Thought this would interest some folks...
**********
New York Times
Friday, April 23, 1999
An Overabundance of Counseling?
By SALLY L. SATEL
WASHINGTON -- Shortly after the police, paramedics and television crews
screeched onto the scene at Columbine High School, the grief counselors
arrived. Coming in by the busload, such experts are now a fixture of
tragedy's aftermath in America.
Many people, including President Clinton, who spoke of dispatching teams
of counselors, assume that they are essential in traumatic situations.
Trained in a technique called grief work, which says that the healthy
response to trauma is to "work it through" and find "closure," counselors
urge the victims to take several steps. First, they must focus on the
awareness of mental pain. Second, they must express their emotions. And
third, they must talk about it. And talk. And talk.
The problem is that this doesn't always work. An emphasis on experiencing
psychic pain can make some people feel even more vulnerable and out of
control. Forced ventilation makes little sense for those whose ordinary
coping style is to remain calm, maybe too calm for some people's taste,
and spring into purposeful activity, like organizing fund-raisers for
victims' families.
Others, like Susan Cohen, who lost her only child in the bombing of Pan
Am Flight 103 over Scotland, just want to be left alone. Writing in Time
a few years ago, Mrs. Cohen called grief counselors "ambulance chasers."
She said that the man assigned to the Cohens showered them with clich�s
about hope, quizzed them on their daughter's hobbies and simply wouldn't
go away, even when her husband insisted on their privacy.
Perhaps this counselor was unusually clumsy, but even so, evidence
suggests that grief work can sometimes do more harm than good. "There is
surprisingly little evidence that talking about trauma in its immediate
aftermath is particularly helpful," says George A. Bonanno, a research
psychologist at Catholic University. "A number of studies even show that
expressing or talking about painful experiences can lead to further
emotional difficulties."
Dr. Bonanno isn't saying that those who want to talk about their grief
should be discouraged from doing so, only that a one-size-fits-all
response to disaster and loss is na�ve.
So why do we impose that? Is it because we, the unafflicted, feel
helpless and simply need to "do something," as my colleague David Fontes
believes? Dr. Fontes, a Sacramento psychologist, was called in to help
with the Northridge, Calif., earthquake of 1994. "Yes, of course
professionals can be helpful, but we shouldn't be intrusive," he says.
"We should be available, maybe set up a tent where people can seek us
out, but not burst onto the scene as white knights who are going to save
these people from their misery."
And then there's the commodification of grief. The Grief Industry is
apparently booming: bereavement books, grief chat rooms, expensive
workshops in grief education and exams for certification. You need us,
the experts say. But do we?
Most people, in fact, are quite resilient and don't need registered
experts to deal with anguish. Are our priests and rabbis not up to the
task? Are our families' instincts to comfort not keen enough? The
deployment of counselors -- a well-meaning effort, I wholly grant you --
sends an odd message: that people are too fragile to soothe and
strengthen themselves.
Add to the tyranny of experts the tyranny of the news media and you have
an unholy therapeutic alliance. While grief counselors push people toward
open self-expression, the microphones are on and the cameras rolling.
Making agony so public is unlikely to help their "clients."
As a therapist, I find this especially unnerving. One of our tasks is to
help our patients protect their dignity. Even more important, as numerous
studies have confirmed, is that the repeated communication of intense
sadness or distress can actually drive away loved ones, the people we
depend on after the experts have packed up their manuals and gone home.
Qualified counselors can be a great help to those who seek them out. I
strongly encourage having them available on the scene and afterward. But
Grief Workers Inc. can't help by presuming that there's one set
prescription, imposing rules for mourning and telling people how they are
going to feel. Communities have long had rituals for coming to terms with
calamity. Grief counseling should not automatically become one of them.
Sally L. Satel, a psychiatrist, is a lecturer at the Yale School of
Medicine and a senior associate at the Ethics and Public Policy Center.
Jim Guinee, Ph.D.
Director of Training & Supervision, Counseling Center
Adjunct Professor, Dept. of Psychology/Counseling
Dept. of Health Sciences
President-Elect, Arkansas College Counselor Assoc.
University of Central Arkansas
313 Bernard Hall Conway, AR 72035
(501) 450-3138 (office) (501) 450-3248 (fax)
"He that won't be counselled can't be helped"
--Benjamin Franklin
************************************************************************
