I've been reading a new book about dealing with trauma that's a little bit different from some of the things we've discussed thus far. It's called "Redirect: The surprising new science of psychological change" and it's by Timothy D. Wilson.
He starts out telling about a seriously traumatic incident that happened to some police officers who were then scheduled to receive CISD, or Critical Incident Stress Debriefing.
The premise of CISD is that people who have been traumatized should air their feelings as soon as possible so that they don't develop PTSD. In a typical CISD session, the participant is asked to describe the traumatic event, express their thoughs and feelings, and talk about physical of psychological symptoms they are experiencing. The facilitator will tell them that it is normal, give stress management advice, answer questions, and decide if the person needs further help that can include medication, etc.
Apparently, numerous police and fire departments have implemented this sort of thing and it sounds helpful. Problem is, it was never really tested. It was just an idea that sounded good and right. The problem is, as Wilson points out, it is not only ineffective, it may actually cause psychological problems. He and his team were testing stuff with well planned double blind studies and found that thirteen months later, a group that had received the CISD intervention had significantly higher incidences of PTSD, were more anxious and depressed, and less content with their lives.
That is: making people undergo CISD right after a trauma impedes the natural healing process and might even freeze memories of the event in the person's mind.
So, what DID work, based on tested evidence???
Instead of asking the person to relive the trauma, they let a few weeks go by... and then, they asked him/her to complete on four consecutive nights, a simple exercise in which s/he writes down a description of the event, his deepest thoughts and emotions about the experience and how it relates to the rest of his/her life.
That's it. No meetings, no group sessions, no stress management advice, just a series of writing exercises that the person does on their own for four nights in a row.
The important part of writing down the deepest thoughts and emotions about the experience is finding the MEANING in it.
It's not the objective world that influences us, but how we represent and interpret the world. When something happens to us, we try to make sense of it.
Trying to make sense of what happens in your life and the answer you come up with, will be a crucial determinant of what happens next in your life.
For example, a young person takes their first test in college. He's a little nervous because the test WAS hard, but he was sure he did okay because he did well on math in high school. But when he gets his paper back, he is shocked to see the low grade.
The personal interpretation will kick in immediately: you will either take responsibility, or blame circumstances. In the first case, you will decide that you didn't study hard enough and this is a wake-up call to work harder. In the second case, you will blame it on some other circumstance, and possibly end up deciding that you just aren't college material after all.
Most people have an optimistic outlook on life, believing that they have good prospects in the future and that they are masters of their fate, even if that is a pack of lies. In some situations, this attitude can be a blessing IF the system that the person utilizes to back it up is on that promotes work and growth. That is, a truly positive "spin" would be to view one bad grade as an indication that one needs to work harder rather than as a sign that one should give up.
Our interpretations are rooted in personal narratives about ourselves, the narratives we construct about ourselves and the social world, i.e. the "false personality". This false personality can be very maladaptive and bring lots of pain and suffering into a person's life. Negative thought patterns, misreading cues from others, having "programs" that were created and set during traumatic childhood events, etc.
The best way to treat these problems is for the person to become aware of them and LEARN HOW TO CHANGE THEM.
The student who immediately assumes the worst about a bad grade - that is, he received a shock and his emotions began to flood his intellect and he started creating negative theories about things - is at risk of becoming depressed and needs to learn to change his negative assumptions about himself.
Psychotherapy is, in general, useless - as empirical evidence shows. But Cognitive Behavioral Therapy has a higher rate of success than other modalities (assuming the person isn't certifiable!) What is needed is for the person to "edit" their story about themselves. Sometimes this can be problematical. Narratives about ourselves are like an oil painting to which we add a little dab of paint every day. Revising that narrative means scraping away layers and layers of paint and starting over again. But in the case of a traumatic event, a shock, it can be easier because that "shock" can act as a solvent to the paint that has already been applied to the image, or can shake off all the old, flaking, paint.
Kurt Lewin, one of the founders of social psychology, said that in order to understand why people do what they do, we have to view the world through their eyes, and understand how they make sense of things. That is, External Considering.
He also had a radical idea that we could use relatively simple interventions to help people change the way they view themselves through, more or less, a social network - social proof.
During WW II, Lewin demonstrated this be getting people to change what seemed to be intractable food preferences, namely, an aversion to organ meats which were in greater supply because the traditional cuts were being sent to the army. He knew that simply lecturing people about the importance of the nutrition in organ meats didn't work. We all know that sort of thing doesn't work. So, what he did was create meetings of homemakers to discuss the issue. Trained facilitators would steer the conversation to how obstacles to serving organ meats could be overcome. That is, how could the housewives deal with the complaints from their families. The women who took part in helping to SOLVE these problems were more likely to serve organ meats than those who simply listened to a lecture on how good for you organ meats are.
In short, a network discussing facts, working on ways to deal with implementing a better way of doing or being, works much better than people going around giving lectures. The network itself edits its own story, its view of itself, and establishes the meaning of the problem at hand.
