PTSD Awareness Month – The State of Debriefing & Treatment

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What is psychological debriefing & why is it harmful – what can we do?

 

This month there have been many traumatic events in U.S. alone. After years of research to the contrary, organizations are still using debriefing type interventions following these incidences. During “debriefing” after a trauma individually or in groups a counselor may attempt to “process” the trauma with you, or may encourage you to “vent” about the trauma. During the process the counselor will likely try to “normalize” emotional reactions to the event. Though a very well-intended process it can be a bad process because research shows not only does it not work, but it can increase the risk for actually developing PTSD.

 

Debriefing involves re-experiencing events and at that time re-traumatizing can occur. For healthy processing after a trauma, the memory of the event has to be organized in the brain such that it can be filed. For example, you may not readily remember your 7th birthday. This is because you understand it, processed it and it is filed away. You can trace back time and likely pull that memory out and revisit it, but it does not likely haunt you or is it something you think about regularly today. When the memory is not properly understood and organized PTSD can develop.

 

The act of debriefing to a “stranger” (counselor you don’t know well) may impede recovery because of what this person may be imposing on your natural thinking process. They do not know you. Your family or friends for example during natural conversations at your discretion can likely help you do a better job of placing the trauma into the context of your own life.

 

Some people have reported crisis counselors telling them what they may experience and how that process can plant seeds to bring those symptoms on. They can also make some more fearful if symptoms do emerge later on because “they shouldn’t feeling this after the debriefing.” Interestingly, no research shows debriefing as being effective for preventing PTSD, depression, or anxiety.

 

Why are people still doing it if it can be harmful?

Organizations that still do it are likely compulsively doing it because it’s been popular. When tragedy strikes, people feel they need to “Do Something.” They often think it the “right thing.” Many institutions are fearing litigation for not reacting. The ironic thing is that if institutions continue to force “debriefing,” one could actually litigate over the debriefing happening. Also, there is still a myth that people have to “Get it out” (like anger) when they have been through a trauma. Though the more you get it out, the more you can be interfering with the process.

 

SHOULD organizations do, nothing?

*If your child were to fall and NOT be hurt, yet you provide first aid and bandage them up– can you see what this could do to future anxiety?

 

It’s not “Doing Nothing” to allow nature to take its course. Like the common cold AND trauma can often both heal naturally. As humans we have defense mechanisms and they serve a purpose. They keep us safe until we are ready to deal with the trauma and process it. People are MORE resilient than we often give them credit in the mental health world. In most cases, the brain can usually organize the attack as a time-limited event – this lets it be processed with no PTSD developing.

 

What should people be doing if it has been over a month and they are concerned about their symptoms?

 

  • There is a 10 item checklist free online called the Trauma Symptom Questionnaire (TSQ). http://farmacologiaclinica.info/scales/trauma-screening-questionnaire/ This measure will help you see if your symptoms meet a level of concern. You can also search for a certified Cognitive Behavioral Therapist trained in PTSD. Ask them if they are trained in the Ehlers & Clark Model. This is a very effective 10 week (or 10 day) treatment originating in the UK. Though it is 2.5xs the effect-size of other treatments, Prolonged Exposure Therapy and Cognitive Processing Therapy can also be helpful.

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