Letters at Length December 21

PTSD rare in children

I am troubled by the reported testimony at the Tuesday, Dec. 15 City Council meeting by Deltra Ferguson quoting information from Diane Portratz of the Southern Oregon University Campus Health and Wellness Center.

I have been a licensed clinical social worker in California and Oregon for 41 years. I also served on the California Board of Behavioral Science Examiners. My practice specializes in people with serious health problems and includes crisis, suicide and post-traumatic stress disorder. I have taught at two universities and one college. I am a published author. I have also served as a court mediator in custody and parenting issues, so I have an extensive acquaintance with real and alleged child abuse.

Portratz' comments are incorrect. What she says sounds like common sense — but it isn't. She is apparently starting with a conclusion and arguing backwards (from trauma to flashback experience of the trauma by seeing a naked person).

Her comments reflect bad social science. There is no empirical evidence that seeing nudity in a public place does any such thing to a child. The reason for this is that PTSD presumes fully formed defenses, which the child does not have. The defense used in such instances is repression — and repression either works or not. Children suffer immediately. We see signs of this immediately, which is why we need to be sensitive to such abuse and treat immediately. PTSD presumes a long period of repression, of which the young child is incapable.

Therefore, the incidence of PTSD among children who are subjected to sexual abuse is negligible and hard to treat when it occurs.

PTSD is a popular diagnosis now for obvious reasons, and is a legitimate diagnosis, but not in children. Ms. Portratz has not been trained in child therapy or PTSD.

Councilor Carol Voisin is correct. And — we do have appropriate laws dealing with (usually clothed) sexual predators.

Philip C. Lang


Bravo Lieberman

Bravo Senator Lieberman.

While the world realizes that our current health care system is unsustainable, you've had the courage to acknowledge there's no problem so dire that the federal government can't make it worse.

To sweep the mounting deficits of the ever-expanding "health care reform" under the Medicare rug is ludicrous. You understand what the average middle-class American under 65 years doesn't: they are already subsidizing Medicare in its current form. If it weren't for the ability of providers to cost shift, no physician or hospital could survive caring for Medicare beneficiaries. See Newsweek's Dec. 7 article "The Hospital That Could Cure Health Care." The Cleveland Clinic is portrayed as being highly effective and fiercely efficient, the administration's poster child in health care delivery. Yet, even this lean, mean machine realizes a 6 percent loss to cost when caring for a Medicare patient. Their doors would've closed long ago were it not for commercial insurance, including a healthy mix of Cadillac plans making up the difference. I can't imagine the load the middle class will have to bear when Medicare reduces reimbursements for $500 billion, effectively increasing the percent lost to cost to 15 percent. The upside, of course, is that anyone of the middle class with commercial insurance will find ready access to care. In contrast, it will be a long and hard search for those on Medicare.

Even now, here in Oregon, the vast majority of primary care providers limit their access to Medicare patients, with a growing percentage closing their practices to Medicare entirely. Our internists in private practice have gone the way of the dinosaur, with the ice age of cold reality being you can't cost shift when 90 percent of your patients are Medicare.

Thanks, Senator, for doing the math and keeping this disaster from getting any worse.

Dr. John G. Maurer


Rein in Congress

Dear President Obama,

I doubt you'll see this letter, but I enjoyed writing it anyhow.

As a former speech teacher (long since retired), I take delight in hearing your speeches. Never have I heard any other speaker so gifted with all the assets of great speech making: voice, timing, enunciation, figure, common touch, self-confidence with modesty and, needless to say, outstanding intelligence.

I am touched by your optimism about this country, though I'm afraid I cannot share it when I observe the functioning of Congress. As I see it, two changes are absolutely required if America is to get a decent government, and I'm afraid it would be impossible to achieve these changes without resorting to revolution. The necessary changes are:

1) Strict term limits for all members of Congress, and

2) Limit on time and money that can be spent on political campaigns — as well as a strictly enforce ban on gifts of any kind to members of Congress.

These are changes no president can give us. Obviously, Congress, in the pay of big business, never will! Without them, America will never have democracy.

However, I take much satisfaction in sending good wishes to a great American president.

Margaret K. St. Clair


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