Wednesday, August 3, 2011


Recent research is making it obvious that much of disease originates with traumatic experiences. A landmark study done by Kaiser San Diego ( demonstrates how closely adverse childhood experiences ("ACEs") correlate with health problems in adulthood. Now two articles in this week's Journal of the American Medical Association (find both at further validate not only that relationship, but suggest an approach to treatment.

One article, from Australia, shows that women who were raped or sexually abused tend to suffer a lifetime of mental disorder and psychosocial disability, including impaired quality of life, overall disability and increased suicide attempts.

In the same issue, a study of over a thousand former child soldiers in northern Uganda who suffered from post-traumatic stress disorder were helped most by simple narrative therapy--that is, talking about their experiences with trained nonprofessional counselors.

Wait a minute. Let's back up a bit. Isn't it already obvious that sexual abuse can confer lifelong problems, or that a child soldier will be prone to PTSD? You'd think we wouldn't have to prove this through scientific research, yet there's something in our culture that declines to make the reasonable link. It's expressed in that non-advice, "Get it behind you." It wasn't pleasant, but it's over now, so get on with your life. People with cancer often tell stories about such "encouragement" from well-meaning friends.

But we don't get over it. These experiences change who we are. In order to understand what we've been through and thus our current existential location, we need to talk about it. Matter of fact, that's all most psychotherapy is. But it needn't even be called psychotherapy, as the Ugandan "counselors" were nonprofessionals. It could equally be part of friendship, people caring deeply enough about one another to ask the right questions. Hopefully this will become a popular skill as we renovate healthcare as though people matter. 

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