So, a bit of social psychology work has been done on this process of "story editing". According to Wilson, it is possible to use these techniques to targe long-standing personal narratives that people have constructed about themselves and the social world around them.
The point is, for people to come up with a coherent interpretation of an important event in their lives that actually serves them well for their future. Something has happened that doesn't make sense and is unpleasant or unhappy to think about. They try to put it out of their minds, which only makes it less likely that they will succeed in explaining it.
And so, the writing exercises become an effective way for people to interpret and reinterpret such events.
The traumas that cause prolonged stress are usually the ones that we can't make sense of because they seem like meaningless, random acts that don't fit into our view of the world as a predictable, safe place. Then we spend an enormous amount of energy trying to banish the events from our minds rather than taking the time to dissect the events and FIND MEANING IN THEM.
The people who benefit the most from the writing exercises are those who begin by writing a jumbled, incoherent account of the traumatic event, and in the end, write a coherent story that explains the event and gives it meaning.
One of the reasons that CISD doesn't accomplish this is the TIMING. The worst moment to try to work through something is right after the event. At that point, you need to just FEEL it, cry, throw pillows break flower pots, whatever. Once that emotional energy has been SPENT, you then take a step back and INTERPRET the event for yourself or with others. Forcing people to talk about a traumatic event right after it has happened can even solidify memories of it and makes it harder to reinterpret it later.
The person who succeeds after a crushing failure is the one who interprets the event as "I guess I need to get in gear and work harder"...
So, there is the writing exercise in which people reinterpret a problem by writing about it, and the social method where others help to prompt them to re-write their view of themselves, and then, there is the "do good, be good" approach.
This idea goes back to Aristotle who suggested that people acquire virtues "by first having put them into action. We become just by the practice of just actions, self-controlled by exercising self-control, and courageous by performing acts of courage." In other words, what you DO can edit your story. If you act kindly towards others (even if you are gritting your teeth inside), you begin to see yourself as having a kind disposition, and the more you view yourself as kind, the more kind you become, actually, inside! This strengthens your new narrative about yourself.
What this means is that very small edits/acts can lead to lasting changes that permeate your entire being. The way this works, taking the student who failed and then decided to work harder as an example: working harder paid off on the next test. This strengthens the self-image of not being a failure, of being college-worthy, and this inspired even harder work which resulted in more successes, higher grades, and finally a degree with honors. The very small edit of the story at the beginning triggered a positive cycle of self-reinforcing thinking.
He starts out telling about a seriously traumatic incident that happened to some police officers who were then scheduled to receive CISD, or Critical Incident Stress Debriefing.
The premise of CISD is that people who have been traumatized should air their feelings as soon as possible so that they don't develop PTSD. In a typical CISD session, the participant is asked to describe the traumatic event, express their thoughs and feelings, and talk about physical of psychological symptoms they are experiencing. The facilitator will tell them that it is normal, give stress management advice, answer questions, and decide if the person needs further help that can include medication, etc.
Apparently, numerous police and fire departments have implemented this sort of thing and it sounds helpful. Problem is, it was never really tested. It was just an idea that sounded good and right. The problem is, as Wilson points out, it is not only ineffective, it may actually cause psychological problems. He and his team were testing stuff with well planned double blind studies and found that thirteen months later, a group that had received the CISD intervention had significantly higher incidences of PTSD, were more anxious and depressed, and less content with their lives.
That is: making people undergo CISD right after a trauma impedes the natural healing process and might even freeze memories of the event in the person's mind.
So, what DID work, based on tested evidence???
Instead of asking the person to relive the trauma, they let a few weeks go by... and then, they asked him/her to complete on four consecutive nights, a simple exercise in which s/he writes down a description of the event, his deepest thoughts and emotions about the experience and how it relates to the rest of his/her life.
That's it. No meetings, no group sessions, no stress management advice, just a series of writing exercises that the person does on their own for four nights in a row.
The important part of writing down the deepest thoughts and emotions about the experience is finding the MEANING in it.
It's not the objective world that influences us, but how we represent and interpret the world. When something happens to us, we try to make sense of it.
Trying to make sense of what happens in your life and the answer you come up with, will be a crucial determinant of what happens next in your life.
For example, a young person takes their first test in college. He's a little nervous because the test WAS hard, but he was sure he did okay because he did well on math in high school. But when he gets his paper back, he is shocked to see the low grade.
The personal interpretation will kick in immediately: you will either take responsibility, or blame circumstances. In the first case, you will decide that you didn't study hard enough and this is a wake-up call to work harder. In the second case, you will blame it on some other circumstance, and possibly end up deciding that you just aren't college material after all.
