The nature of intrusive memories after trauma: the warning signal hypothesis

Individuals who had experienced a range of different traumas were asked to describe the quality and content of their intrusive memories. Visual intrusions were the most common, and thoughts were uncommon. Intrusion quality varied little with type of trauma. Intrusive memories commonly consisted of stimuli that were present immediately before the traumatic event happened or shortly before the moments that had the largest emotional impact (i.e., when the meaning of the event became more traumatic). It is suggested that intrusive memories are about stimuli that through temporal association with the trauma acquired the status of warning signals, i.e., stimuli that if encountered again would indicate impending danger. This explains why intrusive memories are accompanied by a sense of serious current threat. The warning signal hypothesis may be useful in guiding therapists in identifying the moments with the largest emotional impact that will need reprocessing in treatment, and in educating patients about the nature of reexperiencing symptoms.     

“I can Almost Remember it Now”: Between Personal and Collective Memories of Massive Social Trauma

This article explores the psycho-social space between autobiographical and collective memory concerning massive social traumas. It is conceptualized that there is a third type of memory image, termed “my-their.” Individuals appear to “remember” autobiographical memories of elder family members, even though they could not, either because they were born after the trauma happened or because the autobiographers were extremely young at the time of the experience. These emotional “memories” furthermore connect to collective memories of social traumas of ethnic/national groups. Examples from memories of the Holocaust and al Naqba are examined. Furthermore, the roles that “my-their” memory images can play in peace building and reconciliation are discussed.     

Rrepresentations of trauma in infancy: Clinical and theoretical implications for the understanding of early memory

Understanding the nature of the infant's internal experience is a crucial prerequisite for delineating the developmental effects of an early trauma. In addition, to the extent that internal representations of a trauma can be traced over time, traumatic experiences present unique opportunities for the study of early memory. This article will describe case vignettes of children who experienced a trauma in the preverbal period and who evidenced forms of memory of their trauma at subsequent points in time. In conjunction with the clinical material, developmental research bearing on the types of early memories described will be discussed. The clinical data, reinforced by research findings, indicate that preverbal children, even in the first year of life, can establish and retain some form of internal representation of a traumatic event over significant periods of time. The specificity and enduring nature of the internal representations suggest that specific therapeutic interventions over and above general comforting will be required if an infant is to maximally recover from a trauma. The clinical findings have relevance for a number of issues currently under debate in the area of infant memory, including the role of reminders in memory retention, the nature of early memory systems, and the development of autobiographical memory. ©2002 Michigan Association for Infant Mental Health.     

Healing the wounds of our fathers: intergenerational trauma, memory, symbolization and narrative

This paper explores the history of psychoanalytical approaches to intergenerational trauma, both from the Freudian and from the Jungian schools, and addresses the need when we speak of intergenerational or transmitted trauma to better define the nature and the different categories of trauma with particular reference to extreme and cumulative traumas such as those experienced by the survivors of the Nazi death camps and the Russian gulags. Therapy with survivors and with their children requires a particular adaptation of analytical technique as what is at stake is not so much the analysis of the here and now of the transference and countertransference dynamics which indeed can in the early stages be counterproductive, but the capacity of the analyst to accept the reality of the trauma with all its devastating and mind-shattering emotions without losing the capacity to imagine and to play metaphorically with images, essential if the patient is to be able to create a space for representation.     

The coherence of memories for trauma: Evidence from posttraumatic stress disorder

Participants with posttraumatic stress disorder (PTSD) and participants with a trauma but without PTSD wrote narratives of their trauma and, for comparison, of the most-important and the happiest events that occurred within a year of their trauma. They then rated these three events on coherence. Based on participants’ self-ratings and on naïve-observer scorings of the participants’ narratives, memories of traumas were not more incoherent than the comparison memories in participants in general or in participants with PTSD. This study comprehensively assesses narrative coherence using a full two (PTSD or not) by two (traumatic event or not) design. The results are counter to most prevalent theoretical views of memory for trauma.     

