Perceptions of War Trauma and Healing of Marital Relations Among Torture-surviving Congolese Couples Participating in Multicouple Therapy

Citizens of the Democratic Republic of Congo (DRC) experienced widespread torture during national wars between 1998 and 2003. Couples who survived and stayed intact suffered tremendous relationship stress. This study used a critical ethnography framework to explore the prewar, wartime, and postwar experiences of 13 torture-surviving couples who participated in a 10-session Torture-Surviving Couple Group in 2008 in the DRC. The group was designed to address the relational effects of torture and war trauma. Participants reported profound negative effects of the war on their relationships; mostly positive experiences during the group, including marital and peer connection and relationship growth; and a number of improvements in their relationship after the group. Implications include support for the use of relational interventions informed by both treatments for traumatic stress and couple approaches to promote trauma healing. Future directions call for increased funding, research, training, and clinical action to treat the effects of traumatic stress on relational family dynamics.     

Relational Lockdown and Relational Trauma† in the Time of Coronavirus: A Reflection from a UK Family Therapist

Like a meteor hitting the earth’s surface, 44, 131 ^‡ unexpected deaths have shaken, disturbed, and saddened the core of our nation. This reflection considers the consequences of the coronavirus crisis in the UK with particular reference to the impact on families and on the practice of family therapists. The perspective presented can only be partial because of the fast-changing situation and the limited access to alternative perspectives that are available during this period of relational lockdown. The author provides a systemic understanding of what has happened and what is happening.     

Healing cultural trauma and its application to the Router programme

This paper explores the issue of cultural trauma, which is an area of concern in psychology generally and has emerged as one within the International Association for Analytical Psychology’s Router training programme. A summary of responses to the issues of cultural trauma and complexes (alongside cultural differences) within analytical psychology are presented, followed by an overview of findings from the IAAP’s evaluation of the Router training programme. These findings are then aligned with contemporary sociological research. The significant issues involved in healing cultural trauma seem to be ‘working through’, as well as the place of imagination, dreamwork, symbolism and metaphor. Research in Poland has specifically highlighted the importance of good governance, economic vitality, personal and social capital (as in education and social participation), a meaning system, certain external contingencies, channels of mobility and ritualism.     

Adverse Childhood Experiences,Trauma Symptoms,Mindfulness, and Intimate Partner Violence: Therapeutic Implications for Marginalized Men

Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field’s scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men’s physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men’s victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.     

Developmental Trauma Disorder: A Provisional Diagnosis

Developmental trauma disorder is a provisional disorder that characterizes multiple trauma exposure that impairs certain domains of human development. These domains are attachment, cognition, behavior regulation, affect regulation, self-concept, dissociation, and biological functioning and maturation. This article reviews the literature and discusses the present understanding of these 7 domains. It discusses the effects of developmental trauma exposure on each domain and alludes to the importance of clinicians understanding the complexity and diversity of development trauma outcomes.     

Physical and Mental Health and Functioning Among Traumatic Brain Injury Close Relatives: The Role of Posttraumatic Stress Symptoms

Severe Traumatic brain injury (sTBI) often instigates widespread long-lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients’ close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well-documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region > 3) and close relatives were included in a multi-center, prospective cohort study (TRAST-MI). One-hundred patients and their relatives were assessed at 2, 6, and 12 months post injury. Outcome variables included health-related quality of life (SF-12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives’ physical health was predicted by relatives’ PTS symptoms (Slope=−1.76; p = .043), and mental health was predicted by both patients’ (Slope=−2.77; p = .034) and relatives’ (Slope=−6.59; p < .001) PTS symptoms. Functioning level was only predicted by patients’ PTS symptoms (Slope=−.25; p_<.001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.     

COVID-19 Interconnectedness: Health Inequity,the Climate Crisis,and Collective Trauma

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.     

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.     

Conversion Hysteria in a Pre-Adolescent Girl

Abstract

This paper is a case presentation of a 10-year-old girl with classic conversion hysteria symptomatology. Psychological test material as well as the ten session treatment is presented. The original Breuer/Freud conceptualization of hysteria and its linkage with trauma is considered. Current theories of trauma with the usual presenting symptoms of dissociation, abandonment fears, and repetition are also considered.     

