Dr Champion.
527 Dr Champion examined Mr Covington-Thomas on 15 May 2003 and again on 13 October 2005. On each occasion he provided a report. He furnished a further report on 19 October 2006, commenting upon the plaintiff's medical evidence and other reports. The combined reports are voluminous (Ex 15, pp1-63). Dr Champion also gave evidence. He did not accept that Mr Covington-Thomas had suffered PTSD or other psychiatric injury arising from the Melbourne/Voyager collision. He did, however, accept that he suffered from a depressive illness beginning in the mid-1990s and from alcohol dependence (Ex J, para 5).
528 Further, Dr Champion did not quite accept that Mr Covington-Thomas had PTSD arising from his war service in Vietnam, although he recognised that the Department of Veterans' Affairs had accepted that claim and continued to pay a pension. His view on Vietnam was expressed in these words: (Ex J, para 28)
"28. Dr Champion is of the view that the Vietnam experience had not worsened any of Mr Covington-Thomas' pre-existing psychiatric conditions because at that time, in his view, there were none. In Dr Champion's opinion if one were to hypothetically assume that currently Mr Covington-Thomas suffered with posttraumatic stress disorder, then this would most likely be the result of the Vietnam service experiences of which he complains. Consistent with that is the absence of any objective indication or disorder at that time as well as information in Dr Gelb's treatment notes in which Mr Covington-Thomas on one occasion at least, expresses severe upset and guilt in relation to the experiences in the Vietnam service. It is Dr Champion's contention that Mr Covington-Thomas did not develop posttraumatic stress disorder as a consequence of his Vietnam service."
529 When cross examined, Dr Champion described his views as "conservative but not extreme" (T824). His views, emerging from his reports and evidence, may be summarised as follows:
· First, Mr Covington-Thomas, in the first consultation when describing his Naval career, made no reference to the Melbourne/Voyager collision (Ex 15, p33). When asked by Dr Champion to deal with that issue, he did so in a matter of fact way, displaying neither physical nor emotional distress (Ex 15, p36).
· Second, having returned from leave in 1964, whilst HMAS Melbourne was repaired, Mr Covington-Thomas was not concerned about rejoining the ship. Dr Champion would have expected real concern as a symptom of avoidance, had Mr Covington-Thomas been significantly traumatised (Ex 15, p37).
· Third, Dr Champion saw no objective evidence that Mr Covington-Thomas had suffered psychiatric problems, or physical problems, that had disrupted his Naval career (Ex 15, p57). On the contrary, he had performed at a very high level.
· Fourth, having been discharged from the Navy in 1970, the pattern of his employment thereafter did not suggest that he was coping poorly (Ex 15, p39). He married, had children, and was continuously employed.
· Fifth, whilst Mr Covington-Thomas did exhibit some symptoms consistent with psychiatric illness, which were documented in histories taken from medical practitioners, including Dr Stoller (1980), such symptoms were non-specific. The diagnosis of Dr Stoller (mild personality disorder) would appear to have been appropriate (Ex 15, p51). The symptoms so documented did not satisfy the criteria in DSM III or IV in respect of PTSD.
· Sixth, objectively, Mr Covington-Thomas continued to function well until the mid-1990s (T810). His decompensation thereafter is explicable upon the basis of the significant adverse events at that time, he being a person vulnerable to psychiatric disorder genetically and by reason of his emotionally deprived childhood (cf Ex J, para 34).
· Seventh, Mr Covington-Thomas now complains of nightmares and intrusive thoughts concerning the Melbourne/Voyager collision. He has identified other symptoms which he also relates to the collision. Dr Champion believes that he did not complain of, or suffer from, PTSD symptoms until after he had commenced his claim for damages (Ex J, para 19).
· Eighth, Dr Champion stated that it is possible to develop false memories as a result of motivation or suggestion (Ex J, para 12). The symptoms from which Mr Covington-Thomas now suffers (including nightmares concerning the Melbourne/Voyager rescue and intrusive thoughts and images relating to that rescue) are, in Dr Champion's view, "a consequence of the current focus of litigation and the impact of motivation and suggestion, rather than being caused by the presence of a longstanding traumatic memory relating to the Melbourne/Voyager disaster" (Ex J, para 10). The genesis of these symptoms, according to Dr Champion, was the advertisement inserted by a solicitor in 1995, to which the plaintiff responded, as well as the psychiatric examination which was arranged thereafter with Dr Wu, when he was told that he had PTSD arising from the Melbourne/Voyager collision (Ex 15, p40; Ex J, para 19).
