From Post-Traumatic Stress Disorder to Absolute Dependence in an Intensive Care Unit. Reflections on a Clinical Account

by Tina Catherine Sideris

This paper tells the story of one man’s experience of terrifying hallucinations and nightmares in an Intensive Care Unit (ICU). His experience draws attention to the reality that intensive care treatment can cause emotional suffering severe enough to be identified as post-traumatic stress disorder (PTSD). At the same time this patient’s account, and patient experiences described in other studies, clearly show how helpless and absolutely dependent patients are, no only for complex treatment but also for having their most basic needs met. This highlights the relational dimension of professional patient care. The paper argues that the experiences of ICU treatment such as mechnicial ventilation can be terrifying,  but our vulnerability lies in our dependency. There is always the chance of not being hear, not being attended to. When carers don’t respond  to patients distress and the risks of traumatisation are intensified.  On the other hand, research shows that  even the smallest gestures of care nurture safety, and thereby reduce the risk of  patients developing PTSD. The paper raises the question of how we might explain the neglect of relational care that is a recurring theme in medical contexts, without blaming the carers.

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