Is PTSD Preventable?

[anthony]

Please answer the above poll with thought, and accuracy, and even state your reasons in a post upon this thread if you like too. The more information, the better the outcomes. This poll will merely continue to run, with no time limit, so effective capture is obtained from a broad user base.

This is a simple yes or no answer. I do not provide middle ground answers, because people would choose them and sit on the fence, so to speak.

This poll is designed to gain feedback on whether those with PTSD, spouses off and family members, believe whether or not the persons PTSD could have been prevented if immediate counselling, and ongoing counselling was sort after the traumatic event.

More often than not, a traumatic event occurs, and either the person refuses such counselling (which is an immediate red flag), or the counselling is limited because of resources, money, time, or the person thinks they have discussed it enough, so never return to future counselling. At the end of the day, all these things lead to a persons trauma developing into PTSD.

I believe my PTSD was preventable if the military forced me into compulsary counselling for merely being within an operational zone. Instead, all counselling was limited to time, human resources or just lack of association with the people to identify causes of trauma. I had a tick and flick survey which I basically just answered want I thought they wanted to hear, so I could get home to where I felt safe and secure (immediate red flag).

This isn't about blame, because at the end of the day, those with PTSD have it, and nothing can now change that, so there is no point dwelling over spilt milk as such, but future persons could be helped prior to developing PTSD from such common research placed within the right hands.

[YoungAndAngry]

I'm having the hardest time picking "yes" or "no"
(hmmmm... maybe the PTSD/decision making skills are messing with me)
regardless, I'm gonna explain why I can't give a definiate answer.

Number #1, I am so new to this whole PTSD thing that I don't know enough about it to decide if it could prevent it for someone else.

For me?... I think if I would have gotten counselling immediately after the accident I would be ALOT further along in the healing process. But I don't think the PTSD could be avoided.
Unless they have some magic way to erase scars/memories/triggers...

[Nam]

Nope, not preventable...especially in my case. It surfaced when it did and opened pandora's box. I had PTSD from the moment of the first memory. Could I have made it less severe...oh probably, I could have eaten better, slept better, taken care of myself better, etc...but I think you either have it or you don't and I think it starts from the moment of the trauma. Doesn't leave much room for someone to intervene.

[anthony]

I think it starts from the moment of the trauma. Doesn't leave much room for someone to intervene.

Now there is a quite valuable point to this. Thanks Nam. PTSD is generally reflective fairly quickly from medical writings... though I guess many off us just never know until way down the track when all the symptoms are just running riot...

[piglet]

I want to sit on the fence!! I think if people are allowed to say how they feel about their trauma and are listened to with empathy and understanding while they work through it, then ptsd may be preventable. However, I've also read some of the science stuff about certain parts of the brain being reduced in size in people with ptsd - many of these reports can't tell if the size reduction was there in the first place, thus making someone more susceptible to ptsd, or if trauma/ptsd caused these changes.

Something else that I think is that once the trauma has resulted in ptsd, these brain changes seem to be permanent, so I guess the idea is for people to be counselled properly at the time of, and following trauma, in order the reduce the possibility of the brain being affected so much. Then again, how many of us received proper counselling at the time, or even within weeks or months of the trauma. Not many, if any! But maybe there is hope for some, if the right approach is taken.

So - I would like to think that ptsd is preventable, but I think that is "ideal world" thinking for the majority of people who develop ptsd. As for forcing people into counselling - there is no point if they don't want to know. You can lead the horse to water........

[anthony]

Yep, and the question listed above is:

Do you believe PTSD is preventable if forced into counselling after trauma?

Take notice of the "forced into counselling" part!

[piglet]

Ok. Ok! I voted no, although I'm still halfway sat on the fence here. It's not too comfortable either - and not a very strong fence.....

[anthony]

But atleast you made a decision. This is the exact reason why I don't include options to allow people to sit directly on the fence. Either one side or the other... never in the middle, because human natured facts dictate that people will more than often take the middle option, because its easier.

Smart ha!

[YoungAndAngry]

K, point well taken...
I pick "no" it's not preventable.
although peope may be better educated if forced into therapy after a big accident

[anthony]

Nice YA... clear decision, good stuff. Hope you enjoyed your night out too.

[Kerrie-Ann]

No! Don't think PTSD is preventable if 'forced' into counselling. A lot of the effectiveness of any treatment is based on the willingness of the person being treated to participate in the process. It may however, lesson the severity of the inital impact and the severity of long term symptoms. Counselling has its merits in that it lets a person 'debrief' in a safe environment but a person has to be open and receptive to this help.

[wildfirewildone]

Now there is a quite valuable point to this. Thanks Nam. PTSD is generally reflective fairly quickly from medical writings... though I guess many off us just never know until way down the track when all the symptoms are just running riot...
For me...the symptoms were running riot for over 10 years before I ever got a proper diagnosis of PTSD....what I've learned is that it's a very sneaky illness and the Mind can block out the Trauma from childhood even for60 years!!! But the chemical systems are running on "freak-out" BOO-HISS!!!!!

[sonrisa]

Oops, I misread the question and ticked 'yes' when I should have ticked 'no'. No doubt that the right measures and help at the right time would prevent ptsd, but as far as forcing someone, I feel that would surely scar most people deeper and make recovery harder long-term. But with others e.g. if their nature is to keep things in, it could be wise to make them go into counselling, but it all depends on how that is done, if it is done sensitively and with plenty of respect for the individual.

Cat

[anthony]

Cat, do you think trauma therapy can be approached with sensitivity? I don't, but that is me from seeing some of the best in action with myself. But I am curious what you think in regard to this.

[sonrisa]

Cat, do you think trauma therapy can be approached with sensitivity? I don't, but that is me from seeing some of the best in action with myself. But I am curious what you think in regard to this.

