It's difficult to know what goes on in someone else's therapy, and whether or not their therapist or doctor is treating them appropriately. Lots goes on behind closed doors that only the therapist and the client know about. Maybe the therapist has suggested other treatments, including medication, and the guy has declined to pursue it; therapists have to respect a person's right to choose their treatments. Maybe the therapist has worked with him to contain the trauma issues, but the guy is unable or unwilling to try new coping strategies. It's impossible to know.