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EVE SIMMONS: Why I believe raking over the past ISN’T always good for our mental health

Seventeen years after losing my father to cancer – a few days shy of my 13th birthday – I can still hear the nurse’s words: ‘Daddy’s gone, darling.’

Thankfully, somewhere along the way I managed to turn the volume down low enough so I could live a relatively normal adult life. Occasionally I think about that day – anniversaries and birthdays are the worst, as any person who lost a parent at a young age will tell you. But on the whole it is an experience that, while formative, I don’t think has left me particularly scarred.

So when, a decade after Dad died, a therapist sat opposite me asking me to revisit the moment, demanding I ‘face the trauma’, I was bewildered.

I was there to address another, immediate problem – an eating disorder that had left me critically malnourished and hospitalised. But I played along, describing memories of covering my eyes, scared to look at my dad’s lifeless body.

I cried a lot during the session. Afterwards, I called my mother and cried some more.

Daddy’s girl: Eve Simmons pictured with her father. She was asked by a therapist to ‘face her trauma’ – but found it upsetting

I spent a large majority of the following 24 hours weeping. In the sessions that followed, as we continued to discuss Dad’s illness, I was no better equipped to take the first step that would have been integral to getting better: eating.

After six months, I was discharged. I wasn’t perilously underweight any more, but I certainly wouldn’t say I had recovered.

I am better now, but it wasn’t thanks to my well-meaning therapist. I owe it to a no-nonsense dietician who helped me understand the truth about nutrition, which helped me fight the thoughts that scared me off certain foods, and the unrelenting support of an online community I built for others with eating disorders, called Not Plant Based.

In recent weeks there have been a couple of events that have brought back what happened in those difficult, early therapy sessions – and the hunt for the trauma that supposedly triggered my problems.

Most notably, last month Prince Harry gave details of a type of trauma-focused therapy he is undergoing to help him cope with memories of his mother’s tragic death, which he says had a knock-on effect on his mental health.

No one would deny that what he went through as a boy was distressing, but Harry also said ‘unresolved traumas’ are experienced by the majority of us. The isolation caused by the Covid-19 pandemic, he said, was one example. Really?

Then, last week, came the news that Britain’s youngest MP, Labour’s Nadia Whittome, had been signed off work with post-traumatic stress disorder. It sparked debate as to the appropriateness of her diagnosis. It is not yet clear why the 24-year-old developed the condition, but reports suggest it could be linked to a recent tirade of online abuse, including death threats.

That sounds truly horrible and upsetting. But I thought post-traumatic stress disorder was a diagnosis usually given to those who’d survived abuse, but never really recovered from it, or come back from war zones.

When I started to look into it, I discovered social media was littered with posts from psychotherapists, some with hundreds of thousands of followers, suggesting that being the victim of name-calling, or having pushy parents, also counted as trauma.

On Instagram, for instance, popular ‘trauma-informed coach’ Anabell Ingleton tells her 10,000 followers that traumas can be ‘anything that leaves a lasting emotional imprint on your mind, body and soul’. Examples she gives are ‘a look someone gave you’, or ‘the words someone said’ and even a ‘certain smell’.

Hands-on: Prince Harry reveals his meditation technique for trauma in 'The Me You Can't See'

Hands-on: Prince Harry reveals his meditation technique for trauma in ‘The Me You Can’t See’

Meanwhile, on video-sharing app TikTok, therapist Micheline Maalouf tells her 20 million fans that constantly moving house and having ‘emotionally unavailable parents’ are traumas, too.

And on London’s swanky Harley Street, an army of private therapists will charge £300 a session to help you root out hidden trauma, claiming this will combat everything from depression to eating disorders to alcoholism. When I spoke to a number of mental health experts, they had concerns about this trend, warning that obsessing over trauma may do more harm than good.

Dr Lucy Foulke, a psychologist at University College London and author of Losing Our Minds, a new book about mental health, said: ‘The word “trauma” used to be reserved for talking about a very specific type of event – being in a war zone or experiencing violence, abuse or witnessing a violent death.

‘Psychiatrists would look for these experiences in patients suffering specific post-traumatic stress disorder symptoms, such as recurrent flashbacks, night terrors and acute panic linked directly to that event.

IT’S A FACT

Post-traumatic stress disorder is estimated to affect between three and eight per cent of the population.

‘Treatment for post-traumatic stress disorder is unique, and involves helping patients cope better with memories of that event.

‘But today, the term trauma is ever more being used to describe just about any difficult experience, like moving house or falling out with friends – even by psychotherapists.’

One might think that, whatever the label, talking through a difficult experience will ultimately be positive. But surprising research shows this is not necessarily true. Timing, for instance, is key.

In the early 2000s, following the shocking 1996 massacre at Dunblane Primary School, psychologists published research on the mental health of children who had witnessed the violence.

In the wake of the tragedy, the authorities sent in psychotherapists to offer crisis support sessions to the children – talking to them about the scenes they witnessed, and how they felt about them.

Later it transpired that the youngsters who received these sessions were more likely to suffer mental health problems, including post-traumatic stress disorder, in years to come, compared with those who didn’t.