Hi Anthony, I honestly don't know, as I haven't experienced trauma therapy (yet) and haven't had positive experiences re therapy apart from a lot of years ago and this week! Did a lot of years of carework, but all I can refer back to in answering you is that all that was in my mind was either myself being sensitive in handling others or sometimes being handled sensitively, and how that sometimes was helpful to someone else or myself.

I just hope that trauma therapy is approached with sensitivity in every case. Unless you meant in relation to the question, in which case all I feel is that it's a very fine line regarding pushing someone. I suppose if they were someone very close and who you absolutely knew always kept things in and that this always damaged them, then very gentle encouragement towards therapy could really help them. I've just realised I probably had in mind the term 'encouragement' rather than 'push' when I was posting. I find it difficult to think in terms of pushing someone, as I never want to push anyone against what's right for them, or to risk interfering with their growth process. I suppose if someone has said to push them if they start to struggle and it becomes obvious they need help, I'd manage that, but that would only be if they had specifically said to do that.

Cat

[anthony]

Hmmm... fair enough, and well said. I think what your going to find though Cat, to be honest, is when you go through trauma therapy, it is not sensitive in the aspect of a counsellor allowing you to just naturally get things out yourself, because if we could do that, then why would be need to see a counsellor to begin with? Sufferers of PTSD are always fearful of the unknown within their own trauma, ie. if pushed, what will happen. The facts often are though, is that anyone with PTSD does need to be pushed at some point, to help themselves get past the trauma. If someone is willing to work away quite hard themselves, then they don't really need to be pushed... maybe just prodded in the right direction every now and then.

Yes, sensitivity is in their, but getting someone to rid themselves of trauma, is more often than not, a very one sided pushy event. It sounds scary, but it is the most beneficial thing any sufferer could ever do for themselves. It doesn't matter where you do it, and the methods vary, but definately the most beneficial.

[sonrisa]

I think what your going to find ... is ... it is not sensitive in the aspect of a counsellor allowing you to just naturally get things out yourself, because if we could do that, then why would be need to see a counsellor to begin with? Sufferers of PTSD are always fearful of the unknown within their own trauma, ie. if pushed, what will happen. The facts often are though, is that anyone with PTSD does need to be pushed at some point, to help themselves get past the trauma. If someone is willing to work away quite hard themselves, then they don't really need to be pushed... maybe just prodded in the right direction every now and then.

I understand what you're saying, especially about the fear of being pushed too far, too fast, or by the wrong therapist. Pushing through must be appropriate and really good when done correctly and with a trusted therapist. After fighting so long to find a sense of self, and without any natural communication long-term, I honestly would find it very hard if the therapy didn't also include the just naturally getting things out at least to some degree though ... but that's from my own personal circumstances, as the lack of connection/understanding with humans is painful, but also scary. And that's despite working very hard myself at healing for a long time! ... and realising there's probably no way into life but by having to engage with life, at first through therapy.

It really is a tough call when you have nobody else though, as having others must surely help balance any tough effects from therapy sessions, if only to just be able to forget about it all and have some fun or talk about different things! It's terrifying if you've had to keep yourself together, and must keep doing that after therapy sessions. But that maybe sounds a bit negative!? The knowledge of having the next therapy session 'there', and the space between to integrate, would most likely be a good help there though, as well as strengthening your own ability to detach and do other things.

But, yes, absolutely, being pushed in the right way by the right therapist is surely the bridge across to healing/integration. All I can think is that taking however long is needed to build trust and make sure the therapist is someone with heart and understanding is the top priority, and that if this goes okay, then pushing through can really work, as long as the empowerment/enabling/positive control side of things isn't taken away by a therapist being too in control/pushing too much. A very delicate balance I think regarding being pushed, but yes, it's helpful thinking about it, as it's clarified how important taking as much time as needed regarding trusting a therapist, and making sure that it's right, while also making sure that growth isn't being avoided!

Cat

[anthony]

That was so well said Cat... a very intuitive and balanced approach. I actually just really enjoyed reading your reply then... thank you. What you said, is exactly what I try to say most of the time I think. I hope that everyone who reads this thread, takes particular not of your reply, and they use that information to help heal themselves through a trusted professional, or means they feel comfortable with. Well done... giving you some reputation for that one.

[reallydown]

I said "no"...it might lessen the effects maybe...but i think it also depends on the person to some extent...if someone took me to therapy when i was 7, 8, 9 yrs old, i think that that just would have freaked me out even more...

But then a friend pushed me to go see somenone about this when i told her about the nightmares...I wouldn't have even gone if this didn't start interfering with school work...I would've just kept it all in and thought that I could deal with it in my own...

[sonrisa]

That was so well said Cat... a very intuitive and balanced approach. I actually just really enjoyed reading your reply then... thank you. What you said, is exactly what I try to say most of the time I think. I hope that everyone who reads this thread, takes particular not of your reply, and they use that information to help heal themselves through a trusted professional, or means they feel comfortable with. Well done... giving you some reputation for that one.

Hi Anthony and thanks for your message. Glad it is helpful. Always good to have some good reputation going on too! Although I have to admit to finding it hard to read that someone has enjoyed reading a post in which I've really bared my soul about sheer isolation and having concerns about how to keep it together when therapy begins.

[carpediem2006]

If you need to be forced, you will either

1) be scared of therapy itself at that time for whatever reason (symptoms may worsen as a result, as control is taken away, and combined with potential mistrust of counsellor with feelings of entrapment).
2) you will think you do not need it and most likely just so 'yes' and 'no' in the right places and get the hell out of there, mumbling something 'about treehugging hippies' on your way out the door.
3) not be in need of counselling at that time.

More seriously, couselling for some after 7/7 attacks in London was forced...shoddy counselling in which they were forced to relive and explain what happened over a few days before being left to continue alone (counselling recieved, box ticked, government placated) is estimated to have led to worsened symptoms or having created them in the first place in some victims.

