Throughout history, opinions about what makes a person healthy has evolved as more information has become available. People have gone from strictly believing that health simply meant the absence of sickness, to seeing that the body and mind are connected (Schneider, Gruman, and Coutts, 2012). We know that physical health can impact our mental health and vice versa. It is clearer now that social psychology can really do something to improve this body-mind relationship. Someone with anxiety or depression can have improved symptoms through counseling and talk therapy, and the female population of a college can be convinced to practice safer sex through interventions (Schneider et al., 2012). Clinical psychology and the treatment of psychological disorders is interesting on a social level, as the stigma of such disorders is still affecting the ways they are treated. Changing stereotypes associated with psychological disorders could help in the treatment of mental health, specifically post-traumatic stress disorder, depression and anxiety; such changes could also help to improve understanding of the relationship between the mind and body.
One would not expect to go into a therapist’s office to receive treatment for anxiety, depression, or otherwise, and come out feeling worse. However, that is sadly still a possibility in today’s world. Schneider, Gruman, and Coutts note the nature of an anchoring effect, which happens when a therapist bases treatment of a client on the impression of a first encounter (2012). This is particularly true in the case of veterans who have been diagnosed with PTSD; they are judged not only by others, but by their therapists as well. Post-traumatic stress seems to give sufferers a “crazy” stamp on their foreheads, wrongfully branding them as unfit to function in society. I have several friends and family members who are veterans, and they, too have been stigmatized by doctors and friends. Such stigma actually reduces the likelihood that a soldier returning from war will seek help for PTSD, and even disorders such as depression and anxiety (Britt, Greene-Shortridge, & Castro, 2007). Social psychology can help improve the therapist-client relationship, and help to eliminate any bias or stigma that a doctor may hold over a client. This also applies to depression and anxiety.
Despite the fact that they are very common, and that they often accompany PTSD, people are still sometimes embarrassed to seek treatment for depression and anxiety. I have dealt with them myself, and I have known many others who have as well. While interventions to change faulty though processes and boost self-efficacy have been effective for patient treatment, I would also argue that such interventions could improve the therapists’ understanding of the patient’s issues (Schneider et al., 2012). If interventions are designed to alleviate depression and the anxiety that often comes with it, it could give therapists certainty as to the nature of the patient’s psychological disorder. It also shows the value of applying social psychology to treating peoples’ minds and improving their quality of life. Just like the body and mind are inseparable entities, so are social psychology and all areas of life.
As Bandura has showed us with his exposure therapy on people with severe phobias, psychologists can truly help people if they only have the right methods (Lesson 5 Commentary). The question is, how can social psychology be applied to improve the lives of sufferers of other psychological disorders? Let us take PTSD as an example. To start with, a simple intervention can be conducted in order to educate veterans about how their minds and bodies are connected, a chief principle of health psychology. They could be given pamphlets and online access to information that pertains specifically to their own psychological disorders. Secondly, interventions between client and therapist would assist in reducing stigma and improving their mutual understanding. The therapists could receive training in how to treat PTSD in all its forms, and could even have “practice” therapy sessions with veteran volunteers. If the client understands himself, and the therapist can accurately assess treatment needs, then there will ultimately be more success with treatment and mutual trust.
Of course, the aforementioned example can easily be applied to any psychological disorder in a clinical or counseling setting. Seeking to improve such services can allow people to make more informed decisions about their health while increasing self-worth and reducing the stigma that follows mental illness. Whether a person has depression, anxiety or PTSD, she should understand how her disorder affects her body as well as her overall quality of life.
References:
Britt, T.W., Greene-Shortridge, T.M., & Castro, C.A. (2007). The stigma of mental health
problems in the military. Military Medicine. 157-161.
Schneider, F.W., Gruman, J.A., & Coutts, L.M. (2012). Applied social psychology:
Understanding and addressing social and practical problems (2nd ed.). Thousand Oaks, California: SAGE Publications, Inc.
I think an important factor when discussing the best way to treat PTSD is taking the time to understand some of the changes in war tactics that are contributing to increased combat stress. In a paper by Moore & Reger (2006), they discussed that there are several changes in war tactics that are making soldiers more vulnerable to the effects of combat stress. For starters, the military has transitioned to an increased reliance on defensive military techniques which uses a more reactive approach to combat. As a result, many combat soldiers are in situations where they are patrolling and moving between bases in a constant state of arousal because they have no way of knowing when attacks may occur. Additionally, we are using less linear battlefield strategies which creates a dynamic where the front lines are not the only ones with the potential to experience significant loses. These changes in war tactics have left soldiers more vulnerable to combat stress and eventually developing PTSD (Moore & Reger, 2006).
I believe it is essential to engage a biopsychosocial strategy to understanding PTSD and other such issues. The biology of any disease is important, and certainly psychology is a major factor, but the social dynamics at play are essential in determining the best intervention strategies. While it is impossible to truly understand what combat is like for a soldier if you haven’t served, applied social psychologist need to employ every method possible in understanding the social aspects of these issues in order to bring about long-lasting changes.
References
Moore, B. A., & Reger, G. M. (2006). Combating Stress in Iraq. Scientific American Mind Sci Am Mind, 17(1), 30-37.
