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Treating Mental Injury Like Physical Injury

For several years, I worked in what was essentially considered the “step 1” when it came to children’s trauma care. Through the system, there was a general expectation that when there was an allegation of child abuse, it was all about evidence collection and necessary medical treatment, and different types of trauma require different types of medical treatment. The standard operating procedure was to provide what necessary treatment we could in the moment, and then get the child and their family set up with resources to continue with counseling and longer term mental health care. Time and time again after having meetings with families and checking in over time, it became very apparent that kids weren’t getting mental health care even while it seemed like they were having very obvious signs of traumatic stress reactions. It struck me as odd that while we generally had no problem with consent for immediate physical health care, there was always a reason for why they weren’t receiving mental health care, even when there were free options for when cost of services was a concern. I noticed when checking in, I seemed to get a similar answer each time, and that being “I think they can handle it pretty well on their own”. Which is particularly interesting because I find when treating trauma, one of the main things I hear people say is “I just can’t seem to move on and get past it”.

And to that, I say, who said you have to? Why do we think forget it and move on is the goal? Moreover, why is it that physical healthcare from a physician is easy to agree to and mental healthcare is left for an injured person to handle themselves?

I get it, very much, traumatic events are uncomfortable to experience, uncomfortable to hear about, and definitely uncomfortable to choose to grow through. Especially when the general consensus seems to be “if I can just forget about it and move on with my life, then I’m good, right?”

No, not right.

This is why I find it helpful to compare mental injury to physical injury. Say you have a cut on your right hand. You’re right handed, so that’s a real issue, because you need to use your right hand for all kinds of stuff. So what do you do? Leave it, probably and just ignore it? Your handwriting is all messed up, it gets infected and oozy and then someone shakes your hand (pre- or post-pandemic, obviously) and you scream really loud and then pretend like everything is fine, no big deal? Of course not. You need to wash it, you probably need stitches, and you need to become a lefty for handshakes for a minute. You take care of that hand, and no one questions you. No one makes you feel weird for going to get the stitches and when you need a little help with something, someone helps you out because “it just must be so difficult with that hurt hand, I understand that you need some time to heal it before you can use it like normal again”. And the hand might never be quite the same, point being that no one questions a physical injury, so why do our clients (or their parents, their boss, their friends, etc.) question their need for mental health care after something bad happens?

Partially for convenience. The general belief about therapy is that it takes years to see results, that you just go talk about your feelings. Greatest hits include: “what good does it do me to just talk about it, I already know what happened.” First things first, we’re not just talking about it, we’re acknowledging that it exists. It doesn’t come as any surprise that avoidance is the key term when it comes to trauma going untreated for so long. Second, the bones of trauma treatment don’t tend to take more than 6 months. If someone is willing to do the work to feel better, good work gets done.

When treating trauma, a common goal for clients can look like “I just don’t want to think about it anymore” or “I just want to move on with my life”, and that’s great! But it’s not realistic. If you consider caring for mental injury the same way we care for physical injury, we must consider that there is always the chance that a physical injury won’t heal perfectly. Say you have a really bad broken arm; you need surgery, you have to be in a cast for at least 6 weeks, it’s a terrible time. Then, after the time has passed, you go and have the cast taken off and the doctor tells you you’ll need some physical therapy and you’ll probably have to manage some pain in your arm long term. This is how trauma care happens. We are not encouraging our clients to get to a point where they will never think about the event(s) again. We are providing them with the tools they need to care for themselves and manage the emotions and behaviors that can be a result of traumatic stress.

That being said, not everyone wants to hear that. Not everyone is ready to know or hear that their trauma can’t be erased by time, therapy, medication, or anything else; and that’s okay. It’s a lot to ask of someone to agree to dip their toes into the feelings they’ve been avoiding and trying to push away. Care for any kind of injury is never easy, but it absolutely can be worth it.

If you or somebody you know could benefit from working with Haley, give her a call at 405-266-1494 or email her at

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