[anthony]

More seriously, couselling for some after 7/7 attacks in London was forced...shoddy counselling in which they were forced to relive and explain what happened over a few days before being left to continue alone (counselling recieved, box ticked, government placated) is estimated to have led to worsened symptoms or having created them in the first place in some victims.

Now that is a bit of a concern. A few days is nothing to what these people need. More like a year or two of constant counselling to be rid of all the feelings and emotions that are stemming from the incident. Bloody governments...

[serena]

In my case it could be prevented if I have had a family support or a therapist right after the traumatic event occurred. But I think my case is not so severe.

[starshine]

My answer is no.

For sure it certainly doesn't help in the case of longterm chronic traumas over many years.
And the person needs to be ready to enter treatment, and do so of their own free will. After all, trauma wasn't their choice. What's force going to do except maybe compound the trauma...

[Claire]

this is a really tricky one. I cant see how, if you are forced, it could prevent PTSD. I dont think everybody in society is ready for counselling and being forced to go isn't going to change that. They just wouldn't co-operate.

On the other hand I do think that if it was suggested and offered and became more normal to go to then it would be more socially acceptable to go to and therefore more beneficial. Its all about education. Isn't Australia more forward thinking with this kind of thing Anthony? I had an Australian physio treating me after my accident and he told me in Oz you would go to A&E and after physical exam you would be referred to some sort of trauma counsellor. Is this right? In the UK they give you a plaster (band aid) and tell you to take an aspirin!

[cactus_jack]

Yes and no. What I think has been pointed out is that you can make people fence sitters by how you propose a question. Let em show you-

1. Do you believe PTSD is preventable offered counselling after trauma?
YES! Nearly 100% positive recovery.

2. Do you believe PTSD is preventable if forced into counselling after trauma?
NO! Because if you have to force it you are then placing the other person in another defensive role, and it likely will be destructive to the effort, thus making the PTSD worse.

[anthony]

CJ, your complicating the question though and deriving your own questions in order to justify an incorrect answer. The question is ONLY; Do you believe PTSD is preventable if forced into counselling after trauma? That is it, nothing more, nothing less. It is a yes or no answer, hence the way its structured. The question doesn't ask to be restructured in order to derive an opposite answer or to help people sit on the fence.

You answered the question as NO!

Even what your trying to say between "offered" and "forced" as variated differences, do you believe people would take the "offer" of counselling after trauma considering they don't understand or know about PTSD at that time, and are likely to only think they can work past it themselves?

There are a number of questions you could ask that would derive different answers depending upon the question itself, but none of them would relate as "the same" when it comes to this particular topic IMHO.

[cactus_jack]

I disagree Anthony. You are correct- the question is Do you believe PTSD is preventable if forced into counselling after trauma? NO. Because if you "force" anything, it's involuntary. If it's involuntary, to me that's the same thing as brain washing. If the PTSD recipient is not willing to accept that they have PTSD, then it's a lost cause. If they accept it, but refuse the counseling, then is that their fault or the public's? Theirs, clearly. I see it as being dirty.

Go to work on a farm and don't shower. If you recognize you are dirty, do what you can to get clean. Bathe. Shower. Use a garden hose if need be (When I was younger I'd even take a bath in a cow pond). You recognize the problem, so fix it! If you see the problem, you see you have it, you see what it does to you, but you do nothing, who's to blame? But what will the public reaction be? Will women want to date me if I havn't bathed in two weeks, working on a farm? Hell no! Would I be welcome in school? Hell no! I'll be cast out until I am clean, but even then the reputation will follow.

That's why I have worked hard to rehabilitate myself. I'm the dirty cowboy, but no one will afford me the garden hose, or even a visit to a ditch. So I just gotta do what I can by myself.

[anthony]

CJ, that is a good way to look at PTSD, however; we are talking about counselling after the traumatic event, which is the time where a sufferer can be helped. If they are left to recognise a problem, it is often too late by that stage. Males and females are very different in this aspect also, in that females will go and discuss trauma with someone after the fact, they just might not get the correct feedback in order to remove blame or guilt from them, hence PTSD forms anyway. Males on the other hand are terrible at best of times for talking about their true emotions, hence whether forced or offerer, a male will more often than not reject help because they do not see the problem to begin with. You could tell a person after a traumatic event that they could get PTSD, and explain what PTSD is, but they will still ignore that advice and continue on their own because they cannot understand it until they have it, hence the very nature of PTSD. If you don't believe you will get it, or you don't believe you have a problem, then people won't get counselling. This is why the question is structured so specifically, to see what the general opinions are in relation to the short, sharp answers, yes or no, to the specific wording.

What people need is to be forced into counselling after trauma IMHO, at which point they must continue to be forced for atleast enough sessions until they get the message that they are their until such time as they begin to open up and talk about the trauma and their feelings. If a counsellor is happy with what they say, then no more needed; if not, more counselling until such time as the counsellor could signoff and say they have gotten it out of them.

Too late is not the answer basically.....

[anthony]

I don't think it would matter for males though either way.... because their genetic stubbornness and pride would sit it out and waste all the time in the world until released from therapy, then they kick themselves after the fact when PTSD takes over their lives a decade on.

[Marlene]

What people need is to be forced into counselling after trauma IMHO,

Anthony,

I understand your reasons for the above statement, but any program where a human being is forced to do something so intimate and personal would have a tremendous failure rate. I know if someone told me that I was going to be forced to go into therapy, my first reaction would be 'Make me!'. I think that's gonna be a pretty universal reaction. Or people would make something up just to get it done and over and no help is given.

That doesn't even take into account the legal and ethical considerations. Plus the basic human right to privacy.

Offering is good (as long as it's not some half-assed effort). But one of the thing that too many humans have fought for since time unremembered is their independence and freedom. You try to force someone to do something (especially if they don't want to)...you're going to have a big fight on your hands.

