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_______________________
Traumatic stress is found in many competent, healthy, strong, good people.
No one can completely protect themselves from traumatic experiences.
Many people have long-lasting problems following exposure to trauma.
Up to 8% of persons will have PTSD at some time in their lives. People who
react to traumas are not going crazy. What is happening to them is
part of a set of common symptoms and problems that are connected with being
in a traumatic situation, and thus, is a normal reaction to abnormal events
and experiences. Having symptoms after a traumatic event is
NOT a sign of personal weakness. Given exposure to a trauma that is
bad enough, probably all people would develop PTSD.
By understanding trauma
symptoms better, a person can become less fearful of them and better able to
manage them. By recognizing the effects of trauma and knowing more about
symptoms, a person will be better able to decide about getting treatment.
_______________________
PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).
Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.
Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities."
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an
information processing therapy and uses an eight phase approach.
During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of
dual attention. This sequence of dual attention and personal association is repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough
eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures."
www.emdr.com
__________________
Major Depressive Disorder
“Diagnostic Features
The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).
The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).
The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.
If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).
Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.
Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes.
Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.
It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________
Major Depressive Disorder
“Diagnostic
Features
The essential feature
of Major Depressive Disorder is a clinical course that is
characterized by one or more Major Depressive Episodes without a
history of Manic, Mixed, or Hypomanic Episodes (Criteria A and
C). Episodes of Substance-Induced Mood Disorder (due to the
direct physiological effects of a drug of abuse, a medication,
or toxin exposure) or of Mood Disorder Due to a General Medical
Condition do not count toward a diagnosis of Major Depressive
Disorder. In addition, the episodes must not be better
accounted for by Schizoaffective Disorder and are not
superimposed on Schizophrenia, Schizophreniform Disorder,
Delusional Disorder, or Psychotic Disorder Not Otherwise
Specified (Criterion B).
The
fourth digit in the diagnostic code for Major Depressive
Disorder indicates whether it is a Single Episode (used only for
first episodes) or Recurrent. It is sometimes difficult to
distinguish between a single episode with waxing and waning
symptoms and two separate episodes. For purposes of this
manual, an episode is considered to have ended when the full
criteria for eh Major Depressive Episode have not been met for
at least 2 consecutive months. During this 2-month period,
there is either complete resolution of symptoms or the presence
of depressive symptoms that no longer meet the full criteria for
a Major Depressive Episode (In Partial Remission).
The fifth
digit in the diagnostic code for Major Depressive Disorder
indicates the current state of the disturbance. If the criteria
for a Major Depressive Disorder are met, the severity of the
episode is notes as Mild, Moderate, Severe Without Psychotic
Features, or Severe With Psychotic Features. If the criteria
for a Major Depressive Episode are not currently met, the fifth
digit is used to indicate whether the disorder is In Partial
Remission or In Full Remission.
If Manic,
Mixed, or Hypomanic Episodes develop in the course of Major
Depressive Disorder, the diagnosis is changed to a Bipolar
Disorder. However, if manic or hypomanic symptoms occur as a
direct effect of antidepressant treatment, use of other
medications, substance use, or toxin exposure, the diagnosis of
Major Depressive Disorder remains appropriate and an addition
diagnosis of Substance-induced Mood Disorder, With Manic
features (or With Mixed Features), should be noted. Similarly,
if manic or hypomanic symptoms occur as a direct effect of a
general medical condition, the diagnosis of Major Depressive
Disorder remains appropriate and an additional diagnosis of Mood
Disorder Due to a General Medical Condition, With Manic Features
(or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any
age, with an average age at onset in the mid-20s.
Epidemiological data suggest that the age at onset is decreasing
for those born more recently. The course of Major Depressive
Disorder, Recurrent, is variable. Some people have isolated
episodes that are separated by many years without any depressive
symptoms, whereas others have clusters of episodes, and still
others have increasingly frequent episodes as they grow older.
Some evidence suggests that the periods of remission generally
last longer early in the course of the disorder. The number of
prior episodes predicts the likelihood of developing a
subsequent Major Depressive Episode. At least 60% of
individuals with Major Depresssive Disorder, Single Episode, can
be expected to have a second episode. Individuals who have had
tow episodes have a 70% chance of having a third, and
individuals who have had three episodes have a 90% chance of
having a fourth. About 5%-10% of individuals with Major
Depressive Disorder, single Episode, subsequently develop a
Manic Episode (i.e., develop Bipolar I Disorder).
Major
Depressive Episodes may end completely (in about two-thirds of
cases), or only partially or not at all (in about one-third of
cases). For individuals who have only partial remission, there
is a greater likelihood of developing additional episodes and of
continuing the pattern of partial interepisode recovery. The
longitudinal course specifiers With Full Interepisode Recovery
and Without Full Interepisode Recovery may therefore have
prognostic value. A number of individuals have pre-existing
Dysthymic Disorder prior to the onset of Major Depressive
Disorder, single Episode. Some evidence suggests that these
individuals are more likely to have additional Major Depressive
Episodes, have poorer interepisode recovery, and may require
additional acute-phase treatment and a longer period of
continuing treatment to attain and maintain a more thorough and
longer-lasting euthymic state.
Follow-up
naturalistic studies suggested that 1 year after the diagnosis
of a major Depressive Episode, 40% of individuals still have
symptoms that are sufficiently severe to meet criteria for a
full Major Depressive Episode, roughly 20% continue to have some
symptoms that no longer meet full criteria for a Major
Depressive Episode (i.e., major Depressive Disorder, In Partial
Remission), and 40% have no Mood Disorder. The severity of the
initial Major Depressive Episode appears to predict
persistence. Chronic general medical conditions are also a risk
factor for more persistent episodes.
Episodes
of Major Depressive Disorder often follow a severe psychosocial
stressor, such as the death of a loved one or divorce. Studies
suggest that psychosocial events 9stressors) may play a more
significant role in the precipitation of the first or second
episodes of Major Depressive Disorder and may play less of a
role in the onset of subsequent episodes. Chronic general
medical conditions and Substance Dependence (particularly
Alcohol or Cocaine Dependence) may contribute to the onset or
exacerbation of Major Depressive Disorder.
It is
difficult to predict whether the first episode of a Major
Depressive Disorder in a young person will ultimately evolve
into a Bipolar Disorder. Some data suggest that the acute onset
of severe depression, especially with psychotic features and
psychomotor retardation, in a young person without prepubertal
psychopathology is more likely to predict a bipolar disorder. A
family history of Bipolar Disorder may also be suggestive of
subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and
statistical manual of mental disorders. 2000. 4th
ed. Washington, D.C.: American Psychiatric Association.
________________
DID-PTSD-EMDR
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity
Disorder is the presence of two or more distinct identities or
personality states (Criterion A) that recurrently take control
of behavior (Criterion B). There is an inability to recall
important personal information, the extent of which is too great
to be explained by ordinary forgetfulness (Criterion C). The
disturbance is not due tot eh direct physiological effects of a
substance or a general medical condition (Condition D.). In
children, the symptoms cannot be attributed to imaginary
playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure
to integrate various aspects of identity, memory, and
consciousness. Each personality state may be experienced as if
it has a distinct personal history, self-image, and identity,
including a separate name. Usually there is a primary identity
that carries the individual's given name and is passive,
dependent, guilty, and depressed. The alternate identities
frequently have different names and characteristics that
contrast with the primary identity (e.g., are hostile,
controlling, and self-destructive). Particular identities may
emerge in specific circumstances and may differ in reported age
and gender, vocabulary, general knowledge, or predominant
affect. Alternate identities are experienced as taking control
in sequence, ore at the expense of the other, and may deny
knowledge of one another, be critical of one another, or appear
to be in open conflict. Occasionally, one or more powerful
identities allocate time to the others. Aggressive or hostile
identities may at times interrupt activities or place the others
in uncomfortable situations.
Individuals with this disorder experience
frequent gaps in memory for personal history, both remote and
recent. The amnesia is frequently asymmetrical. The more
passive identities tend to have more constricted memories,
whereas the more hostile, controlling, or "protector" identities
have more complete memories. An identity that is not in control
may nonetheless gain access to consciousness by producing
auditory or visual hallucinations (e.g., a voice giving
instructions). Evidence of amnesia may be uncovered by reports
from others who have witnessed behavior that is disavowed by the
individual or by the individual's own discoveries (e.g., finding
items of clothing at home that the individual cannot remember
having bought). There may be loss of memory not only for
recurrent periods of time, but also an overall loss of
biographical memory for some extended period of childhood,
adolescence, or even adulthood. Transitions among identities
are often triggered by psychosocial stress. The time required
to switch from one identity to another is usually a matter of
seconds, but, less frequently, may b gradual. Behavior that may
be frequently associated with identity switches include rapid
blinking, facial changes, changes in voice or demeanor, or
disruption in the individual's train of thoughts. The number of
identities reported ranges from 2 to more than 100. Half of
reported cases include the individuals with 10 or fewer
identities."
Diagnostic and Statistical Manual of Mental
Disorders.
2000. 4th ed. Washington, D.C.: American Psychiatric
Association.
PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress
Disorder us the development of characteristic symptoms following
exposure to an extreme traumatic stressor involving direct
personal experience of an event that involves actual or
threatened death or serious injury, or other threat to one's
physical integrity; or witnessing an event that involves death,
injury, or a threat to the physical integrity of another person;
or learning about unexpected or violent death, serious harm, or
threat of death or injury experienced by a family member or
other close associate (Criteria A1). The person's response to
the event must involve intense fear, helplessness, or horror (or
in children, the response must involve disorganized or agitated
behavior) (Criterion A2). The characteristic symptoms resulting
from the exposure to the extreme trauma include persistent
reexperiencing of the traumatic event (Criterion E), and the
disturbance must cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning (Criterion F).
Traumatic events that are experienced directly
include, but are not limited to, military combat, violent
personal assault (sexual assault, physical attack, robbery,
mugging), being kidnapped, being taken hostage, terrorist
attack, torture, incarceration as a prisoner of war or in a
concentration camp, natural or manmade disasters, severe
automobile accidents, or being diagnosed with a life-threatening
illness. For children, sexually traumatic events may include
developmentally inappropriate sexual experiences without
threatened or actual violence or injury. Witnessed events
include, but are not limited to, observing the serious injury or
unnatural death of another person due to violent assault,
accident, war, or disaster or unexpectedly witnessing a dead
body or body parts. Events experienced by others that are
learned about include, but are not limited to, violent personal
assault, serious accident, or serious injury experienced y a
family member or a close friend; learning about the sudden,
unexpected death of a family member or a close friend; or
learning that one's child has a life threatening disease. The
disorder may be especially sever or long lasting when the
stressor is of human design (e.g., torture, rape). the
likelihood of developing this disorder may increase as the
intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in
various ways. Commonly the person has recurrent and intrusive
recollections of the event (Criterion B1) or recurrent
distressing dreams during which the event can be replayed or
otherwise represented (Criterion B2). In rare instances, the
person experiences dissociative states that last from a few
seconds to several hours, or even days, during which components
of the event are relived and the person behaves as though
experiencing the event at that moment (Criterion B3). These
episodes, often referred to as "flashbacks," are typically brief
but can be associated with prolonged distress and heightened
arousal. Intense psychological distress (Criterion B4) or
physiological reactivity (Criterion B5) often occurs when the
person is exposed to triggering events that resemble or
symbolize an aspect of the traumatic event (e.g., anniversaries
of the traumatic event; cold, snowy weather or uniformed guards
for survivors of death camps in cold climates; hot, humid
weather for combat veterans of the South Pacific; entering any
elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are
persistently avoided. The person commonly makes deliberate
efforts to avoid thoughts, feelings, or conversations about the
traumatic event (Criterion C1) and to avoid activities,
situations, or people who around recollections of it (Criterion
C2). This avoidance of reminders may include amnesia for an
important aspect of the traumatic event (Criterion C3).
Diminished responsiveness to the external work, referred to as
"psychic numbing" or "emotional anesthesia," usually begins soon
after the traumatic event. The individual may complain of
having markedly diminished interest or participation in
previously enjoyed activities (Criterion C4), of feeling
detached or estranged from other people (Criterion C5), or of
having markedly reduced ability to feel emotions (especially
those associated with intimacy, tenderness and sexuality)
(Criterion C6). The individual may have a sense of a
foreshortened future (e.g., not expecting to have a career,
marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety
or increased arousal that were not present before the trauma.
these symptoms may include difficulty falling or staying asleep
that may be to recurrent nightmares during which the traumatic
event is relived (Criterion D1), hypervigilance (Criterion D4),
and exaggerated startle response (Criterion D5). Some
individuals report irritability or outburst of anger (Criterion
D2) or difficulty concentrating or completing tasks (Criterion
D3)."
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing
(EMDR)1 integrates elements of many effective
psychotherapies in structured protocols that are designed to
maximize treatment effects. These include psychodynamic,
cognitive behavioral, interpersonal, experiential, and
body-centered therapies2. EMDR is an
information
processing therapy
and uses an eight phase approach.
During EMDR1 the client attends to
past and present experiences in brief sequential doses while
simultaneously focusing on an external stimulus. Then the client
is instructed to let new material become the focus of the next
set of
dual attention.
This sequence of dual attention and personal association is
repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session
during which the therapist assesses the client's readiness for
EMDR and develops a treatment plan. Client and therapist
identify possible targets for EMDR processing. These include
recent distressing events, current situations that elicit
emotional disturbance, related historical incidents, and the
development of specific skills and behaviors that will be needed
by the client in future situations.
During the second phase of treatment, the
therapist ensures that the client has adequate methods of
handling emotional distress and good coping skills, and that the
client is in a relatively stable state. If further stabilization
is required, or if additional skills are needed, therapy focuses
on providing these. The client is then able to use stress
reducing techniques whenever necessary, during or between
sessions. However, one goal is not to need these techniques once
therapy is complete.
In phase three through six, a target is
identified and processed using EMDR procedures. These involve
the client identifying the most vivid visual image related to
the memory (if available), a negative belief about self, related
emotions and body sensations. The client also identifies a
preferred positive belief. The validity of the positive belief
is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on
the image, negative thought, and body sensations while
simultaneously moving his/her eyes back and forth following the
therapist's fingers as they move across his/her field of vision
for 20-30 seconds or more, depending upon the need of the
client. Athough
eye movements
are the most commonly used external stimulus, therapists often
use auditory tones, tapping, or other types of tactile
stimulation. The kind of dual attention and the length of each
set is customized to the need of the client. The client is
instructed to just notice whatever happens. After this, the
clinician instructs the client to let his/her mind go blank and
to notice whatever thought, feeling, image, memory, or sensation
comes to mind. Depending upon the client's report the clinician
will facilitate the next focus of attention. In most cases a
client-directed association process is encouraged. This is
repeated numerous times throughout the session. If the client
becomes distressed or has difficulty with the process, the
therapist follows established procedures to help the client
resume processing. When the client reports no distress related
to the targeted memory, the clinician asks him/her to think of
the preferred positive belief that was identified at the
beginning of the session, or a better one if it has emerged, and
to focus on the incident, while simultaneously engaging in the
eye movements. After several sets, clients generally report
increased confidence in this positive belief. The therapist
checks with the client regarding body sensations. If there are
negative sensations, these are processed as above. If there are
positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the
client to keep a journal during the week to document any related
material that may arise and reminds the client of the
self-calming activities that were mastered in phase two.
The next session begins with phase eight,
re-evaluation of the previous work, and of progress since the
previous session. EMDR treatment ensures processing of all
related historical events, current incidents that elicit
distress, and future scenarios that will require different
responses. The overall goal is produce the most comprehensive
and profound treatment effects in the shortest period of time,
while simultaneously maintaining a stable client within a
balanced system.
After EMDR processing, clients generally report
that the emotional distress related to the memory has been
eliminated, or greatly decreased, and that they have gained
important cognitive insights. Importantly, these emotional and
cognitive changes usually result in spontaneous behavioral and
personal change, which are further enhanced with standard EMDR
procedures."
www.emdr.com
1Shapiro,
F. (2001).
Eye Movement Desensitization and Reprocessing: Basic Principles,
Protocols and Procedures (2nd ed.). New York: Guilford Press.
2Shapiro,
F. (2002).
EMDR as an Integrative Psychotherapy Approach: Experts of
Diverse Orientations Explore the Paradigm Prism. Washington, DC:
American Psychological Association Books.
|
|
Psychological Trauma
Primary Trauma
Record: 1
|
Title: |
The
Active Ingredient in EMDR: Is It Traditional Exposure or
Dual Focus of Attention? |
|
Author(s): |
Lee,
Christopher W., School of Psychology, Murdoch
University, Perth, WAU, Australia,
chlee@murdoch.edu.au
Taylor, Graham, Private
Practice, Australia
Drummond, Peter D., School
of Psychology, Murdoch University, Perth, WAU, Australia |
|
Address: |
Lee,
Christopher W., School of Psychology, Murdoch
University, South Street, Murdoch, WAU, Australia, 6150,
chlee@murdoch.edu.au |
|
Source: |
Clinical Psychology & Psychotherapy, Vol 13(2), Mar-Apr
2006. pp. 97-107. |
|
Publisher: |
US:
John Wiley & Sons |
|
ISSN: |
1063-3995 (Print)
1099-0879 (Electronic) |
|
Digital
Object Identifier: |
10.1002/cpp.479 |
|
Language: |
English |
|
Keywords: |
traditional exposure treatments; dual focus; attention;
eye movement desensitization and reprocessing; post
traumatic stress disorder |
|
Abstract: |
Very
little is known about the mechanisms that underlie the
therapeutic effectiveness of eye movement
desensitization and reprocessing (EMDR). This study
tested whether the content of participants' responses
during EMDR is similar to that thought to be effective
for traditional exposure treatments (reliving), or is
more consistent with distancing, which would be expected
given Shapiro's proposal of dual process of attention.
The responses made by 44 participants with
post-traumatic stress disorder (PTSD) were examined
during their first EMDR treatment session. An
independent rater coded these responses according to
whether they were consistent with reliving, distancing
or focusing on material other than the primary trauma.
The coding system was found to have satisfactory
inter-rater reliability. Greatest improvement on a
measure of PTSD symptoms occurred when the participant
processed the trauma in a more detached manner.