The same has been found in first responders to the 9/11 terrorist attack in 2001 who were offered immediate counselling, as well as women who have had a traumatic childbirth.

The psychologist who led the research, Arnold van Emmerik from the University of Amsterdam, said these so-called debriefing sessions interfered with the natural way people react and process a traumatic event, and continued to expose them to the memories that they found distressing. After all, not everyone who experiences trauma like this will go on to develop a mental health condition.

Last month Prince Harry gave details of a type of trauma-focused therapy he is undergoing to help him cope with memories of his mother’s tragic death, which he says had a knock-on effect on his mental health

Last month Prince Harry gave details of a type of trauma-focused therapy he is undergoing to help him cope with memories of his mother’s tragic death, which he says had a knock-on effect on his mental health

Studies show that roughly two-thirds manage to recover without long-lasting difficulties. ‘The mere distraction of just getting on with things, the passing of time and social support from friends and loved ones can be hugely important in helping people cope with a traumatic event,’ says Dr Simon Wessely, regius professor of psychiatry at King’s College London. ‘We mustn’t underestimate this and think a psychotherapist is always necessary. Sometimes people like me can get in the way.’

He says it’s only if, further down the line, people begin to develop symptoms of post-traumatic stress disorder that treatment becomes appropriate. And there is another concern about therapists who see trauma as the root cause of all problems: they may be missing other, far more relevant diagnoses and not giving the right treatment.

Being left worse off by raking over difficult experiences is a situation Erica Crompton, a 41-year-old journalist from Staffordshire, knows all too well.

She suffered with psychosis and schizophrenia for a decade – which was treated with anti-psychotic medication. Finally, in 2012, having spiralled into severe depression, she was offered a choice of therapy by her GP.

IT’S A FACT

Sexual assault is the most common traumatic event, according to a study of more than 2,000 people.

‘At the time I was desperately searching for the reason why I became unwell. I wanted to try something that would give me answers,’ she says.

Erica chose something called compassion and exploratory therapy. This involved teaching her to avoid self-critical thoughts and analyse childhood experiences for clues as to how the thought patterns developed.

‘I had to write down past events and think about how they made me feel,’ says Erica. ‘I spoke about my mother, who struggled with alcohol addiction when I was little, and my parents’ messy divorce. The therapist highlighted these things as a potential cause of my illness.’

Erica’s therapist encouraged her to confront her parents, explaining how they’d contributed to her mental ill health.

‘I stopped speaking to them for nine months,’ she says. ‘I blamed them for everything that had gone wrong in my life and felt incredibly bitter and resentful.’

But it is something that she now deeply regrets.

‘It only made me more angry and alone,’ she says. ‘And later I was left to repair those family wounds, which was tough, but when I eventually did rebuild bridges, my mood improved. I never got to the bottom of why I became unwell, but I’ve realised it’s not as important as I thought. The present and the future are what matter.’

Researchers from Yale School of Medicine in the US recently reviewed hundreds of studies and found that compared with therapy that involved looking at early-life traumas, practical interventions, such as cognitive behaviour therapy, which helps patients better cope with difficult thoughts, proved significantly more effective for treating anxiety and depression.

Other research has found the consequences of analysing early-life traumas can be disastrous.

In the UK and US in the 1990s, there were thousands of false accusations of sexual assault against the parents of people who were undergoing psychotherapy.

In recent weeks there have been a couple of events that have brought back what happened in those difficult, early therapy sessions, writes Eve Simmons (pictured)

In recent weeks there have been a couple of events that have brought back what happened in those difficult, early therapy sessions, writes Eve Simmons (pictured)

Eventually researchers identified a phenomenon called false memory syndrome, whereby over-thinking hazy childhood memories causes patients to reinvent it as an exaggerated version of reality.

In some cases therapists were found to have pushed patients into reaching a certain conclusion, especially those with severe depression which is known to impair memory.

It is for this reason that today NHS psychologists prefer to focus on practical techniques, to help patients control the symptoms that affect their life.

And if a traumatic event happens to come up during the sessions, patients are encouraged to speak about it only if they want to.

A number of studies also show that a good rapport between therapist and patient is strongly linked to improvement in symptoms, and is perhaps even more important than the type of therapy given.

‘A good therapist is key because they will understand when exploring an experience will be helpful to a patient and when it will be unhelpful,’ says Dr Wessely.

‘The whole idea of therapy is not to create victims, it is to help the patient feel in control of their past, not allow them to be eaten away by it.’

Of course, I understand the desire to look for the source of a mental health problem.

We see the same concept in other areas of medicine – this idea that, to truly treat an illness, you must find the root cause and tackle that. But in so many areas, from cancer to heart disease and even certain types of diabetes, doctors still don’t truly understand why they happen. That doesn’t mean they can’t find ways to help patients get better.

There’s a good chance I will never truly understand why I developed an eating disorder.

Would I benefit from the answer? I can’t say I’m convinced.

On Medical Minefield this week: Are some people being harmed, not helped by trauma therapy?

Listen now on Apple Podcasts, Spotify, Google Podcasts and mailplus.co.uk

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