Most people have an optimistic outlook on life, believing that they have good prospects in the future and that they are masters of their fate, even if that is a pack of lies. In some situations, this attitude can be a blessing IF the system that the person utilizes to back it up is on that promotes work and growth. That is, a truly positive "spin" would be to view one bad grade as an indication that one needs to work harder rather than as a sign that one should give up.
Our interpretations are rooted in personal narratives about ourselves, the narratives we construct about ourselves and the social world, i.e. the "false personality". This false personality can be very maladaptive and bring lots of pain and suffering into a person's life. Negative thought patterns, misreading cues from others, having "programs" that were created and set during traumatic childhood events, etc.
The best way to treat these problems is for the person to become aware of them and LEARN HOW TO CHANGE THEM.
The student who immediately assumes the worst about a bad grade - that is, he received a shock and his emotions began to flood his intellect and he started creating negative theories about things - is at risk of becoming depressed and needs to learn to change his negative assumptions about himself.
Psychotherapy is, in general, useless - as empirical evidence shows. But Cognitive Behavioral Therapy has a higher rate of success than other modalities (assuming the person isn't certifiable!) What is needed is for the person to "edit" their story about themselves. Sometimes this can be problematical. Narratives about ourselves are like an oil painting to which we add a little dab of paint every day. Revising that narrative means scraping away layers and layers of paint and starting over again. But in the case of a traumatic event, a shock, it can be easier because that "shock" can act as a solvent to the paint that has already been applied to the image, or can shake off all the old, flaking, paint.
Kurt Lewin, one of the founders of social psychology, said that in order to understand why people do what they do, we have to view the world through their eyes, and understand how they make sense of things. That is, External Considering.
He also had a radical idea that we could use relatively simple interventions to help people change the way they view themselves through, more or less, a social network - social proof.
During WW II, Lewin demonstrated this be getting people to change what seemed to be intractable food preferences, namely, an aversion to organ meats which were in greater supply because the traditional cuts were being sent to the army. He knew that simply lecturing people about the importance of the nutrition in organ meats didn't work. We all know that sort of thing doesn't work. So, what he did was create meetings of homemakers to discuss the issue. Trained facilitators would steer the conversation to how obstacles to serving organ meats could be overcome. That is, how could the housewives deal with the complaints from their families. The women who took part in helping to SOLVE these problems were more likely to serve organ meats than those who simply listened to a lecture on how good for you organ meats are.
In short, a network discussing facts, working on ways to deal with implementing a better way of doing or being, works much better than people going around giving lectures. The network itself edits its own story, its view of itself, and establishes the meaning of the problem at hand.
So, a bit of social psychology work has been done on this process of "story editing". According to Wilson, it is possible to use these techniques to targe long-standing personal narratives that people have constructed about themselves and the social world around them.
The point is, for people to come up with a coherent interpretation of an important event in their lives that actually serves them well for their future. Something has happened that doesn't make sense and is unpleasant or unhappy to think about. They try to put it out of their minds, which only makes it less likely that they will succeed in explaining it.
And so, the writing exercises become an effective way for people to interpret and reinterpret such events.
The traumas that cause prolonged stress are usually the ones that we can't make sense of because they seem like meaningless, random acts that don't fit into our view of the world as a predictable, safe place. Then we spend an enormous amount of energy trying to banish the events from our minds rather than taking the time to dissect the events and FIND MEANING IN THEM.
The people who benefit the most from the writing exercises are those who begin by writing a jumbled, incoherent account of the traumatic event, and in the end, write a coherent story that explains the event and gives it meaning.
One of the reasons that CISD doesn't accomplish this is the TIMING. The worst moment to try to work through something is right after the event. At that point, you need to just FEEL it, cry, throw pillows break flower pots, whatever. Once that emotional energy has been SPENT, you then take a step back and INTERPRET the event for yourself or with others. Forcing people to talk about a traumatic event right after it has happened can even solidify memories of it and makes it harder to reinterpret it later.
The person who succeeds after a crushing failure is the one who interprets the event as "I guess I need to get in gear and work harder"...
So, there is the writing exercise in which people reinterpret a problem by writing about it, and the social method where others help to prompt them to re-write their view of themselves, and then, there is the "do good, be good" approach.
This idea goes back to Aristotle who suggested that people acquire virtues "by first having put them into action. We become just by the practice of just actions, self-controlled by exercising self-control, and courageous by performing acts of courage." In other words, what you DO can edit your story. If you act kindly towards others (even if you are gritting your teeth inside), you begin to see yourself as having a kind disposition, and the more you view yourself as kind, the more kind you become, actually, inside! This strengthens your new narrative about yourself.
What this means is that very small edits/acts can lead to lasting changes that permeate your entire being. The way this works, taking the student who failed and then decided to work harder as an example: working harder paid off on the next test. This strengthens the self-image of not being a failure, of being college-worthy, and this inspired even harder work which resulted in more successes, higher grades, and finally a degree with honors. The very small edit of the story at the beginning triggered a positive cycle of self-reinforcing thinking.