Just my opinion.
Lisa

[cactus_jack]

Both of you are correct. As Anthony said, if the counseling is obtained early on, literally an ounce of prevention is better than a ton of cure. And as Lisa said, if it's forced, it's already a failure. They have to be willing for it to work. Counseling is not like giving drugs. Give someone Prozac and it will do it's thing no matter how willing they are. But if you force the counseling, it's not the hard headedness that men have that builds a wall, but the common sense of "if they are going to force it on me I'll fight it!"

Like food. Let's say you hate cabbage. No matter how good it tastes, will you love it and appreciate it if you are forced to eat it? How would you be forced? Ball and chains? Incarceration? Just like with forced counseling. Unless you have them incarcerated 24-7 for the duration of the forced counseling, thre will be no progression. And when you incarcerate someone for counseling, that's brainwashing and very similar to the re-education camps the NVA had. "We will hold you prisoner until you learn that you agree with us even if you really don't, and even that is not a promise you will be free." What if they resist while incarcerated? Punish them? That only makes their belief that they don't need it even more real to them.

[anthony]

I believe soldiers need to be forced into counselling, or another word for it within the military, "ordered" to attend compulsary counselling with people who know when their being BS'd, people who know those that are just dishing out the "right" answers to get out of it quicker, etc etc.

The problem with not being forced into fixing this problem at the stage of prevention, is the cost for something that has no cure. PTSD is becoming a huge burden on many countries governments for compensation and benefits solely to do with the military, let alone all the civilian matters of MVA, rape, abuse, torture, etc etc etc... it is getting out of hand primarily because of the increased exposure all countries are now measuring from United Nations global conflict resolutions. The facts are, it can be prevented if gotten too early enough, or likely fixed whilst not a neurological imbalance, and IT IS the only way at present to lessen PTSD as a burden not only on all Western countries, but also the people who are suffering this illness to begin with.

If the word got out to soldiers/those who are looking to enlist, that if they deployed overseas there is a 50% chance of obtaining a non-curable mental illness that will hurt them, their families, the remainder of their lives beyond reproach.... well, we all know what would happen to enlistment rates, and it is already happening because retention is not possible due to the high numbers of mental illness on return from veterans alone, let alone those in the civilian sector now coming to the forefront of discovery and being recognised for disability due to the illness they now have from being raped two decades ago.

Countries will suffer IMHO, are suffering actually, and the only way I see at present because there is no cure for this, is that potential sufferers are forced into an area they don't want to be in order to hopefully lessen the rate of diagnosis.

I fully am aware the consequences of forcing someone to do something, however; when forced to do something and given enough scope and depth in order to achieve the end result, people will eventually come around, do what they have to do in order to be free of the forced issue to begin with. It is all mental, and mental swings both ways. People do not listen, people don't believe it will happen to them, and they are all wrong. PTSD is becoming a major issue, and you can see that solely from reading the news and simply looking at how many people are coming to places such as this forum, all diagnosed or trying to deal with someone diagnosed in their life, needing help after the fact, instead of fixing the issue before it developed into PTSD.

We are all going to be in more trouble than we know if this continues... uncontrolled PTSD is dangerous, and thats a fact.

[cactus_jack]

Ah, now THAt changes things Anthony. In the US military it's called "psychological debriefing" as in many instances details can be lost in the stress of battle, and those can be details intel wants. They do it in a humane manner with the very thing your speaking about as the goal.

Unfortunately not all get it as the resources are quite limited. So it's pretty uch saved for those in extreme conditions, like USN-SEALs, SpecOps, SF, etc.

[Marlene]

Anthony,

I understand what you’re saying about ordering military that are returning back from a front line position to undergo counseling or a debriefing. Even police, EMTs and fire rescue have similar things when they’ve gone through something above and beyond the usual for their job.

But I ask this: What about those of us who have not been or no longer in the military? Do you want to use the same required counseling standards for us? Or to use myself as an example-my initial trauma happened when I was ten. I didn’t remember it for years. It wasn’t until almost 30 years after the event that the stresses in my life caused my symptoms to go out of control. Where do I fall in this plan? Yes, I am in therapy…by my choice because I want to heal. Others may not want therapy and choose medication instead. Or choose to ‘go it alone’.

Here’s how I see it. It all comes down to a choice of how you want to live your life, how badly you’re willing to work to heal and what quality of life you want for yourself. These are words that you have said again and again on this forum…that it’s a choice to heal. Well, if it’s a choice to heal (and do everything that goes along with it), then it’s also a choice not to.

Also, if made to take therapy, there is no guarantee that the person made to go will be the active participant required for help to be affective (too many people would expect the therapist and/or medication to solve all of their problems for them) AND do the hard work on their own that is required to have any degree of healing and learning to live with PTSD.

Forced therapy is a no-sum gained proposition unless you’re in a field that it can be required (i.e. military, police, etc.). When it comes to dealing with humans, there are too many variables to count.

I’m sorry, but what you’re proposing is reminiscent of eugenics. This was a program of forced sterilization of men and woman starting in the early part of the last century and was most popular through the end of WWII. It was so popular in fact, that the Nazi’s adopted the practice in the early 30’s. The people who were selected were ‘feebleminded, insane, criminalistic, epileptic, inebriate, diseased, blind, deaf; deformed; and dependent’. I’m sure if they’d known about it at the time, PTSD would have been added to the list.

Forcing a person into therapy violates their right as human being to make their own decisions and choices. Couching it in the terms like ‘for the greater good’ is a tried and true way to open the door for abuses of people to start. When a plan starts with the idea of ‘Forcing someone to …’ the plan is dead wrong from the get-go.

