Site Presented By
Tuesday, Feb 9, 2010
Talk therapy only increases the suffering for some trauma victims -- but alternative treatments offer new hope.
Dec 8, 2004 | When Frannie was 35, her fiancé ended their five-year relationship. As breakups go, it was a bad one. She could hardly eat, sleep or get out of bed; she suffered panic attacks. Her friends, concerned that she was suicidal, brought her to see a psychotherapist, Belleruth Naparstek, who began treating Frannie (not her real name) with traditional "tell me what you're feeling" talk therapy, along with Prozac. But she got nowhere. "She sat across from me like a stone, barely able to speak," recalls Naparstek, who has a private practice in Cleveland. When she did speak, there were "long pauses that trailed off to nowhere."
Finally, after several sessions, Frannie -- now 56 and an educator in the Midwest -- began to describe an earlier trauma: losing a previous fiancé, over a decade before, to a brain tumor. Naparstek thought she'd hit pay dirt. But when Frannie started to talk about this loss, she began to have panic attacks at work and episodes of both severe verbal paralysis and strange physical contortions during therapy. Speaking only, Naparstek says, "in disjointed, choppy fragments" -- getting the whole story took months -- Frannie finally revealed that there was yet another trauma underlying the death of the fiancé: One night after visiting him, she was brutally raped, stabbed and left for dead in the hospital parking lot. Her contortions, Naparstek realized, were a physical flashback to the rape, a phantom effort to twist away from her attacker.
Frannie had never reported the rape and never sought counseling -- "I went on with my life and repressed it," she says -- until the memory got triggered in therapy. But talking about the ordeal did not bring catharsis; it made things worse. So Naparstek switched tacks. She began leading Frannie in guided meditations and encouraged her to imagine herself in a safe place, surrounded by loving and protective figures. Eventually, Frannie was able to calm herself at will, and the panic attacks began to fade away.
Frannie is one of approximately 5 million Americans who suffer from post-traumatic stress disorder. Surprising to some is the fact that most of the people who suffer from PTSD did not fight in Fallujah, see their homes swept away by hurricanes or escape from the twin towers. (They're not even the John Kerry people reportedly being treated for "post-election trauma.") People like Frannie develop PTSD from more intimate or individual traumas such as car crashes, surgery, assault or even the constant sense of threat in a violent community (9 percent of Israelis are said to suffer from terror-related post-traumatic stress disorder.) In fact, more people may have PTSD today than anyone ever realized. But because of recent advances in biochemistry, brain imagery and epidemiology, researchers are finding out that all manner of conditions -- some psychiatric, but some also physiological, such as chronic pain -- can be traced to PTSD.
"The symptoms of post-traumatic stress can mimic severe, chronic mental illness, and many people have been misdiagnosed and assumed to be hopelessly ill," says Naparstek, author of "Invisible Heroes: Survivors of Trauma and How They Heal." "But people with PTSD aren't crazy, and they get better." Today, in fact, their prognosis is the best it has ever been. For many years, "we didn't know how to help trauma survivors in any consistent way," says Naparstek. As she herself discovered while treating Frannie, "Talking about it -- the stock in trade of mental health professionals, pastors, good friends and spouses -- is not necessarily all that helpful, and can sometimes make symptoms worse." But now Naparstek, and more and more trauma experts, are using additional forms of treatment -- such as guided imagery and somatic experiencing -- that have only recently shifted from the fringe to the mainstream. Research is even underway on a PTSD pill.
Get Salon in your mailbox!