· Ninth, Dr Champion accepts, however, that Mr Covington-Thomas, in recounting his symptoms, is not malingering.
· Tenth, the heavy drinking and alcohol abuse by Mr Covington-Thomas is accepted by Professor McFarlane and others as a form of self-medication, which can therefore be related to the psychiatric disabilities from which Mr Covington-Thomas is said to suffer. Dr Champion is of a different view. The studies have demonstrated, in his opinion, that the same genes that predispose towards depression, also predispose towards alcohol abuse (T816) (cf Ex J, paras 18-20).
530 The approach taken by Dr Champion was explained in the following passage during his cross examination: (T825)
"Q. Now, part of the problem one always has, when trying to diagnose causation, is that you have to rely upon what you were told by a person who comes to see you?
A. To some extent, but you are often provided with records which either confirm or are different from. Often those records are contemporaneous and you don't rely on that fallible memory that I was talking about earlier.
Q. So it is often better also to go and see what other people observed about the person whom you are assessing or treating because their memory may well be more reliable?
A. Particularly if it is written down and not based on recollection, because any sort of recollection is going to involve those factors that I talked about earlier."
531 One can understand Dr Champion's caution. First, more than three decades had elapsed before Mr Covington-Thomas claimed that his psychiatric problems were attributable to the Melbourne/Voyager collision. Secondly, he had, during those three decades, twice seen psychiatrists, Dr Stoller in 1980 and Dr Parkin in 1994 (Ex J, para 25). Nothing had been said about Melbourne/Voyager. Thirdly, having made his claim in November 1995, Mr Covington-Thomas had thereafter provided many inconsistent accounts in respect of the presentation of symptoms such as nightmares. Fourthly, neither the history he provided (in rejoining the Melbourne), nor his work record, whether in the Navy or after discharge, suggested any obvious disablement.
532 Dr Champion did not, however, have the advantage of seeing and hearing witnesses who could speak of their observations, although admittedly 40 years on. The following was put to Dr Champion in cross examination, putting evidence which was not seriously challenged by the defendants, and which I have accepted: (T834)
"MELICK: Q. Are you saying then if somebody has nightmares, significant nightmares in the immediate aftermath of a traumatic event, that is normal and --
A. Yes. It's a way of working through the trauma.
Q. But is it also not a very strong diagnostic criteria of an acute stress disorder?
A. Not in the first month.
Q. In any event, bearing in mind the collision occurred in February, if at Christmas time of that year he is still having nightmares and then if when he returns from his service aboard HMAS Hobart, which I think was in 1965 or '66, he is still having nightmares related to the Melbourne Voyager collision, that would then be very strong corroborative evidence of the existence of a post traumatic stress disorder, would it not?
A. If they were actually happening, yes."
533 Again, Dr Champion assumed, on the evidence he had, that there had been no psychological problems disrupting Mr Covington-Thomas' Naval career (Ex 15, p57). His reaction, for instance, to seeing the USS Enterprise on the horizon whilst a member of the crew of HMAS Hobart, was a normal response (T819). He was simply reflecting what he had learned from his previous experience (Ex 15, p37). Counsel for the plaintiff, in cross examination, put to Dr Champion the evidence of Mr Fennel, a crew member on the same ship. The evidence, again, was not seriously challenged, and it is evidence that I have accepted (supra para [174]). Counsel for the plaintiff put a question which was objected to. The following question was then put: (T841/2)
"HIS HONOUR: I think you (have) got to put it in terms of an assumption. If you assume it to be the fact that Mr Covington-Thomas, having seen the Enterprise, felt sufficiently concerned to not want to go below deck and described himself as apprehensive and within a short time said to a naval colleague that he wanted to get out of the Navy because he was now frightened of seeing - being in the presence of aircraft carriers, if you make that assumption that that actually --
