Talking it out has long been considered essential to recovering from a trauma. But new research shows that expressing one's thoughts and feelings after a traumatic event is not necessary for long-term emotional and physical health, a finding that could change the way institutions devote money and resources to mental health services following collective traumas.
The study, led by UC Irvine psychologist Roxane Cohen Silver, looked at the relationship between immediate expression after a traumatic event and mental and physical well-being over time among a nationally representative sample. Study participants were questioned following the terrorist attacks of Sept. 11, 2001.
Silver and colleagues say participants who chose not to express thoughts and emotions about the attacks when given the opportunity to do so through an anonymous, Web-based survey, appeared to cope successfully and reported fewer diagnosed physical and mental disorders. In contrast, individuals who communicated their thoughts and feelings about the attacks reported more physical health problems and emotional distress over time, even after controlling for exposure to and distance from the attacks. The study followed participants over a two-year period.
The results have important implications for understanding the role of expression in the coping process and for early post-trauma intervention, according to Silver.
"Some people don't need to express thoughts and feelings after trauma and do just fine, and it's a myth that you must express your distress in order to recover," Silver said. "Mandatory or required psychological counseling is often unwarranted and universal intervention is likely to be a waste of resources."
A standard and universal approach to trauma counseling can result in misappropriation of resources away from individuals who are truly at risk, she said. It also may interfere with the natural coping processes that take place when individuals seek support and advice from family and close friends.
"This study also shows how dangerous it can be to rely on hunches and common sense when attempting to provide intervention after a trauma experienced by a large group of people, such as the 9/11 attacks, but it can also be applied to situations like school shootings," she said.
Researchers analyzed data from a Web-based survey sent to 36,000 participants who received e-mails with an open-ended prompt asking them to share their thoughts about the events of Sept. 11. Nearly 14,000 people responded, and researchers followed a number of these individuals - as well as some of those who chose not to respond - in the years following the attacks. They collected information about physician-diagnosed physical and mental health ailments over two years.
The researchers caution that the higher rates of illness among those who did respond should not be interpreted to mean that expressing thoughts and feelings is harmful. People who want to talk should still do so, but they say it is important to remember that not everyone copes in the same way, and in the immediate aftermath of a collective trauma it is perfectly healthy not to want to express thoughts and feelings.