On Trauma Counseling and Intra-generational PTSD

 

Am going to start including more on PTSD in this blog since many people seem to land here via that search term and I run across quite a few articles about it.

This affects you even if you have never encountered trauma or don’t think you know anyone who has.

One-off Trauma Debriefing

Psychologist Vaughn Bell, has written a piece for the Guardian, Minds traumatised by disaster heal themselves without therapy:Aid agencies that promote one-off counselling sessions after major traumas only prolong victims’ suffering and done a little follow up on his excellent Mind Hacks blog (in which he objects to the Guardian’s headline on his article as being somewhat misleading) Disaster response psychology needs to change

In his blog addendum he summarizes the article and corrects the headline:

Unfortunately, the article has been given a rather misleading headline (‘Minds traumatised by disaster heal themselves without therapy’) which suggests that mental health services are not needed. This is not the case and this is not what the article says.

What it does say is that the common idea of disaster response is that everyone affected by the tragedy will need help from mental health professionals when only a minority will.

It also says that aid agencies often use single-session counselling sessions which have been found to raise the risk of long-term mental health problems. This stems from a understandable desire to ‘do something’ but this motivation is not enough to actually help.

Disaster, war, violence and conflict, raise the number of mental health problems in the affected population. The appropriate response is to build or enhance high-quality, long-term, culturally relevant mental health services – not parachuting in counsellors to do single counselling sessions.

The World Health Organizations textbook Psychological First Aid:Guide for Field Workers [PDF] outlines best practices for assisting in trauma situations. They are against the “debriefing” methods:

WHO (2010) and Sphere (2011) describe psychological debriefing as promoting ventilation by asking a person to briefly but systematically recount their perceptions, thoughts and emotional reactions during a recent stressful event. This intervention is not recommended. This is distinct from routine operational debriefing of aid workers used by some organizations at the end of a mission or work task. (p. 3 footnote)

In the future we are all going to be “Field Workers” dealing with people experiencing trauma so that’s a good read to get some information. We’ve only just begun to recognize the effects of trauma. Additionally the likelihood of a relative or friend experiencing some kind of trauma is rather high. If that sounds a bit dire read on.

Intra-generational PTSD

Mother Jones had an article not too long ago on the effects of PTSD on the family. Is PTSD Contagious? It’s rampant among returning vets—and now their spouses and kids are starting to show the same symptoms.

If you have lived with anyone who has PTSD you know it has profound effects on relationships. You also know that some of the symptoms are “contagious”. For example if a person is constantly hyper-vigilant there is a tendency for others to start experiencing anxiety and having it manifest in similar hyper-vigilence. As well there is STSD-secondary traumatic stress disorder sometimes called Compassion Fatigue and/or Burnout, although I think both are serious misnomers and are too generic for specific STSD. Compassion fatigue and burnout are generally related to people who work with those who have PTSD or have been otherwise traumatized. STSD is not necessarily related to work and is more oriented to continuing relationships. Here’s a webpage about STSD in relation to veterans. Additionally there is a good page there on what is termed Secondary Wounding. Secondary Wounding occurs when people around don’t understand trauma and it’s effects. Mostly it’s due to people’s ignorance and wish to distance themselves from anything unpleasant. This is one reason we should all be “Field Workers” as I mentioned above.

There are certainly overlaps between all of these terms but I think there needs to be much better delineation in the psychological literature and much better explanations available to the public.

The effects of trauma are extended a number of ways. Dr. Joy DeGruy has begun research on the continuing effects that slavery has had on African-American populations. Here is one presentation of hers:

 

Post Traumatic Slave Syndrome can be categorized under both Historical trauma and Transgenerational trauma

This approach holds true, I believe, for other populations as well. Children of refugees and children of war for example. Or children of Holocaust victims and survivors. Or people who have been wrongly convicted or people who have been political prisoners or people who have been marginalized and scapegoated by their societies…it doesn’t end.

We cannot compartmentalize trauma to the directly affected victims only. This is a mistake many treatment modalities make. It affects everyone to some degree. Even if one is not a direct descendent nor had a family member involved in a traumatic situation (that’s getting ever more rare these days) we all interact with those who have experienced trauma so it is important that we become familiar with the effects of trauma and what we can do, in the first instance to mitigate that, and secondly to curtail the types of circumstances that brought about the trauma.

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