing murder and struggle through their lives trying not to remember it. Psychoanalytic psychotherapists help them to cope with the aftereffects of that event, which is always traumatic. Then again, some patients are afraid to remember that they wanted to kill someone earlier in their lives, or even have symptoms, such as anxiety attacks, instead of knowing that they now want to kill someone. These clinicians emphasize the difference between wishes and actions. Although patients punish themselves with symptoms for their unacceptable wishes, psychoanalytic therapists teach them that thoughts are not usually controllable and, in fact, do not need to be controlled. It is actions that hurt other people and those, therefore, need to be controlled, not the thoughts. In fact, if we do not waste time trying to control our thoughts, we generally have more control and choice over our actions.

Psychoanalytic psychotherapists are very helpful to patients who are afraid of being murdered. They are very good at helping patients to assess the reality of their danger and then teaching them how to realistically ensure their own safety.

Patients who say they are going to commit murder or say they have committed murder are more of a problem for clinicians. Regarding future attempts, in every state, the law requires psychotherapists to break confidentiality and attempt to prevent the murder if they believe a patient is likely to actually commit murder, especially if they know who the probable victim will be. One or all of the following options are required, depending on the state in which the therapist and patient reside: warning the potential victim, informing law enforcement agencies, or hospitalizing the patient in a secure facility.

Obviously, some patients say they are going to kill someone but say it in a way that clearly indicates that it is not a serious threat but a wish and a way to express how infuriated they feel. The technique of murder may be too fantastic to be believable or too inept for there to be any real danger of harming the victim; for example, the patient who does not own a gun says she could shoot her husband. Or where the patient might say, "I don't really mean it, but I wish I could kill him (or her)."

When patients recover memories that were unavailable to consciousness that involve atrocities, both patients and therapists wish they could immediately know the truth about the remembered events. The remembrance may be perfectly true, mostly false with some true details, mostly true with some false details, and possibly entirely false. …

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