October 28, 2010

What if the cause of my friend or loved one's PTSD was a person or institution that should have been trustworthy and helpful?

I value your new blog.  Another essential resource on the Internet.  Your accessible writing style is easy on the eyes and heart.  I would love to hear your take on PTSD that's actually caused by people and/or institutions who are supposed to help.  This includes abuse by counselors, doctors, advisers, therapists, clergy, and of course parents.  I myself was traumatized by institutions and persons whose very purpose is to heal, which raises the perversion bar much higher.  In my experience, it's not a good idea for one to put complete trust in even helpers, and to always ensure that in the end we ourselves take responsibility.  All the best, and look forward to following your blog.

Counselors, doctors, advisers, therapists, clergy, and of course parents are all people that we should be able to trust and get help from but unfortunately sometimes these people are the source of trauma. I'm not talking about a situation in which trauma is brought up as a result of the process of therapy.  I am talking about when someone in one of these (or other) roles abuses their position or relationship therefore causing a traumatic experience.

I wish I could say that all people are good but the sad truth is that they are not.  It is especially sad when trauma results from someone abusing their trusted position/role.

PTSD resulting from a source other than those listed above will cause trust issues.  If the source of the PTSD is a person that should have been trusted or someone that should be helping and not hurting, then that adds a whole other dimension of trust issues to the picture.  As mentioned in the comment, it "raises the perversion bar much higher".

Imagine if firemen came knocking on your door one day, stepped inside and then proceeded to burn your house to the ground.  What if cops came bursting into your house and robbed you of all your valuable possessions.  You'd probably have a hard time trusting these people to do the jobs they are supposed to do after you experienced them abusing their positions to do you harm.  You would probably have a hard time trusting anyone in those positions again, regardless if they were the ones that actually perpetrated the crime.  It is, of course, that much harder to heal from PTSD if you feel like you cannot trust the people that you need to help you through the healing process.

Another aspect of this question that should be discussed is when a client comes away feeling re-traumatized as a result of the healing process with a trusted professional who is not abusing his position/role.  I got the following thoughts on this subject from a professional counselor.

With professionals working with people living with PTSD, there is an almost 100% probability that the client will re-experience the traumatic event/relationship at some level.  The issue is not about a professional avoiding re-traumatization, but the pace, purpose and process of the healing journey that may include therapeutic exchange between the trauma event and the client's response to the event.  The goal in PTSD treatment is not to help the client eliminate the event, but to help the client become more effective in living, given the intrusion of the traumatic event as now a piece of history in the present life.
A professional should never bring a client into psychological contact with the event(s) without having a treatment purpose and follow through that brings healing purpose to the contact.

So, we have discussed two aspects of this issue, (1) when a person who should have been trusted has caused PTSD due to an abuse of their position/role and (2) when a client feels re-traumatized by a trusted professional.

In the first aspect, healthy boundaries should be put in place and maintained as quickly as possible.  If a professional has caused the PTSD, then treatment with that professional should be ceased and action taken where appropriate.  If this has been the case for your friend or loved one, then please keep in mind that he/she will be experiencing heightened issues with trust and these are sure to spill over into any interpersonal relationships of the one living with PTSD. 

In the second aspect, it may or may not be the case that the professional has abused his position/role.  Healing from PTSD is not easy and often brings us into contact with feeling and emotions that we would rather not experience.  These can be very threatening at times and sometimes it is hard for us to differentiate where the threat is coming from.  If someone living with PTSD feels re-traumatized in the healing process, then he/she needs to evaluate (probably with with insight of trusted friends or loved ones) whether or not what they are feeling is a valid part of the healing process or not.  As stated by the counselor in the quote above, if the professional does not have a "treatment purpose or follow through", then the professional is not acting properly and the client should consider seeking out treatment with another professional.



If you have a question about what it is like to live with PTSD, please use the link at the top of the page to submit your question to be answered in a future blog.