A. If one makes the assumptions he, yes.
Q. -- what did happen --
A. Yes.
Q. --- what is the significance (if any) of that --
A. Yes.
Q. -- is that evidence?
A. That would be, that would be evidence pointing towards some sort of anxiety state related to previous experiences.
Q. Consistent with post traumatic stress disorder?
A. Consistent with post traumatic stress disorder."
534 The plaintiff, in his case, relied upon the evidence of Mr Pollard (supra para [306]), who worked with him at the Maryborough school in the 1980s. He had witnessed Mr Covington-Thomas alone, crying, in February which would be the anniversary of the Melbourne/Voyager collision. Indeed, it had happened more than once. Dr Champion, in that context, said that anniversaries can cause a flood of feelings. Such feelings do not necessarily, in his view, suggest a psychiatric disorder (T821). In cross examination, Dr Champion said this: (T842)
"MELICK: Q. And being observed to be emotional and crying on the anniversary of the collision on five or six occasions in the early 1980s would once again be consistent with suffering from post traumatic stress disorder resulting from the collision?
A. Well, it could be. It would be, it would be an indication that there was ongoing difficulties dealing with those memories, yes."
535 Dr Phillips gave evidence relevant to this issue. He said this: (T1101)
"Q. Any you may assume this is the position of Mr Covington-Thomas, when asked in effect what he was crying about, he said that he lost mates in the Melbourne Voyager collision, that would be a classic illustration of a person of crying on anniversaries as a result of bereavement or a bereavement-like loss?
A. Yes. I think usually the tears are about someone very close; first degree relative, husband, wife, child. To cry about the loss of 'mates' (witness indicated) at a great distance is perhaps not as relevant from my point of view."
536 The men lost in the Voyager were in no way related to Mr Covington-Thomas. They do not come within the categories identified by Dr Phillips where such a reaction may be expected. I prefer the evidence of Dr Phillips and infer that the observations of Mr Pollard (which were not disputed) were consistent with one aspect of the criteria required for PTSD.
537 Turning, then, to particular issues which were important to Dr Champion's view, reference has already been made to the fact that people may suffer from PTSD, and yet mask their symptoms and perform well in the workplace (supra para [232]). Whilst performance in the workplace is plainly relevant, it is not determinative. I accept the evidence of Dr Phillips (supra para [232]) that it is a slight indicator. I also accept the evidence of Professor McFarlane that people who unquestionably have PTSD, even severe PTSD, are able to work and perform in demanding jobs, notwithstanding their symptoms (T656) (supra para [472]).
538 Dr Champion placed some emphasis upon the absence of emotional stress on the part of Mr Covington-Thomas, when describing his part in the Melbourne/Voyager collision (Ex 15, pp36-37). I have remarked that Mr Covington-Thomas was also "mechanical" to some degree in the way in which he described the same dramatic events when giving evidence (supra para [174]). I accept, nonetheless, that Mr Covington-Thomas feels deeply about the Melbourne/Voyager collision. The depth of his feelings, I believe, is demonstrated, first, by the emotion he expresses with those he trusts, where he sobs openly as he describes what happened that evening (supra para [174). Secondly, the evidence is overwhelming that he has consistently avoided speaking about the collision unless he is absolutely obliged to do so. When he has to give an account of what happened, where the audience is someone he does not know and trust, I accept that his way of coping is to provide a flat, mechanical account.
539 A related aspect was explored with Dr Champion in his evidence. Mr Covington-Thomas, when first seen by Dr Champion, surprisingly said nothing about the Melbourne/Voyager collision, until the issue was raised by the doctor. Dr Champion's evidence on this aspect was as follows: (T851/2)
"HIS HONOUR: Q. … Dr Champion, one thing that puzzled me reading your first report, that is the report of 29 May 2003?
A. Yes.
Q. Was that you had a consultation with Mr Covington-Thomas and he clearly would have understood that you were representing the Commonwealth?
A. Yes.
Q. And this was a medico-legal consultation, and that it was connected with his claim in respect of the Melbourne/Voyager?
A. Yes.
Q. He then, in the course of the consultation, you invite him, and I get the impression from your report in a non-leading way, to describe various things?
A. Yes.
Q. And he describes his naval career?
A. Yes.
Q. Totally missing out the Melbourne/Voyager collision?
A. Yes.
Q. And you make a comment upon that?
A. Yes.
Q. And then you direct his attention to the Melbourne/Voyager?
A. Yes.
Q. And he then describes that?
A. Yes.
Q. And you describe the way in which he does so, which was in quite dramatic terms, although without any obvious display of emotion?
A. Without any emotional distress.
Q. Yes, distress. Now the question I really have is I suppose this: what significance, if any, do you attach to the fact that in reporting his, the original history of his naval career he completely missed out the Melbourne/Voyager?
