|INTERVIEWING TIP OF THE MONTH
# 151 September 2012
A Few Secrets for Uncovering Trauma
TISA Description of the Problem: I recently returned from presenting a week of workshops at the 26th Annual Door County Summer Institute in Wisconsin. I have presented here on multiple occasions. If you like the Cape Cod Symposium, you might really enjoy this wonderful annual event. Many of the presenters are the same as at the Cape. And the resort towns on this delightful peninsula, darting into Lake Michigan, are charming and packed with unique shops and restaurants. It's a hidden gem. Sponsored by the Psychiatry Department at the Medical College of Wisconsin, information can be found at email@example.com or by contacting Dr. Carl Chan’s office at (414) 456-8998.
In any case it was great fun for me and, as usual, I learned a lot from participants. Here are several very useful tips from Kathleen A. Hughes-Kuda, M.D. She emphasizes an easily forgotten fact, that the first trauma a patient reveals to a clinician is not necessarily the worst trauma. In fact, it makes sense that it might be hard for a patient to describe his or her most painful traumas, and, hence, a patient may tend to hold off sharing these traumas until he or she sees how the interviewer handles the current material being shared. Kathleen’s tip is as follows.
Tip: After a patient has finished sharing a trauma, to uncover other trauma, I find it useful to gently ask:
"What's the worst thing that has ever happened to you?"
Another method for helping the client to share other trauma is to ask:
"When you talk about this, what does it remind you of?"
TISA Follow-up: Kathleen also made another often forgotten point. A person who has been traumatized in one fashion, may have been traumatized in one or more other fashions as well. For instance, a victim of incest could have been involved in a serious car wreck or in an incident of street violence. A paramedic, who has been traumatized by helping at the scenes of serious car accidents, may themselves have been a victim of child abuse. Questions such as the above can help to sensitively pull these other traumas to the surface. In a similar vein, it is important to remember that when working with a female vet from Iraq and Afghanistan, who is coping with PTSD from combat, other trauma can be a hidden factor. Unfortunately, the soldier could have been raped by a member of her own troops.
Tip provided by:
Kathleen A. Hughes-Kuda, M.D.
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