There are differences between the way men and women (boys and girls) are socialized so there are differences in the way they process and react to trauma. There are also physical differences in the way men and women react to drugs used to treat trauma. For example: Zoloft (sertraline hydrochloride), is approved for both men and women to treat several conditions, including post-traumatic stress disorder (PTSD). This approval was based on clinical trials in which Zoloft showed little effect in men with PTSD, while the drug’s benefit over a placebo was clear in the women studied.
True gender differences in responsiveness may be one explanation,” says Thomas Laughren, M.D., team leader for the FDA’s psychiatric drug products group. “However, it should also be noted that the types of PTSD differed in the two groups,” he says. Many of the men in these trials had a long-lasting and treatment-resistant PTSD, based on military combat experience, compared to many of the women who tended to have a more acute form of PTSD, based on recent physical abuse.
There are not only gender issues in trauma, there are differences for people with disabilities including people with psychiatric issues (often retraumatization). There are credibility issues (we’re often not believed) and unrecognized issues and the subtle issues of micro-oppression that occur with “treatment.” These are similar to issues related to racial disparity. Of course, there are issues for first responders who witness all sorts of horror from automobile accidents to hurricane disasters and more. Seeing a child burned is traumatic for both the child and those who rescue or treat the child.
There are issues related to trauma that have to do with helplessness. Being helpless in the face of natural disasters is more traumatizing than being helpless in the face of man-made trauma (abuse, neglect, domestic violence, etc.) Note that helplessness is a condition often found in mental patients and people with disabilities and children and the elderly. All of these need special attention. Also note that sometimes there are places that are traumatic. Living in poverty and witnessing or fearing gang related activity can be traumatic.
Single blow trauma (natural disaster, robbery, etc.) is often less traumatizing than repeated trauma (domestic violence, child abuse, etc.). Abuse is often characterized in two ways: acts of omission (neglect) and acts of commission (actual physical abuse). Child abuse impacts upon development and can result in behaviors that make providers uncomfortable such as head-banging or cutting. That doesn’t make these behaviors “wrong” and training should include how to help in non-judgmental ways that don’t immediately take away coping behaviors.
I think that abuse is the most preventable issue in our society. The surest way to create an adult with “mental illness” is to abuse, neglect or traumatize a child. We can do more to “prevent” mental illness if we help the children but it takes both the knowledge and the will to change. We first have to acknowledge that it’s an issue.
I just visited a friend in the hospital. There was the bed that raises feet and head and stuff like that. There were oxygen and other things coming out of the walls. There was a television and privacy. It looks nothing like a psychiatric facility. I really object to calling psychiatric lock-up’s a hospital. There’s nothing medical about them. People are mistreated and abused. “Med call” is like a cattle call. Compliance is the primary issue and power dynamic rules. It’s all about force and it’s very traumatic. We need to change the way the system does business and first we need to let them know that what they’re doing is causing more trauma than recovery. It’s all part and parcel of the same package.
Psychiatric treatment is more like bullying than help. Bullying is also present in schools and in the workplace. We’ve created a more traumatized society and we need to break the cycle. Treatment needs to create safety first and then provide help. It’s not safe inside psychiatric facilities so a curriculum would probably be better taught in the community.