Severe trauma affects all structures of the selfone's image of the body; the internalized images of the others; and one's values and idealsand leads to a sense that the self-coherence and self-continuity are invaded, assaulted, and systematically broken down. The traumatic events overwhelm the ordinary human adaptations to life and generally involve threats to life or bodily integrity, confront human beings with the extremities of helplessness and terror, and evoke the response of catastrophe. The vulnerable self-structure of traumatized individuals is evident in the following ways: (a) difficulties in selfregulation (self-esteem maintenance, lower tolerance levels, and the sense of self-discontinuity and personal agency), (b) appearance of the clinical symptomatology (frequent upsurges of anxiety/fear, depression, and specific fears or phobias regarding the external world or one's own bodily integrity), and (c) reliance on primitive or less-developed forms of the selfobject relatedness. Severe trauma may lead to de-centering of the self (self-at-worst), loss of groundlessness and a sense of sameness, self-discontinuity and ego-fragility, leaving scars on the one's 'inner agency' of the psyche, fragmentation of the egoidentity resulting in proneness to dissociation.
Abstract:Since the Posttraumatic Stress Disorder (PTSD) has been recognised as an independent mental disorder [1] this disorder became leading disorder present in the courtroom. The definition of the psychological trauma and stressor-related disorders have had many changes in order to clarify diagnostic criterion of the disorder related to the exposure to traumatic or stressful event. However, as psychological distress following exposure to the traumatic event or stressful event is quite variable and, for the past more than three decades, the clinicians tried to establish the most reliable assessment and treatment techniques for PTSD. At the same time, the law faces its own dilemma about this disorder in particular when serious clinical case is charged for the offence. To both the medicine and the law it is clear that many individuals who have been exposed to the traumatic or stressful event exhibit a phenotype in which the most prominent clinical characteristics are anhedonic and dysphoric symptoms, externalizing anger and rage, dissociative symptoms, and relationship changes [2]. Subsequently, PTSD made its way into the courtroom as the outcomes of criminal defences for both violent and non-violent crime.
Complex psychological trauma affects all structures of the personality-one's image of the self, images of the others, and one's values and ideals, and leads to the sense that the personality coherence and continuity is assaulted and systematically broken down. Complex trauma, such as war-related trauma, severe brutal rape, kidnaping, terrorism, etc., overwhelms the ordinary human adaptations to life and involves the threats to life and bodily integrity, and confronts human being with the extremities of helplessness and terror, and evokes response of catastrophe. As the complex trauma is a specific traumatic experience, it requires specifically designed trauma-focused therapeutic approach which should deal with: a) the nature of the predisposing factors in complex trauma, b) the manner in which trauma experience and conditioning produce distortions in trauma victim's personality, c) the relationship between the personality structure and trauma, d) the constituents of inner conflicts, e) meaning function and manifestations of trauma syndrome, f) the structure of the psychic apparatus, and g) the mechanisms of defences. The Dynamic Therapy model has been developed as a three-phase treatment while providing therapy for over decade to the complex PTSD patients whose condition has been an aftermath of human-designed disasters (wars, brutal rapes, assaults and serious violence). The Dynamic Therapy model emphasises that there is a complex process in interactions between different phenomenological components of the complex trauma and that there is a variety of the ways in which etiological factors can contribute to the onset of the trauma syndrome. With the patient's complicated clinical presentations, the therapy accentuates the main principles and targets in treating complex trauma syndrome: 1) trauma symptoms reduction and stabilisation, 2) processing of traumatic memories, dissociation, and emotions, and 3) life integration after trauma processing. The model is a goal-directed phased treatment towards the restoration of a disrupted sense of self that affects the inner and the outer world of a traumatised individual.
BackgroundThe war in former Yugoslavia, which commenced in 1990, caused the biggest refugee crisis in Europe since World War II. There are numerous research investigations into the trauma and associated problems. However, there is no available publication concerning refugees’ own perception of the provided support in host countries.AimsTo investigate how refugees evaluated support received (helpful or detrimental) and what kinds of support they wish to receive in the future.MethodThe study participants were 854 refugees from former Yugoslavia settled in the United Kingdom, Germany, and Italy. Alongside demographic data, they were assessed using International Neuropsychiatric Interview (MINI), Life Stressor Checklist–Revised (LSC–R), Manchester Short Assessment of Quality of Life (MANSA), Matrix for Recording Health Care, Social Interventions (MACSI), and an open questions interview.ResultsData revealed that 99.3% of refugees received some kind of support. The most frequent support (98.7%) was primary health care and the least frequent (34.7%) was support in employment and further training. The most helpful (27.5%) was primary health care, and the most detrimental (11.6%) was legal support. The most desired types of support were help in employment (31.8%) and further education/training (20.5%). The educational level of refugees affected their perceptions of support as detrimental or desired.ConclusionsThere are different levels of received and desired support among host countries. There are also differences in the perception of received and desired support with regard to the refugees’ educational levels.
Traumatic memories are highly emotional, life-altering events that would appear to have the best chance of persisting into the entire life. In complex trauma syndrome, they are usually endless causing often dissociative phenomena-the alterations in one's consciousness. Thus, traumatic memories may cause a constant feeling of intense fears, helplessness, loss of control, affliction of the powerlessness, and threat of annihilation. Traumatised person usually reports loss of the basic sense of self and bodily integrity. The principle of healing is empowerment of the patient's ability to re-create the basic capacities for trust, autonomy, competence, identity, and intimacy. The dissociative PTSD subtype is characterised by overmodulation of the affects-predominance of reexperiencing and hyperarousal symptoms with "hidden" and deeply unconscious traumatic memories. Although there are many ways to conceptualise dissociation, in this article we have emphasised the trauma-induced dissociation that involves detachment from the overwhelming emotional content of the experience during and in the aftermath of trauma experience. It has been hypothesised that such experiences elicit dissociation, promoting discontinuity of one's conscious experience and narrative memory. Four-phased patient oriented Dynamic Therapy model in treating trauma-induced dissociation targets three main goals: 1) restoration of a form of the relatedness (Interconnectivity), 2) restoration of a sense of the aliveness/vitality (Dynamism), and 3) restoration of an awareness of the self and inner events (Insight).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.