Complex Collective Trauma Following a Terror Attack in a Small Community: A Systemic Analysis of Community Voices and Psychosocial Interventions

In this ethnographic study, data were collected four months, one year, and three years following a terror attack on civilians in a small Israeli community. The data included protocols of meetings of the intervention team, informal and formal interviews, and follow-up telephone interviews with local leaders and psychosocial professionals who worked with individuals, families, and groups in the community. Content analysis of field notes and interviews led to the elaboration of the theoretical construct “complex collective trauma.” The analysis of the community voices and psychosocial interventions indicated the importance of action-oriented, meaning-making community projects and memorials, screening and government-funded short-term trauma therapy, mapping interlocking circles of vulnerability, and an integrated clinical-community model coordinated long-term (one year) by an outside professional.     

Beyond trigger warnings: Toward a trauma‐informed andragogy for the graduate theological classroom*

Although development of trauma‐informed pedagogy for elementary and secondary classrooms has developed significantly, a dearth of resources for trauma‐informed andragogy in graduate theological classrooms remains. Theological classrooms are a unique context in which many students and professors carry experiences of trauma with them. This article makes the case for the need for a trauma‐informed andragogical model for the graduate theological classroom by: discussing the pervasiveness of trauma; providing definitions of key terms that need to be understood for elaborating a trauma‐informed andragogy; recommending trauma‐informed principles for course design and class‐session planning based in safety, trust, choice, collaboration, and empowerment; and identifying a few next steps for cultivating trauma‐informed classrooms and institutions at the graduate level.     

Racial Differences in Posttraumatic Stress Disorder in Military Personnel: Intergenerational Transmission of Trauma as a Theoretical Lens

Various theorists have explored how intergenerational transmission of trauma impacts minority groups. Intergenerational trauma theories suggest that trauma(s) endured by a community have long-standing effects that can be passed on through generations. However, much of the research has focused on indigenous populations or Holocaust survivors despite the historical experiences of the African American community. The minority stress model adds support to intergenerational trauma theories, in that racial minority groups might suffer worse health due to a variety of stressors. Racial minorities are also at greater risk of developing posttraumatic stress disorder (PTSD). Within military populations, PTSD is one of many mental health issues and has been labeled one of the signature injuries of the recent wars in Iraq and Afghanistan. However, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD do not take into account the effects of intergenerational trauma, discrimination, or racism. This article proposes that intergenerational trauma theories and the minority stress model provide explanations for why many studies have found that African American military personnel have higher rates of PTSD compared to their White peers. Indeed, African American military personnel with PTSD might be better understood through more culturally inclusive frameworks (e.g., complex trauma, race-based traumatic stress), because the stressors they experience as racial minorities might exacerbate or lead to symptoms of PTSD.     

Processing trauma in psychoanalysis in ‘real’ time and in dreams: the convergence of past,present and future during COVID-19

In the current collective unrest, we and our analysands are living in real time and need vantage points from which to make meaning, as subjective experience of time is collapsing. For many analysands, the past is being relived in the present, with no imaginable future. During the time of COVID-19, dreams are providing a valuable mechanism in working with atemporal emotional trauma, previously uncontextualized. Dream metaphor can provide a transitional space to move around in within the analytic framework. This paper explores a variety of dreams from individual analysands demonstrating different ways of conceptualizing personal and collective experience, bridging between the past, present, and future. Parallels between feeling states related to the current condition and unprocessed implicit memories from the past will be examined, as a vehicle for processing past trauma. Dreams expressing current states of dread for an unimaginable future, as well compensatory dreams showing a hopeful vision of the future will be considered.     

The Burden Left My Heart

Abstract

This paper presents psychosocial services for displaced women living in the war zones. Two study groups were formed from two cities in Croatia, Zenica and Tuzla. The services were designed to ameliorate distress and improve psychosocial functioning. A questionnaire-based evaluation indicated that highly distressed women derived greater benefit from group psychotherapy (Tuzla) than did the group who participated in occupational activities (Zenica).     

Coping responses in the midst of terror: The July 22 terror attack at Utøya Island in Norway

This study examined the peri‐trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri‐trauma coping responses and their relation to subsequent post‐traumatic stress (PTS) reactions. Respondents were interviewed face‐to‐face 4–5 months after the shooting, and most were interviewed at their homes. Peri‐trauma coping was assessed using ten selected items from the “How I Cope Under Pressure Scale” (HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem‐solving strategies, whereas women reported more emotion‐focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events.