Philosophy and Ethics of Trauma Treatments

The aftermath of a traumatic experience can have a debilitating effect on an individual's life. Although historically the concept of trauma was used in medicine to depict a physical wound, it was eventually adapted as a metaphor for psychological difficulties following an intense event. This psychological trauma can haunt individuals with shackling symptoms of overwhelming persistence and impaired functioning for their entire lives. Psychological trauma radically alters one's experience of the world. In this way, it uproots individuals from the previous context in which they existed, subsequently stripping them of meaning and exposing them to a harsh and uncertain reality.

The psychological and social difficulties resulting from traumatic experiences have become the focus of critical attention only in the last century. [Page 433]This study of psychological trauma has also endured episodic phases of inquiry, where conceptualizations and treatments were formulated, only to be dropped and subsequently rediscovered. As such, recognition and legitimization of psychological trauma is affected by the sociocultural and political climate. These forces influence the philosophy of psychological trauma and the way it is treated. In this way, it can be said that psychological trauma is a sociocul-tural construct determined by the social context in which it occurs.

Any time there is involvement with human behavior, ethics are an integral part of the process, and the treatment of psychological trauma is no exception. Each clinical presentation must be conceptualized and treated on an individualized case-by-case basis. The American Psychological Association (APA) asserts ethical integrity as the utmost priority, which is clearly delineated by the “do no harm” policy. Although this is a sound doctrine on paper, ambiguity can arise in practice. Furthermore, although codification of psychological trauma through a socially constructed diagnostic framework, such as posttraumatic stress disorder (PTSD), provides standardization of treatments as such, one must consider how complete the diagnostic account is for the client in practice—that is, whether the diagnosis fits all trauma cases or if we fit clients to the diagnosis. Societies and cultures supply structure and meaning for their constituents, and it is to this extent that members will adhere to and proliferate these systems for self-preservation and a sense of belonging. Whether referring to the meanings provided by societies and cultures that individuals adopt or in the socially constructed diagnostic frameworks and treatment approaches that therapists follow, the process is the same. Given this, therapists must consider if the treatments facilitate reclamation of identity, meaning, and everyday engagement with the world or if they are the basis for social norming or control. Thus, the ethics of trauma resides on how it is held and recognized within a sociocultural context.

This entry investigates the origins of the concept of psychological trauma and development of different approaches to viewing psychological trauma and treatments. The entry includes a discussion of the ethical issues regarding therapists and the sociocultural context of therapy. Special attention is paid to the ethics of recovered memories and trauma processing.