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Instead, the therapist helps the victim develop, after the fact, an
emotional toughness so he/she can tolerate ("becoming able to
stand") thinking of the awful abuses he/she has suffered.
Unfortunately, the ideal treatment by an insight therapist involves
hospitalization, then outpatient treatment for a long time, perhaps a
year or more, costing well over $10,000. So, aside from the wealthy
and the well insured, few victims can afford traditional long-term
insight therapy. There are shorter treatments, of course, and, to a
limited extent, things you can do to help yourself.
There are therapists who tend to assume that one major trauma is
the central cause of almost all the patient's troubles. Therapy then
often involves reviewing the patient's life and exploring how the
original trauma--a death, abuse, rejection--led to his/her distressful
experiences. The trauma, even if the events are only vaguely
remember, becomes the way of explaining the client's life and, thus,
the focus of repeated analysis in prolonged therapy. Other therapists
seem to view the traumatic event as a distressing memory that needs
to be desensitized, which they set about doing in rather direct,
they go on to helping the patient cope with his/her life problems in
whatever ways they can without repeated attention to the original
trauma. No doubt both approaches are right for some people but do
we know which people need which treatment?
What other approaches might help? As Judith Herman (1992) has
emphasized, the first task is to stop any currently ongoing trauma, to
protect the person from self-harm, and help them maintain normal
functions, including work and social contacts. Major life changes may
be necessary to avoid some trauma, such as leaving an abusive
partner or an abusive family (see chapter 7), leaving your home and
country if you are a political refugee, etc. These kinds of major life
changes can be difficult and scary. Also, your trauma may upset
others. For instance, a husband of a woman, who has been raped, may
not be able to listen to her terrifying experience for long without
becoming enraged himself, no longer listening to her feelings and
needs. She may experience his reaction as rejection and that could
make her emotional state worse. But talking to an understanding,
empathic person is usually beneficial (avoid people who continue to
dramatically emphasize endlessly the horrible enraging aspects of your
experience, thus strengthening your traumatic reactions). The helper
may be a therapist, a devoted accepting friend, or someone who has
recovered from a similar experience. Talking helps you get rid of
bottled-up feelings (yet, remember, one should probably avoid an
intense emotional discharge of feelings; it isn't necessary--a very
gradual process of disclosing your feelings over a period of weeks or
months is thought to be better). The idea may not be so much to drain
out all the negative feelings, as described in Method #10 in chapter
12, but rather to gain control over the feelings. Talking and expressing
your feelings also gives you an opportunity to "make sense of" the
trauma or, at least, to feel heard and accepted. You are making the
painful memories safe to think about (you will recognize this as a
desensitization process-see chapter 12). When you can tolerate most