Cross-lagged panel correlations suggest that processing
in a more detached manner was a consequence of the EMDR
procedure rather than a measure that covaried with
improvement. (PsycINFO Database Record (c) 2006 APA, all
rights reserved)(from the journal abstract) |
|
Subjects: |
*Attention; *Exposure Therapy; *Eye Movement
Desensitization Therapy; *Posttraumatic Stress Disorder |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Adolescence (13-17 yrs) (200)
Adulthood (18 yrs & older)
(300)
Young Adulthood (18-29 yrs)
(320)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360)
Aged (65 yrs & older) (380) |
|
Tests &
Measures: |
Structured Interview for PTSD
Impact of Event Scale |
|
Methodology: |
Empirical Study; Quantitative Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20060619 |
|
Accession Number: |
2006-06720-002 |
|
Number
of Citations in Source: |
46 |
|
|
|
|
Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-06720-002&site=ehost-live |
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-06720-002&site=ehost-live">The
Active Ingredient in EMDR: Is It Traditional Exposure or
Dual Focus of Attention?</A> |
|
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Database: |
PsycINFO |
Record: 2
|
Title: |
Functional imaging of vegetative state applying single
photon emission tomography and positron emission
tomography. |
|
Author(s): |
Beuthien-Baumann, Bettina, Department of Nuclear
Medicine, University of Technology Dresden, Germany,
b.beuthien@fz-rossendorf.de
Holthoff, Vjera A.,
Department of Psychiatry and Psychotherapy, University
of Technology Dresden, Germany
Rudolf, Jobst, Department of
Neurology, Papageorgiou Hospital, Thessaloniki, Greece |
|
Address: |
Beuthien-Baumann, Bettina, Klinik und Poliklinik fur
Nuklearmedizin, Universitatsklinikum Carl Gustav Carus,
Fetscherstrasse 74, 01307, Dresden, Germany,
b.beuthien@fz-rossendorf.de |
|
Source: |
Neuropsychological Rehabilitation, Vol 15(3-4), Jul-Sep
2005. pp. 276-282.
Journal URL:
http://www.tandf.co.uk/journals/pp/09602011.html |
|
Publisher: |
United
Kingdom: Taylor & Francis
Publisher URL:
http://www.taylorandfrancis.com/ |
|
ISSN: |
0960-2011 (Print)
1464-0694 (Electronic) |
|
Language: |
English |
|
Keywords: |
vegetative state; nuclear medicine techniques; single
photon emission tomography; positron emission
tomography; brain function; extent of brain damage |
|
Abstract: |
Nuclear medicine techniques, such as single photon
emission tomography (SPECT) and positron emission
tomography (PET) have been applied in patients in a
vegetative state to investigate brain function in a
non-invasive manner. Parameters investigated include
glucose metabolism, perfusion at rest, variations of
regional perfusion after stimulation, and benzodiazepine
receptor density. Compared to controls, patients in a
vegetative state show a substantial reduction of glucose
metabolism and perfusion. While patients post-anoxia
exhibit a rather homogenous cortical reduction of
glucose metabolism, patients after head trauma often
show severe cortical and sub-cortical reductions at the
site of primary trauma. To distinguish reduced glucose
metabolism due to neuronal inactivation from neuronal
loss, flumazenil-PET, an indicator of benzodiazepine
receptor density, could add valuable information on the
extent of brain damage. Activation studies focus on the
evaluation of residual brain network, looking for
processing in secondary projection fields. So far the
predictive strength concerning possible recovery for the
individual patient is limited, and PET and SPECT are not
routine procedures in the assessment of patients in a
vegetative state. (PsycINFO Database Record (c) 2005
APA, all rights reserved)(journal abstract) |
|
Subjects: |
*Brain
Damage; *Coma; *Neuroimaging; *Tomography |
|
Classification: |
Neurological Disorders & Brain Damage (3297) |
|
Population: |
Human
(10) |
|
Methodology: |
Literature Review |
|
Publication Type: |
Journal, Peer Reviewed Journal; Electronic
Format(s) Available:
Electronic; Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20050906 |
|
Accession Number: |
2005-08669-015 |
|
Number
of Citations in Source: |
24 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08669-015&site=ehost-live |
|
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|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08669-015&site=ehost-live">Functional
imaging of vegetative state applying single photon
emission tomography and positron emission
tomography.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 3
|
Title: |
Mental
health and academic skills of Sierra Leonean children
from refugee families. |
|
Author(s): |
Feder,
Michael A., George Mason U., US |
|
Source: |
Dissertation Abstracts International: Section B: The
Sciences and Engineering, Vol 66(2-B), 2005. pp. 1168. |
|
Publisher: |
US:
Univ Microfilms International
Publisher URL:
http://www.il.proquest.com/umi/ |
|
ISSN: |
0419-4217 (Print) |
|
Order
Number: |
AAI3163725 |
|
Language: |
English |
|
Keywords: |
mental
health; academic skills; refugee families; childhood
development; psychological adjustment |
|
Abstract: |
There
is little information about the psychological and
academic adjustment of children from refugee families in
the U.S. Yet, it seems clear that refugee children and
children born in the U.S. to refugee parents are at risk
for developing psychological and academic difficulties
(Berman, 2001). This study examines the psychological
adjustment of children from refugee families from Sierra
Leone (S.L.), a country in Western Africa whose refugee
population in the U.S. has yet to be the focus of
empirical research. Seventy-four children (51 born in
S.L.) and a parent/guardian completed surveys assessing
demographic information and trauma exposure. Also, all
children completed paper and pencil measures of
attributional style, psychological functioning, and
academic ability. The moderating effects that personal,
family, and community have on psychological and academic
adjustment are analyzed along with possible differences
in psychological and academic adjustment among children
born in Sierra Leone (primary trauma) and those born in
the U.S. to Sierra Leonean parents (secondary trauma).
Many children reported frequent exposure to war-related
trauma, negative attributional styles, psychological
adjustment difficulties, and low academic ability.
However, some children seemed resilient to these
adjustment difficulties. There were more similarities
than differences among refugee children born in the U.S.
and refugees born in S. L. Furthermore, amount and
durations of trauma exposure, attributions to negative
events, and parental trauma exposure were each related
to children's psychological adjustment in the U.S. These
findings are discussed in terms of their implication for
policies and interventions developed for refugee adults
and children. (PsycINFO Database Record (c) 2005 APA,
all rights reserved) |
|
Subjects: |
*Academic Achievement; *Childhood Development;
*Emotional Adjustment; *Mental Health; *Refugees; Family |
|
Classification: |
Health
& Mental Health Treatment & Prevention (3300)
Educational Psychology
(3500) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Location: |
US |
|
Age
Group: |
Childhood (birth-12 yrs) (100)
Adulthood (18 yrs & older)
(300) |
|
Methodology: |
Empirical Study; Quantitative Study |
|
Publication Type: |
Dissertation Abstract; Print
Format(s) Available: Print |
|
Release
Date: |
20051219 |
|
Accession Number: |
2005-99016-085 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-99016-085&site=ehost-live |
|
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|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-99016-085&site=ehost-live">Mental
health and academic skills of Sierra Leonean children
from refugee families.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 4
|
Title: |
Moderators for secondary traumatic stress in human
service professionals: The role of emotional, cognitive,
and social factors. |
|
Author(s): |
Bates,
Kim M., Capella U., US |
|
Source: |
Dissertation Abstracts International: Section B: The
Sciences and Engineering, Vol 66(6-B), 2005. pp. 3396. |
|
Publisher: |
US:
ProQuest Company
Publisher URL:
http://il.proquest.com/ |
|
ISSN: |
0419-4217 (Print) |
|
Order
Number: |
AAI3178463 |
|
Language: |
English |
|
Keywords: |
emotional intelligence; secondary traumatic stress;
human service professionals; social factors; emotional
factors; cognitive factors |
|
Abstract: |
This
study explored the effects of emotional intelligence and
perceived social support on the incidence of secondary
traumatic stress in a sample of human service
professionals. Previous research efforts suggested these
factors were important for successful adjustment to
primary trauma, but had not investigated their combined
effect on secondary traumatic stress. Based on the
similarity between primary and secondary traumatic
stress and using a survey design and multivariate
analysis, this study investigated relationships between
emotional intelligence, social support, and secondary
traumatic stress. Participants were 52 graduates of an
associate degree program in human services, who
responded to a prequalification letter. Participants
completed mail-out survey packets containing measures of
secondary traumatic stress and compassion satisfaction,
social support, emotional intelligence, and
demographics. The results indicated that emotional
intelligence was positively related to compassion
satisfaction and social support, and negatively related
to secondary traumatic stress. There was a combined
negative relationship between emotional intelligence and
social support on secondary traumatic stress. Additional
research is needed with larger samples. The implications
for human service practitioners and educators are
discussed. (PsycINFO Database Record (c) 2006 APA, all
rights reserved) |
|
Subjects: |
*Emotional Intelligence; *Emotional Trauma;
*Occupational Stress; *Personnel; *Social Services;
Cognitive Ability; Social Support |
|
Classification: |
Health
& Mental Health Treatment & Prevention (3300)
Industrial & Organizational
Psychology (3600) |
|
Population: |
Human
(10) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study; Quantitative Study |
|
Publication Type: |
Dissertation Abstract; Print
Format(s) Available: Print |
|
Release
Date: |
20060410 |
|
Accession Number: |
2005-99024-100 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-99024-100&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-99024-100&site=ehost-live">Moderators
for secondary traumatic stress in human service
professionals: The role of emotional, cognitive, and
social factors.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 5
|
Title: |
Introduzione. Trauma originario e trauma esterno. |
|
Translated Title: |
Introduction. Primary trauma and external trauma. |
|
Author(s): |
Scalmati, Anna Sabatini |
|
Address: |
Scalmati, Anna Sabatini, Via Fregene, 10, 00183, Roma,
Italy |
|
Source: |
Richard e Piggle, Vol 12(3), Sep-Dec 2004. Special
issue: Life and trauma: Elaboration of traumatic
experiences through psychotherapeutic treatment of
children and adolescents. pp. 249-262. |
|
Publisher: |
Italy:
Pensiero Scientifico
Publisher URL:
http://www.pensiero.it/ |
|
ISSN: |
1121-9602 (Print) |
|
Language: |
Italian |
|
Keywords: |
internal trauma; external trauma; automatic anxiety;
infantile trauma |
|
Abstract: |
This
paper takes the concept of automatic anxiety, which has
been the basis of the psychoanalytic theory of trauma
since 1926, as its central point of reference. The dual
origin of anxiety--internal and external--which is
crucial for understanding the trauma situation, allows
the author to conceptualize trauma, the traumatic
situation, infantile trauma, primary trauma and external
trauma. The author shows how external trauma reflects
back on primal trauma and investigates the circular
nature of the trauma state and the events which caused
it. (PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Anxiety; *Emotional Trauma; *Psychoanalytic Theory |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20050725 |
|
Accession Number: |
2004-22448-001 |
|
Number
of Citations in Source: |
26 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-22448-001&site=ehost-live |
|
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|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-22448-001&site=ehost-live">Introduzione.
