Recently, a former client returned to counseling with me complaining of deep depression. I had worked with her five years earlier on low self-esteem, depression and anxiety stemming from childhood experiences. “I thought I had climbed out of the pit and built a fence around it so I’d not fall into it again.” she told me. I assured her that she had done well overcoming depression. Still I understood her sense of greater loss.
Five years earlier, through her hard work, she transformed from despair to hope to personal achievement. She made great progress to becoming the person she wanted to be. Her progress was such that she was able to discontinue medications and she developed into this lovely person full of commitment to life and compassion towards others. Friends and family praised her for her come-back from despair.
Then, in 2015, she was in a car accident. Someone hit her car from behind. She got out of her vehicle, asked about the other driver, and exchanged information. After that, she went about her day as planned. She told me that she felt relieved that no one was hurt and that only minor damage was done to her car. I asked about the possibility of internal injuries or whiplash. She said that she went to the doctor as a precaution only. She did not feel injured. The doctor took x-rays, and found no trauma. But within a week of the accident, her mood changed. She couldn’t sleep. She cried all the time. Going to work, spending time with friends, doing things she once enjoyed became chores for her. She felt defeated and she didn’t know why.
As a clinician, I understand that the cause of trauma does not have to be as huge as 9/11, a battle in Iraq, or Hurricane Katrina. It can actually start with a minor car accident. Each of us have both resilience that protects us from bad experiences and vulnerabilities that overwhelm us when something bad happens. Those qualities of resilience and vulnerability are unique to each of us. That is why two soldiers of the same battle will both come away from the experience profoundly changed: one may come away with PTSD, the other with deeper understanding about life and death. We might prefer always to be like that second soldier when something bad happens to us, but that is not realistic. Nor is it accurate to assume that we are somehow weak if we experience depression or PTSD symptoms after enduring trauma. As I mentioned, we all have qualities of resilience and vulnerability. One of my client’s vulnerabilities was her past.
"Will it always be that way?" she asked. “Any time, I’m in an accident or something bad happens to me?”
"Yes and no." I replied. "Yes, you cannot change your history. No, it does not have to define your present or your future. You can learn to be more resilient to negative events in your life."
My clinical experience has taught me that reducing the symptoms of depression, anxiety, or PTSD might be insufficient as a counseling goal towards wholeness and wellness. Resilience to our emotional vulnerabilities may be the better goal.
In her earlier counseling, we stopped at the reduction of symptoms of depression, rather than explore those strengths that might help the next time she experienced a negative event. I told my client that I admired her for recognizing the relationship between her trauma and her depressive symptoms—moreover, I appreciated her willingness to face it in therapy, not as a weakness to overcome, but as a desire for resilience.