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.

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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.

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Different types of drug use

This is a diagram of drug use that I came across the other day.



The explanation for it follows:

"The road to addiction is different for every person. Some people take their time while others go from zero to 60 in a short period of time. No matter how long your journey is, most rehabilitation counselors agree that there are five main stages of drug addiction: experimentation, regular use, risky use/abuse, and drug addiction and dependency. Not everyone in the first two stages will develop a drug addiction, but individuals in the third stage of drug abuse are very likely to progress into full-blown addicts. Here’s a closer look at the five main stages of drug addiction.

Experimentation is defined as the voluntary use of drugs without experiencing any negative social or legal consequences. For many, experimenting may occur once or several times as a way to “have fun” or even to help the individual cope with a problem. For many, experimentation can occur without any desire to continue using the drug. For others, it can start to become a problem when it moves into the next stage of addiction.

Some people will be able to enter the stage of regular use without developing a dependence or addiction. These people will be able to stop the drug use on their own. The problem with regular use is that the risk for substance abuse greatly increases during this stage. It also increases risky behaviors such as driving under the influence, unexplained violence, and symptoms of depression and anxiety.

Many people stay in the stage of regular use for months or years. Some may not develop a problem but many may not be able to stop by themselves. This is ordinarily the period of time where the consequences of using drugs and/or alcohol regularly begin to show up. Some will completely stop at this point. Others will stop for a period of time in order to get back into the good graces of loved ones or possibly the law; for example if someone gets a DWI and is put on probation they may quit drinking completely or agree with their family never to drink and drive again but as soon as they complete their probation they feel they are “off the hook” and can finally return to their old behaviors. 

Characteristics of dependence include constant use of alcohol or other drugs that lead to the inability to take care of major responsibilities related to work, family, school and other roles. Repeatedly using drugs in situations that are physically hazardous, such as sharing needles or driving while under the influence, repeated legal problems, or any combination of these. Their risky behavior may also escalate to things such as prostitution and stealing from society because they can no longer take from their family. Many dependent people could be categorized as functioning, and are able to work, maintain family relationships, and friendships. They will attempt to limit their use of alcohol or other drugs to certain times, such as evenings or weekends. 

The last stage of persistent abuse of substances is addiction. At this point they have been addicted for some time but this is the point where change is inevitable because continued use will only lead to a few places. Addiction is a disease involving serious psychological and physical changes from constant heavy use of alcohol, drugs, or both. Symptoms include withdrawal and uncontrollable alcohol use and/or other drug craving, seeking, and use that continues even in the face of repeated negative consequences. Addiction is a progressive, chronic, and fatal disease. If left untreated, it can only lead to jails, institutions, death, and dereliction, in no specific order". (End of explanation)

My response

I find this has some accuracies or parts I would agree with. It also is an interesting statement because it typifies some of the ways misconceptions about drug use are presented to the public. I discuss these below:

It says that not everyone in the first two stages will develop a drug addiction. The majority or even the vast majority do not develop a drug addiction. The largest group by far are the social (recreational) users. The dependent users are quite a small group in number.

It kind of implies the gateway drug use scare tactics approach by saying there are 5 main stages to drug addiction from experimentation to dependency. This is true but again it is only quite a small group of users who go through all the five stages and most stop at stage 2. It is like saying eating leads to obesity. Yes it does for a small group but the vast majority of eaters do not become obese. 

To quote them, “Some may not develop a problem but many may not be able to stop by themselves.” This is a typical media driven statement that is using scare tactics. A more correct statement would be - Most will not develop a problem but a few may not be able to stop by themselves.

If these five women all took drugs. Only about one tenth of one of them would ever develop a drug dependency. Four of them would only ever remain recreational users.

It says many stay at the stage of regular use for months or years. As I say in my book - Working with drug and alcohol users - if this happens then a move on to dependent use is unlikely. Most dependent users when they begin using their drug of choice the escalation to dependent use is rapid, within months. It most often does not develop slowly over time. So when they hit what the diagram calls social use they quickly skip to dependent use. If they stay in social use or regular use for months or years then they are unlikely to develop to dependent use.

It says addiction is a disease. This is one view of addiction and is commonly the psychiatric view of addiction. There are other views which see it resulting from adverse psychological development and is not a disease in the medical sense of the word. This psychological view is a widely held view of addiction around the world. 

It says addiction is a progressive, chronic and fatal disease. For the vast majority of dependent uses this is not so. The vast majority do not die when addicted. The  average time of use for the dependent user is 10 years and then they stop using. The vast majority do not die by overdose or due to medical problems when addicted. It may shorten their life span in the long term in varying degrees when they get old but the vast majority will not die when using drugs.

It says that if left untreated it can only lead to jail, institution, death and so forth. I have spoken about the death statement above. In addition research shows that only 40% to 50% of dependent users will ever do any prison time. For at least half or for a small majority, it does not lead to jail.

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Workshop - Cornwall, England

Workshop - Zagreb, Croatia

The development of personality types

Deb from facebook asks if the anti social personality is created as a defence mechanism.

Generally speaking most would see that to be the case along with all 10 personality types listed here in addition to the core belief of each one.

Most theories would say that as the child grows it makes decisions about life. It picks up stories it liked as child and uses these to create a template (or life script) about how to live and what life is going to be like for them. This would tend to be mainstream thinking on the subject and thus would tend to agree with the assertion which Deb makes. The child picks the particular personality type as a way of adapting or defending against what it sees as adverse circumstances in childhood. All children get stressed and suffer varying degrees of trauma. It is in these times especially that they choose which defence they will have and some of those are listed in the diagram above.