Trauma originario e trauma esterno.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 6
|
Title: |
État
de stress post-traumatique: Un levier thérapeutique. |
|
Translated Title: |
Traumatic interpretative framework: A therapeutic lever. |
|
Author(s): |
Waddington, A., Équipe ERIC, Hôpital Charcot, Plaisir,
France
Zeltner, L.
Robin, M.
Mauriac, F.
Ampelas, J. -F.
Bronchard, M.
Mallat, V. |
|
Address: |
Waddington, A., Equipe ERIC, Hopital Charcot, 30, rue
Marc Laurent, 78370, Plaisir, France |
|
Source: |
Encéphale, Vol 30(4), Jul-Aug 2004. pp. 323-330.
Journal URL:
http://www.e2med.com/index.cfm?fuseaction=Revue&idxRevue=102 |
|
Publisher: |
France: Masson
Publisher URL:
http://www.masson.fr |
|
ISSN: |
0013-7006 (Print) |
|
Language: |
French |
|
Keywords: |
Post-traumatic stress disorder; chronic disorder;
psychiatric emergencies; psychopathology; family;
victimization |
|
Abstract: |
Chronic Post-traumatic stress disorder (PTSD) is a very
complex syndrome which is hard to detect because of the
multiplicity of its expressions. Furthermore, these
clinical expressions are far from the "pure" syndrome
described in the DSM IV. So, the clinician faces a
dilemna: how can he account for the traumatic clues
without using the PTSD as a ragbag of a diagnosis? We
found the way to discard this dilemna when we decided to
use what M. Struber said about her experience with
cancer and PTSD. She suggests not to emphasize
psychopathology and to use a post-traumatic stress
framework. This way to reframe some psychiatric
urgencies is very useful because it gives back ability
to the patient. When using a post-traumatic stress
framework we tell the patient and his family that we
acknowledge he has defensible reasons for not managing
with an event which, we acknowledge too, was traumatic
for him. In that way we begin to explore what each
person is experiencing, because the traumatic
experiencing is generally shared by the patient and his
family. The members of the family are often angry and
fed up of the patient behaviour and think themselves as
victims of him. On the other part, the patient feels
himself as a misunderstood person, victim of the others.
The primary trauma is forgotten for a long time or
nobody make any link between it and what is happening in
the present. The manifestations of the PTSD initiate
subsequent aftermaths and suffering for everybody. When
working with psychiatric emergencies, we have to manage
with acute situations in which each people is both
victim and aggressor and in which clinicians run the
risk of being given the role of either victim or
aggressor. The trial of strength played between the
patient and his family is going to be played with the
clinician. These situations are described by S. Lamarre
when she speaks of "victimization" and are overloaded
with control stake. Each one tries to make the other
guilty and disgraced, and the clinician is at risk to
feel and/or make feel in the same way the patient and
his family. These situations are blocked and the
temptation is to resort to a kind of coup when the
clinician decides it's enough! and forces his opinion
and decision. What is not a very good way to create the
essential therapeutic co-operation! In this article we
show how using a post-traumatic stress framework is very
useful to reframe the situation of "victimization", give
the opportunity to discard its trap, open a new sight
which allows to find new solutions and promote a
therapeutic co-operation. It's important to stress the
fact that it's not efficient to use a post-traumatic
stress framework as a formula. The clinician who uses it
has to feel it, otherwise he will be unable to cocreate
this new reality with the system he entered, when
receiving the emergency. (PsycINFO Database Record (c)
2005 APA, all rights reserved)(journal abstract) |
|
Subjects: |
*Family; *Posttraumatic Stress Disorder; *Psychiatric
Patients; *Psychopathology; *Victimization; Chronic
Stress |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20050314 |
|
Accession Number: |
2004-20580-003 |
|
Number
of Citations in Source: |
20 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-20580-003&site=ehost-live |
|
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|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-20580-003&site=ehost-live">État
de stress post-traumatique: Un levier thérapeutique.</A> |
|
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|
Database: |
PsycINFO |
Record: 7
|
Title: |
Agonia
e desespero na transferência paradoxal. |
|
Translated Title: |
Agony
and despair in paradoxical transference. |
|
Author(s): |
Roussillon, René, Sociedade Psicanalítica de Paris,
Grupo Lyonnais de Psychanalyse, Lyon, France,
rene.roussillon@wanadoo.fr |
|
Address: |
Roussillon, René, 12 Quai de Serbie, 69006, Lyon,
France,
rene.roussillon@wanadoo.fr |
|
Source: |
Revista de Psicanálise da SPPA, Vol 11(1), Apr 2004. pp.
13-33.
Journal URL:
http://www.sppa.org.br/ingles/jornal.php |
|
Publisher: |
Brazil: Cesar Luis De Souza Brito
Publisher URL:
http://sppa.org.br |
|
ISSN: |
1413-4438 (Print) |
|
Language: |
Portuguese |
|
Keywords: |
agony;
despair; paradoxical transference; psychoanalysts;
narcissist transference; negative therapeutic reactions |
|
Abstract: |
The
article presents reflections prepared from clinical
research based on the follow-up of inter-vision or
supervision-research groups composed of psychoanalysts
who are members of IPA and coordinated by the author.
These reflections are directed at situations of
psychoanalysis at the limit, the cases called borderline
or limit situations, the narcissists, and those that
involve transferential formations characterized
sometimes by negative therapeutic reactions, or at other
times by passionate or narcissist transference
movements. The author presents a model that has been
reconstructed from the specificities of transferential
situations, from the genesis of states of absolute
desperation, of agony, that are determining factors in
paradoxical transference clinics. This is a model of
primary trauma, a model of trauma that affects the
primordial construction of the connection with the
object and of the narcissistic bond contract. He
specifies the state of helplessness due to the failure
of internal resources, distinguishing it from the
psychic states that also result from the failure of
external resources involving the object. (PsycINFO
Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Narcissism; *Negative Therapeutic Reaction;
*Psychoanalysis; *Psychoanalysts; *Psychotherapeutic
Transference; Emotional States |
|
Classification: |
Psychoanalytic Therapy (3315) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20050418 |
|
Accession Number: |
2004-21566-001 |
|
Number
of Citations in Source: |
8 |
|
|
|
|
Persistent link to this record:
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<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-21566-001&site=ehost-live">Agonia
e desespero na transferência paradoxal.</A> |
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Database: |
PsycINFO |
Record: 8
|
Title: |
Some
thoughts about the impact of domestic violence on
infants and young children. |
|
Author(s): |
Emanuel, Louise, Under Fives Counselling Service,
Tavistock Clinic, London, United Kingdom,
louiseemanuel@lineone.net |
|
Address: |
Emanuel, Louise, Under Fives Counselling Service,
Tavistock Clinic, 52 Inderwick Road, London, United
Kingdom, N8 9LD,
louiseemanuel@lineone.net |
|
Source: |
Journal of Child and Adolescent Mental Health, Vol
16(1), 2004. pp. 49-53.
