Does trauma therapy work?

This morning I heard Lisa Hoodless and Charlene Lunnon on Radio 5 Live.

These two women were abducted when they were schoolgirls and sexually abused before being rescued by police after a long ordeal.

They talked bravely and eloquently of their ordeal. But I found the most interesting discussion concerned their experience with counselling. They had earlier made the same points to my colleague Carol Midgley:

With Hopkinson in prison, the girls' task was to get on with their lives. They returned to school almost immediately, the teachers having ordered the other pupils never to mention the kidnap, but things were not easy.

Both went into counselling, which they loathed. To this day, Charlene seems almost as distressed by the memory of “therapy” as she is by the abduction. “It was about the worst thing they could have put me through,” she says, with a visible shudder. “No one understands how horrible that was.”

When all she wanted to do was play with her friends, the therapy made her relive an experience that she wanted to forget.

Fascinating.

The idea that reliving trauma is the way to overcome it is, if you think about it, a rather odd one. But we don't think about it, it is simply accepted. It has its origins in the work of Sigmund Freud, work that has little to recommend it scientifically.

In his very stimulating book Learned Optimism, Martin Seligman explains that there is no evidence that counselling of the sort Ms Hoodless and Ms Lunnon were subjected to works.

So why do we carry on with it?

Comments

[Nicole Segre]

Why do we carry on with it? Because we think there has to be a cure for everything. Because we think people in poor countries tolerate suffering better than we do. Because we demand nothing less than total happiness. Because someone has to be blamed or something must be done. So when we hear the victims of some horrific accident or assault are receiving counselling, the rest of us can feel much better.

[Nonplussed]

We are obliged to remember it, however unsavoury. Otherwise it fades in to subconcious and becomes subliminaly all powerful. By reliving an event, one can become objective and therefore defeaet said demons. Harsh but true.

[Angela]

Not at all in the same category of sheer awfulness but our family were subjected to a fairly half-hearted home invasion. My young daughter was not actually present but I was sternly assured by a detective that she was deeply traumatised and required counselling immediately. No one was impressed when I pointed out that the best way to allay my daughter's fears was to get off their collective backsides and catch the miserable twerp.

[Elyx]

Answer?
No, it doesn't work. There's been a couple of large studies done, that showed that therapeutic intervention that had people re-calling or re-living (think about it - do you really want to be re-living such a horrible experience?), resulted in more trauma than those not exposed to that therapy.
Having trouble finding them, but it's linked here: http://www.theness.com/neurologicablog/index.php?p=100

I'm sure I saw one for rape victims too, which showed those who'd repressed (/forgotten) more of the event, were scoring as more emotionally healthy than those who hadn't.

When something terrible happens, it needs to be acknowledged, and the victim has to know that it *wasn't their fault*. And that if it wasn't their fault, then it's not their problem, it's just one of those things that happens. Using CBT to counter *thinking* about it can help - each time you focus on it you go, this wasn't my fault, it's not my problem and it's happened so there's nothing I can do differently. I accept myself, and can let go of it.
If they need help getting on with their lives, then, that's what a counsellor should focus on.

[Peter]

As they say,counselling is what counsellors do. Beyond that , there little or no evidence of benefit and it is frequently counter productive.As an ex- GP of many years , I never felt counselling to be of any use ( much to the irritation of counsellors who worked in the same health centre ! )
People are often much stronger mentally than they are given credit for. Personally , I never had a problem with the tea and sympathy approach.

[David Richards]

As an GP and ex-psychiatrist I would ask "Nonplussed" above to provide me with any evidence that something called "the subconcious" actually exists.

[Nonplussed]

David, I couldn't possibly offer you concrete evidence proving the existence of ones subconcious. But I would suggest that it lies in buried memories and experiences and how they dictate ones day to day involuntary actions.

Sorry for the delay in answering.

[Nonplussed]

If I may add, counselling is for some and not others. Horses for courses. No?