Cook is a psychologist and associate professor at Yale University and an Op-Ed Project Public Voices Fellow
In Holland, a Dutch woman in her 20s who reportedly experienced childhood sexual abuse from the ages of 5 to 15 and suffered from post-traumatic stress disorder and other complex negative consequences as a result was allowed to choose lethal injection in Holland when doctors decided her condition was untreatable.
If that doesn’t make me, a trauma psychologist, want to scream or cry, I don’t know what would. Treatment is hopeless? Who says that to their patients? And why should people stand for such cynicism from their health-care providers?
Recovery from such severe trauma is not easy, but telling someone it’s not possible? Well, at minimum, that’s just untrue.
The evidence from dozens and dozens of randomized clinical trials strongly suggests that there are several psychotherapies that can significantly reduce PTSD symptoms, if not eradicate the disorder altogether. Of course, there’s no one best treatment for PTSD, no one-size-fits all solution, no magic bullet. And some trauma survivors may refuse to engage in these therapies when they’re offered to them, drop out after they’ve begun them, or only experience partial benefits. But these psychotherapies do work for the vast majority of people. And when they don’t, there are additional proven techniques that can be added to increase engagement and efficacy.
Treating PTSD isn’t easy, but it can be highly successful, and for a disorder that affects up to 10% of Americans, that’s something that people should know.
The effort to develop and disseminate effective PTSD treatments is great news for many individuals affected by trauma. These include those who have experienced abuse in childhood and carried their psychic burden into adulthood, combat veterans who fought for their country but struggle decades later to find their way home, women who served in the military only to be subjected to sexual assault by the men they served with, victims of random acts of violence, and individuals who directly experienced acts of terror. Thousands of people can now benefit from the PTSD treatments that have been developed in the relatively calm centers of academia.
But several problems exist in getting those treatments to the people who need them. So many trauma survivors wait decades before seeking help, and many more do not receive effective treatment when they do so. There are a host of other reasons for this, including survivor denial or minimization of problems, avoidance of trauma memories and reminders, stigma and wanting to solve problems on one’s own. Those barriers all need to be addressed. But one important way to improve trauma survivors’ mental-health treatment is by encouraging them to come forward.
There are effective treatments for what ails them. And healing doesn’t solely or even primarily mean reduction of PTSD and other mental-health symptoms, though that’s a huge part. Healing also means finding and maintaining a loving support network, engaging in meaningful life pursuits and being able to hold one’s head up, looking oneself in the mirror and others in the eye.
Sadly most health-care professionals have only a cursory knowledge of the traumatic stress literature. And many others either lack formal training in or don’t apply evidence-informed psychological treatments for trauma-related disorders. It’s unrealistic to think that every health-care provider in the U.S. or abroad should have specialized trauma training. But at minimum, they should be able to recognize and assess for trauma exposure and its potential negative health consequences.
Some trauma survivors have complex co-morbid conditions and circumstances—suicidal ideation, difficulties regulating emotions, tendencies to self-harm. It sounds like this was the case for the young woman from Holland as it is for so many survivors of severe, chronic, or childhood trauma. With those complexities, there is an increased need for providers to achieve competency in trauma mental health.
Providers should acquire evidence-based knowledge, skills and attitudes to engage in competent and caring practice with traumatized individuals. Providers need to understand and utilize evidence-informed assessments and psychosocial interventions for PTSD and trauma-related disorders. No provider anywhere should ever tell a trauma survivor that their condition is incurable.