Responses to Cathy Young Boston Globe Column  (3/3/03)

In a March 3 column in the Boston Globe entitled, "The Virtue of Stoicism” , Cathy Young piggybacked on Lauren Slater's New York Times Magazine article "Repress Yourself." . Among other things, Young erroneously included sexual abuse in research cited by Slater concerning the benefits of "repression" for some people after heart attacks and the loss of a spouse.  She also attributed a friend's rather self-centered need to dwell on all the details of their relationship to therapy and said she could do without both.  Below are responses from two of our Board members.

To the Editor:

Cathy Young’s March 3 column “The virtue of stoicism” extols the advice to “suck it up and move on” as the remedy for traumas ranging from sexual abuse to heart attack to death of a spouse. Young cites a New York Times Magazine article by Lauren Slater which reported research that distracting from and repressing trauma leads to better recovery and happier lives, along with anecdotes about friends to support this advice.

This research considered time periods ranging from only 7 months to a few years after a traumatic event. Some individuals who might initially be good  “repressors” have trauma-related emotions and memories return years later. Other people are not adept at repression even in the short term. To say that people not adept at life-long repression should “just say no” to tortured thoughts and symptoms from past wounding experiences is absurd.

Young also questions the benefits of therapy, characterizing it as “letting it all hang out.” She states that therapy focusing on strengths and positive things is a “heretical view.” In fact, there is remarkable consensus in the trauma field that treatment should be phase-oriented and matched to the individual’s coping style, skills, resources, and life stability.

Responsible trauma treatment does not rush headlong into uncovering trauma memories and “letting it all hang out.” Rather, it begins with a stabilization phase that builds skills for coping with and understanding emotions, establishing control over symptoms such as anxiety, depression, and reliving of traumatic events, plus increasing personal resources, strengths, and positive emotions prior to working with trauma. Working on trauma-related memories and emotions begins only in a second phase.

Resolving tragic life events is a complex problem with no simple right answer or one-size-fits-all solution. To suggest that people who are good repressors and happy and well-adjusted should talk about their trauma is no more correct than to suggest that those tortured by the past should “suck it up.” Many people who were previously tortured by past trauma have achieved full, satisfying lives with the help of therapy.

C. Girvani Leerer, Ph.D.  

Director, Center for Women’s Development

Arbour-HRI Hospital Brookline, MA

 

To the Editor:

Before more folks jump on the bandwagon of Lauren Slater’s catchy New York Times Magazine article “Repress Yourself” approach to trauma treatment, let’s set the record straight. Contrary to Cathy Young’s ( 03/03/03 ) assertion in the Globe (“The Virtue of Stoicism”), Slater presented no research that a simple “suck it up and repress it” approach works for victims of complex long-term abuse.  This is because there is none. Slater’s piece, while beautifully and provocatively written, cited research that, for a single, acute trauma experience in an intact adult (heart attack victims and death of a spouse), distraction and repression proved more effective for some. The few individual stories Slater presented of trauma survivors for whom repression worked were just that—stories, not research.

Furthermore, the research Slater did cite presented results from no more than a few years from the event.  While it is true that repression works for some, even for a period of many years, for many, trauma memories re-emerge later with stunning force. Equally important, as the recent crisis in the Catholic church has shown us, even when the actual trauma memories disappear,  distorted belief systems (“I am unsafe,” “I am helpless”, “I am trapped”)  and psychobiological responses to trauma, such as disturbed sleep, hypervigilant anxiety, impulsive bursts of anger, depression, withdrawal and numbness often persevere, with extremely debilitating consequences for daily living.

No competent therapist would confuse the kind of hyper-aroused obsession that Young describes with good therapy, whether for trauma or for any other mental health issue.  The goal in current trauma treatment is never to linger on the details of the memories, but rather, one step at a time, to fully acknowledge their impact, and, ultimately, to become firmly grounded in present reality.  Moreover, current “best practices” in trauma treatment are increasingly incorporating more body-oriented approaches that, for many, are proving much more effective than talking alone in resolving the psychobiological effects of trauma.

Competent psychotherapy can provide significant relief to trauma sufferers. I would hate to see articles like Young’s and Slater’s discourage people in pain from seeking good treatment.

Yours,

Patricia L. Papernow, Ed.D.

Psychologist

Hudson , Mass.

 

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