Schneider, F. W., Gruman, J. A., & Coutts, L. M. (2012). Applied social psychology: Understanding and addressing social and practical problems (2nd ed.). Thousand Oaks, CA: SAGE Publications.
I found it interesting that you place an emphasis on therapist or clinician judgement or bias of patients based on a first encounter. While, sadly I agree that this can and does occur I think it is the exception and not the norm. Often people suffering from anxiety, PTSD, and depression are self stigmatized and hypersensitive to their perceptions of what they believe others to think of them. This simply is part of the disease pathology, individuals who are already experiencing anxiety about therapy in of itself compound the perception of others judging them when in fact it most likely is not the case.
There are of course times when simply there are personality differences, or individuals are uncomfortable with a clinician of another race or sex simply because fo teh nature of their life experience. Example, a woman who was raped may be uncomfortable disuccing the trauma with a male therapist as the sicussion at some point si going to include topics sexual in nature.
I too often think people place the judgement sticker on a clinician simply because they realize that therapy is work. There is no magic button to be pressed by any clinician regardless of their skill set or how holistic their approach may be and people are going to potentially “feel worse” before they get better. I believe this is part of the processing needed for therapy regardless of discipline to be successful, individuals need to explore areas uncomfortable, unpleasant, and awkward in order to move beyond and develop or learn coping skills.
I do think your idea of handing out pamphlets would help when it comes to spreading the word of PTSD awareness. The one thing I would disagree on is on the timing of the intervention. To hand out a pamphlet on PTSD awareness to someone that has already experienced a traumatic event is too late of an intervention. In the case of your example of using Veterans, a pamphlet given out during enrollment would be best. To maximize the effectiveness of the pamphlet the content inside should cover certain areas such as, but not limited to; A definition of what PTSD is, a list of possible causes of PTSD, symptoms of PTSD, the different affects PTSD can have on your health physically and emotionally, and in my opinion the most important thing would be a list of different resources and support groups for those affected by PTSD.
Defined as, a science that helps people be able to relate to one another and understand social issues happening around them in society (Schneider, Gruman, & Coutts, 2012), social psychology could help rid society of the problems of negative stigmas and stereotypes that all people who suffer from PTSD are crazy, violent, and out of control. From the information gathered through Social psychologies techniques and methods, psychologist can create a simulated experience of how people deal with those who suffer from PTSD. Going back to the pamphlet example, there could be one group of participants that received an awareness pamphlet before meeting someone that suffers from PTSD and another group that does not receive the pamphlet before meeting some with PTSD. With this study, the focus would be observing the two separate groups (non-pamphlet and pamphlet) with participants with PTSD symptoms. I would hypothesize that those who received an awareness pamphlet would have a more positive interaction with those who have PTSD.
I agree with both of you on some levels. The negative stigma that has been attached to PTSD is so overpowering that it would definitely take a large amount of support to change. For example, there are many entertainment shows that portray people with PTSD as being violent and uncontrollable. That is not the case with all patients with PTSD. My husband has PTSD. He has tried going to a support group and hearing from veterans like him, but found that many of them have PTSD from single events or trauma, whereas he was in a high combat zone and his PTSD comes from living with the daily stress and daily traumatic events. It becomes difficult for some veterans to associate even with each other because their traumas differ.
One of the biggest struggles for my husband has been the amount of anger and frustration he feels when he is watching a show and suddenly a character is introduced as having PTSD. The character is then portrayed with many negative, violent tendencies and is viewed with a mix of pity and disgust by the other characters in the show. Social psychologists that hope to change the view of the public regarding PTSD should start with mainstream media. By promoting awareness, not to the veterans, but to those that encounter the veterans, the negative stigma can be changed.
Several years ago, my husband had an incident in a mall. One of the mall guard uniforms reminded him of an Iraqi soldier uniform. He was suffering from blood sugar problems, as we later found he was pre-diabetic. I was in another part of the mall, taking my kids to the bathroom and then looking for where he had gone. By the time I got to him, he was in a corner with a barstool to protect himself and the whole section of the mall was cordoned off. The cops were on their way. Most people would have seen this is a huge indicator of violence. However, when I approached him, he tried to get me to hide because he was trying to protect me. He was upset because he didn’t know where his team was and he couldn’t protect them. He wasn’t wanting to attack, He was wanting to protect. Once I brought him back to reality, the cops showed up. I managed to talk to the cop and explain that he wasn’t trying to hurt anyone, yes, I was safe, yes, I felt that I would continue to be safe, and no, I did not want him taken anywhere, we were going home.
The most difficult part for me as a wife was that I then spent the next few weeks having to explain to my family and friends that I was safe. They were so concerned because of the negative stereotypes, that they thought I was hiding something. It has taken years and still I have had people ask me if I really am OK. People have automatically assumed that because he has PTSD, he is abusive.
I have spent more nights holding him and comforting him than I care to count. I have listened to him tell me about some of the horrors he has faced. I have heard him try to work out the details of events and try to decipher if it was his own event or an event of a friend that felt so real to him that he can’t distinguish wish memories are his own. I have also tried to make my friends and family aware that the stigma of the media is not as real as they think it is, and then proceed to explain that I am not trying to cover anything up.
