“创伤后成长”--理解癌症患者的一个新视角

“创伤后成长”是积极心理学的一个新概念,指个体在与创伤性事件或情境进行抗争后体验到的心理上的正性变化。研究发现癌症患者在经历苦难的同时,也会产生创伤后成长,表现在对新的可能性、与他人关系、生活感恩、个人优势等方面的新感知和精神领域的改变。创伤后成长与患者年龄及心理痛苦水平负相关,与受教育水平、家庭收入、积极应对方式、情绪表达和社会支持正相关。这些结果给临床护理的提示是,重视患者的内在潜能,鼓励患者以积极的应对方式、外化的情绪表达来缓解心理痛苦,通过提供充分的社会支持促进其成长,提高患者抗癌的内在力量。     

“There's a deeper level of meaning as to what suffering's all about”: experiences of religious and spiritual growth following trauma

Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, and positive changes in the realm of existential, spiritual, or religious matters. The purpose of the present study was to examine participants’ phenomenological experiences of spiritual and religious posttraumatic growth (PTG). Transcribed data from semi-structured interviews with 10 women, self-identified as Christian, who had experienced spiritual or religious growth following various trauma were analysed using Interpretative Phenomenological Analysis. Results indicated how religion provided a framework that assisted participants to incorporate life changes, and to find meaning in their suffering. The most salient themes identified in relation to religious and spiritual PTG included: process of spiritual and religious growth, strengthening of religious and spiritual beliefs, and personal and spiritual growth and healing. Participants’ trauma and associated distress prompted a process of questioning and meaning-making that facilitated deeply experienced personal and spiritual growth, and was related to intrinsic religiosity.     

Sacrilege: A Study of Sacred Loss and Desecration and Their Implications for Health and Well-Being in a Community Sample

In this study, we proposed that people understand major life events in terms of spiritual as well as psychological, social, and physical dimensions. Specifically, we examined the possibility that life events that are perceived to be sacred losses or violations of the sacred (i.e., desecrations) have significant implications for the health and well-being of the individual. A total of 117 adults, randomly selected from a community, identified the most negative life event they had experienced in the past two years. They then completed measures of the degree to which they appraised this event as a sacred loss and as a desecration, as well as measures of religious coping, the impact of the event, and four sets of criteria: traumatic impact, physical health, emotional distress, and growth. These hypotheses were largely supported. Sacred loss and desecration were unrelated to physical health. However, they were tied to higher levels, though somewhat differential patterns, of emotional distress. While sacred loss was predictive of intrusive thoughts and depression, desecration was tied to more intrusive thoughts and greater anger. Furthermore, sacred loss was linked to greater posttraumatic growth and positive spiritual change; in contrast, desecration was associated with less posttraumatic growth. The links between the spiritual appraisals and outcomes were partially mediated by positive and negative methods of religious coping. These findings underscore the importance and multidimensionality of the spiritual meanings people attribute to major life stressors.     

Therapy with Women in the Later Stages of Life

This paper addresses the importance of a creative spiritual evolution for the woman in later stages in her life, the unique difficulties she faces in pursuing this aspect of her being, and the clinician's role in helping her meet this life challenge and opportunity. In the ongoing process of self-creation, relevant models and symbols become important sources of direction and inspiration. However, for the aging woman, Western culture and religion offer few nourishing images and the quest for spiritual and creative growth can become a lonely and frightening one. As clinicians, we can help to change this experience by working with clients to identify, generate and integrate symbols and psychological paradigms that will energize the realization of evolving need and potential.     

Posttraumatic growth and religion in Rwanda: individual well-being vs. collective false consciousness

Some scholars include changes in spirituality, such as a greater commitment to their religious beliefs or an enhanced understanding of spiritual matters, in the definition of posttraumatic growth; others conclude that questions of spirituality should be excluded from this definition. This article highlights the fundamental difference of religion to other domains of posttraumatic growth because religions are ideologies (and other domains of growth are not). As ideologies, it is argued that religions can affect different levels of identity in different ways. Based on testimonial evidence from Rwandan genocide survivors, the article demonstrates that although religious beliefs can bring existential comfort at the individual level, they can also lead to a state of false consciousness at the collective level. In Rwanda, the dominant religious ideology facilitated the spiritual and moral climate in which genocide became possible. Today, religious interpretations of the Rwandan Patriotic Front's (RPF) leadership provide spiritual backing to a government which has become increasingly authoritarian.     