Again…just my opinion.
Lisa

[cactus_jack]

In essence if you have to force it they will fight it. If they don't fight it, then it's not forced. A wet vs. dry situation, if I may.
I feel if it's offered, peopeple will likely accept it. What you can "force" (though that's not a proper term) is to at least brief them on what they went through, how it can affect them, and then offer them resolution.

Boy, if I had any idea what I was going through and going to experience, I'd take such an offer up in a heart beat! I just want a good life. And right now, I'm living in my own hell.

[anthony]

Basically Marlene, in your circumstances you should have been counselled at age 10 after the trauma. If you where counselled at that point, and I mean counselled to the point where you have talked it all out, you understand what has happened and grieve the trauma itself, you would not have likely got PTSD now from the remainder of your life stressors. That one unresolved point is what caused the chain reaction, simply awaiting the catalyst in life to throw you right over the edge and allow PTSD to become fully developed and formed in the mind. Its a scary thought that most of us could have avoided having PTSD "IF" we knew then what we know now.

No child wants to go into counselling, so you force them into it, regardless their wishes. Sorry, yes its abrupt, its meant to be. People actually will do things when forced if they are progressively made to feel that the forced act is within their best interest, regardless what they think at the time, they will come around and they will help themselves, if for nothing more than to get out of having to attend regular counselling. Forcing a person to do something can and will actually work if done correctly, and if the counsellor is worth their qualification, they will know how to lead them into feeling comfortable and ensure they feel that this forced act is within their best interest, and made to feel that, not just think it.

Once again, counsellors worth their weight are few and far between, sorry to say for those with qualifications, but most are useless when it comes to real counselling, they only do what they know from a text book, because they are not mentally tuned to counsel, more they chose the profession for other reasons, not because they are suited to it. Most should know what I mean... it is like putting any group of people in a job, one person is suited to it and will perform extremely well, the rest just drag themselves through the process of doing what they have been told to do, or learnt to do, not actually necessarily suited to the job itself.

[Marlene]

Basically Marlene, in your circumstances you should have been counselled at age 10 after the trauma.

You've missed the most important part of the question I asked-the fact that I didn't remember for years. Amnesia about tramatic events is used as a tool for diagnosising PTSD. And when I did remember, I resupressed the memories I do have for another decade. Plus the fact that when those of us in the over 30 crowd here remember how going to therapy had such a negative connotation for so long. Actually, I've found out the hard way, anything associated with mental health still has a stigma attached to it. And I think that the stigma is what would doom any forced therapy programs from the beginning.

Education about PTSD (and all it entails) is going to be the key. Even if you take words like 'forced' and 'manditory' and find nicer souding uphemisms..you're really just picking fly shit out of pepper. For years no one talked about depression, now they have TV ads telling you 'If you have these symptoms...you might be suffering from depression...see your doctor'. Changes do happen. Once a month where I work, they include a health newsletter (one page-front and back) in our pay statements. In April's there was a section about PTSD. I could have fallen out of my chair when I read it. But it's going to take governments getting off of their collective asses and their wallets and putting out information, TV/radio/any mass media ads about it, offering councelling (another point-who pays for the councelling if it's forced?), and a myriad of others points would need to be covered.

If there's to be change, it's going to be slow. Human's don't like their change quickly. Also, there are a lot of people out their who need help with what falls under the general heading of 'mental health' and who's voices ask for the same thing. PTSD is important to us because it affects us or loved ones. But to someone who has another problem/issue, theirs is just as important.

If we lived in an ideal world, when something traumatic happened to anyone there would be early intervention and help given and, hopefully, this person would go on to live a happy, fully life without PTSD. But we live in the real world and unless a person has access to unlimited funds, it's a much smaller chance of the above happening.

You asked if PTSD was preventable with forced therapy...I still say no. Offering councelling services with qualified doctor's, educating the person about the risks they're taking, getting rid of the stigma attached to mental health. Those would work much better. But the caveat that needs to be put in here is that without the cooperation of the individual who needs to be helped, time and resources are wasted. And those could be used for someone that does want help.

Again...IMO
Lisa

[anthony]

You are correct in what you say, no doubt, being that in those days people ignored the very things that society today see and recognise as real issues, commone issues, and not simply a person thats crazy or the like. At age 10 though, its not your responsibility to get yourself into counselling, its the adults around you, noticing something has changed, your different, something is wrong, hence to counsel and find out, whether it initially be with someone you trust in order to get the story of what happened, to help you remember, because amnesia doesn't work that way where you have just totally forgotten, but more you simply can't find the answers at that time, hence why most amnesia are temporary, and come back as the mind wants to reveal the answers, as the answers are still stored in the mind, they didn't go anywhere, its only the minds ability to block or unblock the paths to that information. Swelling in the brain is one method amnesia is common, another is trauma (once again temporary) as the mind chooses to displace the information, not forget it. As you well know though by now, the mind is more powerful than we give it credit, and this misplaced information still feeds negativity into our brain, hence we react differently, hence we still end up with PTSD even if temporary amnesia is at play. Rude... but on the mark.

But you are right when talking about our decades Lisa, but what we did is not a reflection of what should occur, nor is it a reflection of the future. We cannot go back and change our pasts, nor can we change how our parents generation view mental illness... hell, nor even our generation, however; we can shape the futures generations, and that is via adults being responsible enough with children to know if they need to take their kids off to counselling, to get someone the child trust even to find the issue if good enough to do so, but the child must not carry the trauma for decades and end up like us. We can change the future of PTSD if we want, but it must be done now. Ignoring it and saying people must choose to get counselled is not necessarily the correct reflection to obtain the future goal, especially when your talking about children and teenagers. None of them want counselling, so why would anyone ask them, instead if your the responsible adult, you would ensure they get what is in their best interest if in doubt. It is like saying we would not protect a child from something hot, instead just let them burn themselves first to learn.... not how it works. Its too late after a child has burnt themselves, and when assumptions are made that the child will only burn themselves a little, nothing bad, is when the child falls under panic, and ends up dead from majority body burns or the like. This is an example... same end result. We must protect and do what is right for those that surround us, even if they don't believe its the right thing to do, as adults and especially those who have suffered trauma and know the end repercussions, forced counselling is likely the only way we will decrease the issue, especially military on return from operations.... it would surely be cheaper to put all soldiers into private counselling sessions, or hire more counsellors for the purpose and intent to ensure all soldiers are counselled weekly for one year after deployment, minimum 3 months, or where the counsellor feels the soldier has been honest and opened up completely about their trauma.

