ABSTRACT
Kendra has been a child protective investigator for the state for the past three years. During that time she has interviewed children who have been hit, burned, neglected, and sexually abused by their caretakers. She has written and read reports that include overwhelming details about these experiences, as well as taken and viewed photographs that document the maltreatment. Her caseload has continued to grow, and as she becomes more experienced, new workers talk to her about their cases because they value her opinion and advice. Although she does not mind helping her coworkers, it has become difficult to do so lately because she has been extremely tired. For the past two months, Kendra has been waking up at 3:00 each morning unable to breathe. She gets out of bed and goes into the living room so she can lay on the couch with the ceiling fan on high. She is hot and sweaty, her heart is racing, and her arms hurt. She cries because she thinks she is having a heart attack and is afraid she is going to die. When she does not die and the symptoms subside, she assumes she is crazy. Finally she falls back to sleep at 5:30, only to have to get up at 6:00 a.m. for work. She also has been having severe pain in her arms and legs, and at times it is difficult for her to walk. Because it is more difficult for her to breathe after she eats, she skips meals and has lost 15 pounds. After her last sleepless night, Kendra promised herself that if she lived until morning she would see her family doctor. After a full battery of medical exams and tests, the doctor was unable to find any physical cause for her symptoms. Although relieved she was not dying, Kendra was upset when the doctor suggested she take an antidepressant 40to help with the symptoms. Thinking this would validate her biggest fear, that she was, crazy she decided not to take the medicine.
