DECREASING BURNED CHILDREN'S PAIN BEHAVIOR: IMPACTING THE TRAUMA OF HYDROTHERAPY

We evaluated the effects of cartoon viewing with the use of a star feedback chart on two burned children's pain behavior during their physical therapy sessions. In addition, the degree to which the observational data corresponded with physical therapists' and mothers' ratings of the children's pain, fear, and cooperativeness was examined. Using a reversal single-subject design, the results showed that the children's pain behavior substantially decreased during experimental treatment sessions compared to their baseline levels. The rating scale data indicated that the physical therapist's and mother's rating of pain, anxiety, and cooperativeness were all correlated significantly with the observational data (p < .05). The contributions of respondent and operant conditioning to the occurrence and treatment of pain behavior in burned children are discussed.     

COMMUNISM AND THE TRAUMA OF ITS COLLAPSE REVISITED

This paper focuses on the intertwinement of society and the psyche as a consequence of 70 years of Communist rule and the trauma of its collapse in the 90’s. The trauma had profound effects on the psyche. An empirical study that was carried out in 1996/1997, which compared the personality structure of adolescents from Russia and Austria, and a research dialogue in 1999, has been re-evaluated in the light of current political events. One aim that we had was to find out whether we could discover characteristic personality features, resulting from the Communist totalitarian society in Russia, as well as from the trauma of its collapse. This led to the development of the concepts of the “impersonal self” and the “denial mode”. The Russians seemed to be frozen in a protective shell with “flat” affects. They were anxious, conflict avoidant, and somewhat lost. Ideas about missing adolescence and the importance of privacy are discussed. Society was shown to not only have intruded into the individual psyche, but also into the members of the intercultural research team in the form of projective identification. The importance of the interaction between society and the individual as a basic psychoanalytic concept dating back to Freud is elaborated. Finally, considerations pertaining to mental health and democracy are presented.     

THE LONG-TERM PSYCHOLOGICAL EFFECTS AND TREATMENT OF HOLOCAUST TRAUMA

The present article gives an overview of the long-term psychological effects of Holocaust traumatization on survivors and their offspring and suggests possible treatment strategies for these client populations. Based on interviews with and treatment of hundreds of such clients and on an extensive review of the literature, it also represents some of the cumulative experience of AMCHA, an Israeli treatment center devoted specifically to this issue.     

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.     

WITHSTANDING TRAUMA: THE SIGNIFICANCE OF EMMA ECKSTEIN'S CIRCUMCISION TO FREUD'S IRMA DREAM

The author considers the medical rationale for Wilhelm Fliess's operation on Emma Eckstein's nose in February 1895 and interprets the possible role that this played in Freud's dream of Irma's injection five months later. The author's main argument is that Emma likely endured female castration as a child and that she therefore experienced the surgery to her nose in 1895 as a retraumatization of her childhood trauma. The author further argues that Freud's unconscious identification with Emma, which broke through in his dream of Irma's injection with resistances and apotropaic defenses, served to accentuate his own “masculine protest”. The understanding brought to light by the present interpretation of Freud's Irma dream, when coupled with our previous knowledge of Freud, allows us to better grasp the unconscious logic and origins of psychoanalysis itself. 1     

UNTOLD STORIES AND THE POWER OF SILENCE IN THE INTERGENERATIONAL TRANSMISSION OF SOCIAL TRAUMA*

There are intergenerational secrets and unprocessed experiences that very often don’t have a voice or an image associated with them but loom in our minds nonetheless. What haunts are not the dead, but the gaps left within us by the secrets of others. This paper will look at the conflict that occurs when unspoken events and memories of one generation haunt the next one. It is my contention that the second-generation survivors of trauma can be deeply affected by something that did not directly happen to them. Utilizing my own personal narrative I will examine how being the daughter of a woman who escaped the Holocaust, and her silence about those events affected my personal development and later my work with patients. I will also explore the unspoken secret that a patient’s mother kept from her, paralleling the writer’s mother’s secret.     

