The Role of Trauma in Mental Health: The issue cannot be ignored any longer

There is no doubt that trauma is a major contributor, and likely cause of the mental suffering of many people who are given diagnoses for mental illnesses. This has recently been established and articulated by people like John Read. You can see him talk about it here http://youtu.be/Y6do5bkUEys

What is most impressive about this issue is the extent to which childhood adversity and trauma is associated with future mental health difficulties. The relevance of trauma vastly outweighs the relevance of biological or genetic factors. And yet the overwhelming majority of interventions people receive are designed to ‘treat’ biological ‘illnesses’. Medications will not address early traumatic experiences. Psychotherapists and psychologists have known this through the therapeutic process for decades. As a psychologist it has become abundantly clear that early experiences shape profoundly the quality and nature of our health and mental health. This has always been evident even looking back in time through the lense of sometimes hazy memory. Listening to people’s stories over the last two decades (almost) has left me in no doubt. However, it is encouraging to see research establishing this reality in a different and very solid way. No longer is this just the opinion of some psychologists and therapists. John Read points out that trauma, particularly cumulative or multiple trauma (the various forms of child abuse for example) multiplies the risk of developing psychosis many many times over. If trauma was somehow magically erased from our society the incidence of psychosis would reduce by about one third. This is a massively important public health concern. The Advese Childhood Experience Scale research has also established firmly the role of early trauma in all sorts of negative health outcomes both physical and mental. The US centre for disease control now views early trauma as a major public health issue.

Every assessment of every persons in mental health care should now include a comprehensive review of early trauma. All mental health professionals should be highly trained in working therapeutically with trauma. Currently this is not the case, very few disciplines have any comprehensive understanding of early developmental processes and the impact of trauma on our development. I include psychologists in this group, although the problem is less so in this group. Most mental health professionals are poorly equipped to assess, understand and facilitate healing from early trauma, despite the enormous role it plays in so many peoples mental health difficulties. There is a wealth of information to facilitate this healing drawing from PTSD literature and psychological interventions ranging from exposure therapy, to psychodynamic and psychoanalytic theoretical and therapeutic understandings to the work of people like Peter Levine. Looking at things from a problem specific angle, like paranoia or depression, we also find a great deal can be done to help psychologically and psychotherapeuctically. So why is this not the driving force of interventions for those people who present to mental health services? Primarily because clinicians are not looking at people who have been hurt, wounded, abused and traumatised, they are looking at illnesses. Looking at people as if they are illnesses obscures the lived experience and reality of people’s developmental pathway towards the mental health difficulty.

In short, mental health services need to become at least in part, sophisticated and expert trauma healing services. The evidence is overwhelming. We must adapt to this understanding.

 

 

 

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The Role of Trauma in Mental Health: The issue cannot be ignored any longer

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