We can prevent, but we cannot prevent if the option is left solely to those who DO NOT know any better, or DO NOT know the consequences of their actions, nor the full extent. You cannot understand PTSD unless you have it, however; do you want the to get it or do you want them to avoid it?

Just my opinion....

[Marlene]

Putting children in the mix puts a whole different spin on things. At least for me, who has been through having a child in therapy. When my daughter started hurting herself and saying things like 'If everyone I love is going to die, why should I stick around?', I would have done anything, given anything, paid any price to help her. Part of the price I'm still paying because of the almost three years of stress and fear that myself and my family went through with dealing with this was part of what caused my PTSD to kick into high gear. Would I do it again-knowing what I know now, knowing what I would have to go through? In a heartbeat and more if needed.

Yes, my parents should have seen that something was wrong with me, that something was different. But when you don't know what to look for...I could point fingers all night and it won't change a damn thing. We were taught to be afraid of 'strangers with candy'. No one told us that trusted family friends (or family) were just as dangerous (or more so) than strangers. Again...now that these issues are being brought out of the dark, so to speak, they can be addressed. But even if my parents had seen something was wrong and wanted to do something about it, there really wasn't anything to be offered during that time. Now there is and that makes all of the difference.

The connotation I got from your initial poll was that this forced councelling applied to adults. Again...you hit a sticking point there. How would you propose forcing an adult to do something they don't want to, don't think they need, ect? Short of damn near incarcerating them, I really don't see how it would work. But I'm also a proponant of having the choice of how I (and others) decide to live.

When I taught school, we would teach children as young as three about 'bad touches' and 'good touches' and telling a grown up if someone touches you in your private places. I didn't even hear the word molestation until I was almost an adult and the meaning wasn't fully understood until later. I agree that educating our children and their children and dealing with situations that arise is as close to prevention of PTSD as we're going to get. Educating adults is a much tougher nut to crack. But at least things are starting to change.

this misplaced information still feeds negativity into our brain, hence we react differently, hence we still end up with PTSD even if temporary amnesia is at play. Rude... but on the mark. BTW-not rude...truthful.

[becvan]

I just answered no. Being "forced" is a far cry from willing. Willing therapy is a two way street where the client/patient works hard with the information they are given. Being forced means the therapist is simply giving them information and attempting to manipulate the client/patient into doing the work. Being forced to do anything never has the results a willing participant has.

Pretty simple in my book.

bec

[just tina]

In the U.S., soldiers are asking for help and not getting it.

It doesn't make any sense for the military to force people into traumatizing situations and then force them into counseling that might not be effective it were entered voluntarily. The military has a long history of treating people like lab rats.

Furthermore, there are nations full of traumatized people who are not being offered help at all.

Doesn't forcing people into counseling place the onus on the victim to survive, instead of questioning the forces that are causing the trauma?

[Awakening]

After my assault the college called me into the deans office and there was a (male) psychologist, I got so agro. I refused. I was so not ready to talk. They really tried to force it so they could follow the procedure in their books. Ironically though, if someone had followed up with me in a month or so, I may have been more willing then.

So I voted no.

[just tina]

"Agro"? Haven't heard this one before.

Good for you for standing up for yourself.

I really don't how coercion can help. If they are forcing you, they aren't very persuasive. Does someone who has been victimized really need to be denied control over their lives to get better? When does that end?

It offends me when a psychiatrist tells me on the first visit that I have if I don't commit to years of therapy with them right then, that I don't want to get better. Is it a sign of mental health to make a commitment to a stranger who hasn't even begun to demonstrate that they have the ability to help you?

[Mayhem]

PTSD "is" a trauma and You cant stop a trauma from happening.

[pandora]

I was forced into therapy as a kid but had no family support to assist me and that might have made it easier or more effective at the time. I think that plays a big part...how supported you are. You also need to be ready...I was not so my answer is no.

[waif123]

the right counseling can help many people avoid developing PTSD, but if forced the person may not respond, and there is some evidence, that suggests things like clinical debriefing can increase the odds of getting PTSD. Each person is very unique on how a trauma will effect them, immediate intervention, does not help everyone. so I voted NO

[Don]

This poll is designed to gain feedback on whether those with PTSD, spouses off and family members, believe whether or not the persons PTSD could have been prevented if immediate counselling, and ongoing counselling was sort after the traumatic event.
anthony,

I think advance preparation for the trauma would have much greater potential for reducing PTSD, than after trauma treatment.

Just as some are able not to be nearly so deeply traumatized by the same events that so horrendously affect others, training can and should be used to locate the more sensitive ones so they can become desensitized (perhaps through simulations) so they're much better able to handle high trauma settings such as when people are sent off to a war zone (or, facing some other setting where severe trauma's encountered).

The military's 'basic training' includes physical training plus some skills, along with obeying orders within the command structure, but what's needed imo is the extra step, of participants being prepared emotionally for all likely and not so likely outcomes.

Don

[anthony]

I absolutely concur with that statement Don.... the military do need this, though they don't do it because the military want soldiers with PTSD on the battlefield as they produce higher aggression, they function longer at more vigilant speeds, they tolerate greater pain thresholds. Shame IMHO.... I agree with you whole heartedly mate, they should prepare at an emotional level also.