Journal URL:
http://www.nisc.co.za/JournalHome/child/home.htm |
|
Publisher: |
South
Africa: South African Association for Child and
Adolescent Psychiatry and Allied Professions |
|
ISSN: |
1728-0583 (Print) |
|
Language: |
English |
|
Keywords: |
domestic violence; infants; young children; primary
trauma; child neglect; child deprivation; child abuse |
|
Abstract: |
This
paper describes the impact on children of both the
primary trauma of severe domestic violence and the
secondary consequences of chronic situations where
domestic violence forms part of a general background of
neglect, deprivation and abuse. Links are made with
Main's (1995) description of 'Disorganised' Attachment
behaviour in children who are faced with a frightening
or frightened parent. The paper stresses the importance
of good early experiences within the family and how
domestic violence can interfere with the basic
requirements for the physical and emotional survival of
the infant. Clinical vignettes illustrate these ideas.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Adolescent Development; *Child Neglect; *Emotional
Trauma; *Family Violence; *Infant Development; Child
Abuse; Deprivation |
|
Classification: |
Behavior Disorders & Antisocial Behavior (3230) |
|
Population: |
Human
(10)
Male (30) |
|
Age
Group: |
Childhood (birth-12 yrs) (100)
Infancy (2-23 mo) (140)
Preschool Age (2-5 yrs)
(160) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20041227 |
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Accession Number: |
2004-20631-010 |
|
Number
of Citations in Source: |
9 |
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Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-20631-010&site=ehost-live">Some
thoughts about the impact of domestic violence on
infants and young children.</A> |
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Database: |
PsycINFO |
Record: 9
|
Title: |
Agonie, clivage et symbolisation. |
|
Author(s): |
Daoust, François |
|
Address: |
Daoust, François, 1209 Fleury est, Montreal, PQ, Canada,
H2C1R2 |
|
Source: |
Journal of the American Psychoanalytic Association, Vol
51(2), Spr 2003. pp. 684-689. |
|
Publisher: |
US:
Analytic Press
Publisher URL:
http://analyticpress.com |
|
Reviewed
Item: |
René
Roussillon (1999). Agonie, clivage et symbolisation;
Paris: Presses Universitaires de France, 245 pp. |
|
ISSN: |
0003-0651 (Print) |
|
Language: |
English |
|
Keywords: |
narcissistic identity disorders; theoretical
elaboration; clinical manifestations; defensive
structure; psychic processes; object relations |
|
Abstract: |
In
this work, the author develops his theoretical
elaboration of the clinical manifestations of
narcissistic identity disorders or, more specifically,
the transferential expressions of identity disorders and
narcissistic disorders of self-regulation. He examines
these patients' difficulties with the symbolization of
their personal history and, consequently, their problems
with the subjective appropriation of relevant aspects of
instinctual life, narcissism, and object relations. The
15 chapters include rewritten versions of 12 texts
published during the last 10 yrs, as well as 3 n3w
texts, including a thorough introduction that provides
an excellent overview of the book. Roussillon proposes a
theoretical-clinical model delineating the sequence of
psychic processes typical of narcissistic identity
disorders. The main assumption guiding his approach is
that suffering in connection with these pathologies is
the result of a specific defensive structure established
to fend off the impact of a split-off primary trauma
which, through the repetition compulsion, continues to
threaten the organization of the psyche and the
development of subjectivity. (PsycINFO Database Record
(c) 2005 APA, all rights reserved) |
|
Subjects: |
*Defense Mechanisms; *Dissociative Identity Disorder;
*Narcissism; *Object Relations; *Psychoanalytic Theory;
Client Characteristics; Psychoanalysis; Psychoanalytic
Interpretation |
|
Classification: |
Personality Disorders (3217)
Psychoanalytic Theory (3143) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Review |
|
Release
Date: |
20030714 |
|
Accession Number: |
2003-06289-016 |
|
Number
of Citations in Source: |
5 |
|
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Persistent link to this record:
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<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-06289-016&site=ehost-live">Agonie,
clivage et symbolisation.</A> |
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Database: |
PsycINFO |
Record: 10
|
Title: |
Childhood Abuse History, Secondary Traumatic Stress, and
Child Welfare Workers. |
|
Author(s): |
Nelson-Gardell, Debra, School of Social Work, University
of Alabama, Tuscaloosa, AL, US
Harris, Deneen, School of
Social Work, University of Alabama, Tuscaloosa, AL, US |
|
Address: |
Nelson-Gardell, Debra, University of Alabama, School of
Social Work, Box 870314, Tuscaloosa, AL, US |
|
Source: |
Child
Welfare, Vol 82(1), Jan-Feb 2003. pp. 5-26. |
|
Publisher: |
US:
Child Welfare League of America
Publisher URL:
http://www.cwla.org |
|
ISSN: |
0009-4021 (Print) |
|
Language: |
English |
|
Keywords: |
secondary traumatic stress; child welfare workers;
vicarious traumatization; compassion fatigue; childhood
abuse history; primary trauma |
|
Abstract: |
Social
workers are exposed to trauma vicariously through the
trauma of their clients. This phenomenon, called
secondary traumatic stress, vicarious traumatization, or
compassion fatigue, presents a risk of negative personal
psychological consequences. Based on a sample of 166
child welfare workers and using standardized measures,
the study findings document the link between a personal
history of primary trauma, childhood abuse or neglect,
and the heightened risk for secondary traumatic stress
in child welfare workers. (PsycINFO Database Record (c)
2005 APA, all rights reserved)(journal abstract) |
|
Subjects: |
*Child
Abuse; *Child Welfare; *Emotional Trauma; *Social
Workers; *Stress; At Risk Populations |
|
Classification: |
Professional Personnel Attitudes & Characteristics
(3430) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study; Qualitative Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20031124 |
|
Accession Number: |
2003-01505-001 |
|
Number
of Citations in Source: |
33 |
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Persistent link to this record:
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<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-01505-001&site=ehost-live">Childhood
Abuse History, Secondary Traumatic Stress, and Child
Welfare Workers.</A> |
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Database: |
PsycINFO |
Record: 11
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Title: |
Jezik
traume i sekundarna traumatizacija--prikaz slucaja. |
|
Translated Title: |
The
language of trauma and secondary traumatisation--case
study. |
|
Author(s): |
Grbeša, Grozdanko, Clinic for Mental Health Care in Nis,
School of Medicine, University of Nis, Yugoslavia |
|
Source: |
Psychiatry Today, Vol 35(1-2), 2003. pp. 79-90. |
|
Publisher: |
Serbia
and Montenegro: Inst Za Mentalno Zdravlje
Publisher URL:
http://solair.eunet.yu/~imz |
|
ISSN: |
0350-2538 (Print) |
|
Language: |
Serbo-Croatian |
|
Keywords: |
secondary traumatisation; traumatic life events |
|
Abstract: |
A
traumatic event engages primarily the emotional
responses of the traumatised person. Findings of partial
amnesiac voids testify to the difficulty of the
traumatic experience to break through to its verbal
expression, so that it can be understood and placed
within the corpus of experiences, belonging in the past.
The case study which is the subject of this presentation
indicates that the verbalisation of the traumatic
experience can also be impeded by a secondary
traumatisation, especially if it develops at the level
of semantic speech distortions that displaced persons
forced out of their environment often have to face with.
Understanding these secondary traumatisation derivatives
allows therapist to organise his therapeutic procedure
on the principle of gradual approach to the primary
trauma and acknowledgement of the legitimacy of certain
temporary regressive functional patterns which are in
this case manifested primarily in speech. (PsycINFO
Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Emotional Trauma; *Language; *Life Experiences; *Speech
Disorders; *Verbal Communication |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20041206 |
|
Accession Number: |
2004-19944-006 |
|
Number
of Citations in Source: |
8 |
|
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Persistent link to this record:
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<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-19944-006&site=ehost-live">Jezik
traume i sekundarna traumatizacija--prikaz slucaja.</A> |
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Database: |
PsycINFO |
Record: 12
|
Title: |
Chronic pain in land mine accident survivors in Cambodia
and Kurdistan. |
|
Author(s): |
Husum,
Hans, Tromsoe U Hosp, Inst of Clinical Medicine, Tromsoe
Mine Victim Resource Ctr, Tromsoe, Norway,
hhusum@c2i.net
Resell, Kirsten, Tromsoe U
Hosp, Inst of Clinical Medicine, Tromsoe Mine Victim
Resource Ctr, Tromsoe, Norway
Vorren, Gyri, Tromsoe U
Hosp, Inst of Clinical Medicine, Tromsoe Mine Victim
Resource Ctr, Tromsoe, Norway
Heng, Yang Van, Trauma Care
Foundation, Battambang, Cambodia
Murad, Mudhafar, Trauma Care
Foundation, Northern Iraq, Iraq
Gilbert, Mads, Tromsoe U
Hosp, Inst of Clinical Medicine, Tromsoe Mine Victim
Resource Ctr, Tromsoe, Norway
Wisborg, Torben, Tromsoe U
Hosp, Inst of Clinical Medicine, Tromsoe Mine Victim
Resource Ctr, Tromsoe, Norway |
|
Address: |
Husum,
Hans, Tromsoe Mine Victim Resource Ctr (TMC), Inst of
Clinical Medicine, Tromsoe U Hosp, PO Box 80, N-9038,
Tromsoe, Norway,
hhusum@c2i.net |
|
Source: |
Social
Science & Medicine, Vol 55(10), Nov 2002. pp. 1813-1816.
