One of the most challenging aspects of forming a system of treating post-traumatic stress disorder (PTSD) and the depression and other problems associated with it is basing treatment on a set of reliable empirical data and theories. As it stands, despite the wide range of literature available on the treatment of PTSD, there is yet a standard that is the reliable and used across the spectrum. It is still difficult for researchers and clinicians to determine what will cause PTSD and furthermore, to what extent the case will be in terms of severity.
The article by Jerome Groopman, “The Grief Industry: How Much Does Crisis Counselling Help Or Hurt raises a number of questions about PTSD, but one of the most important of these is, why is it so difficult to study the phenomenon of PTSD and its treatment empirically? To answer this question about the study of Post Traumatic Stress Disorder (PTSD), Groopman offers evidence from clinical studies of patients exhibiting symptoms such as depression that seem to contradict one another, as well as anecdotal observations provided by therapists and researchers whose professional lives are devoted to the study of trauma and examines the many ways in which the results are slippery and difficult to pin down. It discusses the ways that the field of pyschology has sought to link the symptoms and the psychological behaviors that manifest.
The conclusions Groopman offers in “The Grief Industry” are frustratingly lacking in clarity and thus the article makes it clear just how difficult it is to form any certainties about PTSD and thus its possible treatments. Groopman identifies numerous variables that may impact the degree to which someone is traumatized, as well as how long the trauma and its effects can be expected to persist. Those individuals who have been traumatized in the past, especially during childhood, may be vulnerable to developing full-blown PTSD and depression, as might also be the case for people who are closest to a large-scale traumatic event, such as the terrorist attacks of September 11. After noting these variables, however, Groopman goes on to reassert that the research evidence from the field of psychology is not entirely clear when it comes to explaining who is most vulnerable to experiencing PTSD and persistent symptoms, such as depression, after being exposed to trauma.
This lack of clarity, in turn, complicates the debate about best practices for treatment of PTSD. Groopman spends an extensive amount of time discussing the trauma debriefing model developed by Mitchell, only to go on to cite other researchers and clinicians who hold the opposite view: counseling and encouraging people to talk about their feelings after a traumatic event are not helpful, and may even exacerbate the effects of the initial trauma and lead to further depression.
These same dynamic tensions about diagnosis, resilience, and treatment are identified in the research literature as well, and it seems that there are few clear paths about how to advance our understanding about these subjects as we move into a new generation of research and clinical work (Brywnn Thomas & Wilson 19). Groopman contends that researchers and clinicians may both be starting with an erroneous assumption as their orienting premise, namely, “that we are all at high risk for P.T.S.D. after exposure to a traumatic event.” This is a startling suggestion as it makes clear that the condition is not one that simply emerges in people who are at some kind of risk, but rather, that everyone is capable of succumbing to it if exposed to the right (or wrong) conditions. Interestingly, the evidence that Groopman presents seems to suggest otherwise; however, he does not seem to be attempting to drive a particular personal agenda forward by presenting this argument. Rather, the identification of the historical and contemporary conceptualizations of Post Traumatic Stress Disorder (PTSD) and its treatment help the reader to understand theoretical and philosophical shortcomings of the approaches that have been used to date, both in the field of research and in clinical practice.
Groopman’s article, then, serves as a thoughtful and comprehensive piece of journalism that identifies potential directions for future research and examines the many ways the issue is not being handled correctly in the field of psychology and thus, perhaps not being studied properly either. While we may not yet understand all, or even much, of what there is to know about trauma, what we do know is that traumatic events are an enduring feature of human existence, and any thoughtful effort that can be made to help human beings negotiate and recover from trauma can be useful.
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Works Cited
Brwynn Thomas, Rhiannon, and John P. Wilson. Empathy in the Treatment of Trauma and PTSD. New York: Routledge, 2004.
Groopman, Jerome. “The Grief Industry: How Much Does Crisis Counselling Help Or Hurt?”
