Who can best ease the pain?

Patricia PearsonMarch 8, 2001, Thursday, FIRST EDITION
Pg. 15A

One of the peculiar features of tragedy in North America these days is the ubiquitous presence of "grief counselors."

A bus crashes, a tornado hits, a student murders his peers and all of a sudden, along with the howling ambulances and flashing police cars, comes this bevy of shrinks. They seem to have become a standard element in emergency response teams. Dial 911 from the scene of a disaster, and dispatched in reply will be your paramedics, your cops, your firefighters -- and your earnest, probing therapist offering to chat.

Who are these grief counselors, I always wonder, and what makes us think we need to rush over and talk to them? Why wouldn't we want to talk to our chums or hug our moms or whisper to our husbands in the dark?

Why, for that matter, should trauma victims want to talk at all in the crazy moments after the world turns upside down?

I am imagining the students at Santana High School in suburban San Diego, who were invited, within hours of their schoolmate's senseless rampage Monday, to troop to a nearby church and meet with counselors, swiftly furnished for them by the mental health officials of San Diego County.

What are nearly 1,900 shaken teenagers -- presumably standing in line for the next available counselor or pastor somewhere in the alcoves of this church -- actually expected to disclose?

Something awful happened. It isn't really a question of analyzing it with a trained professional; it's a matter of letting it rip through you.

On Monday afternoon I watched one teenager being interviewed by a reporter from KGTV in San Diego. "Did you see anything happen?" the reporter asked eagerly.

"I saw four students shot," the boy offered in a state of breathless amazement, "and I saw a narc hit the ground." By "narc" he meant a campus security supervisor, and the way his eyes widened when he said this, you could tell he was astonished at the thought of a grown-up being vulnerable, tipping over like a statue, all that trusted solidity crashing to the ground.

It was his own private epiphany. Maybe he would want to contemplate it later, or maybe not, or only ever to his friends, but the idea that he would make this pilgrimage to a church and repeat what he'd said on TV and feel better raises my eyebrows to the roof.

Psychologist Tana Dineen, author of Manufacturing Victims: What the Psychology Industry is Doing to People, argues that the very presence of on-the-spot counselors tends to distort peoples' interpretation of what they have experienced.

"It seems that we have been persuaded," she wrote recently, "that those who witness a tragedy, no matter how indirectly, are themselves victims, because they might be upset by what they saw or felt. And because they were upset, they need professional counseling to recover from the 'trauma' of feeling upset."

The theory behind on-site grief counseling, often called "critical incident stress debriefing," is that people need to be treated quickly in order to prevent post-traumatic stress reactions. Many psychologists believe that a trauma that isn't worked through rapidly will crystallize within the psyche, like an untreated bone fracture that sets at a painful angle. It is a theory of emergency medicine for the soul: If you "debrief" right away, you will exorcise the demon.

The theory reminds me of the time I saw the movie, Seven, which was so horrifying and disturbing that I came home and blurted out the entire plot, scene for scene, as if I needed to expel it from my mind. I did this in my journal, however, and that sufficed. Indeed, critics such as Dineen protest that people need to process the upheavals of life in their own way and not be misled by a counselor's urgent attention into thinking that the experience was more debilitating than it actually was.

George A. Bonanno, an assistant professor in counseling and clinical psychology at Columbia University, has done research on grief and finds the literature supporting the theory of instant disclosure "the poorest, sloppiest research I've ever seen." In his own work, he has found that people who are private and reticent about their experience are often fine, thanks. In fact, those who try to analyze loss or trauma may wind up feeling worse.

"We just find over and over that the more people express their grief, the longer it takes for them to recover," Bonanno told me.

His research made me think of a relative who accidentally killed a child with his car 36 years ago after she darted onto the highway. He has never, ever spoken of it. Stoicism and private reflection are the means he chose to cope.

Being encouraged to disclose his feelings -- the implication being that disclosure is the true path to health -- would have been painful for my relative, and for what? Would he feel any better if there'd been a counselor on the scene all those years ago? His wife was there. She knew. He knew she knew. For all these years, that has been enough.

Beyond the debate about whether immediate trauma counseling is helpful lies a subtler question about whether psychotherapists have any greater claim to help us make sense of tragedy in our community than the ordinary folk we love and trust within the community itself.

In California this week, the counseling available has, at least, been integrated into the community through the church, which isn't always the case. Often counselors appear out of nowhere, with no direct ties to the people who have suffered a disaster.

John McKnight, a professor at the Institute for Policy Research of Northwestern University, once wrote an essay in which he commented on the way ordinary people -- neighbors, friends, family and pastors -- get strangely supplanted in a crisis by "experts."

"Through the propagation of belief in authoritative expertise," he wrote, "professionals cut through the social fabric of community and sow clienthood, where citizenship once grew."

That is one notion that certainly merits "disclosure."