BMJ 1995;311:509-510 (19 August)

Letters

Response to stress is not necessarily pathological

EDITOR,--Beverley Raphael and colleagues' critical examination of the value of debriefing after psychological trauma focuses primarily on treatment after single disasters but could be extended to the wide range of psychological treatments offered to victims of current wars.1 The failure of the concept of post-traumatic stress disorder to embrace the complexity of the experiences of suffering and loss in these situations has been addressed by other authors,2 including me.3 The treatment strategies that follow in its wake are equally problematic. They rest on an assumption of a pathological response to stress that is both universal across different cultures and centred on the individual. They ignore the continuing trauma of flight and resettlement that is experienced by refugees, and of life in regions of continuing conflict. And there is the possibility that they pathologise coping strategies that might be essential to survival. Hypervigilance--the ability to distinguish the sound of an incoming . . . [Full text of this article]


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Relevant Article

Does debriefing after psychological trauma work?
Beverley Raphael, Lenore Meldrum, and A C Mcfarlane
BMJ 1995 310: 1479-1480. [Extract] [Full Text]

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