Matthew Roberts contacted me and ask if i might view his blog and if I had any thoughts about it.
So, I read the blog and then responded with my thoughts ('My Response' below). Matthews Blog:
From there we have messaged more.
My Response to the blog:
"I have become a little less interested in the trauma therapy model now. In my view, this has become, perhaps inadvertently, another way of centering the problem in the brain of the person. I don't think it is intended this way, but we are continuing to look at the problem in the neuro of the person; the problems are in networks, communities, enactment of power around us, not in the persons brain (but acknowledging all experiences have a neuro effect, as such).
Of course, I am included in that as a Nurse Practitioner, and the other mechanisms of power that support my position in the world.
That said, I think the trauma model has some benefits over the psych illness construct. But It inevitably comes down to the narrative of the person facilitating any care/connection/treatment etc.
My career has been shaped in many ways by the work of Laing (interesting to me that LJ and I have talked about the valuable influence of the thinking of Laing). My supervisors for over the last 20 years are contemporaries of Laing and his peers of that era - I have felt very grateful for the freedom inherent in his work, that i have found available to shape my ideas and actions.
I was interested to read in your blog that you think the illness model is difficult etc. But also, that you had 2 caveats as to the point where the doctor/therapist might 'need' to save the patient from something or other, and for me this is the underlying position of the disease / illness model... that we (professionals / supporters) can ultimately fall back on the social construct of mental illness to inform our perception of 'emergency' situations.
This is not to say that i would not give a person drugs for a highly distressing moment. I would give those drugs, just as I would give a green whistle to a person in a trauma moment, but i would want to say that was simply an act of humanity and compassion as mutual sentient being. And, I would acknowledge my threshold for this is from my own stories of living, that have emerged in my awareness at the point i intervene, not ultimately (or dominantly) informed by a considered medical position (in a mental health situation).
I think Joanna Moncrief has a good narrative around a drug based, not disease based, model of prescribing; my interpretation of this being that we acknowledge that we have many different psychotropic drugs, some people find value in some drugs and not other drugs, others find other drugs useful etc. So, we could discuss what relief from distress using drugs might be best for an individual - what drugs, what might relief feel like etc. So, one person might like Olanzapine, another Lorazepam, another Diazepam, another droperidol, another lavender, another deep heat (in addition to topical sensation, this likely has a psychoactive 'feeling' for a person) etc. And importantly, we don't have to pretend this is 'treating' any part of an illness. It is simply providing immediate relief from distress, much like a green whistle at the scene of a broken bone. In such a setting we wouldn't allow a sense of facade that the opiate in a green whistle was being given for anything other than blocking pain receptors in the immediate moment so a person was in less distress and less discomfort. So why not take the same approach to emotional pain?
Hope that makes some sense?
So, my interest has moved to why any professional / supporter acts the way they do, rather than seeking to find the model or solution of illness, trauma concepts or any other. This is also not to discount medicine and what it can offer at any level. But the transparent human to human honesty seems the vital part.
Our Just Listening framework (especially including Dissociachotic) is concerned with the professional / supporter recognising that it is their own narratives in any moment (driven by the stories of their lives; cultures, beliefs, training, trauma, ancestor etc) that creates a rationale for their actions towards a person in distress. It has certainly been very beautiful to offer JL. Unfortunately, it is not the fancy of the modern industry approach to human experience, but it is none the less very beautiful to have the opportunity to sit quietly as a psychotherapist with any person - especially those said to be psychotic or wanting to end their life, and be with them as an aspect of their story emerges; a story that could not have been heard before due to the context of their life. And then notice what they choose to do with hearing that story in that way. And me being asked to simply be with them.
I have gone on, and perhaps not really why you messaged me. If you read all I wrote, thank you for hearing me".
I have fears about the trauma therapy model and its over stating what it can do. Concerns that mirror those of my concerns about traditional psychiatry models ( the main model still practised in reality). And then concerns that trauma therapy has become the new untouchable, easy hyperbole from agencies, practitioners, governments to say they are 'doing' trauma therapy better than anyone else as treatment. And then concerns that really we tell everyone trauma has changed the way the brain operates, and we are essentially back to the wise old therapist being able to fix the broken patient. This is bullshit of course.
Of course, people ( therapists) will shout 'not I as a trauma therapist'. And that too is what people practising biological psychiatry have said, and continue to say, to this day.
Of course, being with people in distress is better that the mental illness stuff. But a person, even inadvertently, being objectified as traumatised and needing to be fixed by the wise person is not much different.
It might just be about 2 people being in connection as mutual beings.
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