Some people have the right attitude for helping people with PTSD. They are effective.
The right attitude consists of respect, an understanding of human
nature, the ability to listen and hear what is being said as well as
what is not being said. They teach you
skills that will help you have a better life if you use them, as opposed
to "I can fix you." Willingness to use a wide variety of techniques is
required because people are different and need different things.
Acceptance of people where they are while encouraging change is another
What is not required is a Ph.D. and an attitude of I can fix you if you just do what I say.
People with PTSD have very sensitive control detectors. They also need
to find what heals them, not follow directions that may or may not work.
History shows that people with PTSD can get better, but also that PTSD
symptoms come back with further trauma whether it is a new war, the
losses of old age, or huge reminders, like 50th Anniversary celebrations
which threw so many stoic WWII vets into the arms of the VA.
So any program that claims to "cure" PTSD is suspect from the beginning. Does it have 50 year follow-ups? I think not.
It is fair to say is we can help you with your symptoms and if they
come back, we will help you again. I have seen people who seemed to be
cured by one technique or another, but I have not seen fifty year
Human nature means if someone is told they are cured and
symptoms come back, that person is going to think they are defective,
not that the cure isn't a cure, and they are unlikely to go for more
I have also met veterans who have been told that we have done
all that can be done for you and you aren't going to get any better. I
do not know of any VA Hospital or clinic that even uses all of the forms
of therapy I mentioned yesterday. (It was not a complete list, just off
the top of my head.) I did not mention all the available forms, and new
ones are developed every day, so that is an outright lie.
Here is a
quote from the Transcend Program's manual (a joint PTSD and Substance
Abuse program which was so effective that the VA cancelled it)
"developing a therapeutic alliance that gives responsibility to the
client for change and to the therapist for guiding and supporting that
change. Basic to this is developing in the client a feeling that taking
responsibility for change will be worthwhile. The concept of self
efficacy guides much of our general thinking....We work at instilling in
clients the benefits of self-exploration, interpretation, and reframing
of life experiences. Gentle tenacity is sometimes needed here in the
face of resistance. However, we see resistance not solely as a client
based problem, but also as an inability of the therapist to frame the
issues and benefits of self-exploration in a way that can help the
client overcome his fears."
Now that is the right attitude! They go
on to say, "there is no real change without behavior change... We see
our position as therapists not simply as facilitators of change, but
promoters of a certain way to change. Teaching new skills, emphasizing
the need to act on newly learned behaviors, assisting clients in
generalizing behaviors...to other situations, and helping them maintain
new skills by providing reinforcement... and also teaching them
Most of what I mentioned yesterday was
also developed by people with the right attitudes. I used to go to the
International Society For Traumatic Stress Annual Meetings and go to the
workshops, looking for people with the right attitudes. Many of the
free Post-Traumatic Gazettes on my web page have reports on that. More