Wednesday, September 11, 2013

To talk or not to talk: Trauma & Human Resilience Part 1.

It seems to be against common sense to suggest that talking may not be good for severe traumatic experiences. This is more so for someone brought up on psychoanalysis; yet, the evidence is clearly against talking especially in severe trauma.
The Cockroach Catcher:
The speaker was a Senior Registrar from the Maudsley.

"......He was a Registrar at the time of the King’s Cross fire. He was just coming out of the station when the accident happened, and so was at the front line so to speak not just as a pedestrian but also as a psychiatrist. He became interested in PTSD (Post Traumatic Stress Disorder) and did a fair bit of research on King’s Cross and other disasters.

He quoted a number of cases, including the Herald of Free Enterprise disaster. There were those who despite help of all kinds would commit suicide. Many were heroes in that they saved many lives. Yet the feeling that they did not deserve to live eventually overtook them and they committed suicide.

What was most surprising was how the group that had counselling generally faired worse, much worse than those without any counselling. The group that did best were the ones that drank, and drank a fair amount.

It was not his intention to promote vodka but he thought we could not be kept from the truth……

His research showed that talking about the incident seemed to make things worse, much worse than anyone ever imagined……”
Then he remembered 
Kim Phuc:
“By rights possibly one of the most damaged psychologically and physically. She underwent no fewer than seventeen operations. The photo of her running down the street of Saigon naked probably changed the course of the Vietnam War and the world’s perception of good and bad. Then came her dramatic escape in 1992 to Newfoundland and her eventual settling down in Canada. Human resilience is not to be underestimated and the imposition of psychological intervention could represent a great under-estimation of our genetical endowment. At one of her public lectures, one of the war veterans who was a helicopter gunner broke down.”
Kim Phuc never had any therapy.

We have to be aware that a whole industry has sprung up based on very inexact theories and it is nice to know that the earlier findings in England have now been 
confirmed across the pondIn cases where mental conditions are entangled with compensation claims it becomes especially difficult to be truly objective.

On the matter of psychotherapy, a good deal of current blog comments are hostile to therapists and their methods. A good therapist is hard to come by, and should be like a wise aunt or uncle to whom one turns to for advice that one may or may not accept or act on. A good therapist needs to be intelligent and broad-minded, and mature with rich life experience. A bad therapist, on the other hand, takes over and does not allow for any leeway on how one should continue with life.

We may forget too that good therapy is for life, and may be more useful for the mentally healthy than for the mentally sick. What government or insurer would allow for that?

Here I will have to quote my Guru again:

“A Therapist is like a toilet really: some may need it three or five times a week; others once in a while. Some patients may have a sort of mental diarrhoea and require therapy sessions more often.”

My only gripe is that where money is involved, one needs to be cautious: the best advice in life is free, like those from your wise aunt or uncle, if you are lucky enough to have one.

NHS: The Way We Were! Free!
FREE eBook: Just drop me a line with your email.

Email: cockroachcatcher (at) gmail (dot) com.

Email: cockroachcatcher (at) gmail (dot) com.


HyperCRYPTICal said...

How I so much agree with the sentiments of this post having seen the damage in individuals provoked by itense psychotherapy.

You are correct in that a good therapist should be that of a 'wise aunt or uncle', who listens and does not make judgements, does not probe with 'how does this make you feel' self-indulgent questions and all the rot littered on the patient - the purpose of which (it seems to me) is to inflate the therapists own ego.

Human emotions are complex and all, to a degree, are a coping mechanism. We should be allowed them and the current belief that we should have all negative emotions 'counselled' out is to me, a very dangerous path to journey. (I am thinking here of the almost immediate swathe of counsellors drafted in after some kind of tragedy).

The image of Kim Phuc brought tears to my eyes and so much more. To me, the most harowing image is that of the male child - the stark horror and pain captured on his young face has lived more in my memory than that of Kims.

On a lighter note - pleased you're back!

Anna :o]

Cockroach Catcher said...

Kindling effect as mentioned in the final chapter of the book has since 1969 been much studied re: PTSD.

In medicine, we have to first observe without bias and then if we are lucky we may find the reasons.