Journal URL:
http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description |
|
Publisher: |
Netherlands: Elsevier Science
Publisher URL:
http://elsevier.com |
|
ISSN: |
0277-9536 (Print) |
|
Digital
Object Identifier: |
10.1016/S0277-9536(01)00315-X |
|
Language: |
English |
|
Keywords: |
chronic pain; land mine accident survivors; trauma;
trauma care |
|
Abstract: |
The
aims of the study were to study chronic pain in land
mine accident survivors, and to study the impact of
trauma and trauma care parameters on chronic pain. The
level of chronic pain was registered (patient-rated and
by clinical examination) in 57 severely injured adult
land mine accident survivors in Cambodia and Northern
Iraq more than 1 year after the accident. As all study
patients had been managed by a standardized trauma
system, the authors could assess the impact of injury
severity and primary trauma care on chronic pain. 64% of
the study patients (n=36) had chronic pain syndromes
(non-significant difference between the two countries).
68% of the amputees (19 out of 28) had phantom limb
pain. Pre-injury trauma exposure, the severity of the
actual trauma, and the quality of trauma care had no
impact on end point chronic pain. In 85% of cases
(n=48), the economic standing of the patients' family
had deteriorated after the accident. Patient-rated loss
of income correlated with the rate of chronic pain
syndromes. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
|
Subjects: |
*Accidents; *Chronic Pain; *Health Care Services;
*Survivors |
|
Classification: |
Physical & Somatoform & Psychogenic Disorders (3290) |
|
Population: |
Human
(10) |
|
Location: |
Cambodia; Iraq |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20030505 |
|
Accession Number: |
2002-08031-004 |
|
Number
of Citations in Source: |
10 |
|
|
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|
Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-08031-004&site=ehost-live">Chronic
pain in land mine accident survivors in Cambodia and
Kurdistan.</A> |
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|
|
|
Database: |
PsycINFO |
Record: 13
|
Title: |
Psychanalyse et psychothérapie psychanalytique:
Variations du cadre psychanalytique pour gérer le retour
du traumatique originaire. |
|
Translated Title: |
Psychoanalysis and psychoanalytic psychotherapy:
Variations in the setting to manage the return of
original trauma. |
|
Author(s): |
Charbonnier, Gilbert, Département de psychiatrie des
Hôpitaux universitaires de Genève, Switzerland |
|
Address: |
Charbonnier, Gilbert, 85, route de Florissant, CH-1206,
Geneve, Switzerland |
|
Source: |
Psychotherapies, Vol 22(1), 2002. pp. 41-49. |
|
Publisher: |
Switzerland: Editions Médecine et Hygiène |
|
ISSN: |
0251-737X (Print) |
|
Language: |
French |
|
Keywords: |
psychoanalytical psychotherapy; non-neurotic patients;
psychoanalytical therapy |
|
Abstract: |
Psychoanalytical psychotherapy is seen as a variation of
the psychoanalytical setting in order to offer to
non-neurotic patients a psychoanalytical therapy and
manage in the best way the return of the primary trauma
projected on the setting. A detailed analysis of the
transference on the setting is necessary. (PsycINFO
Database Record (c) 2006 APA, all rights reserved) |
|
Subjects: |
*Analytical Psychotherapy; *Psychoanalysis |
|
Classification: |
Psychoanalytic Therapy (3315) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20040628 |
|
Correction Date: |
20060717 |
|
Accession Number: |
2003-06896-005 |
|
Number
of Citations in Source: |
25 |
|
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|
Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-06896-005&site=ehost-live |
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-06896-005&site=ehost-live">Psychanalyse
et psychothérapie psychanalytique: Variations du cadre
psychanalytique pour gérer le retour du traumatique
originaire.</A> |
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|
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|
Database: |
PsycINFO |
Record: 14
|
Title: |
Le
psychique et le représentable (une réflexion d'ensemble
à partir de textes prépubliés). |
|
Translated Title: |
The
psychic and the representable. |
|
Author(s): |
Roussillon, René |
|
Source: |
Revue
Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.
Special issue: Psychosomatique et pulsionnalité. pp.
1801-1807.
Journal URL:
http://www.spp.asso.fr/Publications/Rfp/index.htm |
|
Publisher: |
France: Presses Universitaires de France
Publisher URL:
http://www.puf.com |
|
ISSN: |
0035-2942 (Print) |
|
Language: |
French |
|
Keywords: |
primary traumas & nonsymbolized traumas, psychic economy
& ego splitting & hallucinations, patients with
psychosomatic illness |
|
Abstract: |
Presents a synthesis of the papers of various authors on
2 theses, the 1st regarding the impact of primary
traumas, and the 2nd, a discussion of the effects of
these primary traumas, nonsymbolized, on the psychic
economy. Several questions are asked, including the
question of the splitting of the ego, the question of
the status of hallucination vs the hallucinatory
satisfaction of desire, and finally, the question of the
topographic situation of the traces of nonsymbolized
traumatic experiences. The author proposed a model of
ego splitting that attempts to take into account all
these clinical data. He notes that the majority of the
authors reviewed by him refuse to take a
nonpsychoanalytic approach to psychosomatic illness. By
the same tokes, the also refuse to separate the
treatment of so-called psychosomatic patients form that
applied to other psychopathologies. (PsycINFO Database
Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Ego;
*Emotional Trauma; *Hallucinations; *Psychoanalytic
Theory; *Somatoform Disorders; Early Experience;
Symbolism |
|
Classification: |
Psychoanalytic Theory (3143) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal |
|
Release
Date: |
19990801 |
|
Accession Number: |
1999-13162-043 |
|
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Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1999-13162-043&site=ehost-live">Le
psychique et le représentable (une réflexion d'ensemble
à partir de textes prépubliés).</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 15
|
Title: |
Interacting with trauma: Child protective service
workers' responses to working with child abuse and
neglect. |
|
Author(s): |
Rogentine, Kristin Louise, California School of
Professional Psychology - Berkeley/alameda, US |
|
Source: |
Dissertation Abstracts International: Section B: The
Sciences and Engineering, Vol 57(10-B), Apr 1997. pp.
6590. |
|
Publisher: |
US:
Univ Microfilms International
Publisher URL:
http://www.il.proquest.com/umi/ |
|
ISSN: |
0419-4217 (Print) |
|
Order
Number: |
AAM9706612 |
|
Language: |
English |
|
Keywords: |
Interacting with trauma: Child protective service
workers' responses to working with child abuse and
neglect |
|
Abstract: |
Child
abuse is an increasingly prevalent and serious problem
in today's society. Though there has been much research
conducted examining the effects of child abuse on the
child victim, there has been little focus on how the
professionals who intervene are impacted. Because these
professionals have such a critical role in protecting
children, it is important to have an understanding of
the unique stressors they face and how these could
impact their effectiveness. The present study, in
qualitative format, sought to understand the impact
continual exposure to child abuse and neglect has upon
Child Protective Service (CPS) workers. Specific areas
of inquiry included CPS workers' affective reactions,
experience of secondary trauma, countertransference
responses, interrelation of past life experience and
intervention style, and characteristic coping
strategies. Twelve Child Protective Service workers were
recruited from Alameda and Contra Costa Counties in
Northern California. They each participated in an hour
long semi-structured interview designed by the
researcher to probe their thoughts, feelings and coping
strategies in response to working with abuse and
neglect. They were also each administered the Maslach
Burnout Inventory at the end of the interview. The
interviews were audiotaped and transcribed verbatim,
then analyzed for thematic content. Several themes were
identified from the interviews. All the subjects were
intensely impacted by the nature of their work; many
spoke of strong feelings of sadness, grieving, guilt,
anger and fear. There appeared to be two styles of
responding to the stress of the job, to either become
overinvolved or depersonalizing and angry at the
clients. This may vary within subjects depending on the
dynamics of a particular case, but can lead to
overexhaustion, burnout and clinical insensitivity.
Several subjects described how being of a different race
and social class distanced them from the reality of
their client's situation and the experience of their
pain. Both primary trauma and secondary trauma were
described by some of the subjects as a result of their
work, with some enduring post-traumatic symptoms
evident. Those who appeared to cope better had a better
split between work and personal life, more outside
interests, a strong network of family and friends, and a
strong sense of spirituality. All subjects experienced
lack of support from their departments, which has a
strong exacerbating influence on experience of stress.