A. Well, I don't attribute a great deal to it, one could see this as he was avoiding that area. But he showed no evidence of avoiding it when he was asked about it at all. I think that he was responding to my questions about his naval career and he was going through his naval career and he focused on that; that's the way I interpreted here."
(emphasis added)
540 Dr Champion's evidence continued: (T852)
"Q. He did give some evidence here, you might assume, throughout his time, indeed before he saw the advertisement he did avoid talking about Melbourne/Voyager. And I think you've answered the question, but the issue occurred to me, whether or not the way in which he recounted his naval career might by chance have provided an insight into that avoidance behaviour?
A. Yes, I certainly have considered that. But I've also considered the fact that he seemed quite prepared to respond to the advertisement about the Melbourne/Voyager; which is the opposite of avoidance. One would have thought if he was really avoiding he would have thrown the newspaper away and he wouldn't of had to go through all of the examinations and recalling. I mean, maybe unknowingly he had opened up an area in which he was going to be focused on the Melbourne/Voyager collision, which is the thing he's supposedly been avoiding, one would have thought that he might have avoided it more easily by avoiding answering the newspaper advertisement."
541 Professor Tennant, likewise, did not attach significance to Mr Covington-Thomas not referring to Melbourne/Voyager until prompted (T1246). However, it seems to me extraordinary and consistent with his avoiding talking about Melbourne/Voyager which so many witnesses described.
542 Let me move from that to a matter which was fundamental to the view formed by Dr Champion, namely, the effect of "motivation and suggestion", said to arise form the advertisement inserted by a solicitor in 1995 (Ex 15, 59; Ex J, paras 10-12). Dr Champion gave the following evidence: (T822/3)
"Q. And if, as appears to be common ground, Mr Covington-Thomas was in fact suffering from depression and anxiety through the 1990s and in 1996 what is the significance of that when he starts seeing solicitors and they send him to doctors like Dr Wu, in relation to the Melbourne Voyager collision?
A. Well, I think that it is possible and probable in this case, given the other background factors, that there is a temptation to explain the current distress, in terms of previous memories, and particularly being asked to recall those memories and particularly when you are given a statement, that the cause of your current problem relates to the past, it is easier to come to believe that and develop a strong focus upon what you come to regard as the cause of your current problems. As we have talked about earlier, the cause of depression and anxiety are often rooted in formative years experience, and the factors which are associated with the emergence of that sort of disorder are proximal factors; those are factors operating at the time from which they emerge.
Q. And in Mr Covington-Thomas' case, is that necessarily a conscious process by which he, as it were, does attribute that?
A. No. People believe quite fully in what they piece together. They believe them to be accurate memories and it is impossible to distinguish an accurate, for the individual, to distinguish accurate and inaccurate memories.
Q. And if, as it would appear to be the case, that Dr Wu told this man in 1995 that he had post-traumatic stress disorder as a result of the Melbourne Voyager collision, that revelation, for want of a better word by Dr Wu, came on top of other things which were causing decompensation psychiatrically?
A. Well, I think it afforded Mr Covington-Thomas an explanation for why he was so depressed and anxious at the time.
Q. Were you aware that the proceedings had actually been started before he even saw Dr Wu?
A. Yes."
543 Professor McFarlane did not agree. The difference between their views is encapsulated in the following paragraph from a joint report which each signed: (Ex J, paras 9 to 13)
"9. Dr Champion and Professor McFarlane agree that Mr Covington-Thomas currently complains of intrusive and distressing recollections of the Melbourne/Voyager disaster and that he was having dreams about the disaster.
10. Dr Champion believes that these symptoms are as a consequence of the current focus of litigation and the impact of his motivation and suggestion, rather than being caused by the presence of a long-standing traumatic memory related to the Melbourne/Voyager disaster.
11. On the other hand, Professor McFarlane is of the view that if Dr Champion's opinion is accepted, Mr Covington-Thomas is a malingerer and is factually misrepresenting his complaints to the Court. If this is the case, his diagnosis should be accepted as being a factitious disorder or malingering.
12. Dr Champion is of the opinion that it is possible to develop a false memory of the effects of an event such as the Melbourne/Voyager disaster leading to claims of intrusive and distressing recollections of the events. Dr Champion does not believe Mr Covington-Thomas to be a malingerer.
