Friday, October 13, 2006

Oprah, Child Abuse, and Secondary Trauma

Secondary trauma is the trauma that docs (and nurses and other health care professionals) experience when they LISTEN to a really violent, yucky story.

We can't zone out, really, ala Dr. K (see that anecdote).

Unless we're able to separate ourselves psychologically from our patients, we can take home some pretty nasty stories.

It could be a very ugly thing, being a professional.

Secondary trauma can happen to you, too. I had a patient who watched Oprah's series on child abuse over the summer. Apparently Oprah interviewed survivors (I hope they were survivors) of all kinds of horrible, horrible childhood abuse, physical, verbal, sexual, emotional, you name it.

You'll notice I haven't told you over ANY really horrible stories on this blog (well, one, Gone Postal but that was to get you to sympathize with therapydocs, not be mad at us all the time). Why would I? You need this? It's bad enough one of us has to know these things.

Anyway, now you, too, can watch Oprah and get traumatized.

My client, by the way, found her interviews insensitive and traumatizing for the interviewee, the person being interviewed. She said, Last I checked, Oprah doesn't have a degree in psychology, or social work or counseling?

I don't know, but most journalists don’t have social science degrees, probably, and they do go in for the jugular on a story.

Twenty years ago I treated a journalist who said there was no "being nice". You try, but it's the story people want. FYO, every journalist I've ever met has been really nice. Of course, I idealize and love all my clients as a rule, so maybe I'm not being objective.

But journalists have to be sensitive, don't they? TLike police people, they have to suffer from at least a little secondary trauma, if not a lot. And the little I've known of Oprah, she seems to be sensitive, too, why else would she air those shows on child abuse, or go to Auschwitz with Elie Wiesel (yeah, I watched that one).

As a rule, however, I don't watch her, and don't have to because my clients are very ready to tell me the latest thing they LEARNED on her show.

Anyway, why would I watch shows like this, when I can get reruns of Lassie on cable? Come on!

So how is it that those of us survive secondary trauma? How do we separate ourselves from the people and the stories we hear?

How should you get over what you saw on Oprah?

First of all, if you're a sensitive person, you have no right watching scary stuff to begin with. Don't expose your brain to garbage that will be keeping you up at night. My feeling is that if it does keep you up that you're not sick, or weird, or psychotic, or in need of drugs. You're simply sensitive to violence, and maybe that's a GOOD thing.

Once the damage is done, (sensitivity's only good to a degree, I guess) you have to realize: a) you aren't sick, or weird, or psychotic, b) you weren't victimized like the people you saw on television/street/t.v., and c) you weren't victimized like the people you saw on television/street/t.v..

And of course, the chances are next to nil that you will be. You and what you see on television are so NOT the same. You're safe at home, you're okay. They're not. The world can be a terrible place to live. People can be egregiously mean and horrid to one another.

But MOST people aren't. Most people are really nice, kind, good-hearted, and even share their newspaper, well, they'll leave the newspaper on the seat for you when they get off the bus.

So what do we do if we ourselves HAVE been traumatized, if we're survivors of childhood abuse of some kind?

That's a long, loaded question, and it's a little too depressing to get into right now. I wanted this to be a HOPEFUL post.

But I'll give you one story.

Had a patient who was married to a real S.O.B. (her description, not mine). He never hit her, but really was psychotic and delighted in tormenting her emotionally.

(They could make a t.v. show out of that marriage. People would LOVE it.)

Anyway, when he passed away, violently, but not at her hands, she suffered guilt for the happiness she felt, but mostly she felt trauma from her memories for many years afterward.

After much listening, and many visits, (she gets to leave me the junk, see, so she can go home and feel better) I said, You have to reconstruct them. You have to change your memories so that your brain remembers them differently. CHANGE THE BLANKING STORY. MAKE A BETTER ENDING.

I thought a trap door would work, you know? Like she could press a button and he'd fall into one of those pits with snakes you see in movies like Raiders of the Lost Ark.

She liked seeing his head being flushed down the toilet. That worked for her.