The findings from this study show that CPS workers are
indeed strongly affected by the difficult nature of
their work. They have strong emotional reactions which
are dealt with differently by each individual. It is
important for these emotional reactions to be analyzed
and understood so the workers may make objective
decisions regarding their cases, unclouded by their own
feelings and reactions and general burnout. The agency
should be structured so that staff are encouraged to
process and work through their emotional reactions.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Coping Behavior; *Occupational Adjustment;
*Occupational Stress; *Professional Personnel;
*Protective Services; Child Abuse; Child Neglect |
|
Classification: |
Health
& Mental Health Treatment & Prevention (3300)
Industrial & Organizational
Psychology (3600) |
|
Population: |
Human
(10) |
|
Location: |
US |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Tests &
Measures: |
Maslach Burnout Inventory |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Dissertation Abstract |
|
Release
Date: |
19970101 |
|
Accession Number: |
1997-95008-070 |
|
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Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1997-95008-070&site=ehost-live">Interacting
with trauma: Child protective service workers' responses
to working with child abuse and neglect.</A> |
|
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Database: |
PsycINFO |
Record: 16
|
Title: |
Psychanalyse et postmodernité: La psychanalyse en
procès? |
|
Translated Title: |
Psychoanalysis and postmodernism: Psychoanalysis in
process? |
|
Author(s): |
Richard, Hélène, U Québec à Montréal, Canada |
|
Source: |
Revue
Québécoise de Psychologie, Vol 18(1), 1997. pp. 83-102. |
|
Publisher: |
Canada: Revue Quebecoise de Psychologie
Publisher URL:
http://www.rqpsy.qc.ca/ |
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ISSN: |
0225-9885 (Print) |
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Language: |
French |
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Keywords: |
postmodernism & psychoanalysis & Freudian psychoanalytic
framework |
|
Abstract: |
Discusses the relevance of psychoanalysis in the
societal context of postmodernism. Some modern clinical
psychoanalytic literature on the "new maladies of the
soul" is examined, and technical changes that these new
psychopathologies have necessitated in the Freudian
psychoanalytic framework are described. The influence of
culture on psychoanalysis, problems related to
particular methods of mental representation, the
clinical picture of primary traumas, and technical
aspects of therapist-patient communication are
discussed. (English abstract) (PsycINFO Database Record
(c) 2005 APA, all rights reserved) |
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Subjects: |
*Freudian Psychoanalytic School; *Postmodernism;
*Psychoanalysis |
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Classification: |
Psychoanalytic Therapy (3315) |
|
Population: |
Human
(10) |
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Publication Type: |
Journal, Peer Reviewed Journal |
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Release
Date: |
19980601 |
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Accession Number: |
1997-06911-004 |
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Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1997-06911-004&site=ehost-live">Psychanalyse
et postmodernité: La psychanalyse en procès?</A> |
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Database: |
PsycINFO |
Record: 17
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Title: |
Art as
an adjunctive therapy in the treatment of children who
dissociate. |
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Author(s): |
Sobol,
Barbara Semionova, George Washington U, Graduate Art
Therapy Program, Washington, DC, US
Schneider, Karen |
|
Source: |
The
dissociative child: Diagnosis, treatment, and management
(2nd ed.). Silberg, Joyanna L. (Ed); pp. 191-218.
Baltimore, MD, US: The
Sidran Press, 1996. xxvi, 368 pp.
Publisher URL:
http://www.sidran.org |
|
ISBN: |
1-886968-06-3 (hardcover) |
|
Language: |
English |
|
Keywords: |
primary & group model of adjunctive art therapy &
relation to trauma therapy, children with dissociative
disorders |
|
Abstract: |
(from
the chapter) Proposes 2 models of adjunctive art therapy
to be used in working with children who dissociate. Both
models strongly rely on the use of art as therapy and a
full engagement in the art process. One model parallels
the work of the primary trauma therapists, following
closely the sequential pacing of the work with deepening
and enriching use of the art process; the second
provides a support structure through the group
involvement in the art process, but with less emphasis
on closely following the trauma model. Illustrations are
given of how each model may work. The building of
"environments"--a specific technique that can be used
successfully in either model--is described and
illustrated. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
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Subjects: |
*Art
Therapy; *Dissociative Disorders; *Emotional Trauma;
*Group Psychotherapy |
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Classification: |
Art &
Music & Movement Therapy (3357) |
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Population: |
Human
(10) |
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Age
Group: |
Childhood (birth-12 yrs) (100) |
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Intended
Audience: |
Psychology: Professional & Research (PS) |
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Publication Type: |
Book,
Edited Book |
|
Document
Type: |
Original Chapter |
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Release
Date: |
19990101 |
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Accession Number: |
1998-06751-010 |
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Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1998-06751-010&site=ehost-live |
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1998-06751-010&site=ehost-live">Art
as an adjunctive therapy in the treatment of children
who dissociate.</A> |
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Database: |
PsycINFO |
Record: 18
|
Title: |
Treating PTSD: Cognitive-behavioral strategies. |
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Series
Title: |
Treatment manuals for practitioners |
|
Author(s): |
Foy,
David W., (Ed), Fuller Theological Seminary, Graduate
School of Psychology, Pasadena, CA, US |
|
Source: |
New
York, NY, US: Guilford Press, 1992. xvi, 172 pp.
|
|
ISBN: |
0-89862-209-3 (hardcover)
0-89862-220-4 (paperback) |
|
Language: |
English |
|
Keywords: |
discusses the behavioral assessment & treatment of
post-traumatic stress disorder in survivors of combat,
battering & sexual assault |
|
Abstract: |
(from
the preface) This book was written to provide behavioral
strategies for assessing and treating survivors of
several prevalent types of human-induced psychological
trauma. It is intended for graduate students and mental
health professionals whose clinical work involves these
survivors. It is unique in its "cross-trauma" approach
by which familiar behavioral methods--fear extinction,
cognitive restructuring, and skills training--are
adapted for treating survivors of combat, battering, and
sexual assault. While clinical work with each primary
trauma population must consider its unique aspects, it
is reassuring for clinicians to know that there are
basic principles of behavioral assessment and treatment
that can be applied across types of survivors. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Behavioral Assessment; *Cognitive Therapy;
*Posttraumatic Stress Disorder; Battered Females;
Behavior Therapy; Combat Experience; Sexual Abuse |
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Classification: |
Neuroses & Anxiety Disorders (3215)
Cognitive Therapy (3311) |
|
Population: |
Human
(10)
Female (40) |
|
Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Publication Type: |
Book,
Edited Book |
|
Release
Date: |
19930101 |
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Accession Number: |
1992-97963-000 |
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Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-97963-000&site=ehost-live |
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-97963-000&site=ehost-live">Treating
PTSD: Cognitive-behavioral strategies.</A> |
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Database: |
PsycINFO |
Record: 19
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Title: |
An
adaptational view of trauma response as illustrated by
the prisoner of war experience. |
|
Author(s): |
Eberly, Raina E., Dept of Veterans Affairs Medical Ctr,
Psychology Service, Minneapolis, MN, US
Harkness, Allan R.
Engdahl, Brian E. |
|
Source: |
Journal of Traumatic Stress, Vol 4(3), Jul 1991. pp.
363-380.
Journal URL:
http://www.wkap.nl/journalhome.htm/0894-9867 |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0894-9867 (Print)
1573-6598 (Electronic) |
|
Language: |
English |
|
Keywords: |
evolutionary adaptive negative affective & other primary
PTSD responses to traumatic environment, secondary
symptomatic coping with primary responses, former WWII
prisoners of war |
|
Abstract: |
Proposes a model of posttraumatic stress disorder (PTSD)
symptoms in which symptoms have positive evolutionary
adaptational value in traumatic environments.
Persistence of PTSD symptoms following return to more
benign environments may result from biological changes
within the organism, reflected by a primary response of
increased levels of underlying traits such as negative
affectivity (NA). Secondary symptoms (social withdrawal,
substance abuse) are viewed as subsequent coping with
the primary trauma response. This model was tested using
data on 413 former World War II prisoners of war.
Results were consistent with the model, indicating an
enduring high level of NA as measured by the Minnesota
Multiphasic Personality Inventory (MMPI). Captivity
severity scores were related to lifetime and current
diagnoses of PTSD, generalized anxiety disorder, and
major or minor depression. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
|
Subjects: |
*Adjustment; *Coping Behavior; *Posttraumatic Stress
Disorder; *Prisoners of War; *Symptoms; Models;
Personality Traits |
|
Classification: |
Neuroses & Anxiety Disorders (3215)
Military Psychology (3800) |
|
Population: |
Human
(10) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal |
|
Release
Date: |
19920101 |
|
Accession Number: |
1992-01756-001 |
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Persistent link to this record:
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-01756-001&site=ehost-live">An
adaptational view of trauma response as illustrated by
the prisoner of war experience.</A> |
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Database: |
PsycINFO |
Record: 20
|
Title: |
Aggression and projective identification in the
treatment of victims. |
|
Author(s): |
Catherall, Donald R., Northwestern U Medical School, IL,
US |
|
Source: |
Psychotherapy: Theory, Research, Practice, Training, Vol
28(1), Spr 1991. Special issue: Psychotherapy with
victims. pp. 145-149. |
|
Publisher: |
US:
Division of Psychotherapy (29), American Psychological
Association |
|
ISSN: |
0033-3204 (Print) |
|
Language: |
English |
|
Keywords: |
aggression & projective identification for trust
reestablishment in therapy, victims of trauma |
|
Abstract: |
The
victim must reestablish trust both in order to do the
work of exploring the hidden affects associated with the
primary trauma and in order to overcome the secondary
trauma, which is a breakdown in the victim's
relationship with his/her social world. To rebuild trust
in the self and others, the victim seeks a connection
with the therapist that allows him or her to (1)
overcome feeling different and (2) identify with the
therapist's capacity to experience aggressive
victimizing urges without acting on them. The mechanism
of the patient's connection with the therapist is
projective identification. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
|
Subjects: |
*Emotional Trauma; *Identification (Defense Mechanism);
*Psychotherapeutic Processes; *Psychotherapy;
*Victimization; Aggressive Behavior; Projection (Defense
Mechanism); Trust (Social Behavior) |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10) |
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Publication Type: |
Journal, Peer Reviewed Journal |
|
Release
Date: |
19920201 |
|
Accession Number: |
1992-06235-001 |
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Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-06235-001&site=ehost-live |
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-06235-001&site=ehost-live">Aggression
and projective identification in the treatment of
victims.</A> |
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Database: |
PsycINFO |
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Full Text Database: |
PsycARTICLES |
Record: 21
|
Title: |
The
playground of psychoanalytic therapy. |
|
Author(s): |
Sanville, Jean, Los Angeles Inst for Psychoanalytic
Studies, Training & Supervising Analyst, Los Angeles,
CA, US |
|
Source: |
Hillsdale, NJ, England: Analytic Press, Inc, 1991. xx,
288 pp. |
|
ISBN: |
0-88163-091-8 (hardcover) |
|
Language: |
English |
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Keywords: |
discusses the role of play in psychoanalytic therapy
with children |
|
Abstract: |
(from
the jacket) Taking as its point of departure Freud's
notion of transference as a "playground" and building on
the foundations of the "independent tradition" of
British object relations theory and modern infancy
research, "The Playground of Psychoanalytic Therapy"
proffers a new understanding of the role of play in the
clinical situation. Jean Sanville takes the reader on a
fascinating journey in which the safe playground of the
therapeutic situation, the therapist's playful
engagement of the patient, and the latter's emergent
ability to embrace playfully the liberating
possibilities of psychoanalytic therapy figure as major
signposts. Following a summary of research findings
about the close relationship between meaning-making and
playing in infancy, Sanville presents two cases that
exemplify the differences involved in doing therapy with
children who can, and cannot, play. She then proceeds to
a series of analogous adult cases, paying special
attention to the diverse ways in which a stunted or
conflict-ridden capacity to play is implicated in
psychopathology, even as the maturation of this capacity
is intrinsic to successful treatment.
