‘Nobody In Their Right Mind Wants to Talk of Horrible Things’

But  trauma therapist are  going to make you at the drop of a hat. Surprise, surprise lots of people drop out. The problem is that therapists are poor at making the distinction between cognitive avoidance and saving normal.

Ms X was on a works training course , but got upset when discussion got around to the Manchester bombing and she left the room. She had escorted her 2 children from the arena. Ms X was referred to Occupational Health     and seen by a therapist who said that she was not suitable for learning to manage workplace trauma. Ms X’s reaction was arguably a normal reaction to an abnormal situation , it had not been ascertained whether she was suffering from PTSD or any other recognised disorder.

 The therapist had not appreciated  that traumatic memories have to be handled with ‘kid gloves’ , there is a normal aversion reaction to such encounters. Recognising and accepting Ms X’s response is acknowledgement of the need to ‘save normal’ . This is not to say that on occassion , there is not a need to learn a better way of handling an intrusive memory when it is significantly impairing functioning (e.g in PTSD) or to reconstruct the memory so that it is a better template for predicting everyday life. But the burden of proof is with the therapist to demonstrate that this is necessary.

Dr Mike Scott

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