Spirituality and Resilience in Trauma Victims

The way people process stressors is critical in determining whether or not trauma will be experienced. Some clinical and neuroimaging findings suggest that posttraumatic stress disorder patients experience difficulty in synthesizing the traumatic experience in a comprehensive narrative. Religiousness and spirituality are strongly based on a personal quest for understanding of questions about life and meaning. Building narratives based on healthy perspectives may facilitate the integration of traumatic sensorial fragments in a new cognitive synthesis, thus working to decrease post-traumatic symptoms. Given the potential effects of spiritual and religious beliefs on coping with traumatic events, the study of the role of spirituality in fostering resilience in trauma survivors may advance our understanding of human adaptation to trauma.     

Secondary traumatic stress and adjustment in therapists who work with sexual violence survivors: the moderating role of posttraumatic growth

ABSTRACT

Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who work with sexual violence survivors completed measures of secondary traumatic stress, posttraumatic growth and a range of adjustment indicators. Hierarchical multiple regression analyses demonstrated that posttraumatic growth moderated the negative impact of secondary traumatic stress on therapist depression, anxiety, personal meaning and satisfaction with life. Posttraumatic growth sustained positive affect through a direct effects model only. This study provides support for the protective role of posttraumatic growth in adjustment to secondary traumatic stress.     

Assessing the Intersectionality of Religious and Sexual Identities During the Coming-Out Process

Lesbian, gay, and bisexual (LGB) individuals often experience internalized and/or externalized religious rejection due to their sexual orientation. Initial steps in the coming-out process can be especially difficult and can result in existential crises, including questioning one's place within the religious/spiritual realm. The authors propose a developmental framework for conceptualizing the role of religion and spirituality in the coming-out process. Cass's (1979, 1984) stage model of coming out and Genia's (1995) model of religious development, along with additional literature addressing LGB spirituality, serve as foundations for this framework. Counseling and research implications of the framework are also discussed.     

Posttraumatic spiritual growth: a phenomenological study of cancer survivors

A small but growing body of research has sought to investigate the specific role of religion and spirituality in posttraumatic growth. Recently, investigations have reported identifying spiritual growth following trauma, specifically that of cancer patients and survivors. The purpose of this qualitative study was to investigate how having cancer affects the spiritual growth of cancer survivors across a multidimensional conceptualisation of spirituality. The researchers investigated posttraumatic spiritual growth by studying the lived experience of 13 cancer survivors using phenomenological data analysis. Participants reported experiencing spiritual growth across the following domains of spirituality: (a) general spirituality, (b) spiritual development, (c) spiritual social participation, (d) spiritual private practices, (e) spiritual support, (f) spiritual coping, (g) spirituality as motivating forces, (h) spiritual experiences, and (i) spiritual commitment. Growth was not endorsed by participants in the following three domains of spirituality outlined in the model: (a) spiritual history, (b) spiritual beliefs and values, and (c) spiritual techniques for regulating and reconciling relationships. Two additional domains of growth emerged beyond the theoretical model that was used to guide this study from participants’ narratives, including evangelism and enhanced spirituality of family/friends.     

PTSD and the influence of context: The self as a social mirror

The principal accepted models of posttraumatic stress disorder (PTSD) are based on both memory processing and biological/brain changes occurring when one's life or well-being is threatened. It is our thesis that these models would be greatly informed by community studies indicating that PTSD is predicted to a greater extent by earlier life experience and experiences that occur distant from the threatening event. These findings suggest posttraumatic responding is best conceptualized through the lens of the self-in-context, as opposed to imprinting that results from a given event at a given time. Moreover, studies of non-Western populations often do not express trauma as PTSD, or at least not primarily as PTSD, which argues against specific neural or memory encoding processes, but rather for a more plastic neural process that is shaped by experience and how the self develops in its cultural context, as a product of a broad array of experiences. We posit that fear and emotional conditioning as well as the ways traumas are encoded in memory are only partial explanatory mechanisms for trauma responding, and that issues of safety and harm, which are long term and developmental, are the common and principal underpinnings of the occurrence of posttraumatic distress, including PTSD.     

