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Mark Rubinstein, M.D.
Mark Rubinstein M.D.
Post-Traumatic Stress Disorder

PTSD and the Legal System

The Jodi Arias Case

Let me say at the outset, I never examined Jodi Arias or reviewed any records in the case.

Jodi Arias is on trial for murder in Arizona.

She admits to shooting her boyfriend, Travis Alexander, stabbing him multiple times and slashing his throat from ear to ear. Ms. Arias claims to have little or no memory of the murder. A defense-retained psychologist testified Jodi was suffering from Post-Traumatic Stress Disorder which arose from the murder itself.

This diagnostic assertion is ludicrous because PTSD and the claim of not remembering a traumatic event are mutually exclusive.

In fact, Post-Traumatic Stress Disorder applies when a person remembers too much of a trauma. Intrusive thoughts and recollections (flashbacks) of the incident are played over and over in the victim's mind. Recurrent nightmares awaken the person in a state of terror. If discussing the traumatic event, the victim exhibits uncontrollable anxiety bordering on panic. In essence, the signs and symptoms of PTSD preclude a person from being unable to remember the trauma. The disorder involves "over-remembering" the event.

In addition, for PTSD to be properly diagnosed, the victim must experience the trauma with fear of imminent death or the threat of severe harm to self or others. Stressors which may evoke the disorder include forcible rapes; violent muggings; wartime combat; witnessing others being killed, maimed or tortured; tsunamis; plane crashes; and similar horrific occurrences.

In every legitimate case of PTSD, the person was a victim, not the aggressor, as in the Arias case. In addition, Ms. Arias has testified about the murder for six weeks without any semblance of anxiety. She confabulated different scenarios of the murder, ranging from denying having done it, to “masked intruders” and then, “self-defense.” Keep in mind, the murder was sparked by her photographing her boyfriend naked in the shower

As a forensic psychiatrist, I have examined many patients who survived catastrophic incidents, including more than 300 survivors of the 9/11 attack at the World Trade Center. However, during other consultations, I've encountered some people claiming to suffer from PTSD following situations that would never evoke the disorder. Whether it was tripping on a sidewalk, or a fender-bender car accident not even requiring a trip to the emergency room, the flagrant misuse of the term PTSD has earned it the dubious distinction of being the most abused and misapplied diagnosis in the psychiatric-legal lexicon.

The Arias case demonstrates a larger issue. The claim of PTSD seeps into courtroom proceedings far too frequently because the disorder primarily involves symptoms, with relatively few (if any) objective signs. And, the word stress is a loaded concept presented to juries, often in a distorted way that trivializes real PTSD.

True Post-Traumatic Stress Disorder, renders the victim unable to stop reliving the helplessness, terror and sense of impending annihilation. There is absolutely nothing about the Jodi Arias defense that even remotely approaches rendering an honest diagnosis of PTSD.

It's time for the courts to require rigorous criteria be applied to this diagnosis before allowing more specious psychiatric claims to be presented to juries.

*Again, I never examined Jodi Arias or reviewed any records in this case.

About the Author
Mark Rubinstein, M.D.

Mark Rubinstein, M.D., is a former professor of psychiatry at Cornell. His most recent book is the novel Mad Dog House.

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