F*ck Your Black Box

“Sometimes we have thoughts that even we don’t understand. Thoughts that aren’t even true—that aren’t really how we feel—but they’re running through our heads anyway because they’re interesting to think about.

If you could hear other people’s thoughts, you’d overhear things that are true as well as things that are completely random. And you wouldn’t know one from the other. It’d drive you insane. What’s true? What’s not? A million ideas, but what do they mean?”
Jay Asher, Thirteen Reasons Why

I recently consulted with another therapist that labeled themselves an expert in treating post-traumatic stress. As I mentioned in a previous post, I’m focusing on learning more about updated and valid interventions related to different types of PTSD. The field of psychology is ever changing and it is important that clinicians stay up-to-date on empirically validated treatments.

I’m not about bashing other professionals, so I will not call this person out by name but I will say I was greatly displeased with the suggestions they gave me in terms of the interventions they use.

1. They shared their own trauma history, in detail, with their clients. No. absolutely not acceptable. We talked about this in the post The Wounding Healer. There is an appropriate level of self-disclosure between a therapist and a client; however, sharing detailed accounts of a therapist’s history is not indicated and is detrimental to the client.

2. They strongly encouraged clients to pay for expensive medical procedures (e.g., brain scans, DNA tests, and chiropractic care, and supplements). I don’t necessarily have a problem with these suggestions or interventions; however, a lot of clients cannot afford daily life, let alone expensive interventions that may or may not benefit the client. I appreciate that these interventions may be helpful to some people and I think that is appropriate but we should not try to “up sell” our clients on services unless it’s a necessary and beneficial part of the treatment plan. And, a lot of clinicians are not naturopaths and should not be suggesting supplements without consideration for how they may interact with other medications or the clients physiology.

3. They told their clients that they were not allowed to think of the trauma. THIS HAD ME ENRAGED. There is stop thought concept in cognitive behavior therapy that sometimes involves a black box (an intervention I seldom use as I primarily use acceptance and commitment therapy,  compassion focused therapy, radical acceptance, Brene Brown’s work, and other valid ecelctic models).

They said they tell their client that they are only allowed to think of the trauma at certain times and to shove the thoughts in a black box. Well, it would be nice if I could schedule my thoughts but I can’t. And, I refuse to feel badly if a thought comes up at an inconvient time. I also don’t think it’s healthy to compartmentalize our thoughts and feelings that way. I wish I could shove all my negative thoughts into a box and bury it in the back yard but it doesn’t work that way. It’s all about how I respond to my thoughts. We have an estimated 40,000-70,000 thoughts a day and I can’t even begin to think about parsing them out and shoving some in a black box. This also implies that some thoughts are bad and others are good. Again, it’s all about how we respond to our thoughts. If a sad, scary, upsetting thought comes up, I need to treat myself with compassion and understanding. I don’t need to shove it down or put it in a box. I don’t have control of what thought comes up and when it comes up and I surely don’t want to play tug of war with my thoughts. This intervention suggests that if sad, scary, upsetting thoughts come up at inconvenient times and I am unable to shove them down, I am somehow failing or doing something wrong. This is problematic because, when a traumatic thing happens to us it is stored in an emotionally charged part of the brain that is different from the way other memories are stored. This means when I remember (have a thought or flashback) the event, my body literally feels like it is happening again. I need to take special care of myself in the event that that happens. And, trying to shove it down or push it aside will likely cause it to physically and emotionally feel worse and last longer.

Needless to say, I was not impressed and frankly a little concerned about their style. I did not find anything eggregious or reportable in their interventions, I just strongly disagree with what the person does in their practice.

So much of therapy is about fit and style, I imagine that this person does well with some people. They must given the size of their practice. However, I think that if you muster up the courage to go to therapy and you find that the intervention or person is not a good fit for you, please, please try again. The right intervention for the right person can be unbelievably life changing. Unfortunately, the wrong intervention with the wrong person can make things worse.

“Some stressful experiences – such as chronic childhood abuse – are so overwhelming and traumatic, the memories hide like a shadow in the brain. At first, hidden memories that can’t be consciously accessed may protect the individual from the emotional pain of recalling the event. But eventually those suppressed memories can cause debilitating psychological problems, such as anxiety, depression, post-traumatic stress disorder or dissociative disorders.”

– See more at: http://www.northwestern.edu/newscenter/stories/2015/08/traumatic-memories-hide-retrieve-them.html#sthash.QC6lzb9t.dpuf



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