ABSTRACT
The family referral of victims of trauma, where the victim denies problems, is a common occurrence since it is the family who has the most experience living over time with a loved one who has PTSD. Despite this man's denial, the presence of chronic insomnia, isolation, difficulty relating with people, as well as work problems and self-medication with alcohol and drugs, are important indications that PTSD may be present. Further workup is necessary to make an accurate diagnosis. This man's sense of alienation from American society and specifically his unconscious resentment for Caucasians had already interfered with his social and work life. The patient admitted that his dislike of Caucasians started with the Vietnam War, where colleagues in his own company called him a "gook." He never felt accepted by the other American soldiers. "I felt that I had to fight and shoot my own people, sometimes it was terrible." This latter conflict was a core issue in his treatment and would make treatment by a Caucasian clinician difficult unless acknowledged and dealt with early in the course of therapy.