I however would suggest there is an exception to this and that is the narcissistic personality and to a lesser degree the anti social personality type. With all the other types the child grows into them as a defence but with these two it is different. Instead the child never grows out of them.

All children are born narcissistic and to a lesser extent anti social. Freud called this primary narcissism. All children are born completely narcissistic and the goal is to grow out of that narcissism. Thus one could say that the adult who has a narcissistic personality never achieved this. He didn’t grow into the narcissistic personality type as a defence instead he just never grew out of it. In this way the narcissistic personality type is unique amongst all the other personality types.

Back to the original point about the anti social. It is somewhat similar in this way to the narcissist but to a lesser degree. For instance many anti socials have very little empathy for others. All children are born with no empathy. They are out for number 1 and if others suffer along the way then so be it. People acquire the skill of empathy later in life. They have to grow into it. The anti social personality never does this. They do not grow into a lack of empathy as a way of coping instead they just never grew out of a lack of empathy like most others do.

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Libraries - Working with drug and alcohol users

Current list of university, college and training insititute libraries that have the book - Working with drug and alcohol users

The book has only been out 4 months and there are a 116 (& these are only the ones I am aware of at this stage)

The British library - British National Bibliography (UK)

Ashforn Library Kent (UK)

Tunbridge Wells Library Kent (UK)

Norfolk County Council (UK)

Reading Borough Libraries (UK)

Westminster Libraries(UK)

University of Sussex (UK)

University of East Anglia (UK)

University of Hertfordshire (UK)

University of Huddersfield (UK)

University of Hull (UK)

University of Leicester (UK)

University of Cambridge (UK)

Kingston University (UK)

Brunel University (UK)

Oxford University (UK)

Sandwell Hospital library (UK)

Prince of Wales Hospital library (Wales)

Cefn Coed Hospital, Swansea (Wales)

Neath Port Talbot Hospital (Wales)

Glan Clwyd Hospital Library (Wales)

National Library of Wales (Wales)

National Library of Scotland (Scotland)

Tubingen University (Germany)

Oslo University College (Norway)

Stockholms Universitet (Sweden)

Zurich Central Library (Switzerland)

University of South Africa (South Africa)

University of the Western Cape (South Africia)

Library and Archives Canada (Canada)

Algoma University (Canada)

Atlantic School of Theology (Canada)

Nova Scotia College University (Canada)

Saint Francis Xavier University (Canada)

Cape Breton University (Canada)

Mount Saint Vincent University (Canada)

Saint Mary’s University (Canada)

Sherbrooke University (Canada)

Dalhousie University Design & Technology library (Canada)

Dalhousie University Health Sciences library (Canada)

Dalhousie University Law library (Canada)

Dalhousie University MacRae library (Canada)

Dalhousie University Killam Memorial library (Canada)

Wilfrid Laurier University (Canada)

University of Alberta (Canada)

University of King’s College (Canada)

University of Waterloo (Canada)

University of Calgary (Canada)

Université Sainte-Anne (Canada)

Université du Québec en Outaouais (Canada)

Chisholm Institute of TAFE  (Aust)

Cairns Base Hospital (Aust)

National Library of Australia (Aust)

Mater Hospital Library (Aust)

King Edward Memorial Hospital (Aust)

University of Newcastle (Aust)

University of Ballarat (Aust)

University of Canberra (Aust)

Monash University (Aust)

Deakin University (Aust)

Bond University (Aust)

RMIT University (Aust)

Queensland University of Technology (Aust)

Gold Coast Health Services (Aust)

State library of Western Australia (Aust)

University of California, Merced (USA)

Library of Congress  (USA)

Marylhurst University (USA)

Richard Stockton College of New Jersey (USA)

SUNY College at Plattsburgh (USA)

Marymount University (USA)

New York University (USA)

Brigham Young University (USA)

Pennsylvania State University (USA)

Ohio State University (USA)

Arizona State University (USA)

Colorado State University (USA)

Multnomah County library (USA)

Tennessee State University (USA)

University of Tennessee (USA)

Austin Peay State University (USA)

Indiana University (USA)

Webster University (USA)

Temple University (USA)

Southern Methodist University (USA)

Eden Seminary Library (USA)

Birmingham-Jefferson Public Library (USA)

Saint Mary of the Woods College (USA)

Williams College (USA)

Rensselaer Polytechnic Institute (USA)

Central Michigan University (USA)

George Mason University (USA)

Virginia Commonwealth University (USA)

Southern Illinois University (USA)

Boise State University (USA)

Purdue University Library (USA)

Appalachian State University (USA)

University of North Carolina at Greensboro (USA)

University of Virginia (USA)

University of Notre Dame (USA)

University of Missouri - Columbia (USA)

University of Chicago (USA)

University of Colorado at Boulder (USA)

University of Iowa (USA)

University of Minnesota (USA)

University of Alabama (USA)

University of Texas at Dallas (USA)

Texas State University-San Marcos (USA)

Unitec Institute of Technology (New Zealand)

Rotorua Public Library (New Zealand)

Central City Library (New Zealand)

Mt Albert Community Library (New Zealand)

University of Auckland (New Zealand)

Hong Kong PolyU Library (China)

Chinese University of Hong Kong (China)

University of Hong Kong (China)