right back to the house. If you can do this, you’ll get a medal for
bravery beyond the call of duty.”
Neil begins to walk hesitantly down the steps.
His wife shoulders her rake and salutes.Even if Neil does see a you-know-what and runs, he still earns his
medal. It’s important to have an easy means of escape if you try something
like this. The only way it could go wrong is if the frightened person
feels trapped.
Usually, therapists will advise you on specific approach strategies,
and teach fearful people techniques for moving closer. You may not have
to come up with the plan, but you will have to follow it, even if it’s incon-
venient, and you’d really like to have the oven cleaned and the floor waxed.
Think of it as an investment.
SECONDARY GAIN ANDPTSD The fact that PTSD, by definition, is
caused by somebody or something else makes secondary gain a primary con-
cern. Regardless of who caused the disorder, it cannot improve until the
fearful person takes responsibility for it, even if it is more profitable not to.
Trish is suing the driver of the pickup who smashed into her car
for psychological damages. For weeks she would have panic
attacks even at the thought of driving. When she told her lawyer
that her psychological treatment involved getting back behind
the wheel as quickly as possible, he asked, “What’s your hurry?”Sometimes it can actually cost money to get over PTSD. In Trish’s
case there was never any question of not driving. She wanted to get better
more than she wanted a big settlement.
Correctly diagnosed, PTSD is a disorder so painful that it creates
strong incentives to do whatever it takes to get better. I have seen many
cases of PTSD in people who have been in accidents, and in law enforce-
ment and emergency personnel who were involved in or witnessed deadly
situations. When the diagnosis is applied incorrectly, the patient must some-
times choose between the relief of healing and the benefits of staying sick.
110 ❧Explosions into Fear