Parental Emotional Response to Children’s Traumas

To better understand how parents react to their child’s trauma exposure and evaluate whether different reactions are related to different types of traumas, 120 parents (79.2% mothers, 18.3% fathers, 2.5% other caregivers) were asked about their emotional reactions related to their child’s self-reported worst trauma. Emotional reactions were assessed with the Parental Emotional Reactions Questionnaire (PERQ). Parents reported high levels of distress and guilt. Furthermore, there was a significant relationship between type of trauma and parents’ overall emotional reactions. Parental distress was equally endorsed among the different trauma groups. Parents of children who experienced intrafamilial violence and extrafamilial sexual abuse reported the highest levels of guilt, and child exposure to intrafamilial violence was associated with higher levels of parental shame.     

Changes in Neuroticism Following Trauma Exposure

Using longitudinal data, the present study examined change in midlife neuroticism following trauma exposure. Our primary analyses included 670 participants (M_age = 60.55; 65.22% male, 99.70% Caucasian) who completed the NEO Personality Inventory at ages 42 and 50 and reported their lifetime exposure to traumatic events approximately 10 years later. No differences in pre‐ and post‐trauma neuroticism scores were found among individuals who experienced all of their lifetime traumas in the interval between the personality assessments. Results were instead consistent with normative age‐related declines in neuroticism throughout adulthood. Furthermore, longitudinal changes in neuroticism scores did not differ between individuals with and without histories of midlife trauma exposure. Examination of change in neuroticism following life‐threatening traumas yielded a comparable pattern of results. Analysis of facet‐level scores largely replicated findings from the domain scores. Overall, our findings suggest that neuroticism does not reliably change following exposure to traumatic events in middle adulthood. Supplemental analyses indicated that individuals exposed to life‐threatening traumas in childhood or adolescence reported higher midlife neuroticism than individuals who experienced severe traumas in adulthood. Life‐threatening traumatic events encountered early in life may have a more pronounced impact on adulthood personality than recent traumatic events.     

Sexual trauma and personality: developmental vulnerability and additive effects.

Two types of sexual trauma, sexual abuse in childhood and rape in adulthood, were investigated in terms of possible effects on personality. Four groups of participants were studied: women who had experienced sexual abuse in childhood, women who had experienced rape as adults, women who had experienced both of these sexual traumas, and a control group of women who had experienced no sexual trauma. Personality functioning was assessed using the Dimensional Assessment of Personality Pathology. Groups who had experienced childhood sexual abuse displayed the highest degree of personality disturbance; however, the additive effects of repeated sexual trauma were limited. These findings may reflect the outcome of specific adversity in childhood on the psychobiological constructs underlying personality.     

Towards a cognitive-behavioral model of PTSD in children and adolescents

Posttraumatic stress disorder in children and adolescents has been studied only for the past 15–20 years and is the subject of a burgeoning corpus of research. Much research has focused on examining whether children and adolescents have the same responses to trauma as those experienced by adults. Many of the research tools used to investigate children's responses are taken from measures designed for use with adults, and these measures have proven to be useful. However, it has not been established that children's responses to traumatic events are related to the same underlying processes as are adults' responses. The possible application of 2 recent cognitive models of PTSD in adults to understanding PTSD in children and adolescents is discussed in this paper, within the context of what is already known about children's reaction to trauma and existing theoretical accounts of childhood PTSD. Particular attention is paid toward the nature of children's memories of traumatic events and how these memories relate to the reexperiencing symptoms of PTSD, and cognitive processes that may play a role in the maintenance of PTSD. It is proposed that the adoption of a more specific cognitive–behavioral framework in the study of this disorder may be beneficial and lead to better treatment outcomes.     

