When a person’s brain is exposed to overwhelming stressful information all at once, the phenomenon is understood as a potential traumatic situation.
Traumatic experiences are combined with extreme fear. What happens is that all the sensations (smells, noise, colors, sights, etc. ) received during the traumatic situation is locked up in long-term memory fragmented.
Non-traumatic or explicit memory, on the other hand, is contextual, conscious and to a certain extent, stable. This type of memory can be re-called or put aside almost at will, can be described, re-worked, and emotions surrounding the memory does not control the person’s here-and-now. The person is able to use this memory to make meaning, learn, make adjustments. This kind of memory is coupled with language and we can talk/write about them.
Traumatic memory, on the other hand is quite different.
Memory from traumatic occurrences can become intrusive. Sensory stimulation from sights and sounds trigger the memories. The individual becomes almost unable to put the memories aside. Emotions from the traumatic situations are felt as if the trauma is still occurring. Sometimes these memories trigger flashbacks. The person is rendered helpless against the flood of the memories.
These memories are also fragmented. The person finds it difficult to put the events into a cohesive whole. Some pieces are forgotten, and cannot be recalled.
Often the memories are decoupled from speech. The person can feel and see the memories in the mind, but finds difficulty in putting the contents of it into verbal language.
Patience, empathy and contact
Psychical trauma is injury to the psyche, and sense of the self. The consequence of trauma renders a person helpless against being overwhelmed by memories and flashbacks. Therapy with patients of trauma need time, trust and patience. Combined use of verbal and non-verbal communication makes for effective therapy. Empathic communication with the client relieves the individual of the isolation of having to live with such events.
Schubbe, O. (2004). Traumatherapie mit EMDR. Order, 22, 99.
While PTSD is a typical response to a single stressor in adulthood, Complex posttraumatic Stress Disorder ( CPTSD ) is the result of childhood experience of abuse.
Complex Posttraumatic Stress Disorder CPTSD occurs in neither ICD nor DSM, but it has been proposed for over two decades (p.190). Adult victims of CPTSD suffer lifelong effects of emotional and physical instability of varying degrees of severity, making them also vulnerable in the face of stressful life situations.
Consequences of CPTSD:
Another name proposed for this disorder is “developmental trauma disorder.” CPTSD compromises an individual’s identity, self-worth, and personality; emotional regulation and self-regulation; and ability to relate to others and engage in intimacy.
Individuals can experience ongoing despair, lack of meaning, and a crisis of spirituality.
Children are Victims of CPTSD
While PTSD is an atypical response in traumatized adults, developmental trauma may be a very common (and thus the typical) response in traumatized children. Such trauma often goes unrecognized, is misunderstood or denied, or is misdiagnosed by many who assess and treat children.
Children are, due to their immaturity and helplessness, are more prone to being traumatized than adults. They are also easy targets for narcissistic abuse.
Types of Abuse in CPTSD
CPTSD is generally associated with a history of chronic neglect, trauma, and abuse over the course of childhood. Neglect in early childhood compromises secure attachment and tends to result in avoidant or resistant/ambivalent attachment—or, most severely, toward the disorganized/disoriented attachment style that leads to significant dissociative pathology.
This neglect sets the stage for trauma in early childhood, which further interferes with normal affective maturation and the verbalization of feelings, leading to anhedonia, alexithymia, and intolerance of affective expression. Children and adolescents are more prone to dissociate than are adults.
Experience of Betrayal
Dissociation is especially linked to betrayal trauma—the neglect that allows for, or passively tolerate, more active trauma.
In the face of continued betrayal trauma, dissociation is the child’s best life-saving strategy.
The Bystander Parent
Repeated trauma in childhood involves a perpetrator and victim, but also a parent who permits the trauma to occur; is uninvolved, oblivious, and neglectful; or else is paralyzed by fear into inaction. Patient and therapist may find themselves playing any of these roles and their opposites.
Psychotherapeutic Treatment of CPTSD
When a client comes to therapy, it is often not apparent that he/she suffers CPTSD. Adult clients visit therapy for an array of symptoms that include (but not exclusively) depressive, anxiety, obsessive-compulsive, posttraumatic, dissociative, somatoform, eating, sleep-wake, sexual, gender, impulse-control, substance and non-substance dependency disorders and personality disorders.
There is a danger that therapists who are not aware of CPTSD overlook childhood experiences and spend too much focus on the diagnosed symptom.
If the therapist were to treat the trauma of CPTSD itself, this treatment if successful can ameliorate all the symptoms. This requires that the childhood abuse experiences be recounted and worked through.
The Therapeutic Process
It is common that the patient who has CPTSD will not be able to recollect the events of abuse. If he/she did, he/she may not be able to experience the feelings associated with the time. This is because of the dissociation of the child who was in the situation. Freud explains that what the client does not remember, he acts out. It is important for the therapist to be observant to the repeated behavior of the client in the interaction with the therapist.
