Counselling with Care
Many people who have been bullied will need to seek counselling or some kind of medical assistance. This page is not to advise people on the right treatment for any physical or psychological disorder they may have as a result of being bullied (we are not doctors), but to draw attention to the fact that the effects of bullying are not always properly recognised and understood by doctors and therapists.
People who have been bullied may face either or both of these two problems when they turn to a counsellor/therapist for help:
- the bullying itself is not recognised as a form of abuse (or an assault) which constitutes a trauma
- the resulting emotional and physiological disorder is not recognised as post-traumatic stress, and may be misunderstood and misdiagnosed as mental illness (which may sometimes then be viewed as the cause rather than an effect of the bullying)
The result can be that an already traumatised victim of bullying is further damaged and traumatised. A typical scenario might be that the counsellor misunderstands the abusive nature of bullying (seeing it more as a conflict and/or something the victim allowed to happen), and tries to focus on the client's perceived responsibility for what happened. Unfortunately, this tends to trigger or reinforce feelings of failure and self-blame, thus increasing the client's distress and trauma responses, which the counsellor then struggles to understand, since he/she has not recognised that the client has experienced a trauma.
The counsellor then starts to look for other possible explanations of the client's symptoms and may come to the conclusion that the client is seriously disturbed, has a personality disorder or is in some other way seriously mentally ill. This further provokes the client's symptoms, but this may then seen by the counsellor as further "proof" that their conclusions are correct.
So how can this be avoided?
Firstly, it is very important that people who've been bullied do not hold back from seeking appropriate help simply because there is a potential for being further traumatised by counsellors. Sympathetic support, along with the opportunity to talk about the bullying, is vital, and the right help in the early days will give them a much better chance of avoiding long-term problems and of being able to put the experience properly behind them. Suppressing the painful memories and trying to cope without support may do more harm than good in the long run.
Instead, the following suggestions may help in finding the right counsellor.
Before starting counselling:
- Don't assume that a counsellor with lots of qualifications and experience will necessarily know anything about bullying or trauma, so
- Do ask the counsellor specific questions about any training and experience they may have in dealing with bullying and trauma
- Do ask if they are aware that the symptoms of post-traumatic stress can be easily confused with the symptoms of other disorders (eg. the emotional numbing typical of PTSD may be confused with depression)
- Do ask the counsellor what their understanding of bullying is
- Do ask whether the counsellor relies on rigid counselling models or whether they recognise that most of these are unhelpful in dealing with post-traumatic stress
- Do ask about confidentiality
- Do ask if the counsellor is willing to discuss their observations and interventions during counselling - being bullied usually involves loss of control, so it is important that you feel in control during counselling
- Do ask what supervision the counsellor receives, whether they can supply references, and if they are affiliated to any professional organisation
- Don't agree to see any counsellor if you have reservations about their approach, their methods or their experience
Once counselling has begun:
- Don't assume that any counselling is better than no counselling
- Do listen to your feelings about the way the counsellor is working
- Do recognise that with effective trauma therapy your symptoms may get worse before they improve, but
- Do be concerned if the counsellor is undermining your self-confidence or increasing any feelings of failure triggered by the bullying
- Do be concerned if the counsellor urges you to put the bullying behind you and move forward, without first helping you to deal with your memories (i.e. encouraging suppression rather than resolution)
- Do be concerned if the counsellor seems to want to focus more on your childhood or your personality than on the bullying (NB. Some victims of bullying may have pre-existing problems which will need to be addressed at some stage, but generally the immediate trauma needs to be tackled first)
- Do be concerned if the counsellor treats you as if you are mentally ill
- Do be concerned if the counsellor responds to any concerns you may voice about the counselling process with manipulative comments such as "Don't you want to get better?"
- Don't be afraid to stop the counselling if you think the counsellor's approach is unhelpful
Effective therapy after bullying will include:
- Affirmation that you have been abused, that you are a damaged person and that you are not to blame for the bullying
- Validation of your experiences
- Help in dealing with any traumatic memories so that they no longer control you or take over your life
- Help in understanding and managing any post-traumatic symptoms you may be suffering
- Help in overcoming fears and anxieties - but without pressure to tackle things before you are ready and willing to do so
Doctors and psychiatrists
The advice so far relates to finding a good counsellor. Some people who have been bullied will need to seek the advice of their doctor and may at some stage be referred to a psychiatrist, but will often have very little choice about who they see. However, it is wise to be aware that some psychiatrists may also have very little understanding of bullying and the effect it has on people. Sometimes victims of bullying are wrongly diagnosed and offered inappropriate treatment.
Whilst we would not recommend self-diagnosis (which can be dangerous), there are plenty of resources on the internet where people can check out a diagnosis they have been given, find out more about the condition and gather information to question the diagnosis if they feel this is necessary. (See, for example, http://www.mentalhealth.com.)
Update for the UK: At the end of March 2005, the National Institute for Clinical Excellence (NICE) published information about its guidelines to the NHS on the treatment and care of people with post-traumatic stress disorder (PTSD). These new guidelines may assist in obtaining appropriate diagnosis and care after bullying because they:
The booklet Post-traumatic stress disorder (PTSD) - Information for the Public is available free of charge, either by download from the NICE website at http://guidance.nice.org.uk/CG26/PublicInfo/pdf/English or via the NHS Response Line (0870 1555 455), quoting reference number N0849.
FURTHER INFORMATION:
Gaslighting, The Double Whammy, Interrogation and Other Methods of Covert Control in Psychotherapy & Analysis - Theo. L. Dorpat (Jason Aronson Inc.)
VEX - The Support, Information and Campaign Group for Survivors of Therapeutic Abuse Worldwide:
http://website.lineone.net/~vex/
Bullying, Stress and the Effects of Stress on Health:
http://www.bullyonline.org/stress/health.htm
Symptoms of Post Traumatic Stress Disorder (PTSD):
http://www.bullyonline.org/stress/ptsd.htm
Where next?
BALM Home Page
Introducing the Founders of BALM
How to Support a Bullied Minister
What Not to Say to a Bullied Minister
How Bullying has Affected Me
Bullying and Spirituality
Group Dynamics
Links to Other Websites and Organisations
Book List
Counselling with Care
Bullied in Ministry
Bullying in the Church
Bullying and Burnout
Submission on Clergy Stress
Media Requests
Additional Resources on Church Abuse