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Silence may be appropriate trauma response for some

NEW YORK (Reuters Health) - People who don’t talk about their feelings after a traumatic event are no more likely to have problems down the road than those who do express them, new research shows. In fact, they may be better off.

“If someone doesn’t want to talk about it, that can be perfectly fine,” Dr. Mark D. Seery of the University at Buffalo, The State University of New York, one of the study’s authors, told Reuters Health.

While the conventional wisdom has been that it’s healthier for people to talk about how they feel in the aftermath of trauma, Seery noted, there’s little scientific evidence that this is actually true.

To investigate whether or not a person talked about their traumatic experience affected their subsequent mental and physical health, Seery and his colleagues looked at data from an ongoing Web-based survey panel including about 36,000 people. All had agreed to respond to a few short surveys each month.

On September 11, 2001, the company running the survey sent the following e-mail to the panelists: “If you would like, please share your thoughts on the shocking events of today.”

Out of 2,138 people who had opened the e-mail immediately after September 11, there were 1,559 who wrote a response. Receiving the e-mail is a “reasonable proxy” for being approached by a counselor immediately after a traumatic event, the researchers say.

Individuals who responded to the e-mail were significantly more likely than those who didn’t to have post-traumatic stress symptoms 1 and 2 years after the attacks, the researchers found. The longer a person’s response, the worse their physical and mental health; specifically, people who wrote longer e-mails had higher levels of generalized distress and more physician-diagnosed health problems 1 and 2 years later.

Two weeks after September 11, the responders reported doing more “venting” and using more strategies to cope with the tragedy, suggesting that they were more distressed by the attacks than those who didn’t respond, Seery said.

Certain therapies, such as critical incident stress debriefing, are based on the idea that talking about a horrible event can help a person cope with that event, the researcher noted. “There’s no evidence that it’s helpful for people, and there’s some evidence that it might actually be harmful,” he said.

The findings shouldn’t be interpreted as showing that expressing oneself after a trauma is harmful, he added. But they do show, Seery and his colleagues conclude, “the importance of allowing individuals to choose for themselves whether to express their thoughts and feelings after a collective trauma and, more broadly, to choose to participate in interventions rather than being compelled to do so.”

SOURCE: Journal of Consulting and Clinical Psychology, June 2008.

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