Vantage point in traumatic memory

Abstract— Persons with posttraumatic stress disorder (PTSD) spontaneously recalled the traumatic event that led to their condition from either a field or an observer vantage point. In the former case, participants recollected the event as if they were seeing it again through their own eyes; in the latter case, the event was recalled from the perspective of a detached spectator. Analysis of the two types of recollections revealed marked differences in their contents. Whereas field memories afforded richer accounts of the affective reactions, somatic sensations, and psychological states that participants experienced during the focal trauma, observer memories contained more information about participants' physical appearance and actions and the spatial layout of the traumatic scene. Observer trauma memories were also experienced as less emotional and anxiety provoking than field trauma memories. The discussion focuses on the clinical implications of these findings and prospects for future research on traumatic memory.     

The use of play to promote insightfulness in the analysis of children suffering from cumulative trauma

Psychoanalytic opinion continues to be dichotomized in regard to the role of trauma versus intrapsychic conflict as contributing to pathogenesis. This paper emphasizes the importance of conflict in both the experience and processing of trauma, so that problems in talking about it and processing it verbally are taken as evidence of conflict and defense. Cumulative trauma and its analysis in children are emphasized. While children in analysis find remembering and talking about their traumas difficult, they can know such experiences and modulate the anxiety of knowing when they do so in play. A clinical vignette is presented to demonstrate this way of using play to promote more advanced mentalization or insightfulness.     

(In)Visible Scars: Two Siblings,a Shared Trauma History,and Their Play

ABSTRACT

This paper tells the story of two siblings and their shared trauma history, with one in the role of the abused, and the other of the bystander. In their play both children reveal true differences and similarities of their heart-wrenching life stories. Several examples of Donnie and Angelique’s play over the course of treatment are compared for the purpose of reflecting on ways these siblings, who experienced markedly different attachment models and different perspectives of violent abuse, symbolized and healed from trauma. This kind of case study has implications about the role of attachment and the value of play-based treatment to psychological processes in severely traumatized youth.     

The impact of depression and PTSD symptom severity on trauma memory

Posttraumatic stress disorder (PTSD) and depression frequently co-occur following a traumatic event. Differences in the processing of autobiographical memory have been observed in both disorders in the form of overgeneralised memories and negative intrusive memories. The current study examined how symptoms of PTSD and depression influence the phenomenological characteristics of trauma memories. Undergraduate students who had experienced a traumatic event (n?=?696) completed questionnaires online including measures of PTSD and depressive symptom severity. They rated their trauma memory on several phenomenological characteristics using the Memory Experiences Questionnaire [Sutin, A. R., &; Robins, R. W. (2007). Phenomenology of autobiographical memories: The memory experiences questionnaire. Memory.]. Moderated multiple regression was used to examine how PTSD and depressive symptom severity related to each phenomenological characteristic. Symptoms of PTSD and depression were related separately and uniquely to the phenomenological characteristics of the trauma memory. PTSD severity predicted trauma memories that were more negative, contained higher sensory detail, and were more vivid. In contrast, depressive symptom severity predicted trauma memories that were less accessible and less coherent. These findings suggest that depressive and PTSD symptomatology affect traumatic memory differently and support a distinction between these two disorders.     

Mothers and Children Together

Summary

Treatment groups for both mothers and children together who have experienced mother assault is a unique therapeutic milieu which has been underutilized in the treatment field. This article presents a 10-week feminist-informed family systems group model as part of a treatment approach for children exposed to family violence and can be used with families of children from pre-school to adolescence. This model provides a context in which the experience of family violence can be debriefed, and issues related to trauma, safety, secrecy, and post-abuse family restructuring can be addressed by family members together. In addition, play and art therapy based interventions are presented and are tailored for the beginning, middle, and end of the group process.     

