The massacre in Norway raises many points about mental health, bereavement, grief and trauma.
Let’s look first at Anders Behring Breivik whose actions resulted in 76 people being killed or, as we write this, unaccounted for. While it might have been legally judicious for his lawyer to label Breivik “insane”, using that word says more about prejudice than it does about understanding mental health.
When people retreat from the norm – behaving anti-socially, whether by withdrawing from others or behaving inhumanely towards themselves or others – it is often because they feel out of kilter with the world, or misunderstood by it, or because they cannot manage their emotions. This is not a defence of Breivik’s behavour (clearly extreme and exceptional) but it is an example of what can happen if mental illnesses are not recognised, diagnosed or treated.
While the majority of our clients are well-informed and self-aware, mental illness remains a taboo. Talking about mental health issues with partners, family, friends – or with colleagues at work – is not something everyone has the chance or inclination to do. Keeping concerns private does not often lead to extremes of behaviour – but it can cause significant shifts in behaviour or personality, turning people in on themselves. And that could lead to self-harm, eating disorders, mis-using drugs or alcohol, an over-reliance on smoking; it could cause anxiety, panic, stress, phobias, sleep issues. It can also affect behaviour and performance at work and relationships. Anyone feeling they do not fit in, that others are against them, or that they cannot cope deserves support and encouragement. Yet, as our human instinct is often to shy away from exposing what we think of as private weaknesses or inadequacies, support is often hard to seek.
The Norwegian tragedy also shows how others can be affected, directly or indirectly.
We’ve heard about the guilt that some survivors of the incident feel – that they escaped his attention or were just of out range so they lived but others didn’t. There is anger at the police – for taking what the public considered too long to respond to the incident, and for not having the right means to get their fast. Many who witnessed the incident were immediately traumatised and may remain affected by the trauma for some time. Some parents felt relief on learning their child was safe, but their relief was tinged with sadness at others’ loss. We saw the tearful response of the King and Queen of Norway at the memorial service, shocked and saddened by the individual deaths and by what was the country’s biggest loss of life since the second world war. And we noted the stunned expression on the Norwegian prime minister’s face as he took control of the incident, balancing his emotions with his responsibilities to set a lead for the country and protect its reputation as a tourist destination.
Paramedics who reached the scene described the people they found as traumatised. Those paramedics are likely to have built up resilience that helps them manage their reactions to traumatic incidents but they might need continuing support to maintain that resilience.
And we’ve experienced our own reactions, at a distance from the incident, trying to make sense of it from our perspectives, with many of us reliving grief at lives lost years ago or recently.
All of these reactions are normal – grief is a complex emotion even when a death or loss occurs naturally and is expected. Sometimes it takes an extreme act for people to notice the extent of their own or others’ mental distress – and to give themselves permission to seek help to overcome it.
If this traumatic incident has triggered difficult emotions, changed behaviours, or reopened issues you thought were under control, do get in touch with us for professional, therapeutic support. We offer a range of therapies including EMDR (recognised by NICE as particularly effective for recovering from trauma), CBT, hypnotherapy, psychotherapy and counselling - and often recommend a blend of therapies so each person receives the form of therapy that is best for them.
29/07/2011 | Posted in Psychotherapy, Psychodynamic therapy, Psychoanalytical therapy, Person-centred counselling, NLP, Integrative counselling, Hypnotherapy, Humanistic psychotherapy, Gestalt therapy, Existential counselling, EMDR, EFT, Counselling, CBT, Sensorimotor psychotherapy,
The world is in awe of the way in which the Chilean government, the mining company, the miners and their families (and, for that matter, the world’s media) have handled this staggeringly unusual crisis. It would be wrong to be complacent while the rescue operation continues but it would be wrong, also, to focus only on the miners' release and the immediate aftermath. The miners who are already above ground are now in medical care; checking their physical health is a priority of course.
So is managing their mental health and the Chilean government has already said it will do all it can to support the miners for the long term which must include understanding and treating their psychological reactions.
What about others? Everyone closely involved in the operation could be affected by this internationally-followed crisis – the rescuers who travel down the mine to assess the health and welfare of the miners before they are transported above ground; the people deciding who should be rescued first, last and in between; the people who built and tested the rescue pod or who created and lined the shaft; the families waiting, uncertain whether the crisis would end in tragedy or joy; wives, partners, mistresses (as reported by the media), children, parents who find their husband, lover, father, child has changed having lived for so long with uncertainty, underground; the head of the mining company; the media observing it all; even the president of Chile. All could be affected by this incident, and in unpredictable ways – or not affected at all and be accused of callousness or indifference. That’s the effect of trauma.
Even the word trauma conjures up dramatic incidents, but a trauma cannot be measured on any scale other than the one by which the person affected measures it. Something others perceive as trivial or inconsequential could have a massive impact for the person experiencing it. No one else should be your judge and jury; if you feel you have experienced a trauma, you’ve experienced a trauma. And that means you could be struggling with post traumatic stress disorder (PTSD).
The effect of trauma can come and go, be ever-present, last for life, or disappear soon after it emerged. The good news is that much more is known, now, about PTSD and the way it can be treated. One particularly effective treatment, recommended by the National Institute for Clinical Excellence (NICE), is EMDR (to continue with the acronyms – this one stands for eye movement desensitisation reprocessing). The effect of EMDR is thought to be similar to REM sleep, during which the brain makes sense of the day’s events, reprocessing the memory and releasing problem emotions and associations.
EMDR could help the Chilean miners and others associated with them, just as it could help anyone who has experienced a trauma, whether the cause of the trauma was obviously dramatic to a wide-eyed world or invisible to everyone but you. The point is to seek help, not suffer in silence believing you ought not to be affected.
13/10/2010 | Posted in EMDR,
As news breaks of the death of another British soldier in Afghanistan, it is worth thinking not only of the impact of his death on his family, friends and colleagues but also of the long-term effects of the stress of combat on the troops who make it back home alive.
A recent report, published in The Lancet and summarised in Therapy Today, revealed that today’s troops serving in Afghanistan and Iraq have a 22 per cent higher risk of alcohol mis-use than other servicemen and women. The greatest problems were among those serving in combat roles.
Alcohol mis-use is one of many potential effects of post-traumatic stress disorder (PTSD).
Whilst the causes of PTSD among our forces are obvious, they are not always so in civilian life where it can be triggered by any event that causes psychological trauma – and that can vary from person to person. For some, it might be neglect, abuse, assault or witnessing a violent death such as suicide; for others, simply hearing about a traumatic event can lead to PTSD.
The good news is that several therapies have proved to be highly effective in treating PTSD including psychotherapy, CBT (Cognitive Behavioural Therapy) and EMDR (Eye Movement Desensitising and Reprocessing).
If you know someone who appears to be mis-using alcohol, or other substances, be aware that it could be their way of coping with the emotional chaos of a traumatic event – and an expression of PTSD. The first step is to recognise that alcohol mis-use is a symptom – not a cause – and that it can be treated.
07/07/2010 | Posted in Psychotherapy, EMDR, CBT,