Natural trauma debriefing

Dena on facebook says

“Sounds like interesting work Tony, do you have a particular way of working with individuals returning from combat?’ (end quote)

I have always been somewhat bemused by the debate about how to treat trauma. I find it quite easy to work with and I think I have been reasonably successful in doing so. My view is that trauma debriefing is a natural human process anyway which makes the counselling process easier and more likely to succeed. 

Humans when they have been traumatized in some way will most often spontaneously engage in the reparative process of trauma debriefing. Hence the goal of the therapist is basically to make sure the natural process proceeds as it should. They are kind of just helping the natural process along and are a bit of a bystander in this way, unlike other counselling situations.

Once the shock has subsided and any serious physical damage is made reasonably stable then the person as I said will spontaneously engage in remediating their damaged psyche. The steps basically are.

1. The person enters into the relational. That is they do not isolate self and seek out others to engage in about talking about the traumatic episode. Here the therapist is looking out for things like a Be strong, Don’t trust or Don’t be a child script messages. People with these may falter at this first stage by tending to isolate self and not seek others out to talk about the incident.

2. They talk about what happened and this can be as basic as describing what physically happened in the event. What were their reactions to what happened and so on.

3. Cathartic release. Whilst doing number 2 most people will begin experiencing feelings and then one wants some kind of cathartic release of emotions. Some can falter at this stage because they have a Don’t feel message of some kind.

4. The get a sympathetic response of some kind by the other person they are talking to.

And that is about that. To me it all seems rather simple and uncomplicated. The person will do the same process a number of times over weeks or months and after that the debriefing is usually complete.

As I said before I think this is a natural human process. Watch people after a car accident. Most will automatically seek others out, want to talk about the event, show some emotions and want to get reassuring hugs which covers the four points I mentioned above.

Graffiti

Adult and Child information processing

On my facebook there has been a discussion about trauma. I wrote the following:

“In recent months I have been working with a US marine who served in Iraq. He says that whenever he hears fireworks going off he has an instant strong anxiety reaction. Apparently the sounds are similar to explosions one hears in war. He also says that if he sits and watches a fireworks show he has no anxiety reaction at all. It’s curious how the Child ego state works sometimes.” (end quote)

Dena commented about the different neurological processing that would go on in the different circumstances which was interesting. In addition to this there would also be alternate psychological processing going on. It is a good illustration how the different ego states function differently especially in how they process information in order to come to conclusions about the world.

The US marine presented two different situations he found himself in:

1. When hearing fireworks he only has audio information - anxiety experienced.

2. When watching fireworks he has audio and video information - no anxiety.

This demonstrates how the Adult and Child ego states process information differently. This is explained further in the following three diagrams.

When he can only hear the fireworks (and not see them) he knows in his Adult they are only fireworks and not real bombs. However his Child ego state he is not 100% convinced they are not bombs. This is a type of magical thinking. His Child believes that some how by magic they may be real.

To the person who has not been traumatized in a war zone it is not important for the Child to be fully convinced. To the marine who has been in situations where he could have been killed by the bombing it becomes very important and hence he experiences high anxiety in reaction to those sounds.

When he can watch the fireworks directly, see what is going on and see the bangs being connected to the fireworks exploding he has no anxiety. This shows how important video is to Child ego state information processing. With such visual confirmation his Child is 100% convinced they are not real bombs and he experiences no anxiety.


Magical thinking




Anyone who has studied child psychology knows the importance a young child puts on what they see rather than on words they are told. Children quickly learn that a parent’s actions are far more important than what a parent says. Indeed when it is preverbal it only has visual (& kinesthetic) information available to it.

The US marine reminds us that we never loose the Child ego state part of us even when we are a mature adult. We continue to process information in an illogical way with magical thinking no matter how old we are.

Graffiti

Life isn’t fair

This is an interesting concept that comes up reasonably often in psychotherapy. Indeed I will often bring this idea up with a client. Some people have the belief that life should be fair. That people are reasonably equal and if something unfortunate happens to some one then something should happen in response to that to make things fair.

From what I have seen of people, most have a view that fairness in life is a good thing. The whole concept of I’m OK, you’re OK is based on fairness and that people are equally OK. Anti discrimination laws are based on a view that fairness is a good thing. People are not discriminated against because they are of a particular race or gender. Indeed the whole legal system of some countries has the idea of life being fair at its core. The adage of “an eye for an eye” could be seen to take on the concept that life should be fair.

However in counselling the more one has the view that life should be fair the more they will suffer psychologically. If a person has the view or belief that life isn’t fair (sometimes) then they are more psychologically robust and healthy. Whilst one may want life to be fair and governments often publicly espouse that view of society, in the reality of day to day living, life just isn’t fair, sometimes. For a person to accept this allows them to be more adjusted to life and to not get stuck or fixated.

The person who’s Child ego state accepts that life isn’t fair (sometimes) is more psychologically robust than the individual who does not accept this view. This unfairness can range from the banal to tragic. You are waiting in a car in a long line of traffic. Another car passes you in the empty lane beside you and then pushes in up the front of the line. That isn’t fair and an example of minor acts of unfairness that we come across each and every day.

At the other end of the scale, your spouse is walking along the road and is run down and killed by a drunk driver. The trial comes and the driver gets a very minor sentence. Some may find this grossly unfair. The more the individual can understand that this was a grossly unfair set of events and then accept that sometimes life just isn’t fair the less they will be negatively impacted by it.

As mentioned before the more one accepts that life is not fair (sometimes) the less likely they are to get stuck or fixated on an event. What is wrong with getting fixated on an event? Consider the words of Deepak Chopra

“Holding on to anything is like holding on to your breath. You will suffocate.” 

Accepting that life isn’t fair allows one to avoid the process of getting stuck on an unfair event. It allows one to move through life and ‘let go’ of past events more easily than the person who has the view that life should be fair.

Some subcultures of society operate on the basis of an 'eye for an eye'. That is fair.

This takes on special importance when working with a client on their childhood traumas. Many people have feelings that unfair things happened to them as children. The more they accept that life isn’t fair the more they will be able to move on from and transcend those early events that trouble them in the here and now.

Graffiti