The nation’s reaction to yesterday’s mass murder at Virginia Tech University have been understandable and predictable: lots of speculation and emotion.
One of the more predictable responses is coming from my industry. Already, I have heard therapists in the media warning us about the dangers of vicarious trauma, the trauma of anniversary dates (the eighth anniversary of the Columbine massacre is just three days away), and the trauma of compound traumas.
If the university where I teach is any indication, well-intentioned mental health professionals are coming out of the woodwork to help. In a campus-wide email, we were reassured that counselors were available to students, faculty, and staff in the event that we were “touched by today’s tragedy.”
I am most certainly touched by today’s tragedy. My heart aches for those who lost loved ones.
But in regard to my own mental health, I’d like to pause for a moment, take a breath, and assess the situation. Do I really need a counselor today? Probably not.
Don’t get me wrong. If I didn’t believe in mental health services, I would never have earned a doctorate in psychology. But my industry gets carried away sometimes. When we’re not careful, we can do more harm than good.
Shortly after the 9/11 attacks on the World Trade Center and Pentagon, 19 psychologists warned the American Psychological Association of our industry’s tendency to overreact:
“In times like these, it is imperative that we refrain from the urge to intervene in ways that – however well-intentioned – have the potential to make matters worse…. Unfortunately, this has not prevented certain therapists from descending on disaster scenes with well-intentioned but misguided efforts. Psychologists can be of most help by supporting the community structures that people naturally call upon in times of grief and suffering. Let us do whatever we can, while being careful not to get in the way” (quoted in Hoff-Summer & Satel, 2005).
Wise counsel. Since 9/11, (and before, actually) we have learned that the way in which mental health workers approach disasters is sometimes counter-productive. Critical Incident Stress Debriefing (CISD), a group-based intervention invoked after tragedies such as today’s, has come under particular fire for its lack of empirical support. In fact, it appears that it can actually increase the risk for adjustment and anxiety disorders for some people (see, for example, Devilly & Cotton, 2004, for a critical discussion of the debriefing industry).
One of the ways that mental health workers can make matters worse is by interfering with natural individual and group processes that contribute to healthy coping – for example, by pressuring people to talk to professionals rather than gathering with friends and family. Overly enthusiastic counselors can also stay mired in the details of a tragedy long after their clients are ready to move on, thereby standing in the way of recovery.
Mass interventions such as CISD operate under the assumption that people are generally ill-equipped to respond to tough times. Nothing is further from the truth. Most humans, most of the time, are resilient creatures with good coping skills and solid support systems. In a study of Israelis who had suffered at the hands of terrorists, Bleich, Gelkopf, & Solomon (2003) found that the majority were optimistic about their future and felt that they could function well during a terrorist attack. Only five percent reported the need for professional assistance with mental health issues.
And there’s nothing wrong with being in that five percent. The task of mental health professionals during crises is to assist people when they get off-track in the natural process of assessing, responding, grieving, and recovering.
Self-destructive responses such as drug or alcohol abuse are a sign that a person is getting off-track, as are intractable and overwhelming emotional reactions. When thoughts or emotions interfere with normal functioning for days on end, then it is time to seek help.
And, of course, being directly affected by an event might require more assistance than friends and family are equipped to offer. If any of this describes you, please find a professional to help you make sense of the situation and find your strength again.
But if you feel that you’re doing OK, you probably are. If a professional tries to convince you otherwise, tell them to bug off. It might be the best thing you can do for your mental health.
-IS
References:
Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Isreal. Journal of the American Medical Association, 290(5), 612-620.
Devilly, G.J. & Cotton, P. (2004). Caveat emptor, caveat venditor, and Critical Incident Stress Debriefing/Management. Australian Psychologist, 39(1), 35-40.
Hoff-Summer, C. & Satel, S. (2005). One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance. New York: St. Martin’s Press.