Treating the psychological effects of trauma

by Marc Wilson / 23 June, 2016
A Canterbury quakes-inspired initiative aims to nip the psychological effects of trauma in the bud.
Photo/Getty Images
Photo/Getty Images

Talk of moving the mental health ambulance from the bottom of the cliff – trying to shift the emphasis from treatment-only to prevention – makes a lot of sense. Although part of me worries it’s motivated by trying to save money, it’s also the right thing to do.

But even with a focus on prevention, psychological distress can be a response to things that we cannot control. When bad stuff goes down, it can leave a mark in the short and, under the right circumstances, long term. Psychological research and practice have shown that ­experiencing traumatic events can have a range of negative effects on well-being, including anxiety and mood disorders, avoidance coping through substance use or self-harm, and relationship problems. And post-traumatic stress disorder (PTSD).

Researchers and practitioners know a lot of this courtesy of John Briere, associate professor of psychiatry and psychology at the University of Southern California and director of its Adolescent Trauma Training Center. Thanks to Briere and others, we know that whether someone develops PTSD is influenced by such things as genetic predisposition, coping style, social networks and support and, importantly, history of past trauma.

John Briere: how many traumas you have counts towards predicting PTSD.
John Briere: how many traumas you have counts towards predicting PTSD.

Last year, Briere spoke at the New Zealand Psychological Society’s annual conference about cumulative trauma. Simply, this is the number of traumatic experiences an individual has had over his or her lifetime; it turns out to be more important in predicting PTSD symptoms than the nature of the traumatic events themselves. In other words, it’s not just the trauma but how many traumas.

So you can visit a clinical psychologist to help deal with your PTSD, or you can hope that it doesn’t get to that point because of early intervention. Which is why the news in April that the Australian Red Cross has teamed up with the New Zealand Psychological Society and other organisations to develop techniques for psychological first aid (PFA) training is exciting. According to the World Health Organisation, PFA is “a humane, supportive response to a fellow human being who is suffering”.

First aid is what you do when an accident happens and someone is physically hurt; PFA recognises that psychological injury might not be so immediately obvious but is another consequence of bad events. New Zealand backing for PFA is motivated by the Canterbury quakes experience; overseas, natural and human-caused disasters – terrorism or mass shootings – have been the spurs to action.

PFA aims to foster resilience by providing a sense of calm, comfort and safety. It also sets out to connect people and remind them that they have power over how they respond to bad events. And it tries to give hope.

Importantly, anyone can do it. PFA is not a therapy in the way that cognitive behavioural therapy, say, or counselling, is. Rather, it’s a set of tools, or skills, that we’ve all got hidden away that boil down to being actively there for someone.

PFA dos include such things as active listening and understanding, acknowledging when you don’t have the answer and undertaking to find someone who does. PFA don’ts include avoiding pressing people to talk about their experience and analysing the details of the traumatic experience.

Other elements of PFA are useful in everyday life, not just in the unlikely event of an emergency. It encourages us to think carefully, for instance, before saying “I know how you feel” or “you’ll feel better soon” because that might not be the case.

I’ll be signing up for training.

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