Stress: When talking about it is just too much

Sept. 19, 2002

Secrets are out of style. We live in a culture of confession, and the pundits of personal well-being caution that what goes unspoken today will surely haunt us tomorrow.

Therapists say we must talk and talk and talk about our problems. But a growing body of evidence is suggesting that all that talk might actually be harmful to our mental health

British Columbia psychologist Tana Dineen, the author of Manufacturing Victims, says the so-called "psychology industry" banks on the premise that talk cures.

"Sometimes I'm inclined to use the word 'snake-oil,' because I think that's largely what we're selling," Dineen says.

She has sharp criticism for a profession that she claims manufactures its own victims. Dineen says that by pathologizing normal emotional processes, psychologists lead people to believe they need help.

"What we might have called natural human reactions at one point, now we call them symptoms. And we cluster them and it makes it seems like we've got a disease," she says.

Dineen says psychotherapy plays on people's emotional vulnerability by keeping them focused on painful memories, thereby making it difficult to leave the trauma behind.

But what happens if we don't talk out our trauma?

Dineen argues counsellors and therapists have vilified repression, and have cautioned us against bottling things up inside.

But Dineen says repression gets an unnecessarily bad rap. Instead, she says it should be praised. According to Dineen, repression is a valuable, reasonable coping tool --one that's seriously undervalued in our talk-centred society.

Bert Madill doesn't feel the need to let it all out. A decorated fighter pilot from the Second World War, Madill has plenty of stories about the good times. And he saw the brutality of battle. But Madill doesn't talk about that. Not to family or friends and certainly not to a psychologist.

"I can't imagine someone coming in to tell me what the hell is wrong with me or my family or my wife or my kids. That's out of the question. I think we already know if we got a problem." he says.

Now a new study published in the prestigious medical journal The Lancet finds Madill might be on to something.

Based in part on a review of trauma workers who were at the site of the World Trade Center after the Sept. 11 terrorist attacks, the study finds some kinds of talk therapy do nothing to prevent emotional trauma and could actually cause it. By forcing people to recall traumatic events and discuss their feelings, researchers found an increased risk of creating distress in people who were otherwise coping well.

The study also finds talk therapy with professional counsellors can make people less likely to talk about traumatic events to family and friends, but more likely to believe they need help.

Not everyone is convinced that talk therapy is a waste of words. Dr. Zindel Segal, chair of psychotherapy at University of Toronto's Department of Psychiatry, insists the empirical evidence proves the benefits of talk therapy.

"People accessing psychotherapy are over 70 per cent of the time benefited, compared to people who have emotional problems but don't seek any treatment." Dr. Segal says.

Segal says for therapy to be successful, there has to be the right psychologist-patient combination. And the timing has also has to be good. Patients must be ready to talk in order for talk therapy to work.

Segal says the real benefit of talk therapy is providing patients with tools to replace negative thoughts with positive, reasonable ones.

Bert Madill does his best to focus on the positive. He admits that there were some terrible times overseas, but he prefers to leave those behind.

"I think you're crazy to try and burden yourself with something you can do nothing about."