Image from slides by Prof Milroy, sourced from the Royal Commission’s Messages to Australia book.
Welcome, welcome, welcome… to hearing the uncomfortable truths of trauma.
‘Welcome, welcome, welcome!’ At 9am this morning, Uncle Charles 'Chicka' Madden welcomed us to the traditional lands of the Gadigal people of the Eora Nation. This was the beginning of Trauma Matters, the 2018 TheMHS Summer Forum.
I felt welcomed down to my bones, yet I was on the edge of my seat, worried about what I would hear. Would this align with what people like me, survivors of trauma and compulsory psychiatric systems, want and need? Would this, like so many other forums and meetings, be painfully triggering and blaming? Or, just possibly, could it be hopeful and helpful?
Prof Helen Milroy, psychiatrist and commissioner from the Australian Royal Commission into child sexual abuse, spoke first. I was moved when Helen shared a profound personal discovery of the importance and healing power of bearing witness to the testimony of abuse survivors during the Royal Commission.
Routine psychiatric tasks get in the way of bearing witness
What most resonated with me was Helen’s questioning about how psychiatrists can possibly bear witness, when in reality they are so busy doing things they ‘have’ to do, like assessment, diagnosis and formulation. These tasks get in the way of witnessing.
She reflected that it is easier for clinicians to deal with diagnosis, because it leads to well-understood algorithms. Trauma, and people’s painful stories of it, are much harder. How can we ‘marry’ these processes together, she asked us, even if they are done at separate times?
Helen’s questions brought so much to mind for me.
I thought of what we, as consumers/survivors, have said for so many years—that what we most want is for someone to really listen to us, to hear our story, and to work alongside us to help us find our way forward – rather than fill us up with labels and pills. Indeed, how can a clinician even understand our experience without having deeply listened, and so are these tasks of assessment and formulation fundamentally flawed because they are developed far too early? And can a clinician ever be a position to decide what we need? As consumers/survivors we have long argued for an end to paternalistic treatment and rights violations caused by others deciding what is best for us. Just imagine if clinicians didn’t have to come up with the solution, because actually their job was to support us to find our own solutions? To become facilitators and supporters, rather than ‘fixers’?
Helen’s talk also reminded me of a comment made by Prof Mike Slade, at last year’s TheMHS conference, that ‘relationships are not the vehicle through which we deliver treatment; relationships are the treatment.’ For me, this is just another way of reinforcing the healing benefits of empathic listening. Certainly, my own personal healing has benefited far more from those who listened to me with compassion, than it ever has from being diagnosed and ‘treated’.
Perhaps this is part of the way we can shift clinical paradigms.
Thank you Helen for confirming that we haven’t done enough, and that we have a long reform agenda ahead. Yes, we do.