Child survivors and childbearing; memories from the Holocaust invading the present

In this article—based on 40 video-taped interviews with Jewish child survivors—the author discusses how memories from the Holocaust invade the present and affect one of the most sensitive phases of the life cycle, the period of reproduction. This is discussed as applied psychoanalytic research of oral testimonies. Four areas of knowledge—history, autobiography narrative, cognitive memory research and psychoanalytical theory—are argued to help to elucidate memories and understand the tremendous force which the intersection exerts on them in the present, which is the fundamental idea of this article. The author discusses both the possibility to work through massive traumas, and the distorted concept of time. The Nazi deeds which were intended to eliminate women and children, to split families, that is, break down the continuity of life, affected both those who were directly involved, and those women and men who witnessed these deeds.     

Characteristics of memories for traumatic and nontraumatic birth

Evidence for memory characteristic differences between trauma and other memories in non‐clinical samples is inconsistent. However, trauma is frequently confounded with the event recalled. This study compares trauma and nontrauma memories for the same event, childbirth, in a non‐clinical sample of 285 women 4–6 weeks after birth. None of the women met diagnostic criteria for post‐traumatic stress disorder. Traumatic birth, defined by the DSM‐5 event criterion, was reported by 100 women. The ratings of some memory characteristics did not differ between memories for traumatic and nontraumatic birth: All were rated highly coherent and central to women's lives, with moderate sensory memory. However, women who experienced traumatic births reported more involuntary recall, reliving, and negative/mixed emotions. Thus, trauma memories differed from nontrauma memories. In this non‐clinical sample, this is likely to be due to encoding during trauma rather than the distinctive memory profile for memories retrieved by those experiencing trauma symptoms.     

Neuroticism and self-criticism associated with posttraumatic stress disorder in a nationally representative sample

Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.     

Transformation of Perception of Trauma by Child Survivors of the Holocaust in Group Therapy

Intensive work with child survivors of the Holocaust has made us aware of the clinical importance of understanding the ways children perceive their traumas and the conclusions they draw about how they must live their lives. When these perceptions are transformed congruently with the child's development, the survivors can cope quite well. In this paper we refer to now middle-aged survivors who are still guided by their child perceptions. We will describe how we have used conjoint group psychotherapy to facilitate processes of transformation even at this late stage. The model we provide for trauma work with Holocaust survivors whose traumatization occurred decades ago may well provide tools to reduce future suffering of children who are victims of massive traumatization today.     

Trauma event autobiographies: An exploratory multiple case study

This multiple case study explored trauma event memories of three individuals to characterise underlying meanings important for their recovery. The three participants were women in the age range of 43 to 54 years old, who shared their own memories of a trauma-laden event four to five years post-occurrence. Thematic analysis of the autobiographical narratives indicated underlying memories across cases of silence imposed on trauma victims by their social environments and communities. Differences in trauma autobiographical memories were in meaning making within the context of the participants’ own culture, society, and community. Autobiographical memory studies appear to have value for understanding likely pathways to recovery from trauma     

Mothers who were severely abused during childhood and their children talk about emotions: Co‐construction of narratives in light of maternal trauma

The article focuses on detailed examination of the co‐construction of emotion dialogues between mothers and their 6‐year‐old children in light of mothers' experiences of being sexually, physically, and emotionally abused during childhood. We present examples from dialogues between 3 mothers and their children about emotional events experienced by the children and illustrate emotionally mismatched co‐construction processes. To better understand these difficulties, the article also provides vignettes from interviews with mothers about children's inner worlds and show how examining the interviews may help explain the unfolding of the dialogues and particularly points of difficulty. The dialogues between the mothers and their children were assessed using the Autobiographical Emotional Events Dialogue procedure (Koren‐Karie, Oppenheim, Chaimovich, & Etzion‐Carasso, 2000). The maternal interviews were obtained using the Insightfulness Assessment procedure (Oppenheim & Koren‐Karie, 2002). The discussion focuses on the significance of mother–child dialogues in shaping children's inner world, and points to the importance of providing intervention for adults who experienced childhood traumas that address not only their own personal issues but also their functioning as parents.