The Unspeakable Mind: Stories of Trauma and Healing from the Frontlines of PTSD Science

by Shaili Jain

Overview

From a physician and post-traumatic stress disorder specialist comes a nuanced cartography of PTSD, a widely misunderstood yet crushing condition that afflicts millions of Americans.

"Dr. Jain’s beautiful prose illuminates this widely misunderstood condition and makes for fascinating reading.  It is a must for anyone who has a survived trauma, their loved ones and the healthcare professionals who care for them." —Irvin Yalom, bestselling author of When Nietzsche Wept

The Unspeakable Mind is the definitive guide for a trauma-burdened age. With profound empathy and meticulous research, Shaili Jain, M.D.—a practicing psychiatrist and PTSD specialist at one of America’s top VA hospitals, trauma scientist at the National Center for PTSD, and a Stanford Professor—shines a long-overdue light on the PTSD epidemic affecting today’s fractured world.

Post-Traumatic Stress Disorder goes far beyond the horrors of war and is an inescapable part of all our lives. At any given moment, more than six million Americans are suffering with PTSD. Dr. Jain’s groundbreaking work demonstrates the ways this disorder cuts to the heart of life, interfering with one’s capacity to love, create, and work—incapacity brought on by a complex interplay between biology, genetics, and environment. Beyond the struggles of individuals, PTSD has a tangible imprint on our cultures and societies around the world.

Since 9/11 and the wars in Iraq and Afghanistan, there has been a huge growth in the science of PTSD, a body of evidence that continues to grow exponentially. With this new knowledge have come dramatic advances in the effective treatment of this condition. Jain draws on a decade of her own clinical innovation and research and argues for a paradigm shift in how PTSD should be approached in the new millennium. She highlights the myriads of ways PTSD care is being transformed to make it more accessible, acceptable, and available to sufferers via integrated care models, use of peer support programs, and technology. By identifying those among us who are most vulnerable to developing PTSD, cutting edge medical interventions that hold the promise of preventing the onset of PTSD are becoming more of a reality than ever before.

Combining vividly recounted patient stories, interviews with some of the world’s top trauma scientists, and her professional expertise from working on the frontlines of PTSD, The Unspeakable Mind offers a textured portrait of this invisible illness that is unrivaled in scope and lays bare PTSD's roots, inner workings, and paths to healing.  This book is essential reading for understanding how humans can recover from unspeakable trauma. The Unspeakable Mind stands as the definitive guide to PTSD and offers lasting hope to sufferers, their loved ones, and health care providers everywhere.

Product Details

ISBN-13:	9780062469076
Publisher:	HarperCollins
Publication date:	05/12/2020
Pages:	416
Sales rank:	496,097
Product dimensions:	5.20(w) x 7.90(h) x 1.20(d)

About the Author

Shaili Jain, M.D. is a British born American Physician of Indian ancestry.  She is a psychiatrist and Post-Traumatic Stress Disorder specialist and currently serves as the Medical Director for Integrated Care at the VA Palo Alto Healthcare System. She is a trauma scientist affiliated with the National Center for PTSD, a consortium which is widely regarded as the world's leading center of excellence on PTSD, and a Clinical Associate Professor affiliated with the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine. 

Dr. Jain’s work is widely accredited for elucidating the role of paraprofessionals and peers in the treatment of American veterans with PTSD. Her research has been published in some of the most prestigious medical journals, such as the Journal of the American Medical Association, Psychiatric Services and the Journal of Traumatic Stress, in addition to being featured in national publications such as The New York Times. Her medical essays and commentary have appeared in the New England Journal of Medicine, Psychology Today, Kevin MD, STAT, public radio and elsewhere.