13. On the other hand, Professor McFarlane is of the opinion that the events of the Melbourne/Voyager disaster are one of objective reality and there are sufficient external witnesses of that event to establish whether Mr Covington-Thomas's reported experiences are relatively indicative of the truth. Given the severity of that stress, the most parsimonious explanation for his memories is that they are a traumatic memory of the actual incident."
544 Professor McFarlane elaborated when giving evidence. He said this: (T721)
"HIS HONOUR: Q. But as I understood the difference between you and Dr Champion you, but not Dr Champion, thought it was fundamental, or at least important, to confront the issue of whether or not this was manufactured?
A. That's correct, and I think I don't believe that he, this is simply suggestion. I think his experience and his very severe experience isn't that of something simply responded to the suggestion. This man clearly has been symptomatic. We have evidence from the 1980's, a Dr Parkin's report of 1994, that he is symptomatic prior to the Melbourne/Voyager disaster. The question I think remains what was, what were the factors that contributed to that condition and what was that condition, or those conditions."
545 Counsel for the plaintiff then asked Professor McFarlane the following question, reading from the testimony of Mr Pollard (the gardener from Maryborough college who had seen Mr Covington-Thomas weeping), which the Professor was asked to assume. He said this: (T722)
"HIS HONOUR: It is put by way of assumption if you assume that is an accurate description of what that person saw what relevance, if any, does that have?
BARRY: I object to it because I didn't ask him any questions about that particular subject.
HIS HONOUR: I will allow you Mr Barry, within limits, to cross examine on it if you wish. Put the question.
MELICK: Q. You were asked a question by --
HIS HONOUR: I will allow the question.
MELICK: Q. -- about whether the 1995 advertisement would have revised memories which hadn't been present in the intervening years. Are you able to comment upon that suggestion in view of that evidence, if you assume that evidence to be correct?
A. If I assume that evidence to be correct, your Honour, that is strongly suggestive we had a man who has distressing and intrusive recollections of that disaster that was certainly present at that point, so it would suggest it is not simply the occurrence of this advertisement that has made him focus on something that otherwise would have been a trivial recollection in his mind. "
(emphasis added)
546 Dr Parkin gave evidence relating to the same issue. He said this: (T596)
"Q. And memory, of course, is a difficult thing to assess from a psychiatric perspective, isn't it?
A. Correct.
Q. The problem is reconstruction often occurs depending upon what the stimuli may be?
A. I'm not sure about the word 'often' but reconstruction can occur, yes.
Q. So if you trigger memories in different ways, the memories then become real to those people and were it not for the triggers they may well have not ordinarily had any recollection of those particular matters?
A. That can occur, yes.
Q. Did it occur to you that that may well be what has been occurring with this man since 1995?
A. Certainly that's a possibility.
Q. And if that were the case, that would be a complete explanation, would it not, for the fact that in 1994 he gave you no history in relation to the Melbourne Voyager collision?
A. Well that, that requires a very large reconstruction of his memory which I find incredible ."
(emphasis added)
547 Dr Gelb, likewise, rejected Dr Champion's hypothesis that Mr Covington-Thomas' symptoms could be explained by the advertisement to which he responded in 1995. Counsel for the defendant put the following: (T540/41)
"Q. Having focussed on it in the context of litigation, do you think that that produced the result that there was then an attribution by him to psychiatric conditions from which he was then suffering which he then thought were related to the Melbourne/Voyager collision?
A. No, I think that he had post-traumatic stress disorder all the way along. He kept a lid on it with alcohol and other forms of denial and that this (sighting) of the advertisement when he was under pressure and stress when his defence mechanisms were overstretched, that that (sighting) of the advertisement reminded him more of the disaster and overwhelmed him. In other words, I think there was evidence that this was not something that was never on his mind. But he was quite successful in suppressing the impact of that disaster using the means that veterans so often do.
Q. But this had not affected him or his functioning until he saw the advertisement in 1995; what we did not get until then was the re-experiencing phenomena?
A. The defence mechanisms themselves are effective in suppressing symptoms, but the person still has post-traumatic stress disorder. Where you saw it is in those other symptoms that cause problems. For example, once (sensitised) by the Melbourne/Voyager disaster the chances of him recalling the sexual abuse and being more traumatised by that event than he would otherwise have been are very high. The inter-relationship between all these traumas really needs to be appreciated."
