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Hysteria and litigation: coping with the real of trauma.

The Letter, Issue 3, Spring 1995, Pages 36 - 44


Aisling Campbell

The topic of my discussion today is one which may not impinge very much on the practice of analysts, but about which, nevertheless, I think analysis has something to say. I am going to talk about those patients, ubiquitous in psychiatric practice, who suffer from "post-traumatic stress disorder" as a result of accidents and who subsequently seek financial redress through personal injury claims. I think that these patients are the "new hysterics" of our time, perhaps replacing Anna O. and Dora and the other hysterics to whom we owe so much. As a psychiatrist I am in the happy (or perhaps not so happy) position of having seen a lot of these patients and I hope that my comments will hold some interest for you.

Most of you will be aware that personal injury claims have increased at a dramatic rate in Ireland over the past ten years. For some, litigation is so profitable that this method of making an income is affectionately known as "The Compo". Here, four times as many claims arise as in the UK, and our settlements are the highest in Europe. Some of the claims made on insurance companies and city corporations are deliberately fraudulent and their perpetrators are motivated only by greed. This phenomenon is not the topic of my discussion today. However, there is undoubtedly a large number of individuals who genuinely suffer injury and mental anguish after an accident of some sort and who seek compensation in court without any intent to defraud. Psychiatrists and other doctors see many of these patients as we are frequently called upon to bear witness to the genuineness of their suffering. They are extremely difficult to treat and seem to do badly in any sort of therapy, even when the therapist has no part in the provision of medicolegal reports. Analysts certainly see few of them, particularly before settlement. They present particular difficulties for analysts by virtue of having received financial reward for their suffering.

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