The trauma and neglect of CPTSD are essentially relational, and so the therapeutic relationship itself becomes the principal vehicle of change. How the therapist feels, thinks, and acts depends on what aspect of the neglect/trauma drama is being played out with the patient (p.191).
Dealing with childhood trauma is a complicated process in therapy. There may a degree of enactment in the transference and this can be confusing. What is really necessary is a sound therapeutic alliance based on trust. Within the transference relationship, the client a therapist experience the client’s enactments and attitudes towards the abusing parent, the bystander parent and the client as victim and perpetrator. For this reason, the therapist has to be alert to the phenomenology and the here-and-now of what unfolds in the therapy sessions.
Lingiardi, Vittorio. Psychodynamic Diagnostic Manual, Second Edition (Page 192). The Guilford Press. Kindle Edition.
“Personal control” was identified as the psychological concept central to privacy.
Definition of Privacy
Wolfe &Laufer (1974) write: “The need and ability to exert control over self, objects, spaces, information and behavior is a critical element in any concept of privacy” (p. 3).
Three aspects of privacy, all of which are concerned with control:
freedom to choose or control of choice,
control over how much access others have to one’s thoughts and behaviors,
control over how much the environment can affect one, i.e. the ability to shield oneself from the effects of the environment if necessary.
Altman (1974) defines privacy as “the selective control over access to the self or to one’s group” (p. 6).
Definition of Personal Control
The term “personal control” is related to terms like “autonomy,” “freedom,” and “power”.
Personal Control as a Psychological Concept
Byrne and Clore (1967) : Situations that threaten a person’s perception of personal control are noxious to the person. This motivates the person with the need to attempt at restoring effective control over him/herself in the situation. The person adapts to the situation by reacting in a way to maintain personal control.
When personal control is greatly compromised, and if the situation is not improved, the individual adapts to this situation through behavioral responses, and/or psycho and somatic responses, which are part of the creative adjustment to the adverse environmental situation.
This is not different from the response of a person to traumatic situations. What are the symptoms of trauma? What are the adaptations to traumatic experiences?
Privacy may be described as two-way information control. For Altman, “Privacy is an interpersonal boundary control process, designed to pace
and regulate interactions with others” (p. 3, emphasis added).
Wolfe and Laufer (1974) suggest that privacy has three aspects:
control over choice,
control over access, and
control over stimulation.
Westin (1967) : Privacy is the “claim of individuals, groups or institutions to determine for themselves when, how, and to what extent information about them is communicated to others” (p. 7)
“…the most serious threats to an individual’s autonomy is the possibility that someone may penetrate the inner zone and learn his secrets … [which] would have him naked to ridicule and shame and would put him under the control of those who know his secrets” (p. 36, emphasis added).
Interesting point. What is the intention of the other to deprive the individual of privacy? Control? What is behind this behavior? Fear? misstrust? Insecurity? How does projective identification does this.
Kelvin (1973) views privacy as a kind of counterpower that one can exercise to modify or nullify the perceived power of others. “Thus privacy is not simply freedom of action due to the absence of intervention or constraint, but freedom in a context of potential power which might inhibit it” (p. 11).
In sum, privacy as control is behavior selection control. As such it is particularly immune to consistency validation. As a result, privacy concerns are more likely than many other control concerns to create conditions for stress. Research suggests that disease may be a consequence of uncertain outcome control (i.e., low behavior-selection control, Weiss, 1972). Other data suggest that suddenly losing control–as when behav- iors which previously had been adequate, fail to work in a new situation– is also highly predictive of disease (Stroebel, in Luce, 1971).
Holmes and Rahe (1967) found that chronic disease correlated highly with
the magnitude of social readjustments required of people in a given duration. The authors argue that uncertainty, especially about how to act in new situations, produces stress that contributes to disease. Certain aspects
of privacy as well (i.e., uncertainty about privacy requirements) may prove contribute significantly to disease. Some concern about this relationship has been expressed recently in the medical literature (Kornfeld, 1972). In view of these possibilities, imaginative and well-designed research into
the relationship between privacy and disease, especially between privacy and recovery from disease in hospitals and other treatment facilities, is called for.
Altman, I. Privacy: A Conceptual Analysis. In S. T. Margulis (Chm.), Privacy as a Behavioral Phenomenon, Symposium presented at the meeting of the Environmental Design Research Association, Milwaukee, Hay, 1974.
HOLMES, T. H., &RAHE, R. H. The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 1967, 11, 213-218.
KELVIN, P. A Social-Psychological Examination of Privacy. British Journal of Social and Clinical Psychology, 1973, 12, 248-261.
WOLFE, M., &LAUFER, R. S. The Concept of Privacy in Childhood and Adolescence. In S. T. Margulis (Chm.), Privacy as a Behavioral Phenomenon, Symposium presented at the meeting of the Environmental Design Research
A ssociation, Milwaukee, Hay, 1974.
WESTIN, A. F. Privacy and Freedom. New York: Antheneum, 1967.
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