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[chibam]

This is an interesting article I happened upon this afternoon, based upon a public statement released by the mother of one of the Bondi Junction stabbing victims.
https://www.msn.com/en-au/health/other/mother-of-bondi-junction-stabbing-victim-calls-for-better-cri...

Feel free to comment on anything you find interesting about this article. But what really stood out to me is the insinuation this woman seems to make that most of her extended family, from all around the country - even the young children - have gone into therapy as a result of this incident, which I thought says a lot about the times we live in.

When I was a kid, I had an uncle who lived in another state with his family who (relatively) quickly died of cancer. I think there was only about four months between when the word "cancer" was even first mentioned, and when he was dead. I know it's not quite the same as having a family member suddenly stabbed to death in a shopping mall, but the similarities are probably more pertinant then the differances, you know?

As far as I know, nobody in the whole extended family - not even his immediate family - felt any need to go to a therapist over this. We all just got on with our lives.

And it's gotten me thinking about incidents in high school where one student attempted suicide, and another got hit by a bus, and there was never any push by the school to get any of us to talk to councilors/therapists. We all just shook our heads, said: "Oh dear, that's terrible!", and got back to our schoolwork - mostly, I think, because the vast majority of us had utterly no idea who these victims were.

But I'm starting to see that that's not the world we live in today. I really get the sense that anytime anything bad happens, no matter how tenuous your connection to the incident may be, your expected to go into therapy over it.

And the reason I bring this up is, if we do have such a hair trigger regarding our inclination to go into therapy (or to push someone else into going into therapy), then is it any wonder why the industry is so choked up, and why we constantly hear about 6 month waiting lists to see a therapist these days? Have we, as a society, become far too inclined to go into therapy, simply because it's what's expected of us?

I'd be really interested to hear others' thoughts on this.

[GreyWolf7]

Interesting conversation to bring into discussion. I think pretty much everyone can benefit from the therapeutic experience. The question you're raising is that we don't have infinite resources, which brings into question should everyone have access to therapy? I think so. I think what we have to get better doing as a society is recognising the different skills of different professional occupations - that it's not just psychologists and psychiatrists who are able to offer therapy. But, people with appropriate training in counselling and psychotherapy, such as psychotherapists, social workers and nurses. I think if medicare recognised the broader skill sets of some of these professions, then we might be able to reduce the demand on just two professions. 

But that said, I think we have to be more judicious as a society in how we use the word 
"trauma". To me "trauma" involves in a *serious* threat to sense and to self. But I see some practitioners using it a bit too liberally, in my opinion. I think the problem of this is two-fold. It doesn't recognise the legitimate experience of those who really do experience acute or chronic trauma - i.e. PTSD and C-PTSD. While it pathologises what are everyday parts of the human experience and I don't think does favours to the person who then carries the "title" - for example, once of situations of the following: failing an exam, having an argument with a parent, sibling or another human being, and a lost friend - they carry the full embodiment of trauma. Yes, there is argument in the literature that we shouldn't judge someone's "trauma" and it's about the person's perception of an event, but I'm of the camp there has to be some limits. I'm seeing psychologists and psychiatrists pathologise everyday experiences and I don't think that's reasonable.

[8ppleTree]

Hi @chibam 

Great discussion question! 

Personally I think anything that normalises avenues for people to connect and heal is very good! The fact that there aren't enough mental health supports for people probably is a reflection on society in both good and bad ways, i.e. reduced family and social community supports over the last 100 years or so, different norms re: work, family structures, societal roles, etc. 

Acknowledging the suffering that has come from the incident isn't bad. How people access their supports or why can be complex. 

[Jynx]

@GreyWolf7 just wanted to share my two cents. I totally agree on your first point - if more types of mental health professions were recognised by medicare, it would make a huge difference! And would also make it more accessible for folks who do want or who would benefit more from that type of support. Like someone having relationship issues might be better with a relationship counsellor than with a psychologist. 

Re: the way we talk about trauma - sometimes I've heard folks use the phrases 'Big T and little t' types of trauma. Big T being stuff like natural disasters, sexual assault, etc., little t being for stuff you mentioned, like failing an exam or having an argument with parents or something. Cos by definition, trauma is just 'any experience that overwhelms our current ability to cope', and some of those experiences deinitely fall under that banner. I think a single instance, or several instances spaced out, of little t trauma is usually not enough to push us past our limits... However, if it is a relentless, sustained experience of little t trauma, it can still create issues for us - like childhood emotional neglect for instance; one occasion of little t where our parents ignore us crying probably won't have too big of an impact, but repetitive experiences of that is how we end up with C-PTSD. 

I think you're right, that we can end up pathologising normal human experiences, but I think that's because of how much we've pathologised people's normal trauma responses. E.g. someone whose parents were abusive, and thus has a very strong stress response to relationship tension, might end up labelled as having BPD (I've even heard of a movement to rename BPD as 'Developmental Trauma', but I digress). They're stigmatised as having 'something wrong with their personality' when really, they're responding exactly as their innate stress response wants them to act, because that is what they learned as a child to help keep them safe. The current MH system would pathologise someone's entire personality based on them formulating particular patterns of behaviour necessary to survival. So to my mind, we need to de-stigmatise people's trauma responses as being a 'disorder' and move towards being able to say, "It's okay, you're reacting exactly as expected of a human animal in this situation. This is normal."

[8ppleTree]

@Jynx 

Yes, I love that. You're reacting normally as a normal human-animal might. 

When an animal is traumatised, we try to create a supportive environment, ie food, water, calm routine, other supportive animals nearby, reduced stimuli for a while until gradually trust can be rebuilt. If it can't, the animal is left alone, usually with other support animals to live peacefully. You take an animal and put it in an unsupportive environment, with improper training practices, or plants with improper companions and poor soil...?! Call it what you like, but we're all nature. 

