Could Trauma Be a Major Cause of Mental Health Symptoms?

Last fall I attended a conference on trauma and I was surprised by what I found to be the common perspective on trauma.  It differed completely from what I have experienced in my work with clients.  The main idea that I came away with was that most psychotherapists do not see trauma as a core issue in helping their clients heal from their mental health issues. In fact, most therapists don’t even ask their clients about past traumas. I was stunned.

Most therapists, it seems, only look at trauma as a single event or issue – say a client were in a bad car accident and now was afraid to drive or a client saw combat in the war and now was having flashbacks and nightmares. In general, clinicians are not looking at their clients’ past histories and seeing how those histories in which various other, even subtler traumas, may have occurred and contributed to their clients’ reaction to the most recent trauma. They are only looking at present symptoms and trying to alleviate them through changing how clients think or behave toward the most recent event or through pharmacology.  What about the past?

If clinicians are not aware of past trauma, that can have a profound effect on their treatment of their clients.  It is no wonder that therapy is so slow and difficult for clients.

I am coming from the perspective that trauma (and I will look more closely at what I think trauma is in a later blog) is the source of many psycho-therapeutic diagnoses such as depression, anxiety, post-traumatic stress disorder, panic disorders and many more. I believe that if you can resolve the trauma – present and especially past traumas should they exist, then the symptoms for these and some other diagnoses dissipate. And I do just this in my practice, as do other trauma specialists.

Now I want to make clear, I am not saying that therapists who do not look at trauma are bad therapists, I just feel they are overlooking a significant piece of the puzzle that makes up their clients’ mental health issues. I would like to see the intake process consistently include asking questions about past traumas instead of as a rare occurrence. In my opinion, this would be a start in getting clients better, faster.

 

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2 Responses to Could Trauma Be a Major Cause of Mental Health Symptoms?

  1. I totally agree with you. After working for 38 years in mental health and 20 year of owning and running a nationally known inpatient trauma program, therapist do not ask about trauma or see that PTSD symptoms produce and make worse mental health problems. I am glad you had the strength to write what I have encountered for years.

  2. Yoly Zentella, PhD says:

    This is an important post.
    I am also amazed at the compartmentalization of issues in mental health settings. Having worked in a variety of settings I have seen clients treated like assembly line products. They come in for alcohol abuse, they are placed in a program that addresses the issue, only. Then they are on their way, only to come back later because they relapsed. Often in my clinical work I have found that there is often trauma in the background of a presenting issue. Sometimes the trauma had never been disclosed, until a particular session. As I see it, the possibilities of a connection between a trauma and an issue the client has sought help with, are real. What I have noted though, is that clients are also afraid of working on the trauma for fear of what they will feel and probably more important what they will find and how this will change their lives.

    I am hopeful that Diane will continue writing on this topic, this shadow, that unless addressed continues to haunt the individual and impacts our communities.

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