Unmasking trauma-informed care
The truth is that compassion for the patient has always been a part of what constitutes good medical care. In psychiatric practice, where the therapeutic relationship is itself a part of the treatment process, much attention has always been paid to how this relationship is negotiated. Although physicians, as all human beings, may differ in empathic ability, the goal of medical treatment has always been the relief of suffering, an idea that one would be at pains to separate from sympathy for those who suffer. Contrary to what one hears in so-called nonviolent communication training sessions, compassion for the patient is not a discovery of trauma-informed care. As a Clinical Psychiatry News columnist wrote, “There is nothing specific to trauma-informed care that is specific to a history of trauma. The need to be sensitive and humane … is just good psychiatric care.”
Trauma-informed care ostensibly claims to reduce the stigma of illness by reframing it in nonmedical terms. When an illness is no longer an illness, a patient is no longer a patient, and consequently, a doctor is no longer a doctor. Yet somehow, while apparently aiming to level the playing field between medical experts and patients, trauma-informed care proponents see no contradiction in claiming to be empathy experts who view those who are not “trauma-informed” as part of a culture that needs to be changed. The proposed culture change consists in convincing people that it is not medical pathology that requires medical expertise but empathy deficiency that requires trauma-informed care training.
It is sadly ironic that just as the treatment that we administer to the patients in our state psychiatric hospital is mandated by a judge’s order, trauma-informed care training, the treatment for our presumed empathy deficiency, also is compulsory. After all, “implementing cultural shifts of this scope requires the full participation of administrators, supervisory, direct service, and support staff, and consumers,”(italics mine), according to a discussion on the topic by Community Connections, a nonprofit mental health agency. Maybe we are all victims, after all.
Dr. Vatel is a staff psychiatrist at Evansville (Ind.) State Hospital and a lecturer in the department of psychology at the University of Evansville.