Family-Valued and Personally Important Posttraumatic Growth in American and Japanese Adolescents

Posttraumatic growth,the positive psychological changes experienced following stressful events, may serve as a protective factor in adolescents against decreased self-esteem resulting from a stressful experience. Because posttraumatic growth is a value-laden concept, there could be individual and cross-cultural differences in the importance of different contents of posttraumatic growth experiences. This study examined whether personally important posttraumatic growth and family-valued posttraumatic growth affects self- esteem in the same way across American and Japanese adolescents. High school students (age range 15–18 years) from the US (n?=?118) and Japan (n?=?138) who experienced a stressful event within the past three years completed the Rosenberg Self-Esteem Scale and Posttraumatic Growth Inventory, and reported which items on the Posttraumatic Growth Inventory are personally important and which items they believe their family would want them to experience. Results indicated that personally important posttraumatic growth is significantly related to self-esteem only in American adolescents. However, experiencing posttraumatic growth in ways that adolescents feel their family would want them to experience was a significantly associated with self-esteem across both American and Japanese adolescents. These results indicate that adolescents’ self- esteem is likely to be attained despite stressful events when their posttraumatic growth experiences align with their perceptions of their families’ values. This study demonstrates how adolescents’ perceptions of their families values play an active role in their adjustment post stressful experiences in not just collectivistic cultures like Japan, but in individualistic cultures such as the U.S. clinicians should pay attention to the individual differences in the value of posttraumatic growth when developing intervention programs.     

The evolving self: finding meaning in near-death experiences using Interpretative Phenomenological Analysis

Near-death experiences (NDEs) have become a topic of increasing interest to medical and psychological researchers over the last 35 years. During the course of this research agenda, several studies have focused on the phenomenology of the experience and its after-effects, mostly from a nomothetic stance. The aim of this study was to investigate the experience of having an NDE and what meaning NDErs attribute to that experience and its resultant after-effects by taking an idiographic, phenomenological approach. Three female participants took part in recorded face-to-face, semi-structured interviews. Interpretative Phenomenological Analysis found that to more deeply understand the impact of NDEs it is crucial to consider how the experience fits within the biographical context of an individual's life. Rather than being an overall influence on personal and spiritual growth, individuals may choose elements of an experience which are most personally meaningful for them and take that into their later lives. Each participant in some way came to a new understanding in their lives as a result of their NDE. In addition, the process of integration was helped or hindered by physical and psychological factors concomitant at the time of the NDE. Also evident were the challenges the NDE, or elements therein, have on the individual's sense of self and how they maintain and develop that self in the years succeeding the event.     

Whitehead and Wilber: Contrasts in theory

Abstract

The question of how to interpret the ideas and evidence from the transpersonal realm has been a challenge to western psychology since its inception. This article illustrates how process philosophy, as developed by Alfred North Whitehead, can serve as a theoretical foundation for transpersonal psychology. Making it especially qualified for this role are process philosophy's unique approach to the nature of experience, its openness to spiritual matters, and its ability to offer a single framework of thought capable of integrating these issues with the concerns of the scientific and academic communities as well as our experience of everyday life. Following the introduction of some of Whitehead's basic ideas that illustrate this philosophy's relevance to psychological and transpersonal metatheory, aspects of Ken Wilber's new work are examined and criticized from a Whiteheadian perspective.     

Traumatic stress,neural self and the spiritual mind

According to recent findings stressful experiences may influence various physiological disturbances and also neuroanatomical changes and some studies also show that psychotherapy and meditation may influence brain functions. Traumatic stress is frequently related to a dissociative response that disintegrates conscious experience. In this context, self-reflection is an essential principle in the process of posttraumatic growth related to spiritual experiences and meditation states that enable mental integration and create the novel integrated self. According to recent findings there is no widely accepted evidence about specific neural mechanisms of processes related to mental integration linked to the spiritual experiences and meditation. Nevertheless there is growing evidence that these integrative experiences are related to various alterations in the brain’s physiology and morphology. These findings provide a new paradigm for understanding of mental disorders and emphasize the fundamental role of mental integration and integrated self in the therapy of psychiatric disorders.     