[GreyWolf7]

Thanks for your reply Jynx. I'm in agreement with all that you have said and how you have articulated the relationship between a repeated series of events and the later development of a psychological disorder - most particularly C-PTSD. I probably didn't articulate myself well on the issue as I was racing to get into chat. I used the wrong examples - I probably should have said something like dealing with a minor illness, normal romantic breakups and disappointing exam results.

I was thinking about the original poster's comments about people seeking treatment for about a range of everyday things (in addition to traumatic events). It got me thinking about the work of Nick Haslam at the Uni of Melbourne where he talks about "The Creeping Concept of Trauma" (research available on research gate). "Trauma" appeared at an almost 20 times higher rate in psychology journal articles in the 2010s as it did in the 1980s. As a consequence the words and concepts around 'trauma' are becoming - as Eleanor Cummins described - "uselessly vague". Jessica Bennett asked "if everything is trauma, is anything." The upshot of all of this is for people who go through legitimate experiences of trauma that led to illnesses like PTSD, C-PTDS, they start to fall into the "uselessly vague" area. I've found that people are a bit 'blase' as it doesn't catch the impact it use to mean.

Instead, Haslam notes "Others worry that the growing popularity of trauma narratives represents an encroachment of medical language into the realm of ordinary adversity, reducing unjust social arrangements to individual pathologies, or promoting personal fragility. Still others have voiced concerns that the concept of trauma has become politicised." So we're at risk of calling moderate life challenges as mind-shattering traumas that undermine our resilience.

Of course there will be repeated adversities that will take people beyond their comfort point. Yes, in childhood, persistent denial of a child and their cries could lead to attachment issues, developmental trauma/BPD. But, there are adversities that take people beyond out of their comfort zone, like the lost exam, or lost friend that are getting the full experience of trauma. The research suggests the act of making these "trauma" can affect the persons experience of the event making it loom larger and longer than they need be. There is no benefit in labelling everything a trauma, in fact it can be counterproductive.

Haslam, N., Vylomova, E., Zyphur, M., & Kashima, Y. (2021). The cultural dynamics of concept creep. American Psychologist, 76(6), 1013–1026. 

Jones, P. J., & McNally, R. J. (2022). Does broadening one's concept of trauma undermine resilience?. Psychological Trauma: Theory, Research, Practice, and Policy, 14(S1), S131. 

[tyme]

Hey @Jynx ,

I believe the post above was for you 🙂

[chibam]

@Ru-bee  @GreyWolf7  @8ppleTree  @Jynx  @tyme  I notice many of you making observations to the tune of: "this increased public appetite for therapy has made acknowledging mental health issues less taboo, therefore it is a good thing." And I really get where that is coming from. I mean so much could just be solved in an instant if we were just able to talk freely with the people around us and just get the help we need, without any fuss, exploitation, or judgement.

But with that in mind, I'd just like to make some personal observations, based off my own experiance:

When I first went in to therapy, doing so was a lot more toxic to one's social image then I suspect it is today. I mean, I imagine today that it's like: "Oh, your in therapy? Pfft! Who isn't?" So, when I was first confronted with the fact that therapy was the only option I had left, the potential dammage this could inflict on my public image was a major stumbling block.

But that being said, I had only about a 5-6 week wait to see the psychiatrist; and I think only about a 1 week wait to see the psychologist. Today, we're typically hearing about 6-month waiting periods to get in to see these sorts of people; and many of them have completely closed their books to new patients!

In my case, it's all pretty moot, since the therapists never did anything anyway. But in a theoretical world where therapists do actually help their patients with their actual, real-life problems...

If I had to choose between bearing the social stigmata of needing to ask for help; or waiting 6 more months for my life to start, I would definitely choose to bear the stigmata, rather then losing another 6 months of my lifetime.

So while I'm totally on board with the idea that it's a good thing to be getting rid of the taboos around "mental illness", if the cost of this more open atmosphere has been these horrendous wait times, then I would suggest that the cost probably hasn't been worth the supposed rewards.

Which brings me to my second point: Does therapy need to be so trendy in order for us to speak freely about our problems? Can't we talk about our problems, without pushing the idea that therapy is the solution to them? In fact, in a great many of situations, therapy isn't a meaningful solution at all, but it seems like this realization isn't getting much traction.

I think that the dialog about our problems and this idea that "everyone needs therapy" are two completely separate ideas, and it is entirely possible to have one in our society without the other.

[NatureLover]

Hi @chibam , I know you're not generally in favour of therapy as it has done you a lot of damage, for which I'm sorry.

I think everyone can benefit from therapy - as long as it's with a good therapist. 

I know if my father had sought therapy, he wouldn't have taken it all out on us kids, damaging us for life. 

But back then, as you say, it wasn't common. 

[chibam]

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@NatureLover wrote:

Hi @chibam , I know you're not generally in favour of therapy as it has done you a lot of damage, for which I'm sorry.

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I know that history is probably tainting my perspective on this, @NatureLover ; but I'm just wondering whether this issue goes beyond the question of whether or not therapists can do patients good, and is more a question of whether they are being misused by the community.

Like, you might believe that doctors do a lot of good for the community, and you might also believe that everybody should be able to see a doctor whenever they need to. But if you have a massive proportion of the population going to the doctor to get blisters on their big toes popped, or band-aids applied to scrapes on their elbows, then I think that indicates there's a problem with the way society uses doctors. And if your living in such an environment, and you start hearing that it's now typical for there to be an outrageous wait time to get in to see a doctor, then I think you'd probably need to acknowledge that all that misuse of doctors is a major factor in those wait times.