When is trauma really trauma?
Researchers and psychotherapists alike are concerned about the historical accuracy of the narratives reported. Memories can fail or phantasies can be mistaken for memories. This is not that we disbelief the subject or client. Even as therapists ourselves who have done hundreds of hours of personal therapy, we are aware of the fact that we too are not sure about what we remember and what we forget. Forgetting is after all a very present phenomenon of trauma.
Retrospective reports are driven by current experiences. What is in the foreground today may affect how we perceive the background.
Studies have also shown that childhood exposure to trauma leads to sometime destructive relationship patterns.
“Recent research has shown not only the accuracy of retrospectively obtained abuse histories, but also the stability over time of these reports, even when comparing pre- and post-therapy reports (Maughan & Rutter, 1997; Paivio, 2001). This study also used an interview-based method in which the rater was required to identify vignettes in which the individual trauma types could be identified. This approach may protect against false positives.” (Drapeu & Perry 2004)
What is traumatic?
When is an event traumatic enough to be considered as trauma, to the point of having a significant effect on the person?
This raises two possibilities in regards to the present study. The comparison of adult relationship patterns is made between trauma and non-trauma group.
“In this case, trauma could be seen as a dichotomous variable (present–absent). However, secondly, if the effects of trauma are cumulative, then correlations may reveal positive findings not captured by group comparisons. In this case, a dichotomous approach would not be sufficient, and other aspects of trauma such as duration or severity of the abuse or number of perpetrators should also be considered.”
the Traumatic Antecedents Interview (TAI) Scale.
What are the necessary conditions that have the impact of being traumatic?
“Childhood events can be considered traumatic either as a matter of definition or because a stressful event had certain traumatogenic qualities, such as feeling threatened, unable to protect oneself, fend off, or otherwise master a threat, and feeling responsible for its occurrence. Most research takes the approach of identifying traumas ostensively and focusing on clear-cut events such as physical or sexual abuse that are considered gross psychological traumas by wide consensus (Roy & Perry, 2004).”
Thus, trauma is often divided into two broad categories:
- (1) gross psychological trauma and
- (2) patterns of experiences or more subjective or “subtle” trauma. e.g. CPTSD
Studies on the first category, that is, with major traumata, as assessed using the TAI (Herman, Perry, & Van der Kolk
In its original form (Herman et al., 1989), the TAI was a 100-item semi-structured interview designed to elicit the reporting of both intra- and extra-familial interpersonal childhood trauma.
In the research by Drapeau & Perry (2004), three additional variables have been added for the present study to assess 12 areas, 10 of which are considered as possible gross trauma. These include Physical abuse, Sexual abuse, Witnessing violence, Physical neglect, Emo- M. Drapeau, J.C. Perry / Child Abuse & Neglect 28 (2004) 1049–1066 neglect, Significant separations, Losses, Domestic chaos, Verbal abuse, and Parental discord. Two additional positive variables are also included: the presence of Caretakers/confidantes and the display of Mutual affection between the parents.
For scoring purposes, a subject’s childhood is divided into three periods, including an early period (0–6 years), a middle period (7–12 years), and a late period (13–18 years). In this study, however, only the total scores across all three-age periods will be examined.
Physical and Sexual abuse, Witnessing violence, Significant separations, Losses, and Verbal abuse are each given scores from 0 to n, with n being the number of perpetrators (or significant separations or losses) in each of the three developmental periods. Physical and Emotional neglect, Domestic chaos, Parental discord, and Parental mutual affection are given scores of 0 (absence) or 1 (presence) for each developmental period. Caretakers/confidantes are scored from 0 to 2 for each age period, reflecting the common finding of two caretakers in a healthy, western nuclear family. Specific predefined criteria are provided for eight of the variables in the instrument’s rating manual (Perry & Herman, 1992). This manual also contains examples of scored vignettes to which the rater can refer when scoring the TAI. The reliability of the TAI variables ranged from acceptable to excellent (median Intraclass R = .73) (Roy & Perry, 2004), and previous studies have demonstrated robust associations between specific types of trauma and both Axis II disorders and self-destructive phenomena (Herman et al., 1989; Van der Kolk, Perry, & Herman, 1991).
Bibliography
Drapeau, M., & Perry, J. C. (2004). Childhood trauma and adult interpersonal functioning: A study using the Core Conflictual Relationship Theme Method (CCRT). Child abuse & neglect, 28(10), 1049-1066.
Herman, J. L., Perry, J. C., & Van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490–495.
Van der Kolk, B. A., Perry, J. C., & Herman, J. L. (1991). Childhood origins of self-destructive behavior. American Journal of Psychiatry, 148, 1665–1671.