BROKEN NARRATIVES: TRAUMA,METACONSTRUCTIVE GAPS,AND THE AUDIENCE OF PSYCHOTHERAPY

A constructivist model of posttraumatic psychotherapy is presented with particular attention to the metaphors of "narrative" and "audience." Metaconstruction, implicit construing, and narrative continuity are explored to conceptualize how persons story their experiences, and how some experiences (e.g., traumas) disrupt the storying process. Then the elements of posttraumatic psychotherapy are discussed with case examples illustrating how the therapist, as audience member and conarrator, facilitates the reconstruction and renarration of the client's life story.     

Feeling good,living life: a spiritual health measure for young children

Following previous work on the spiritual health of secondary students, the author wondered if it was possible to develop a spiritual health measure for younger children. Taking Fisher's model of spiritual health as the basis, items were developed to reflect relationships with self, with others, with the environment and with a god. The children's ideals for spiritual health (what makes them Feel Good) were compared with their lived experience (Living Life) to ascertain their levels of spiritual health. Factor analyses on responses from 1080 students in 14 schools (State, Catholic, Independent and Christian Community Schools) in Victoria and Western Australia are reported in this paper.     

The Dying Process of a Conscious Woman—Virginia Satir

SUMMARY

This article relates the author's experience with Virginia Satir in the last eight days of her life. The detail of incidents and interactions is most revealing of Virginia's ability to deal with such a poignant time in her own life in an open, focused manner and in a process like she taught others. There is a strong spiritual and human quality that the reader will find deeply moving.     

负性生活事件、社会支持和创伤后应激障碍症状：对汶川地震后青少年的追踪研究

创伤后应激障碍是灾难后常见的心理病理问题, 灾后继发负性生活事件和社会支持是影响创伤后应激障碍症状的重要因素。该研究采用追踪设计, 历时2年对汶川地震后都江堰地区1573名青少年进行3次测查, 考察震后继发负性生活事件、不同类型社会支持与创伤后应激障碍症状之间的相互作用关系。研究发现：不同类型的社会支持与震后继发负性生活事件、创伤后应激障碍症状存在不同的作用关系; 震后继发负性生活事件不仅直接影响个体的心理健康还对个体的社会支持系统有损害; 震后负性生活事件、主观支持与创伤后应激障碍症状存在联动效应, 即三者中任一方面的变化都可能引起其他方面的变化。     

States of Spiritual Awareness by Time,Activity, and Social Interaction

We explore how people experience the sacred in their everyday lives using a recently developed research technique—smartphone‐based experience sampling method (S‐ESM). The primary goal of our experience‐driven approach is to explore the contours and variations of spiritual awareness within people's day‐to‐day lives. We seek to better understand when and where spiritual awareness is likely to arise, and the contexts in which it is rare. Our smartphone‐based data allow us to track the many contexts in which an awareness of the sacred occurs, as reported in real time during people's normal daily activities. We parse out how immediate contextual factors and how people's more habitual behaviors are related to their spiritual experiences. This illuminates a wide range of factors that influence spiritual experiences that have not received much scholarly attention, and enables us to connect cutting‐edge quantitative methods with qualitative scholarship on spirituality. We hope this will open the door to the development of new theories of situated spiritual experience.     

Predictors of posttraumatic growth following bone marrow transplantation for cancer.

There is growing recognition that the experience of cancer can have a positive as well as a negative psychological impact. This longitudinal study sought to identify predictors of posttraumatic growth among cancer patients (N=72) undergoing bone marrow transplantation. Greater posttraumatic growth in the posttransplant period was related to younger age; less education; greater use of positive reinterpretation, problem solving, and seeking alternative rewards as coping strategies in the pretransplant period; more stressful appraisal of aspects of the transplant experience; and more negatively biased recall of pretransplant levels of psychological distress. Findings partially support J. A. Schaefer and R. H. Moos's (1992) model of life crises and personal growth and also suggest that temporal self-comparisons contribute to the experience of posttraumatic growth.