Table of Contents

Prologue xiii

Introduction xvii

Part 1 Discovering Traumatic Stress 1

The Road Trip with My Father 3

A Pressing Public Health Concern 10

A Brief History of Trauma 16

Old Wine in a New Bottle? From Shell Shock to Battered Women to PTSD 21

Rocky Roads: Overdiagnosis and Underrecognition 25

Part 2 The Brain 33

A Disorder of Memory 35

Nightmares 49

Flashbacks 55

An Unlived Life: The Hidden Cost of Avoidance 58

Denial Land: When Trauma Memories Are Deeply Buried 66

Carrying Sorrows in the Blood: Cortisol, Epigenetics, and Generational Trauma 70

A Wildness in the Bones: Acute Awareness and Shady Moods 76

Dissociation: The Two-Thousand-Yard Stare 83

Part 3 The Body 87

Bodily Wounds 89

A Soldier's Heart: PTSD and Cardiac Disease 96

Russian Roulette: The Perilous Bond Between Traumatic Stress and Addiction 101

Broken Smiles: The Toxicity of Childhood Adversity 110

Senescence: Traumatic Stress in Late Life 120

Part 4 Quality of Life 129

Complex Trauma 131

Intimate Violence: A Secret Pandemic 139

A Danger to Others: Hurt People Hurt Other People 149

Angry Loving: The Stubborn Imprint of Inner-City Poverty 155

The Fairer Sex? Rape, Secondary Injuries, and Postpartum PTSD 163

Shame: The Cinderella Emotion 171

The Science of Suicide Prevention 180

Part 5 Treating Traumatic Stress 187

Talking Cures and Beyond 189

Psych Meds 198

Medication Management 209

The Allure of Magic Bullets 216

Part 6 Our World on Trauma 223

Trauma of the Masses: A Wicked Problem 225

The 1947 Partition 229

War, Disaster, and Terror: Hard-Earned Knowledge and Lessons for the Future 239

An Americanization of Human Suffering? 250

Part 7 A New Era: An Ounce of Prevention 255

Prevention with Precision 257

The Golden Hours 262

Reaching the Hard to Reach: Making PTSD Treatment More Accessible 266

The Power of Social Networks 272

The Science of Resilience 275

Afterword: A Precious Inheritance 285

How This Book Was Written 291

Acknowledgments 295

Notes 301

Glossary 361

Resources 365

Index 371

Editorial Reviews

[A] comprehensive survey of the state of knowledge concerning PTSD. . . . Jain carefully lays out what can be said with confidence about [PTSD]…and what is more speculative, all with an eye to potential cures. . . . Given epidemic anxiety and stress disorders, this is a timely book that will greatly interest those who suffer from [PTSD] as well as family members and medical practitioners.”  — Kirkus Reviews

“This instructive resource can be recommended not only for those who have personal experiences with PTSD and trauma, but for anyone interested in learning more about the disorder and how it affects society.” — Publishers Weekly

“Jain asserts that the importance of accessible treatment and early intervention for PTSD cannot be overstated, while also emphasizing the genuine healing value of empathy and simply listening.” — Booklist

An atlas of the elusive yet very common condition of PTSD, The Unspeakable Mind makes for an engrossing read in which Jain serves as our trusted guide, deconstructing the entity known as PTSD symptom by symptom.  She deftly weaves riveting depictions of patient encounters with her rich and informed observations to reveal how PTSD goes far beyond issues of mind and brain—it is interwoven into our physical well-being, quality of life, and exerts an insidious influence over our culture and society. Dr Jain’s beautiful prose illuminates this widely misunderstood condition and makes for fascinating reading.  It is a must for anyone who has a survived trauma, their loved ones and the healthcare professionals who care for them. — Irvin Yalom, M.D., Emeritus professor of Psychiatry, Stanford University and bestselling author of When Nietzsche Wept

“Shaili Jain has written a wonderfully creative mixture of handbook on trauma, research report, personal memoir, and cultural commentary.  The result is a thoroughly engaging book about the hardest parts of life presented gently, beautifully, insightfully, and with wisdom.” — Edward Hallowell, M.D., co-author of the New York Times bestseller Driven to Distraction

“In The Unspeakable Mind, noted psychiatrist and scholar Shaili Jain, presents an absorbing and comprehensive account of one of the scourges of our modern age. Anyone suffering from PTSD - or their loved ones - should read this book to learn, understand, and heal.” — Sandeep Jauhar, M.D., New York Times bestselling author of Heart: A History

