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The Expert: Louis Damis, a psychologist practicing in Florida, who details the impact the injuries and ultimately the death of the fire chief had on his wife.
Testifying in a 2019 Florida trial, Dr. Louis Damis, a Florida clinical psychologist, discusses the impact of the injuries and ultimately the death of a fire chief on the victim’s wife after a crash with a Domino’s Pizza delivery driver.
The testimony from this treating psychologist begins with a discussion of post-traumatic stress disorder and complex bereavement syndrome, both of which were diagnosed in this case. The initial emphasis in treatment was on the PTSD because that was significantly complicating her bereavement process.
PTSD, the expert explains, is technically an anxiety disorder. There are three forms of anxiety caused by unwanted intrusions of thoughts related to the traumatic event. First, is encountering stimuli that remind the victim of the trauma. In this case, things that were related to the fire department, flying, or songs that were special to their relationship, would cause the plaintiff to experience intense anxiety as a connection between the stimuli and memories of the accident. In addition, people with PTSD will have “anxious intrusions that just come to them,” the expert notes. These are internally generated and could include nightmares.
Lastly, victims with PTSD are plagued with a nervous system that is sensitized to danger because “our minds are designed to learn about bad things and not forget them.” This causes those with PTSD to be in a chronic state of hyperarousal or hypervigilance.
In this particular case, the plaintiff was fearful that she was now unprotected at night and might be attacked or killed by an intruder. Another phobia that she now experiences is a fear of people driving her in a car. She would actually demand that the driver stop the car to let her out when this anxiety occurred.
Damis then goes into the treatment of PTSD. The first phase is called “stabilization.” This entails teaching skills and techniques to master anxiety and restore the feelings of safety. This focuses on “implicit memory,” which is entirely based upon associations. One of the techniques he used in treating her was hypnosis. After repeated hypnosis sessions, the patient should begin to “experience safety again.” Theoretically, this repeated experience becomes internalized and replaces the anxiety that was learned as a result of the trauma.
In teaching the plaintiff to deal with anxieties, the expert used cognitive strategies that reinforced that these arousals and fears are going to pass, as well as strategies to make her more grounded. In using these strategies, additional issues with her husband’s loss were frequently unearthed. For instance, her husband made her feel safe and protected, even after the accident. The loss of this comfort led to anxiety and fear that was treated not only with therapy sessions but also with antidepressant medication.
Damis notes that, after years of his treatment, the plaintiff stopped seeing him for about two years. After regaining her insurance, she saw different mental health professionals only to return to the expert’s care with a significant deterioration in her condition. When questioned about the plaintiff’s chances of recovery in the future, the psychologist relates that his patient is highly motivated and frequently asks for ways that she can engage in self-help, so he is hopeful that she will improve moderately with continuing therapy.
However, the fact that the situation is now chronic has led to a lowering of expectations for the future. Rather than aiming to render her completely symptom-free, he now hopes that she can become reasonably comfortable. These symptoms include avoiding being in public, problems being in a car with other people, surges of anxiety attacks that are embarrassing, and chronic sleep disturbances with nightmares. Although she has periods when “she feels reasonably OK” she still falls victim to some trigger that throws her back into grief. Her life thus becomes “constricted.” She will continue to require treatment by health professionals for PTSD and complex bereavement disorder.
The doctor’s testimony proved to be effective, as the jury awarded the plaintiff $8.97 million.
Gary Gansar, MD, is residency-trained in general surgery. He served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Touro Infirmary and Mercy Hospital in New Orleans, LA. Dr. Gansar was Board Certified in general surgery while in active practice. He joined AMFS in 2015 as a Physician Medical Director.
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