[coolgirl]

i believe it can prevent ""some"" , not all.

[anthony]

Hi coolgirl, welcome to the forum. All opinions valid here.... I don't think it could prevent all either, though a majority I believe. If that narrowed those who obtain PTSD from x% by 2/3rds or more, that would be astounding to just achieve that IMHO.

[nor]

I voted "no". The damage has been done. It is permanently ingrained in your brain. I don't have any scientific or medical knowledge to back that up-just personal experience and observations.

In my past, there were various situations in which I would react strangely. I never knew why-I just did. It was the memory of the trauma that haunted me and my reaction to it at a young age. I highly doubt that forced counselling at the age of 6 could have prevented these memories from festering.

I understand that several of the posts here deal with getting therapy at an older age, when there is actual decision making processes involved. But, my initial trauma happened at an age where forced counselling wouldn't have helped with the "prevention of PTSD". How do you prevent a memory from resurfacing? I can't-they just happen.

And I also believe that young children that are sexually molested at a young age-even after counselling-will experience the remnants of the trauma throughout their lives-in some form.

From what I remember in child psychology-many many years ago-the child's brain develops different areas until the age of 12. IMO if a trauma occurs at an early age, the brain will engrain and retain that memory in some form.

You could have a million counsellors telling a 6 year old that "it wasn't their fault, and that the person who abused them was wrong, not them"-but what will actually register in that developing mind will be something totally different. It will rationalize as best it can, so that the child will continue living day to day. At least that is what happened to me.

Counselling may be beneficial in showing a young impressionable child various techniques to handle the memories. What happened with me, is that I used the same bad technique (dissociation) with all other traumatics encounters I experienced throughout my life. Perhaps if someone assisted me with the first trauma, I may have been better apt in handling the future ones.

I believe that counselling comes into play to assist the trauma recipient with the management of the memory. But the memory still exists, as will various responses to it. Through therapy we learn to face the trauma with different tools, so that we can continue living. Things don't have to stop because of a PTSD episode. That is why I think counselling would be helpful in guiding the sufferer towards productive management-but not prevent anything.

Sorry-didn't mean to go off on a tangent, just got a little wrapped up in my own past experiences.

[cactus_jack]

I need to add a bit from me. Because of my conviction I am forced by the court to get counseling. In my case *I* am paying for it, *I* have to drive 35 miles one way for it, and *I* have to pay for the fuel for the trip. They are doing exactly what is NOT supposed to be done. I need it, and I want it. Only reason why I'm cooperating. But even then, I have had to fire counselors because they tell me I had no right to use force to defend myself. Or like the second to last one, that I'm not trying to get rehab'd because I won't try EMDR, then she tells me how jail is good for me because of the networking and how I don't have to do my own laundry or cook for myself. I have a few comments about her that are best left unsaid. My question is what the hell do they expect? I have nothing to lose by not getting counseling under these conditions. I'll be sent off to prison, and there I get NOTHING. So what's the loss? As much as I know I need it, forcing me builds an internal resistance to the counseling. Doesn't matter how much I know I need help, my inner "defense" will object. I have already seen it when I get smart-assy with the counselor.

With that said, the PTSD continues to get worse. In my appeal my lawyer verbally pointed out that I was convicted for being a victim, not a criminal. The jury used that against me and decided I am a man of poor character because I was raped, assaulted, a man tried to murder me, another assaulted me with a deadly weapon, infinitum ad nauseum. So when I see that someone I never disclosed my personal feelings to points this out nearly to a "T" of how I felt, it hits me to the core. I am still stunned, though it's wearing off. The irony is there.

So, who are they trying to help? Punish me for the crimes that have been committed against me and then force me into counseling? WTF?

ETA: any referral to books reports or publications that verify the damage I am talking about is greatly appreciated.

[anthony]

CJ, if your resisting and its not working for you, then the obvious is to stop resisting and trust these people to do what is in your best interest! What have you got to lose? Making yourself vulnerable at worst?

[rat]

The military is thinking of giving propranalol to soldiers immediately post-trauma. It blocks physiological and emotional effects. I don't think PTSD is preventable by therapy simply because the bad guys aren't going to stop torturing you and let you get therapy, then start in on you again. In some instances I guess it could work, like when on-site mental health professionals counseled people at Ground Zero.

[cactus_jack]

CJ, if your resisting and its not working for you, then the obvious is to stop resisting and trust these people to do what is in your best interest! What have you got to lose? Making yourself vulnerable at worst?

Not that easy Anthony. I have opened up and trusted before. And I got royally screwed. Just ain't worth the risk.
Of course now things have changed, not the court order, but the fact that my privacy is gone. Just a matter of time before someone beats the crap out of me because they "don't approve", tries to murder me because I won't give them the intimate details, or shoves a loaded gun to my head because I won't loan them money. I guess in the eyes of Colorado I deserved all of that.
Not mine. Not ever. F**k the State of Colorado.

[anthony]

Rat, Australian soldiers are monitored nowadays on operations, and they are sent to a padre, SNCO or officer for counselling on any matters during operations. Prevention is better than cure, I believe the saying goes. Soldiers don't get away with it anymore... because military must take responsibility for their actions.... just because the US fails their troops, not all other countries are that ignorant. I was in a time where it was still being discovered so readily and how best to prevent it, so I was unlucky, though by the time I left the military they where starting to get some very good strategies in place with compulsory counselling to all troops on operations before they left the operation zone, then further follow-up counselling at scheduled dates on return. Again, it doesn't fix all, but it is fixing some, it is preventing... that is the aim.

Its a shame that the USA simply use and abuse their troops and do not actively support them after the fact.

[Kathy]

Rat, Australian soldiers are monitored nowadays on operations, and they are sent to a padre, SNCO or officer for counselling on any matters during operations.

