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"This doesn't have to be done with a professional," Nicoletti goes on. "Some people can process trauma by talking to friends or mates. They just have to make sure that person won't be judgmental; they won't say something like, 'Why would you do that?' or 'That was a stupid thing to do.' But the important thing is that they get it out -- because if they don't, there can be real problems."
For Dr. Feinberg of the NEAT team, the incident that best illustrates this point was the first one to which his people responded: the abductions and murders of three young girls (one in 1996, two in 1997) in Spotsylvania, Virginia, by an assailant who remains unknown. After the disappearance of the last two girls, Feinberg says, "we immediately called the community and asked if we could be of assistance, and they declined -- which is certainly their right. Sometimes the press has indicated to its readership that people like us are just crisis junkies waiting for these kinds of occurrences to descend on communities, but we don't believe in that. We only go in at the invitation of a major player in the community -- a mayor, a chief of police -- and if they say, 'No, thank you,' we respect that. Even if we don't agree with their decision-making, they ultimately decide."
Three months later, Feinberg's instincts were proven accurate, he feels, when a Spotsylvania representative phoned NEAT "to tell us that they were emotionally paralyzed, and they needed us to come down and help them sort out the unresolved issues." Shortly thereafter, NEAT, in cooperation with the National Organization for Victim Assistance (NOVA) staged a "group crisis intervention" for locals at which the police chief, whose own daughters had been playmates of the girls who'd been killed, "broke down into uncontrollable sobbing," Feinberg recalls. "She'd been working feverishly, seventeen or eighteen hours a day, to find the perpetrators of this terrible crime and had been unsuccessful, which made her feel terribly guilty. But no one in the community thought she wasn't doing her job, and she might not have gotten their affirmation if she hadn't shared what she was feeling."
Such tales only confirm to proselytizing grief therapists what they've contended all along -- that while not pressuring people to get counseling may sound nice, backing off isn't necessarily in their best interest.
The Center for Loss's Wolfelt thinks most people live in a state of denial about mortality ("One of my European friends says, 'The first thing you should know about North Americans is that they think death is optional'"), and when they're confronted with it, their conditioning, which teaches them to embrace the ideal of rugged individualism, causes them to bury their genuine responses for fear of looking weak. Yet he says those not burdened by this theory often have problems as well, particularly if they don't have any firsthand experience with mourning. He claims that a considerable portion of the populace lives in "the world's first death-free generation" because many don't experience a close personal loss until they're in their forties or fifties -- and when these shocks finally come, they're unprepared to deal with them.
"That's why I do outreach," he says. "I don't buy into the philosophy that we sit back and wait. I believe in the role of advocacy in bereavement counseling."
In other words, anyone certain he doesn't need grief counseling probably needs it very, very badly. But this opinion isn't universally held. No scientific consensus has been reached regarding the value of grief counseling, debriefing or its various affiliates, but controversial data is surfacing that suggests it may do more good for outsiders wanting to help than it does for the mourners themselves.
Little of this info is coming from the United States, where relatively few studies expressing reservations about grief counseling and debriefing have stirred waves; only a modest splash was made by a 1998 report by New York psychologist George Bonanno showing that grievers who continually share their distress with others tend to have more difficulty coping than do less demonstrative types -- a blow to the if-it's-kept-inside-it-will-fester supposition. But researchers and thinkers in other countries have taken up the slack, foremost among them Simon Wessely, a professor at London's Institute of Psychiatry who's just published a survey of eight separate studies about debriefing that reaches some damning conclusions.
"There is no evidence that single session individual debriefing reduced psychological distress nor prevented the onset of post traumatic stress disorder," Wessely wrote. "There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety. All the modern studies fail to show any advantage to debriefing."
Even more disquieting were a pair of in-depth trials -- one looking at patients at a Cardiff burn unit, the other focusing on victims of traffic accidents in Oxford. In the former, Wessely reports, post-traumatic stress disorder rates were higher for those who were debriefed than for those who weren't; in the latter, no statistically significant differences between the well-being of the counseled versus the uncounseled were documented, with one exception: Visibly upset victims who were debriefed were worse off than analogous subjects who didn't receive this treatment.