Prince Harry has been seeing a therapist for seven years to overcome the trauma of losing his mother. Photo / Getty Images
Prince Harry has been seeing a therapist for seven years to overcome the trauma of losing his mother. Photo / Getty Images
COMMENT
When Prince Harry spoke at a JP Morgan event in Miami about being in therapy to overcome the trauma of losing his mother, it didn't strike me as particularly newsworthy given the couple's interest in mental health. What did was the fact Harry said he'd been seeing a therapist for the past seven years.
As a survivor of trauma myself this set off alarm bells in my head. A lot of questions have recently been raised about the efficacy of talk therapy, particularly the open-ended kind, and particularly for trauma. "Trauma is something you absolutely don't want to remember," says Besel Van Der Kolk one of the world's most respected trauma experts and author of The Body Keeps the Score.
"Neuroscience research shows that very few psychological problems are the result of defects in understanding. Therefore, improving one's understanding doesn't help. Most psychological problems originate in deeper regions of the brain that drive our perception and action."
The entire country's heart went out to the 12-year-old Harry who had to appear in public so soon after his mother's tragic accident. The fact that Prince Diana's death was exacerbated by other factors including being chased by paparazzi in a car driven by someone intoxicated - would make the grief even harder to process.
I was also 12 when Tasha, my 14-year sister, was murdered on the grounds of her school in Mclean, Virginia. I too was forced to attend - in my case an open casket funeral-and to kiss her cold face which was covered in sticky make-up. The fact that my father was then working for Henry Kissinger at the White House and that the murder took place at a well-known private school made us household names. Therapy wasn't a thing then and we got through it the way people have for millennia; by moving on with our lives, and also moving cities.
It wasn't until I saw a psychotherapist many years later who suggested I talk about what happened that I started to exhibit symptoms of full-blown PTSD. Like Harry, my story wasn't simple. It took a series of things to go stratospherically wrong for my sister to be killed. Unpicking each layer in therapy made me angrier and consequently more traumatised. I imagined myself in her shoes.
Tasha was sexually attacked by a man who stood 6 feet 7, tied her to a tree and left her to die in the freezing rain. My father was the one to find her (after several failed attempts by the police). Whatever healing had occurred to date was immediately undone by all the horror I envisaged. I now felt terrified from morning until night.
Like Harry, I had also waited 20 years before seeking help. My issue was a deep sense of foreboding that accompanied any happy moment. On the first day of my honeymoon in Africa, for example, I tried to open the door of the cockpit to jump out. It wasn't rational to assume the plane would crash because I had found the love of my life but that's what was happening. Happiness is complicated for trauma victims; strong memories become "fused" together and what should feel good suddenly feels terrifying.
The Duke of Edinburgh, Prince William, Earl Spencer, Prince Harry and the Prince of Wales follow the coffin of Diana. Photo / Getty Images
I wanted to tackle the symptoms: my therapist wanted the backstory. I needed lessons in self-soothing; he wanted fact-finding. This therapist was like the plumber who tells you what's wrong with your sink then mentions he doesn't have any tools (but still bills you).
Post Traumatic Stress Disorder comes with a range of excruciating symptoms from hyperarousal, anger, irrational fears, difficulty concentrating to numbness, flashbacks, suicidal thoughts and intense physical responses of reminders of the event. For this reason, "treatment is meant to be short and sharp" says trauma specialist Joshua Dickson, clinical director of Resurface UK. "Often going into too much detail will trigger a client out of their the window of tolerance and can become overwhelming, with the client often distressed or 're-traumatised'."
We now know that trauma lodges itself deep in our cells and in our intestinal walls. According to Van der Kolk, trauma patients often have abnormal activation of the insula, a small region within the cerebral cortex. The insula transmits fight-or-flight signals to the amygdala when necessary. In people with trauma, these signals are firing all the time without any conscious influence.
A college friend who survived a terrible car accident where another friend died which left her with hideous injuries told me that she might have been better off had the hospital not sent in a psychiatrist. Over the years she visited many therapists but it wasn't until she started practising meditation and yoga that she began to recover. "Gratitude really does help" she says. "What I felt when I saw Prince Harry and Meghan in that documentary was just how little of it they have" she says. "Here they were travelling across Africa where people have miserable lives and what they showed was a brazen display of ingratitude".
We know now that trauma resides in the limbic part of the brain that only has four responses: fight, flight, freeze and dissociation/submission. Modern treatments like EMDR (eye movement desensitisation and reprocess) which involves a therapist directing a patient's eyes as he talks help to reset the software. It's in this dual attention state that positive messages (I am safe. I am loved) can seep in. EMDR is now the treatment of choice for organisations such as the World Health Organisation (WHO) and the American Psychiatric Association (APA). Many patients report benefits from just one session.
My issue with talking therapy is that it's a form of storytelling where many conclusions are possible. A good therapist can change someone's life: a bad one can ruin it. There are no Trip Advisor reviews you can scroll through before committing hundreds if not thousands of pounds to let's face it, a business relationship. The more naïve the patient the more extreme the psychological hold can be.
A therapist persuaded a friend to leave her husband after she discovered he was having an affair. Her instinct was to protect the family and heal the wounds; the therapist disagreed. She later discovered her therapist was married to a serial philanderer who seduced his clients. She quit therapy and saved her marriage.
Harry and William with their late mother Diana in 1995. Photo / Getty Images
One has to wonder what sort of advice Harry's long-term therapist is providing. After all, he's fallen out with his friends, brother, waged war against the media and quit his job and country. He's lost his title and fallen out with his grandmother. In my mind, a good therapist is one who teaches you to get along with the world, not to blow it up. The fact he's still there after 7 years also says something. "I see a good therapist as someone who helps a client to become as autonomous as possible," says Dickson.
Of course therapy can be an effective treatment, especially when we get stuck in "faulty" thinking about ourselves and others. Many people have difficulty accessing emotions or are afraid to admit them. Therapy can be a safe place to let go, and form a sustaining relationship, which is a large part of healing.
But what has helped me with my own trauma is not revisiting the event, but understanding that my limbic brain is often trying to steer the car. It means well but it doesn't know how to use the brakes. This kind of faulty thinking responds well to directed therapy such as Cognitive Behavioural Therapy and its offshoots which, unlike a lot of talk therapy, have been scientifically scrutinised and held to account.
I have friends who see a therapist twice a week and have done so for years. What do they discuss? Paint colours? My biggest issue with some talk therapists is just that: in order to keep you coming back and paying their hefty bills, they need to convince you that things are really bad. Seven years suggests that whoever is working with Harry is doing a very good job.
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
OR IF YOU NEED TO TALK TO SOMEONE ELSE:
• LIFELINE: 0800 543 354 or 09 5222 999 within Auckland (available 24/7) • SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7) • YOUTHLINE: 0800 376 633 ,free text 234 or email talk@youthline.co.nz or online chat. • NEED TO TALK? Free call or text 1737 (available 24/7) • KIDSLINE: 0800 543 754 (available 24/7) • WHATSUP: 0800 942 8787 (1pm to 11pm) • DEPRESSION HELPLINE: 0800 111 757 • SAMARITANS – 0800 726 666.