“Shaili Jain’s The Unspeakable Mind is a riveting conversation about trauma and PTSD. It is a very personal narrative built around Dr. Jain’s clinical experiences as well as the story of her family’s trauma during the partition of India in 1947. She has skillfully embedded a comprehensive review of the relevant science and practice in the field that will thoroughly captivate and enlighten readers.”  — Matthew J. Friedman MD, PhD, Senior Advisor (and Former Executive Director), National Center for PTSD & Professor and Vice-Chair for Research, Department of Psychiatry, Geisel School of Medicine at Dartmouth   

“Highly recommended for a wide variety of readers, but especially to those who may have undergone trauma or the family members with whom they share their lives. . . . Told in a compassionate and humanistic manner that makes the pain of this condition come alive for the reader.” — New York Journal of Books

From the Publisher

Jain asserts that the importance of accessible treatment and early intervention for PTSD cannot be overstated, while also emphasizing the genuine healing value of empathy and simply listening.

Booklist

05/13/2019

Jain, a psychiatrist who specializes in PTSD, draws on her experiences working with sufferers of the disorder to outline a commonly misunderstood problem and its possible solutions. At a time when millions of Americans have suffered from trauma, this work sheds light on the symptoms of PTSD as well as the different types of treatment currently available, among which the “gold standard,” in her view, is cognitive behavioral therapy. Describing symptoms such as flashbacks and increased anxiety, Jain argues that “the goal of treatment should be to help survivors thrive in their new normal.” She also explores the diverse types of trauma that can lead to PTSD and related disorders, through stories from people she has treated. These include a woman traumatized by both her infant’s death from sudden infant death syndrome and by being blamed by her parents and ex-husband for the death, and a man whose memory of witnessing, over five decades before, a racially motivated assault suddenly manifests itself in late-onset stress symptomatology. This instructive resource can be recommended not only for those who have personal experiences with PTSD and trauma, but for anyone interested in learning more about the disorder and how it affects society. (May)

Publishers Weekly

Highly recommended for a wide variety of readers, but especially to those who may have undergone trauma or the family members with whom they share their lives. . . . Told in a compassionate and humanistic manner that makes the pain of this condition come alive for the reader.

New York Journal of Books

In The Unspeakable Mind, noted psychiatrist and scholar Shaili Jain, presents an absorbing and comprehensive account of one of the scourges of our modern age. Anyone suffering from PTSD - or their loved ones - should read this book to learn, understand, and heal.

Sandeep Jauhar

Shaili Jain’s The Unspeakable Mind is a riveting conversation about trauma and PTSD. It is a very personal narrative built around Dr. Jain’s clinical experiences as well as the story of her family’s trauma during the partition of India in 1947. She has skillfully embedded a comprehensive review of the relevant science and practice in the field that will thoroughly captivate and enlighten readers.” 

Matthew J. Friedman MD

An atlas of the elusive yet very common condition of PTSD, The Unspeakable Mind makes for an engrossing read in which Jain serves as our trusted guide, deconstructing the entity known as PTSD symptom by symptom.  She deftly weaves riveting depictions of patient encounters with her rich and informed observations to reveal how PTSD goes far beyond issues of mind and brain—it is interwoven into our physical well-being, quality of life, and exerts an insidious influence over our culture and society. Dr Jain’s beautiful prose illuminates this widely misunderstood condition and makes for fascinating reading.  It is a must for anyone who has a survived trauma, their loved ones and the healthcare professionals who care for them.

Irvin Yalom

Shaili Jain has written a wonderfully creative mixture of handbook on trauma, research report, personal memoir, and cultural commentary.  The result is a thoroughly engaging book about the hardest parts of life presented gently, beautifully, insightfully, and with wisdom.

Edward Hallowell

Jain asserts that the importance of accessible treatment and early intervention for PTSD cannot be overstated, while also emphasizing the genuine healing value of empathy and simply listening.

Booklist