Wednesday, October 13, 2010
According to an article on Harvard’s Intelihealth: "There is some evidence that people who receive counseling and supportive therapy immediately after a trauma have a lower risk of developing PTSD than those who don't."
A feature article in the New York Times Magazine by Lauren Slater, author of Prozac Diary, challenges that assumption, making a strong case for keeping trauma repressed, contrary to an industry of therapy built on prizing loose bad experiences from survivors. As early as 1952, a study found that psychotherapy in general healed no more than the passage of time, and observations coming out of 9/11 indicate that many survivors actually got worse in the hands of their therapists. The article cites an Israeli study of 116 heart attack victims, which found those who repressed the occurrence "fared better in the long run." After seven months, the "repressors" experienced only seven percent PTSD compared to 19 percent among those who sought to "lift the lid."
Researchers hypothesize that repressors may perceive the magnitude of events differently, say "where you see a downpour, they see a drizzle." Another theory is that repressors are good at turning attention away from the disaster, or else believing - rightly or wrongly - that they can cope. According to Kansas City psychologist Richard Gist, who has assisted survivors of disasters but is questioning the worth of his efforts: "For all we know, the repressors are actually the normal ones who effectively cope with the many tragedies life presents. Why are we not more fascinated with these displays of resilience and grace? Why are we only fascinated with frailty?"
In this blog and other outlets, I frequently refer to two studies that shed light on how our brain interacts with our environment and vice-versa. The bottom line is that those of us born with certain gene variations (say the short allele to the serotonin transporter gene) appear to be predisposed to over-react to stressful situations, which opens the floodgates to depression, anxiety, PTSD, and no end of maladaptive behaviors.
A lot more research needs to be done, but it appears that resilience and vulnerability are genetic traits rather than moral virtues or defects. Technically, one may ascribe the traits to character, keeping in mind that character is heritable. No doubt, miners possess "the right stuff" to spend a good deal of their waking lives deep inside the earth. What we have yet to learn is how much horror the resilient can be exposed to before they, in turn, become vulnerable.
Two studies conducted on populations involved in the Serbian-Albanian conflict - people who reported being deprived of food and water, being in a combat situation, fleeing their homes, and being close to death - found a high rate of psychiatric disorder amongst the survivors. What surprised the researchers was how high this figure was - 43 percent, twice their expectations. Adopting less conservative criteria raised the incidence to 83.5 percent.
Obviously, "get over it" and "stiff upper lip" are misguided attempts by the resilient in forcing their agendas on the vulnerable. Equally, we the vulnerable need to be mindful of ramming our therapies down the unwilling throats of the resilient. We have so much to learn. In the meantime, we have a lot to celebrate.