Social psychology could be used to create media campaigns, approach television networks, and create general awareness not to those with PTSD, but to those that might encounter it. Soldiers need to speak up about how they feel about having this negative stigma. Until we can change the public’s perspective, most help that can be provided to the soldiers is minimal, because even if they leave the doctor’s office feeling better about themselves, they will turn on the TV and see a character with “PTSD” attacking the loved characters of a show.
As I was about finished typing this, I somehow managed to press the “back button” with my keyboard, which served to erase the entirety of my reply. This is my second attempt, which may be a good thing, as the first time, I was a little fired up.
*Disclaimer* I’m not calling out, accusing, badmouthing, or in any other way talking smack unto, any person or persons associated with this course, either as a student or instructor. This is simply a subject that really gets me worked up. I’ve done my best to remain academic and non-combative 🙂 (<— see?)
Here's the thing- as a veteran, whenever I hear about someone talking about PTSD, the conversation is going one of two ways; they're talking about something in a purely academic context, or they generally have no clue what they're talking about.
Veterans who experience combat stress are not a new phenomenon; humans have been experiencing it for as long as there has been mortal conflict. What is a new phenomenon is the level of awareness of it; it can't be dismissed as "shell shock" or a "thousand-yard stare" anymore.
But here's the other thing- as a veteran, if you walked up to me with a pamphlet about understanding my PTSD, unless you're female, wearing glasses, or wearing a rank patch that puts you several pay grades above my own, I'm going to have to try very hard to avoid socking you on the nose. Hard.
Pamphlets are not the answer. Empathy is not the answer, at least not entirely. Talking about Bandura's phobia exposure therapy experiments is definitely not the answer. Not if you're in a room full of veterans, and you value your facial bone integrity, anyway. PTSD is not a phobia. The guys that quake and tremble in the heat of battle are usually the newbies, not the salty, 100%-disabled-for-PTSD-but-didn't-take-VA-benefits-so-he-could-deploy-with-his-brothers-one-more-time warrior. That comparison doesn't fit except to sound smart. And simply sounding smart won't get us any closer to the answer.
The answer is finding the answer.
Schneider, Gruman, and Coutts discuss a similar scenario, at least as I see it, regarding how cancer patients reported feeling when assisted by non-cancer patients.
"For example, people without cancer believed that they should try to 'cheer up' cancer patients, whereas cancer patients themselves said that this kind of unrelenting optimism was more disturbing than helpful. People without cancer also believed that cancer patients would be better off not discussing their illness, whereas cancer patients reported wantin to discuss worries and concerns about their illness… From the perspective of cancer patients, minimization of the problem, empty reassurances, and forced cheerfulness were unhelpful behaviors, as was misplaced empathy… to provide effective support to someone with a… disease, it is important not to make assumptions about what will be helpful but rather to find out what will be the most beneficial from the patient's own perspective" (Schneider et al, 2012).
I think that's really what gets me worked up about people talking about 'helping veterans understand PTSD-' no one ever seems to be interested in asking us what we need, or what would be helpful to us. The real trouble with helping, it seems, it that pesky part about actually, you know, helping.
Millions of dollars get funneled into research groups, charities, universities, and more, to the end of helping cure all kinds of diseases throughout the world. Every year, veterans get to watch as there's another 'run for the cure' of something or another. Cancer runs, AIDS runs, multiple sclerosis, cerebral palsy, cystic fibrosis, and other runs to come up with research money. All these things happening to get the public on board to funding science to help these patients, and yet on PTSD, the National Institute of Health has managed to conclude that "support from family and friends can be an important part of therapy" (NIH, n.d.). There are no huge events. No fun runs. Just a faceless procession of every 7th person walking by you in a subway tunnel who mumbles a halfhearted, monotone recitation purporting to thank you for your service.
If you want to stage an intervention to help combat the cruel chains of combat stress, it doesn't start with giving vets pamphlets, or explaining to them that they too, can find it on the world wide web; some of us may not have degrees, but we're all mostly good at using the internet. All the mandatory PTSD training we have to do on the computer every month is good practice. We aren't drones waiting for the benevolence of someone coming to us and saying "it's okay, there's no stigma anymore!" Things simply aren't that easy.
If you want your intervention, you'll need to generate more national interest than an occasional CNN piece. You'll need an army of supporters, a massive infrastructure, and enough money to run for public office. You'll need scientists, researchers, campaigners and lobbyists, and you'll need to create more massive, positive image media spectacles than the Susan G. Komen foundation creates negative ones. You'll need to do this because PTSD is every bit as elusive to effectively treat as cancer, or any of the other diseases listed above. The intervention, where social psychology can really be applied, must take place on a large scale.
Because good intentions, empty reassurances, and pamphlets just aren't going to work anymore.
Schneider, F., Gruman, J., Coutts, F. (2012). Applied Social Psychology. 2nd Ed. Thousand Oaks, Sage.
National Institute of Health (n.d.). Post-Traumatic Stress Disorder. Retrieved from http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml