|
|
|
|
The Sunday Times - Britain
March 02, 2003
NEAR-DEATH experiences and other disasters are best survived not through counselling but by maintaining a stiff upper lip, the latest psychological research has concluded. After years of encouraging the victims of traumatic events to “relive” the experience in counselling sessions, evidence now suggests that the people who cope best are those who refuse to dwell on the tragedy. The British tradition of mutual support and suppression of the worst memories is the best way for most people to recover. The new research, published by the Oxford-based Cochrane organisation which provides worldwide guidance to doctors, reviewed the evidence for psychological counselling as a means of preventing post-traumatic stress disorder (PTSD). It concluded that such counselling was at best useless and at worst made people more likely to suffer PTSD. In addition, it found no evidence that counselling reduced subsequent levels of other forms of mental illness, depression or anxiety. Simon Wessely, professor of psychological medicine at the Institute of Psychiatry who led the Cochrane review, has also completed a study of 3,000 soldiers who served in the Bosnian conflict, a war which saw thousands of men, women and children massacred in cold blood. Only 3% of the servicemen suffered long-term trauma. “Undoubtedly some people do suffer, but most do not,” he said. “The toxic effect of counselling is that some people begin to see themselves as having a mental health problem when they do not.” Other psychiatrists point to the mental survival of heroes like Scott of the Antarctic, whose diary counting down to certain death is a model of self-control. Similarly, John McCarthy, the Beirut hostage who spent each day of his four-year captivity expecting to be killed, and Aung San Suu Kyi, the Burmese democracy fighter imprisoned by the country’s military regime from 1989 to 1995, have both come to terms with their traumatic ordeals without ongoing counselling. Nevertheless, Britain now has more counsellors than soldiers. There are 30,000 working on a full-time basis, 270,000 volunteer counsellors, and a further 2.5m who do it as part of their work. Membership of the British Association for Counselling and Psychotherapy (BACP) reflects this burgeoning industry, and now stands at more than 20,000 compared with 1,300 in 1977. Qualifications for professional counsellors are vague. Several years ago, the BACP was tricked into signing up comedian Bernard Manning, the king of the offensive joke, when he presented bogus qualifications as a counsellor specialising in stress related to racial and sexual discrimination. As many as 9,000 therapists offered their services to New Yorkers in the year following the World Trade Center attacks on September 11, 2001 — three for every person who died. Wessely drew anger when he recently advised American psychiatrists’ meetings that the therapists’ attentions were probably a waste of time. However, a study tracking witnesses to the destruction of the twin towers has now come to the same conclusion. George Bonanno, assistant professor of psychology at Columbia University in New York, who led the research, said counselling of the victims was an “enormous waste of money”. “There is little evidence that getting people to ‘open up’ actually helps them,” he said. “There is more data supporting the view that talking about how unhappy you are just makes it worse.” Janet Maxwell, 41, a health insurance worker, narrowly survived that day. She hid under an ambulance as the buildings collapsed and was nearly suffocated by debris. To this day she remains afraid of bangs and loud noises. Yet she did not find counselling helpful. She went to a few therapy sessions organised by her firm because she thought she should. She soon gave them up. “They wanted to keep rehashing everything and I didn’t want to,” she said. “I just wanted to forget about it and move on. There’s one person I know still talking about it to this day. I say: ‘Get a life’.” Her view is partly supported by Trevor Hicks. He vainly tried to save the lives of his daughters Sarah, 19, and Victoria, 15, when the family attended the FA Cup semi-final at Hillsborough in 1989. The girls were among the 96 football fans crushed to death. Hicks’s final memories of his daughters were his own attempts to resuscitate them after their bodies had been dragged onto the pitch. He went on to found the Hillsborough families’ support group, and says the best counselling was the support the victims received from one another. “Everyone handles grief in a different way, and ham-fisted counselling can certainly make it worse,” he said. “We were inundated with counsellors in the immediate aftermath and most of them had no idea what to do.”
|