Wednesday, May 13, 2009

Is Venting Therapeutic?

Today they call it "critical incident stress debriefing." As therapy for trauma, debriefing instructs victims to recall the event, to recount it in detail, and to vent the proper emotions.

This technique echoes Freud's initial attempt to treat hysteria. With one difference. Where Freud's treatment involved remembering forgotten traumas, debriefing involves traumas that are fresh in memory.

Still, debriefing owes a debt to Freud. It follows his lead in suggesting that the effects of trauma can be mitigated once the event is narrated with sufficient anger and anguish.

By now this has become the commonly accepted approach to dealing with trauma.

Any time a trauma victim appears on a talk show or writes to an advice columnist or is depicted in a television drama, someone inevitably declares that the person must seek counseling to talk it over, to work it through, and to vent intense emotions about it.

All of which begs the question: Does it work?

A recent research project led by Dr. Mark Seery from the University of Buffalo suggests that it does not. An essay on this research is posted on Psyblog. Link here.

Studying the effectiveness of debriefing in cases of traumatic stress, Dr.Seery discovered that victims who kept silent were more likely to do better than those who had expressed their feelings and told their story. Venting was most often associated with a worse outcome.

Psyblog offers one correct explanation. Debriefing mistakes a metaphor for reality. Based on the assumption that negative emotions build up in the mind like compressed gas, debriefing suggests that if they do not find a release valve, they will eventually explode.

Other therapists have gotten beyond hydraulic metaphors, only to fall into a different mistake. They assume that trauma produces bad ideas, thus mental toxins. Then they propose removing those toxins by attaching them to a story and expelling the whole mess orally.

All in the interest of another metaphor: mental hygiene.

We can also consider that if trauma injures by demoralizing, thus stripping away human dignity, perhaps the correct response is to cover up, not to open up.

When a trauma victim tells his story and vents his emotion he is not asserting a better version of himself. He is using the trauma to behave in a way that he would normally consider beneath himself.

Psychologists have known for some time that venting anger is countertherapeutic. The immediate cathartic rush always yields to feelings of emptiness and foolishness.

These begin the minute the venting individual takes a step back and starts saying to himself: What was I thinking?

Exposing yourself as a trauma victim and making a display of your private emotions is indiscreet. It runs counter to the ethical principles that guide our lives.

I would explain Dr. Seery's results by saying that a person who acts ethically under the stress of trauma is on a better path to overcome its debilitating and demoralizing effects than is someone who uses the occasion to compromise his principles.

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