A moving chronicle of the
playful discoveries and self-discoveries of a gifted
clinician, "The Playground of Psychoanalytic Therapy" is
a major exploration of Winnicott's claim that
psychotherapy occurs "in the overlap of two areas of
playing, that of the patient and that of the therapist."
It will be read appreciatively by analysts, therapists,
and developmentalists, all of whom will delight in
Sanville's graceful style as they are edified--and
playfully challenged--by her trenchant insights.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Psychoanalysis; *Psychotherapeutic Processes;
*Recreation; Child Psychotherapy |
|
Classification: |
Psychoanalytic Therapy (3315) |
|
Population: |
Human
(10) |
|
Age
Group: |
Childhood (birth-12 yrs) (100) |
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Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Publication Type: |
Book,
Authored Book |
|
Release
Date: |
19920701 |
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Accession Number: |
1991-98946-000 |
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Persistent link to this record:
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1991-98946-000&site=ehost-live">The
playground of psychoanalytic therapy.</A> |
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Database: |
PsycINFO |
Record: 22
|
Title: |
On the
initial stage of psychic experience. |
|
Author(s): |
Vauhkonen, Kauko, Finnish Psychoanalytical Society,
Finland |
|
Source: |
Scandinavian Psychoanalytic Review, Vol 13(1), 1990. pp.
16-31. |
|
Publisher: |
Denmark: Syddansk Universitetsforlag
Publisher URL:
http://www.universitypress.dk |
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ISSN: |
0106-2301 (Print)
1600-0803 (Electronic) |
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Language: |
English |
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Keywords: |
interpretation of repetitive dream in early childhood in
conjunction with illness & fever, adult patient |
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Abstract: |
Describes the dream of an adult patient that occurred
with compulsory repetitiveness in early childhood in
conjunction with illness and fever. The dream is
interpreted as repeating the origin or birth of
awareness, (i.e., psychic consciousness) as the
consequence of thumb sucking during the fetal stage.
Issues relevant to the dream include the primary trauma,
primal repression, primary narcissism, the pleasure
principle, repetition compulsion, and the primordial
experiential contents of Eros and Thanatos. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Disorders; *Dream Analysis; *Early Experience;
Hyperthermia |
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Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
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Population: |
Human
(10) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal |
|
Release
Date: |
19910601 |
|
Accession Number: |
1991-16141-001 |
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Persistent link to this record:
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1991-16141-001&site=ehost-live">On
the initial stage of psychic experience.</A> |
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Database: |
PsycINFO |
Record: 23
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Title: |
Über
Ichveränderungen, die Analysen unendlich machen. |
|
Translated Title: |
On ego
alterations which make analytic processes interminable. |
|
Author(s): |
Anzieu, Didier |
|
Source: |
Jahrbuch der Psychoanalyse, Vol 20, 1987. pp. 9-30. |
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Publisher: |
Germany: Frommann-Holzboog
Publisher URL:
http://www.frommann-holzboog.de |
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ISSN: |
0075-2363 (Print) |
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Language: |
German |
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Keywords: |
ego
alterations & interminable & inconclusive analytic
process, analysands |
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Abstract: |
Expands Freud's (1937) reasons for interminable and
inconclusive analyses and presents a case report and
clinical vignettes of anaclitic and paradoxical
transferential relationships accompanied by negative
therapeutic reactions rooted in traumas in their
personal and family histories. A female analysand is
described who resisted ending analysis because of her
need for an auxiliary ego, her inability to reveal her
sexual conflicts, a preverbal primary trauma, and the
condensation of several additional traumas. Three other
patients are also described who made their analyst the
object of their incestuous, oedipal desires and whose
egos underwent negative alterations when the analyst
unmasked their death wishes, omnipotence desires, and
repetition compulsions. (English abstract) (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
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Subjects: |
*Ego;
*Psychoanalysis; *Psychotherapeutic Processes;
*Treatment Termination |
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Classification: |
Psychoanalytic Therapy (3315) |
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Population: |
Human
(10) |
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Age
Group: |
Adulthood (18 yrs & older) (300) |
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Methodology: |
Empirical Study |
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Publication Type: |
Journal, Peer Reviewed Journal |
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Release
Date: |
19871101 |
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Accession Number: |
1987-31939-001 |
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Persistent link to this record:
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1987-31939-001&site=ehost-live">Über
Ichveränderungen, die Analysen unendlich machen.</A> |
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Database: |
PsycINFO |
Record: 24
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Title: |
Acerca
de algunas alteraciones del yo que transforman a los
análisis en interminables. |
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Translated Title: |
Concerning some ego modifications that make analysis
interminable. |
|
Author(s): |
Anzieu, Didier |
|
Source: |
Revista de Psicoanálisis, Vol 43(3), May-Jun 1986. pp.
487-504. |
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Publisher: |
Argentina: Asociación Psicoanalíitica Argentina |
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ISSN: |
0034-8740 (Print) |
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Language: |
Spanish |
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Keywords: |
Freud's analysis of ego factors predisposing to
interminable analysis, female patient |
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Abstract: |
Discusses 7 questions raised by Freud in his 1937 paper
on interminable analysis, and presents a case study and
clinical vignettes illustrating ego factors predisposing
to interminable analysis. A female patient is described
whose 2nd psychoanalytic treatment was marked by 4
difficulties: (1) condensation of several traumas, (2)
primary trauma previous to the acquisition of speech,
(3) need for a permanent auxiliary ego to make use of
certain psychic functions, and (4) resistance to the
analysis of her sexual inhibitions. (English & French
abstracts) (4 ref) (PsycINFO Database Record (c) 2006
APA, all rights reserved) |
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Subjects: |
*Freud
(Sigmund); *Psychoanalysis; *Psychotherapeutic Processes |
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Classification: |
Psychoanalytic Therapy (3315) |
|
Population: |
Human
(10) |
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Publication Type: |
Journal, Peer Reviewed Journal |
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Release
Date: |
19870601 |
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Correction Date: |
20060530 |
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Accession Number: |
1987-16217-001 |
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Persistent link to this record:
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1987-16217-001&site=ehost-live">Acerca
de algunas alteraciones del yo que transforman a los
análisis en interminables.</A> |
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Database: |
PsycINFO |
Record: 25
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Title: |
La
angustia en las cardiopatías orgánicas. |
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Translated Title: |
Anxiety in the organic cardiopathies. |
|
Author(s): |
Cárcamo, Celes Ernesto |
|
Source: |
Patología psicosomática. = Psychosomatic pathology.
Rascovsky, Arnaldo (Ed); pp. 141-165.
Oxford, England: 'El
Ateneo', 1948. 768 pp. |
|
Language: |
NonEnglish |
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Keywords: |
HEART,
DISEASE, ANXIETY IN; DISEASES, HEART; ANXIETY, IN
CARDIOPATHIES; PSYCHOSOMATICS |
|
Abstract: |
It is
maintained that the anxiety of the patient with organic
heart trouble originates in the perception of a real
danger for the integrity of the psychophysical Ego. It
is a complex psychological structure in which at the
moment of actual anxiety are revived simultaneously the
series of traumatic experiences which from the primary
trauma of birth to the secondary ones of libidinal
development have hewn their engram in the unconscious.
Real anxiety is tinged in every case with an amount of
neurotic anxiety on whose intensity depends the
particular signification which each individual gives
personally to the process. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
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Subjects: |
No
terms assigned |
|
Classification: |
Psychological & Physical Disorders (3200) |
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Publication Type: |
Book;
Print |
|
Document
Type: |
Original Chapter |
|
Release
Date: |
20020405 |
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Accession Number: |
1950-01401-003 |
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Persistent link to this record:
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1950-01401-003&site=ehost-live">La
angustia en las cardiopatías orgánicas.</A> |
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PsycINFO |
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