‘Counselling may be counterproductive’

Mental health services should not rush in and “pathologise” people
caught up in last week’s terrorist attacks, a psychiatrist has
warned.

Dr Jim Bolton said relatives, emergency workers and those who had
suffered near misses, as well as those directly involved, would all
have an emotional reaction that could involve distress or
difficulty sleeping.

But he warned that sending in psychiatrists and counsellors to talk
victims through their experiences had proved counterproductive in
the past.

Bolton, who has written a leaflet on dealing with trauma for the
Royal College of Psychiatrists, said “debriefing” could interfere
with people’s normal coping mechanisms.

“What’s best for most people is to get on with their lives with
their usual social support,” he said.

People should only seek professional help if they had no one else
to confide in, if they felt overwhelmed by their feelings over a
number of weeks, or if they increased drinking or smoking to help
them cope, Bolton added.

Mental Health Foundation chief executive Andrew McCulloch said some
of those in close proximity to the atrocities would develop
post-traumatic stress disorder but services would be able to cope.
In the wider population, he said, people were bound to be more
worried about travelling by underground train.

“People need to be encouraged to get back to work as quickly as
possible and be supported to do that in a way that’s right for
them,” he said.

McCulloch said the response must strike a balance between not
pathologising rational fear as a mental illness and providing for
those suffering from a serious mental reaction.

Sophie Corlett, director of policy at Mind, said mental health
services needed to be ready to offer people a choice of therapies
because everyone experienced post-traumatic stress differently.

“While, for some, talking therapies may be the best solution,
others may prefer not to talk at all,” she added.

• Coping with trauma leaflet at www.rcpsych.ac.uk/info/trauma.asp
• A booklet on post-traumatic stress disorder is available from
  www.mind.org.uk