I have come to question whether talking through traumas is really the best strategy for some survivors. I think that there are such serious traumas that some people experience (the Holocaust, severe child abuse, torture), where re-calling the trauma threatens the coping ability of the client. Certainly an initial treatment strategy is to try to build up the coping ability but sometimes people are so traumatized that this can’t happen. I have seen some terrible outcomes with clients whose therapists pushed them to talk under the well-intended assumption that this would be helpful but instead the client decompensated. All of which points to the importance of a proper assessment. And the same strategy Beckner discusses in her work in Rwanda applies with some clients of learning to manage the symptoms through medication and/or behavioral strategies. Of course clinicians need to be careful that not pushing to talk is truly indicated by their careful assessment of the client’s needs and not their own unwillingness to hear about trauma.
COMMENTS
BY kwandrei
ON August 31, 2007 03:28 PM
I have come to question whether talking through traumas is really the best strategy for some survivors. I think that there are such serious traumas that some people experience (the Holocaust, severe child abuse, torture), where re-calling the trauma threatens the coping ability of the client. Certainly an initial treatment strategy is to try to build up the coping ability but sometimes people are so traumatized that this can’t happen. I have seen some terrible outcomes with clients whose therapists pushed them to talk under the well-intended assumption that this would be helpful but instead the client decompensated. All of which points to the importance of a proper assessment. And the same strategy Beckner discusses in her work in Rwanda applies with some clients of learning to manage the symptoms through medication and/or behavioral strategies. Of course clinicians need to be careful that not pushing to talk is truly indicated by their careful assessment of the client’s needs and not their own unwillingness to hear about trauma.