Times has a brief but interesting interview with Scott Lilienfeld, a psychologist, discussing ‘post-disaster counselling’, ‘critical incident stress debriefing’ etc.
So, how could the counseling of survivors immediately after the tsunami and earthquake possibly backfire?
No one knows for sure why it’s not a good idea, but given what the research shows, [some kinds of debriefing can be harmful]. It usually involves putting people in groups very shortly after the traumatic event and strongly encouraging them to “Get their feelings out” and “Talk about it” and so on. In classic debriefing, they almost prescribe symptoms, saying things like “Don’t be surprised if you start feeling X, Y or Z” or “There’s a good chance you’ll have nightmares or flashbacks.” There’s some speculation that that [in itself] might bring some of the symptoms on, so I’m not sure that’s a great idea.
What does the research find?
The research shows that [this type of debriefing is] probably at best ineffective and may actually be harmful in some cases. [It’s not clear why]. Some of what happens is that you have to respect individual coping mechanisms. Some people are ready to talk and some prefer not to talk. One problem with classic debriefing is that it often strongly encourages or urges people to talk about emotional memories that they may not really want to talk about. It’s best to kind of leave it alone.
[Another] thing we know is that if you want to deal with anxiety, you have to allow anxiety to peak first and then pass, and give people enough opportunity to fully process it. [These techniques] may bring up some anxiety and increase it, maybe even bring up new anxieties and not really resolve them or make them worse.
But one recent paper claimed that the evidence of harm [from debriefing] was overstated, so there is still some controversy over whether it’s useless or actively harmful — but even these authors admit that when used sloppily, [debriefing] probably is harmful.