On trauma and madness in mental health services

BY Noël Hunter

Each day the news appears to top itself with stories of the various ways in which we, as humans, suffer and cause suffering. There are endless tales of abuse, racism, violence, gaslighting from those in the highest of powers, oppression, and injustice that challenge the lengths to which our minds and bodies can cope. What happens when people seek out help for their suffering? How do people heal from the atrocities that life throws our way?

I never wanted to be a psychologist – I moved to New York City over 15 years ago to pursue a career in theater … just after I got a degree in psychology and swore I’d never look back. I loved the stage and I continue to perform regularly in improv comedy. Singing and dancing my way out of a reality that was too difficult to hold was how I learned to cope. Yoga and fitness also helped me cope. It’s when I went to a mental health professional that I learned none of these counted. Only what they had to offer was real.

As a child, I had many family members who were in and out of hospitals, drugged, labelled, and excused for their abusive behaviors under the guise of illness. Because I was “fine”, the chronic trauma that I experienced was never recognized and instead went dismissed, despite the numerous mental health professionals in and out of our lives. I was constantly pulling my bootstraps until there were none anymore.

It wasn’t until I was an adult that I started realizing that my difficulties – my constant difficulty breathing (I swore I had a tumor!), my frequent blackouts for events and people when I never touched a drink, the screams and hateful comments of the voices in my head, my inability to have an intimate relationship that was not abusive or emotionally absent, and my constant physical and emotional numbness – might actually have something to do with my past.

When I made the fateful decision to seek out counseling I never thought that it would result in being more traumatized than what the previous combined 30 years had contributed. But, that’s exactly what happened.

I was lucky, though. I managed to avoid hospitalization and a life sentence as a patient. I pulled through this experience scarred, but whole. Not many others can say the same. That’s when I decided, wisely or not, to join the very field that almost killed me.

My entire motivation for returning to school was to explore the human rights violations and social injustices of the mental health field (I had no idea what I was in for!). I naively thought going in that the problem was simply a matter of misunderstanding or lack of awareness of the numerous studies showing the association between trauma and “mental illness”, the harmful effects of many standard treatment practices, and the lack of validity of the current mental health paradigm.

Turns out, this was not the problem.

Therapy was enormously helpful once professionals could get past freaking out, threatening drugs and hospitalization, and needing to always be right. I was fortunate enough to find someone who was capable of that. So, why wouldn’t professionals want to know how they might sometimes harm and can actually do better?

Trying to take someone else’s perspective based on one’s own emotions and experiences is actually associated with decreased understanding! This is entirely what the mental health field is based upon – observing and making sense of an ‘other’s’ experience through one’s own perspective. What actually increases understanding? Asking the people whose experience one wishes to understand. (also, it apparently took a study to figure this out).

And, that’s what I set out to do.

Trauma and Madness in Mental Health Servicestrauma and madness' is based on my doctoral thesis, which interviewed individuals from around the world on their experiences in the mental health system, and what they found to be helpful and harmful. It also combines other first-person perspectives from across diagnostic categories in this exploration of recovery. The book covers a brief history of trauma and madness, the politics within the mental health field, and the changing trends in the mainstream, particularly as it relates to psychosis, dissociation, “serious mental illness”, and borderline personality disorder. It covers a vast array of research on neurology, genetics, psychological theory, and racism and discrimination to conclude what we intuitively know: we suffer for a reason, and the more we suffer, the more we breakdown.

It also offers hope for the future by recommending changes in the system and, more importantly, things that people find outside the system for their own personal healing journeys. Mental health professionals can be helpful for some, but by no means are they necessary nor helpful for all. It ends with helpful tips, resources, and suggestions for the future.

And, the entire book is written from the first-person perspectives of individuals with lived experience, including me. The status quo must continue to be challenged. Many of our lives depend on it.

I hope you check it out!


Noel_HunterNoël Hunter is a clinical psychologist in private practice in New York City.  Her work focuses on the link between trauma and altered states, human rights, and alternative approaches to healing. She is the author of Trauma and Madness in Mental Health Services. Follow her on Twitter or Facebook.

4 thoughts on “On trauma and madness in mental health services

  1. In 2000, I attended a [Dartmouth] “Grand Rounds” presentation by an Epidemiologist noting: “52% of Detroit Metropolitan Area Schoolchildren met the DSM-IV criteria for PTSD”. Similar numbers have subsequently been reported in Philadelphia, Baltimore, Atlanta, and last month at 5 charter schools in New Orleans. That was before I learned of the US CDC/Kaiser-Permanente ACE [Adverse Childhood Experiences] Study, the Texas ACE sequel study, and the World Health Organization’s adoption and adaptation of the CDC/Kaiser ACE Screening Tool–which WHO used in their 2013 assessment of the world’s healthiest children (The USA ranked only 25th world-wide in that assessment. Keep in mind that the USA remains the only ‘Non-Signatory Nation [on earth]’ to the UN Convention on Children’s Rights.


  2. Cant wait to read this book. So does your thesis hold that a Person Centred Therapy is what helps?


  3. Thank you! Me too – the one seen as missing the family trauma, just because I met a neighbor family who helped me for a while in my childhood, before they left the country. They did teach me that I was fine, but this was seen by my own family as if I had been a traitor, so I learned that life is safer without family. I saw how psychiatric services “treated” my older sister, medication, shock treatments and institutionalization in any of her crises throughout life – without ever paying attention to the situations she faced in society and relationships, not noticing her family and society’s lack of preparation to understand, guide her, set limits on her while affirming her – so she would go out of control. I moved to a different country, tried studying rehabilitation, but found the courses unfamiliar with humanity and support – only training students the laws and definitions of categories. I found some help in experiences of giving and leadership, but not relational, for our society defines “independence” as the goal, and finding alternatives that support people in growth, seems impossible. I aiso wrote a paper on how the reliance on “objectivity” was over applied, cutting off recognition of what can be gained in relational responsiveness, empathy, which it defined as it risky, biased, chaotic, unreliable, and then teaches those supposed to be helping, to avoid empathy. I will find your work and look at it – though I’m less academic now, but there is a very good novel just out, Eleanor Oliphant is completely fine – brilliant and beautiful, showing learning process in society, that includes involvement – the one piece our helping systems leave out, and cannot teach, without social change.


  4. So beautiful written. Thank you for shedding light on those of us whose traumatic experience have gone unnoticed, who have been shamed into silence, made to mistrust our own internal experiences. This book is a welcome sign for all of us to begin to accept the impact these experience have on us.


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