I don’t know, but I do know that there comes a point where you no longer have enough space mentally to stand and do the work you need to do. I suspect that there is a point where someone’s story of suffering consumes them so totally that even a very qualified therapist, or maybe the Buddha himself, couldn’t pull that person back from the brink. That power to heal has to come from inside, and at some point that person may just fully believe that the power is spent. It can’t be spent in truth, but that doesn’t matter if the belief exists that it is spent.