I am pleased (and relieved!) to report that there is a similar program available to my son and all Canadians currently serving in Afghanistan. Along with family support, we are hopeful this helps him to not develop PTSD. I am sorry to hear that apparently such a program does not exist in the USA, it is well worth the effort in my opinion.

[upstream]

No.

In my experience therapy was only as effective as I allowed it to be.

I was forced into therapy as a child, and decided it was all a bunch of BS. As a result of those experiences I stayed away from therapy until I was so bad I was desperate to try anything. Had I not been "forced" into it initially, had I not reached those conclusions, I may have sought it out on my own years earlier... before I got that bad.

I guess my question would be, could forcing a person into therapy do someone more harm then good? Some might view it as dis-empowering, degrading, or even embarrassing... adding insult to injury.

[spiritofnow]

'Forced', implies the person is not aware of their issues? Isn't the whole point of therapy that the person receiving it is self -aware and is not in denial about their issues and where they stem from. Therapy and therapists are facilitators not miracle healers.

How can someone work on a a broken down car and fix it if they do not feel the car is broken?

I guess the major point to this post for me is that you get to a person before they have PTSD symptoms, they receive counselling for their trauma and because of it as a preventitive measure, rather than them being 'forced' to do sometihng that they are not aware of. Counselling after a traumatic event for me would mean, to educate and explore and in this instance I voted yes!

Spirit x

[CaliSparrow]

I cannot speak from experience as to the benefits of receiving treatment soon after the trauma. Unfortunately, a doctor told my parents that I would forget the chronic abuse and the assault in time (pretty sad what this doctor robbed me of in light of studies affirming PTSDisorder).

So, I did NOT receive help and developed the disorder.

CS

[Firedancer4]

The key word of the question that made me lean towards "no" was the word "forced." Anyone forced into counseling after a trauma is in a different mindset than someone who willingly and desirably chooses to get help after trauma. Someone forced will most likely enter into counseling with a negative and resistant mindset and won't be as receptive to the help.

I believe if I had received loving support and help after my trauma, and then encouraged to get counseling and supported during that time, the outcome might have been different for me. I can't say that I never would have developed PTSD, but maybe it wouldn't be as severe if I'd had support?

I know there are risk factors that can make some more susceptible to PTSD after a trauma than others, so who's to say that someone who received counseling immediately after a trauma and didn't develop PTSD was ever going to? Hard to say.

I had delayed onset PTSD, where my trauma happened during childhood, was compartmentalized for 15 years, and then triggered during the traumatic birth of my second daughter. So I'm 36, and have now been dealing with severe PTSD symptoms of my childhood trauma for the last five years. I never had symptoms following the trauma, and WAS forced into counseling at 14 years of age (and though they were full of sh--), and one psychologist in particular traumatized me even more so that didn't help!

So long story short (I know, too late), I guess I don't think it's preventable. If you're going to get it, you're going to get it, but hopefully you allow yourself to get help right away.

[cactus_jack]

Take two groups of people. In both groups have them chose "A"s & "B"s. Have equal of both in both groups.

Now have the A's in both groups clinch a fist. Have the B's in group 1 try their hardest to make the A's open their fist. Try hard, physically, in any manner possible to force them to open their hands.

Now have in group 2 the B's try by more peaceful means to talk the A's into opening their fists.

In every case this experiment is tried you will find that a peaceful means is far more acceptable and successful.

Such as is with counseling. Right now I'm in forced counseling. And exactly how successful is that? It's not. It's making my stress level far worse than before. The road trip to see him is physically painful. The work I have to do to afford paying him, is physically painful and emotionally draining. How successful is that supposed to be?

Only thing forced counseling (in my case) succeeds in doing is creating anger, and hatred. The longer it goes on the worse it gets. When I cannot get more than maybe on a good day 6 hours of sleep because of the pain, what kind of an ally am I?

[2quilt]

no, because of the word forced.
And possibly no also if the psychologist and the patient did not "fit" well.

I personally believe that the PTSD begins during the adrenolin rush of the trauma, when the brain and body are just trying to survive. Adrenolin or some other brain chemical overload.

Counseling even one hour after that trauma can reduce PTSD, but not eliminate it or prevent it.

[CaliSparrow]

Apparently I blocked out the word "forced". And how that happened, who knows because it's quite a "forceful" word!

So in light of this, I would change my answer. I was putting too much assumption into my previous answer. In studied regarding the treatment of PTSD, two factors need to be established at the gitgo: 1) validation for how you feel, and 2) control (over therapy, pace of therapy, etc... It is supposed to be a co-creative process between therapist & client.

The very nature of PTSD would harbor resentment towards being "forced" to do ANYTHING outside of your control since it's very likely that WHAT CAUSED the PTSD was out of your control as well. So, no. Above all else, forcing someone into therapy could very likely Cause the disorder of which the therapy portends to avoid in the first place!

CS

[cactus_jack]

no, because of the word forced.
And possibly no also if the psychologist and the patient did not "fit" well.

I personally believe that the PTSD begins during the adrenolin rush of the trauma, when the brain and body are just trying to survive. Adrenolin or some other brain chemical overload.

Counseling even one hour after that trauma can reduce PTSD, but not eliminate it or prevent it.

I think the counseling you are talking about is commonly referred to as "debriefing". I feel that if debriefed properly one's chances of having PTSD is a lot less than without it.

[ChrisB]

Anthony- I said No because of the wording of the question. To force us to get help is a mistake. I instituted a stress debriefing after each incident with strict privacy rules. I started by admitting how I felt or simply said "Holy shit that was wild, I was scared but we all made it okay." That tended to open up a conversation because if the Lt. felt it, it's ok to talk. We talked, bonded, cried, laughed and supported. Problem was when it came to the real deal with me everyone thought (much like I did) that nothing could harm the Lt., he always comes out on top. Not! I was never debiefed so it festered.