Everyone's a comedian. See why I love this job? But it worked. It'll only work if you really replace that pathway in the brain, keep the intervention going over and over again to rewire your connections. But it does work.

Reconstructing memories, by the way, is a cognitive intervention.

Pleasant dreams.

Copyright 2006, TherapyDoc


Eccentricly Dull said...

Um change the story? Remeconstruct memories? So train yourself to learn a lie? Um, what if your problem stems from finding the lies in the 'truth' you had believed put it back togther with more lies? Sorry Doc I don't understand.

katiebird said...

THIS. Is a very interesting post.

When I was a kid my mother listened to talk radio all the time. And the host of the show that was on in the afternoons after school was very sensationalistic in his stories.

That trauma you describe that your patient felt from that Oprah story is a very familiar story to me. It was my life. I worried about the 8 year old boy who was addicted to pot (I was 8 myself at the time and couldn't help but worry about all the pots in our cupboard). And had nightmares about all the unwed mothers forced to give up their children to adoption (this was the very early 1960s.) When a local boy threw himself off the Golden Gate Bridge and lived -- oh my. It was a long time before I felt comfortable going into The City after that.

I could go on and on -- everyday it was a new horror.

I've always wondered why I hated summer vacation as a child. But typing this makes it clear. Summer probably meant listening to that damn radio all day long (shudder.)

As an adult I read only happy books. It's not good enough that the books be romantic or have happy endings. They have to convey messages of hope and happiness and loyalty and successful dreams.

And I'm sure that's a reaction to my mother's taste in radio programs.

Thank you so much for clarifying this for me. I'd nearly pushed those memories out of my mind. But they sure explain a lot about the person I've become.

therapydoc said...

Sounds complicated, and I'd need more details to help you here. This intervention helps when you really enjoy the new construction of the event and can get comfort by referring to that instead of the very traumatic rendition that is in your brain.

Anonymous said...

Works for really bad dreams, too. You change the ending so you can get bvack to sleep.

Anonymous said...

this only works for mild stuff most of the friend a nurse sugguested giant stomping kittens to take away the bad dreams/memories....hahahha. It worked sometimes as well as other tactics from other nurses like building brick walls and in-bubbl-ating (encase in a bubble or force field or bury in a garden.

therapydoc said...

Mild stuff...would that it were all mild stuff, right?

Doc's Girl said...

All I can think about when I read this post is when I saw a therapist after my parents passed away and she asked me where I thought my parents could have done better in raising me. (Female from extremely dysfunctional family here.)

It was a very uncomfortable silence in that room. It was even comical. :)

I realize now, looking back on the last 3 years that they have been gone...that I've really re-written a lot of old childhood memories in my mind...probably for the sake of my sanity and to find peace in the situation.

There is so much to be said about the mind healing itself.

therapydoc said...

What a terrible question, What could your parents have done better?

The What Was She Thinking Question answer is, Not.

therapydoc said...

I don't know, but snow or no snow, I've GOT to get some exercise.

Isle Dance said...

Thanks so much for this. It helps a lot.

Isle Dance said...

Thanks so much for this. It helps a lot.

KateGladstone said...

TherapyDoc, you didn't answer the first commenter's strong concern (which I share) about lying to yourself (teaching yourself to remember things the way they didn't happen). Please answer that concern, because it keeps me from trying the technique you recommend.

therapydoc said...

I didn't answer because I didn't understand the question. Could you clarify what she meant? You're right in thinking that you shouldn't just throw techniques out unless you're pretty sure they're appropriate, based upon a full diagnostic.

KateGladstone said...

To clarify, TherapyDoc:

Training myself to create and believe an untruth (such as giant kittens killing someone who harmed me, or her head getting flushed down the toilet) sounds like brainwashing myself into a world of lies. I find this idea particularly threatening *precisely* because (like many survivors of abuse) I had to survive people forcing me to tell lies and to deny facts (because if I told the truth, these people would abuse me for lying).

therapydoc said...

In that case, the intervention wouldn't be suitable.