So, today's topic is Jake's PTSD.
I will base my arguments on the criteria for the diagnosis of ICD-11 and my memories of the book. If you remember anything else that supportsorrefutes my point of view, write about it in the comments, and we'll get started.
(I must say right away, I'm not a psychologist and all the information is taken from an article on the Internet)
So, to begin with, chat gpt says that Jacob has PTSD, but we won't fully believe the information from there. Just as the fact that this has an exposure is kept in mind.
For a diagnosis according to ICD-11, we need 3 main symptom complexes, we will look for
A traumatic event involuntarily pops up in the form of obsessive memories, images, nightmares, or flashbacks, accompanied by intense fear and distress
– As we remember, Jacob lived through the same memory in his nightmares MANY TIMES after his grandfather's death, and this left a strong mark on him, which clearly unnerves him. Hallucinations about him in the Empty City and hysteria in the House when he found the photos worth it
1/3 of the symptom complexes
The persistent desire to avoid thoughts, memories, feelings, conversations, people or places related to trauma in one way or another
– This was definitely not noticeable in his behavior, moving on
3. Constant perception of threat
A persistent state of heightened alert to danger, manifested by increased fearfulness, irritability, problems with sleep and concentration, and a fright reaction.
– Unfortunately, I don't remember this in his behavior either. Except that the sleep problems were definitely based on those memories. I REVIEWED THE MOMENTS, and yes, he had episodes of panic and danger preparedness, delusions of persecution, so I'll count that too.
2/3 of the symptom complexes
According to ICD-11, we cannot say that Jacob has PTSD. Additional "check-up" according to DSM-5 (the nosological system "nomenclature" of mental disorders used in the USA since 2013. In this case, it is more liquid because Jacob is from the USA and he would have been diagnosed with PTSD). The DSM-5 provides more detailed structure of 4 symptoms
1. Obsessive symptoms (intrusions)
of memories, nightmares, flashbacks, psychological distress at reminders of trauma
– we have already confirmed it
Avoiding thoughts, feelings, and external reminders (people, places, conversations)
– 50/50 here, because in the future he didn't avoid anything related to Abe, but in the initial stages – definitely yes. Although if it only talks about negative memories, then it's true.Let's count it out
3. Negative changes in mindset and mood
The inability to remember parts of the trauma, negative beliefs about oneself and the world, a sense of alienation, a persistent negative emotional background
– Negative changes in thinking and mood - 50/50, of course, his mood swam, but I'm not sure about thinking. One more correction, he had a feeling of guilt, but more often it is classified as a protective mechanism of grief. The inability to remember parts of the injury is not, although Golan tried to mess with his brain, it's more like gaslighting than the inability to remember parts of the injury, 50/50. Negative beliefs about yourself and the world – definitely yes. The feeling of alienation is definitely yes. Persistent negative emotional background – 50/50
In general, I think there are enough signs, 3/4 of the symptoms.
4. Changes in reactivity and excitability
Irritability, outbursts of anger, self-destructive behavior, hyper-vigilance, concentration problems, exaggerated fright reaction.
– Irritability is not permanent, but yes. Outbursts of anger are rare. Self–destructive behavior - in the initial stages, DEFINITELY yes. Hyper–vigilance, yes. Concentration problems are 50/50. An exaggerated fright reaction is not.
We can say that Jake has such vivid symptoms only for the first few months, however, it is normal practice for PTSD to experience such symptoms for the first few months, and then notice their decline. But at the same time, they continue to affect life, and Jacob's symptoms are much more similar to OCD – acute stress disorder, which is his canonical disorder as i know
But Wikipedia says that if the symptoms remain active for 1 month after the injury, then PTSD is also valid, and Jake's symptoms still active.
About triggers and their manifestation:
Due to the peculiarities of storing information about trauma in brain structures, traumatic memories (unlike ordinary memories) appear regardless of a person's desire, often in the form of re-experiences or nightmares. At the same time, it is impossible to stop thinking about the event by willpower.
