Newsletter #414 – Treating Trauma

Sometimes I am amazed how we teach and do therapy, counseling or coaching using the same old ways, oblivious to changes in the world around us.  Psychotherapy Networker (November/December 2010), focuses on victims and veterans of war, showing how the needs are enormous, the mental health community is overwhelmed and resources are limited. Conventional therapeutic approaches often are ineffective and unsuited to military culture. Methods and models that focus on individual treatment do not mesh well with the communal values of the military including its resistance to mental health professionals, especially civilian outsiders. The Networker magazine (currently online here) focuses on veterans and their families but many conclusions extend to other kinds of trauma.

Traumatic situations can involve people in three roles. Predators cause trauma. For many reasons, including military training, people learn to fight, to hurt others. The prey are the victims of the trauma. Their natural impulse is to flee. Witnesses are those who observe trauma and often freeze, sometimes unable to move. Each of these predator-prey-witness experiences makes a unique biological impact. Each can require a unique form of treatment. People in trauma may experience only one of these roles but the military is among the environments where all three occur at the same time. Troops are trained to be tough predators. In combat they are prey, always alert to danger. In battle they witness and experience significant stress. Many also believe that good soldiers don’t go for therapy believing this shows weakness and can block promotions.

Here are some thought provoking conclusions that apply broadly:

  • Therapy as usual often can’t serve the needs of traumatized people including returning troops and their families.
  • Trauma work is cross cultural. To be credible and effective, care givers must learn about military or other cultures, including common terminology, expectations, values, and accepted ways of handling stress.
  • Diagnoses like PTSD may turn survival responses of the automatic nervous system (fight, flight, or freeze) into psychiatric diagnoses that lead to long term hopelessness, helplessness and despair.
  • In many situations, including postmodern or communal cultures, community based approaches work better than individual therapy.

How do you respond?

  1. My experience as a missionary has helped me to enter into many different (sub) cultures. The principle to see counseling as a ‘dance, rather than as confrontation William R. Miller & Stephen Rollnick in “Motivational Intervieuwing, Preparing People for Change, Guildford Press, has grately helped me. Also in the man individual sub-cultures of Abuse Survivors (vdWeele 1995). I believe in community training as it helps common people to help each other.The Church is also a community, when people understand the principle of “The Priesthood of all believers” they learn to do so much. So thank you again for bringing this to our attention Garry.

  2. As a 20+ yr USAF chaplain, this article is right on the money. It is often theraputicaly untrained chaplains who are considered the only “safe” counselors for troops woried about how any sign of “weakness” can harm their careers. Psych Ed type communical work is often helpful to those needing to be stabilied and return into the “fog of war.” Using the world view and language of a “Warrior culture” is the only way to earn trust. Not psychopathologizing the mindsets that help them survive is necessary if we intend to help them cope during times of conflict AND peace!

    • Thanks Jan,

      Last week’s newsletter was about Greg Mortenson who wrote “Three Cups of Tea.” This book has been a hug best-seller, as you know, and his message is that the most effective way to impact Pakistaon and Afghanistan is to provide education. That is accepted by the local people and even by many Taliban leaders if outsiders, even Americans, learn and respect the culture and try to learn the language first. For ten years I taught US Air Force Chaplains as an outsider visiting Maxwell AFB and sometimes speaking at air bases internationally. I concluded that the Air Force is a unique culture (same with the other branches of the military service) and like all cross-cultural work I needed to learn the jargon, respect the culture and earn trust as an outsider coming in who took the time to learn how Air Force personnel think and communicate. As a result I was accepted and kept getting invited back.

      As a footnote to this, I wish more speakers going on mission trips would learn about the culture where they are going. I think if they did this their impact would be much more effective.

    • David Fogleboch
    • December 20th, 2010

    1. I want more on this topic.

    2. It is very difficult to find a place to change your email address on your site.

    • 1. IF Anybody WANTS MORE ON THIS TOPIC PLEASE GO TO http://www.psychotherapynetworker.com. The current issue is now on line so you can read the articles yourself.

      2. David, thanks for your comments about changing your address. I will look into making address changes easier. In the meantime if you want to contact me directly (at grc@garyrcollins.com) I will make sure the address change gets into the system.

    • David Fogleboch
    • March 4th, 2011

    Changing my email address is very hard or impossible on your system. Does this work?

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