The Medicalisation of Trauma

The Medicalisation of Trauma

“The medical model of health asks “What is wrong with you?” It does not ask “What happened to you?” This is the question that puts our health into an environmental context. What support did you have? Was anyone listening?”

Dr. Gabor Mate
Glasgow 2019 – ‘Aces to Assets’

For over 200 years the medical profession has largely stigmatised the traumatised of our society by labelling them as “mentally ill”.

 Practically the whole of DSM V is a baroque paean to this labelling of those who have suffered catastrophic trauma as being “mentally ill” – as if they are suffering from some kind of brain disease. This disease model of mental health is of course borrowed from the disease model of physical medicine and many writers have challenged the complete lack of any scientific evidence for this approach, including Dr. Gabor Mate.

 To call a person who has suffered intolerable trauma “mentally ill” would be no different to labelling a shattered leg as “an intrinsically diseased leg” when it had in fact been run over by a car. It takes the context and the environment out of the illness.

Yet we are not separate from our environments. I know for a fact that if I had been born into a different part of the world or to a different family, I would not be the person I am.

The neuroscience is now showing us with absolute clarity that the very development of my brain,  including its size, depends on how the first years of my life progressed. As climate change and international economic inequalities reach dangerous levels, most therapists are asking “Can we really separate our clients from the economics of their situation or indeed the state of the world”? Here in Britain we have recently seen the trauma of Brexit spill over into the treatment room. Does this trauma mean that the brains of our clients are diseased?

To illustrate the power of our environment, I have drawn the comparative sizes (to scale) of the MRI scans of two 3 yr old children – one that suffered neglect and trauma and one that had a more normal childhood.

The continuing studies of the effects of neglect on the ageing Romanian children from the 1990’s speak volumes for the impact of trauma on both the brain and on our behaviour. The mental and physical illnesses that arise from neglect, abuse and violence are not really the problem at all – they are simply the consequences of the problem. The real problem is trauma.

 

The mental and physical diagnoses are merely highly detailed descriptions of the symptoms of trauma. The A.C.E. study by Felitti et all in 1997 proved beyond all possible doubt that both physical and mental illness are the consequence of trauma – and in this study they were only looking at those traumas that can be remembered or were known about. This excluded all of the early attachment ruptures and traumas that happened before the memory part of the brain (the Hippocampus) was fully formed at three years old. We are just left with the family stories for these early years, and many of the most traumatised families cast an impenetrable cloak of secrecy over such early and painful history.

As long as the medical profession continues to focus almost exclusively on the consequent behaviours that arise from trauma, and tries to treat these behaviours and symptoms, the core issues themselves will remain unattended to. Yet even when doing GCSE science we learn that “energy cannot be destroyed – it can only be changed.” So what happens to all this locked up energy of the trauma if all we are doing is trying to fix the symptoms or the behaviours? Where does it all go?

As counsellors and psychotherapists we are often the ones left to witness how these unresolved traumas turn inward like a gangrenous infection and cause pain and illness to our clients that can destroy their lives. It is up to us to help our clients find their way back to these locked up traumas and to help them release and heal them.

But here’s the thing…

We now know that those traumas are locked away in the Amygdala, deep in our limbic system and that this part of the brain is not susceptible to influence form the traditional “talking therapies”. In order to make a real difference to the lives of our clients we need to learn how to “speak nervous system” which is a largely non verbal language.

It is my own belief that, to ‘speak nervous system’ as counsellors and psychotherapists, we need to “cross over”  and learn from the world of shamans, healers and bodyworkers who have been soothing and healing the nervous systems of their clients for millennia…and bring this understanding and knowledge back into the treatment room to help our clients dissolve and discharge their long held traumas.

 To find out more about “Talking Nervous System” through an original approach that integrates bodywork with counselling and psychotherapy, click here

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