PSYCHOTHERAPY BEYOND THE FRINGE, continued
Discussion — Learning Learning of Learning
Traumatic anxiety (now called Post-Traumatic Stress Disorder or Reaction) is a bit tricky to treat. But it is even harder to recognize. The problem is both that its symptoms take so many different forms, and that the onset of symptoms is usually delayed from three months to a year after the traumatization. This last is due to the time needed for ‘long-term consolidation’ to structure the symptoms and to integrate them into the organization of behaviour which is called personality (also see George’s story). The ‘long-term consolidation’ ‘delay’ in symptom-development makes it hard for the patient and for most non-psychologist professionals to recognize the relationship between the original traumatizing incident and the later development of symptoms. In fact, many patients and others simply reject out-of-hand the idea that a set of symptoms could be related to a much earlier traumatic incident. We are all too used to thinking of causality as based on contiguity between events in space and time. In the universe of psychological events, contiguity, or contact, is often not all that good as an indicator of causality since learning is usually at stake, and learning nearly always requires consolidation time. Forty-eight hours, for short-term consolidation, commonly elapses before the first ‘discomfort’ symptoms may emerge. Multiples of six weeks, for long-term consolidation, may pass before ‘organized’ symptom clusters, or syndromes, appear.
Another interesting thing about traumatic conditioning is worthy of note in passing. Post-traumatic stress disorder may be one of the few (if not the only) kind of psychological disorder in which the ‘initial’ or antecedent cause (the only kind of cause recognized in the physical sciences) is manifestly the prime operative cause in the disorder. The traumatic events ’cause’ the later effects through the arousal underlying the symptoms. In most other psychological maladies, while initial causes play a (frequently complicated and transformed) part, other kinds of causes, such as ‘final cause’ (or purpose) and ‘perpetuating cause’ (or habit strength or skill), seem to play much more important parts. And these other kinds of causes are often the only kinds of ’causes’ available or susceptible to treatment interventions.