Memoirs of A Healer/Clinical Social Worker: Autobiography of Bruce Whealton

Chapter 42: Understanding Trauma and Related Disorders & Treatment

[Disclaimer: I have used aliases to protect the confidentiality and identity of clients or patients. No other names have been changed.]

Throughout this section of the book, I will present my experiences working with people who had various disorders, problems, or conditions. So, in case you are wondering, no, I didn't stop focusing on one condition and move to the next. I am merely describing different treatments or issues in different chapters.

Keep in mind that all this was happening at the same time. It's not like I stopped treating the clients who had problems or issues that were described previously and moved onto other things.

In addition, while it is true that psychotherapists do specialize in treating certain conditions, issues, or problems and they specialize in using certain techniques we also need to be eclectic – skilled in using various techniques depending on the problems that a client is facing. Actually, not every therapist is eclectic but many of us are.

I was keeping my options open but I did have my own toolset that I brought to the treatment of various issues or problems.

Ever since I first got started in the psychiatric field, I was using the DSM-IV to make diagnoses that describe the problems that clients or patients were confronting when they sought treatment or were required to receive psychiatric care, i.e., they were involuntarily committed to a psychiatric facility.

The DSM-IV is the Diagnostic and Statistical Manual of Psychiatric Disorders Volume IV (four).

One particular class of disorders seemed to be particularly mysterious and controversial. Those are dissociative disorders. The most extreme of these disorders was Dissociative Identity Disorder (DID) which used to be called Multiple Personality Disorder (MPD). To me, these disorders did not seem any more unusual or perplexing than many other disorders.

If someone were to state that they are seeing or hearing things that are not there, we would not say they are just making that up.

In addition, for me, hypnosis offered me some valuable insights into these mysterious conditions. During a hypnotic trance, we seek to alter a person's consciousness and help them to focus on a particular stimulus, idea, or to visualize something.

At this time, I was interested in learning about dissociative disorders, and I will describe this below. As a point of reference, the condition DID is only one of a variety of dissociative disorders. The understanding was that these were trauma disorders. If you are wondering what the heck a dissociative disorder is, I will be getting to that.

Trauma and Post Traumatic Stress Disorder (PTSD)

Before I discuss the treatment of or understanding of dissociative disorders, I wanted to talk about trauma disorders more broadly. In particular, I am describing Post Traumatic Stress Disorder (PTSD).

We can organize the symptoms of PTSD into an outline. This will be important in understanding what my own experiences were later in the book. I also noticed later that some of the symptoms of PTSD and/or dissociative symptoms can occur in response to events that do not seem to be "traumatic" from an objective standpoint.

So, to describe PTSD let's consider the following points.

First, we have exposure to or learning about events that could cause death, or that involve serious injury or sexual violence.

Then we have intrusive symptoms. This can include involuntary and intrusive memories of the event, nightmares, flashbacks, heightened reactivity to stimuli that are similar to the traumatic event, and things such as a heightened startle response.