Thoughts on Treatment

Advances in Treatment for PTSD

PTSD was added as an official diagnosis for mental health providers in 1980, less than 40 years ago (as of when the article was written in 2017). Prior to 1980, there was no official diagnosis related to trauma in the behavioral health field. Certainly people had awareness that trauma could affect people, but a person’s symptoms and the awareness of how trauma may be triggering or prolonging the symptoms a person was experiencing were not conceptualized as they are now. It was kind of like medicine before germ theory, it seemed like something caused people to have problems, but what it was unclear what forces were at work, and how those forces affected people were not understood with any systematic clarity. However, Since 1980, there has been a great deal of research and development of techniques that help to resolve PTSD. While there is still much to learn, treatment protocols are getting better every day. The result is that even today, when we still have much to learn about the effects of trauma, there is a very good chance that a person who gets treatment for PTSD will have a strong recovery from it.

The study of trauma on people’s mental health is called traumatology. The importance of the field is growing, and there are are now certificates available for people to specialize in trauma care. This has evolved significantly in the past few years, and encompasses much more than crisis counseling. This emerging field is helping bring more awareness to helping professions about the prevalence of people with trauma in their personal backgrounds, and how to support those people within various professional roles.

Trauma Informed Care

Another part of the growing awareness about the effects of trauma is the emergence of something on an agency level called Trauma Informed Care (TIC). Trauma Informed Care is an organizational level awareness about the high levels of trauma based responses consumers likely will have as they utilize an agency’s services. It is focused on how environmental issues can trigger (or support) a person struggling with trauma in their backgrounds. As such, it is not focused on treating the person on an individual level, but on examining and changing organizational processes and policies to be more aware of and supportive of the many people using an agency’s services who have trauma in their backgrounds. The number of agencies are that examining how their processes affect their consumers is growing rapidly, and agencies looking to improve their outcomes, are invested in making their processes and policies more helpful to those dealing with trauma based symptoms. A good summary of the principles of TIC can be found at SAMHSA’s Webpages on the topic.    We will delve into how to make corollaries between agency level TIC and systemic and cultural level Trauma Informed Policy Making in the future.

Growing Awareness of How Systems Affect Us

From the mid- 20th century onwards, we in the US have experienced an almost constant expansion of awareness about how our cultural norms get transmitted and changed. The modern social movements towards equality have all been comprised of various groups pointing out unexamined cultural and personal assumptions.  These vocalizations have made huge impacts on the quality of life for members of those groups. While the groups have been diverse, the basic formula for bringing issues to more awareness has been more similar than dissimilar. In the early stages, small and decidedly fringe groups start questioning the status quo, until their demands for equality move to the center of our cultural values.  With the concept of Cultural PTSD, there is every reason to believe that the same kinds of dynamics will help to spread awareness and foster healthier responses.

Indeed, we’ve also grown more sophisticated in grasping how various systems affect our cultural contexts in general.  With the spread of social media,  like minded people are able to access information that helps the spread of information and knowledge.  The effects of everything from the dangers of drunk driving, to the spread of slang terms like “woke”, [which with a deep sigh I  now need to edit in 2022 and say: I wrote this article well before those on the right tried to misappropriate the term in completely misguided quests to (unironically) hurl it as an insult to folks who are using reason and compassion in how they analyze the world].  Anyway, many of us are able to more quickly see how examining previously unexamined cultural assumptions often leads to improvements in how people are treated in our immediate spheres, and in the larger world.

While a general understanding that cultural legacies full of trauma have triggered trauma based reactions on a cultural level is not currently the norm for most people, it is still my hope that the awareness of it can spread fairly easily by illuminating some of the many corollaries between individual PTSD and Cultural PTSD.