As we can see, triggers can also manifest as nightmares (but maybe I misunderstood..)
So, Jacob may be experiencing PTSD, but he continues to experience the recovery stage. Of course, the symptoms remain, but they don't have the same effect on Portman's life as before.
Let's repeat the analysis based on Wikipedia and Wikipedia only
Criterion A – in our case, the individual was a direct witness of the event that happened to Abe
Criterion B – the presence of symptoms of intrusion (obsessive re-living of the event) is observed – periodically recurring involuntary obsessive and painful memories of a traumatic event, Jake manifests himself in nightmares.
Dissociative reactions in which an individual seems to relive a traumatic event – Jacob's paranoia.
Intense painful experiences are something that recalls a traumatic event, in Jacob's case, this is observed only at the moment of the first visit to the house.
Physiological reactivity – I didn't notice
Criterion C is the tendency to constantly avoid what may be associated with a traumatic event. It is confirmed by at least one of the following two symptoms:
1. Efforts are being made to avoid the appearance of memories, thoughts and feelings related to a traumatic event – 50/50, of course, he tried to get rid of thoughts, but at the same time he went to his grandfather's house
2. The desire to avoid contact with someone who can remind you of a traumatic event – well, it's already clear that there is no :/ it's unlikely that peculiars don't correlate with Abe in any way.
Criterion D is a violation of cognitive processes and emotional state. It is confirmed by at least two or more of the listed symptoms :
1. Inability to recall important aspects of the traumatic event (not related to traumatic brain injury / taking psychoactive substances) - this is not observed, although gaslighting Golan could have created such an effect. We keep it in mind
2. Persistent negative beliefs and expectations about yourself, others, or the world around you – 50/50. Jacob's clear experience of the "it's all my fault" complex and his parents' accusation that Abe was "only taken care of by him"
3. Constant condemnation of himself or other people, if an individual considers himself/others responsible for a traumatic event – is even more appropriate than the previous point, we count
4. Persistent negative emotions related to trauma (e.g. fear, anger, guilt, shame)– I can clearly note Jacob's guilt and anger at his parents, as well as fear in the future due to nightmares.
5. Constantly underestimated interest in previously significant things for the individual – I don't remember what significant things he had.. But given his reclusion, it's more likely a yes than a no.
6. The feeling of alienation, indifference, lack of emotional involvement in relation to other people, feeling like a "stranger" among the people around them – well YES.
7. A steady decrease in the ability to experience positive emotions/ experience love – is not observed.
Criterion E – noticeable changes in arousal and reactivity that appeared/became more intense after the injury. It is confirmed by at least two or more of the following symptoms :
1. Irritability / outbursts of anger or aggressive behavior towards other people – irritability yes, outbursts of anger rather no than yes, aggressive behavior no
2. Autoaggression that is dangerous for the individual himself – no
3. Constant state of heightened alertness – yes
4. Fright reactions in response to minor incentives – no
5. Impaired concentration – no
6. Sleep disturbance – yes.
Criterion F – To make a diagnosis, it is necessary that the symptoms described in criteria B, C, D, and E have been present for more than one month
B – yes, more than one month
C – no, it wasn't noticed
D – yes, more than one month
E – 50/50, but definitelymore than one month
Criterion G – in addition, all the violations described above lead to violations in the individual's body/his professional and social life – yes
Criterion H – the disorders described above do not relate to the physiological effects of any substances (alcohol, drugs, drugs) or manifestations of epileptic seizures - no
in this way, I can say that Jacob probably has post-traumatic stress disorder, but it is important to remember that this diagnosis has a lot of aspects and details, I've been checking only the clinical symptoms. I can add something else to my review, if it's necessary. Jacob canonically has acute stress disorder, so all of these symptoms are more likely to relate to him than to PTSD, but we're free to explain what we want. Thanks for reading, I will be glad for your reaction❤️🩹