548 The view of Professor Tennant on this issue was similar to that of Dr Champion. He said this: (T969)
"Q. What effect, if any, did it have on this man to be told in 1995 that a psychiatrist then thought he had PTSD?
A. I think that allows your assessment to change and be influenced by the expert. I did notice something about recovered memory symptoms which Professor McFarlane denied. It was not recovered memory and he said it does not exist, which is true. People can be encouraged. It is not through malingering or over fabrication. They can be used to change their stories. A lot of it is about suggestion to change the way you think about that. So suggestion is there for all of us. If an eminent expert like Dr Wu makes that suggestion it is not unreasonable that the client would himself start to adopt that model for his symptomatology and not through deceit or lying, or not necessarily."
549 What findings should be made concerning this aspect? It is relevant to note that 15 months or more before the advertisement was inserted, Mr Covington-Thomas saw Dr Parkin (June 1994) in connection with his application for a pension arising out of his Vietnamese war service. Dr Parkin, it will be remembered, diagnosed PTSD as a consequence of that service. He expressed the view that Mr Covington-Thomas was, at that time, significantly disabled psychiatrically (supra para [374]). He thought him in need of urgent treatment.
550 The advertisement having been inserted in November 1995, Mr Covington-Thomas responded. He gave an account to his solicitor, apparently over the telephone, sufficient to enable that solicitor to draft a Statement of Claim, which was then filed (to stop time running). Mr Covington-Thomas, a month or so later (23.12.95), saw Dr Wu. He provided Dr Wu with a history. Reference has been made to that history which, although not comprehensive, did include many symptoms consistent with a diagnosis of PTSD, which Dr Wu then made (supra paras [380ff]).
551 The plaintiff thereafter saw many doctors at the request, either of his solicitors, or the defendant. He also saw a number of doctors who provided treatment. To each he gave a history and described his symptoms. The histories he provided were, in some cases, inconsistent, as has been noted. Mr Covington-Thomas then gave evidence in this Court, again describing at length the same symptoms. Again, on some issues, there were inconsistencies. That being the context, I find Dr Champion's view improbable. Mr Covington-Thomas' recollections incorporate simply too much detail. Like Dr Parkin, I believe that to attribute such detail to "motivation or suggestion" would be incredible. I accept the view of Professor McFarlane that one must confront the issue whether Mr Covington-Thomas, in recounting his symptoms, is being truthful, or whether he is malingering. Professor McFarlane did not believe that he was a malingerer (T721) and nor did Dr Champion (Ex J, para 12). Doctors Parkin and Gelb likewise accept that Mr Covington-Thomas is genuine. I, too, accept that he is not malingering. I believe that his recollection of symptoms, as given in evidence, are genuine, even though at times he was inaccurate in terms of chronology.
552 Finally, I should deal with Dr Champion's view concerning alcohol abuse and its supposed connection with other psychiatric disorders from which Mr Covington-Thomas suffers. It will be remembered that Professor McFarlane believed it was not unreasonable to regard the consumption of alcohol by those who suffer from PTSD and depression as a form of self-medication. Dr Champion gave the following evidence relevant to this issue: (T847)
"HIS HONOUR: Q. But at a commonsense level, if you're feeling awful resorting to alcohol is not uncommon?
A. Well, yes. But I take your point, you said at the 'commonsense level'. What all of scientific research tries to do is discover what we believe to be true from commonsense is actually in fact true and very often it isn't; scientifically."
553 Dr Champion then made reference to an academic study known as the McLeod Study which (at p272) made the following statement, as set out in the transcript: (T847)
"Although this study clearly demonstrates that relationship between PTSD symptoms and alcohol use is mediated by genetic influences, this does not negate the importance of environmental factors of PTSD or PTSD syndrome or alcohol use. These results suggest that environmental modification, particularly for those individuals at risk may have a profound impact on whether or not those individuals develop PTSD symptoms and a high level of alcohol use."
554 Dr Champion pointed out that the study was careful to avoid saying that PTSD comes first and that it causes the alcoholism (T847/8).
555 Dr Phillips, however, appeared to accept the self-medication view of Professor McFarlane. In the context of nightmares, Dr Phillips said this: (T1068)
"A. People use alcohol to diminish the experience and sometimes that works. … "
556 I prefer the views of Professor McFarlane and Dr Phillips on this issue.