SEVERITY OF CHILD SEXUAL ABUSE AND REVICTIMIZATION: THE MEDIATING ROLE OF COPING AND TRAUMA SYMPTOMS

Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that conceptualized the relationships among these variables. Specifically, CSA severity was conceptualized as leading to the use of avoidant coping, which was proposed to lead to maintenance of trauma symptoms, which would, in turn, impact severity of revictimization indirectly. This comprehensive model was tested in a cross-sectional study of a large, geographically diverse sample of college women. Participants were 99 female undergraduates classified as having experienced CSA who completed measures of abuse history, coping style, current levels of trauma symptoms, and adult sexual revictimization. Multivariate path analysis indicated that the data fit the hypothesized model for verbally coercive, but not physically aggressive, revictimization. Specifically, increased CSA severity was associated with the use of avoidant coping, which, in turn, predicted greater levels of trauma symptomatology and severity of sexual coercion in adulthood. Although cross-sectional in nature, findings from this study suggest that coping strategies and trauma symptoms may represent modifiable factors that place women at increased risk for verbally coercive sexual revictimization.     

OUR CONSTRUCTIONS OF TRAUMA: A DIALECTICAL PERSPECTIVE

The field of mental health has been confronted by issues of psychological trauma since its inception. Throughout its history there have been a host of oscillating and conflicting views on the reality and consequences of many types of psychological trauma. A dialectical stance provides a useful framework with which to consider and work with these contradicting views. Such a stance enables a focus on the total context in which professional narratives of trauma are formed and looks for useful elements from both sides of the debates about trauma. In this article, dialectical thought is applied to professional narratives regarding the prevalence, responsibility, consequences, and treatment of trauma.     

INTIMATE PARTNER VIOLENCE AND INFANT SOCIOEMOTIONAL DEVELOPMENT: THE MODERATING EFFECTS OF MATERNAL TRAUMA SYMPTOMS

The aim of the present study was to investigate the impact of intimate partner violence (IPV) on infant regulatory difficulties at 3 months of age and infant socioemotional problems at 12 months of age. Maternal trauma symptoms were explored as potential moderators of these associations. Participants included 120 primarily low‐income, ethnically diverse women and their infants. Results revealed that infants whose mothers experienced IPV during pregnancy did not have significantly more regulatory difficulties at 3 months than did infants whose mothers did not experience prenatal IPV. However, infants whose mothers experienced IPV during the first year after birth displayed significantly more socioemotional problems at 12 months, as evidenced by both maternal report and observational data. Furthermore, maternal posttraumatic stress avoidance symptoms served as a moderator of the association between prenatal IPV and infant regulatory difficulties at 3 months whereas maternal posttraumatic stress hyperarousal and reexperiencing symptoms served as moderators of the association between IPV during the first year after birth and infant socioemotional problems at 12 months. The findings highlight the detrimental impact that IPV can have on very young children and the importance of maternal trauma symptoms as a context for understanding the effect of IPV on young children's functioning.     

FREUD ON SEXUAL TRAUMA: AN HISTORICAL REVIEW OF SEDUCTION AND BETRAYAL

An historical review of the development and rejection of Freud's seduction theory is presented. Questions are raised regarding the relationship of self-analysis to Freud's repudiation.     

EFFECTS OF FEEDBACK AND SELF-MONITORING ON HEAD TRAUMA YOUTHS' CONVERSATION SKILLS

The effects of feedback and self-recording on the small group conversational behaviors of two head trauma youths were evaluated. Feedback involved providing clients a light signal corresponding to positive or negative social interactions. The self-monitoring procedure required that the clients flip a switch corresponding with their positive or negative interactions. An A₁-B₁-C₁-A₂-C₂-B₂ design in which the feedback phase (B) and self-monitoring phase (C) were alternated to control for order effects demonstrated the efficacy of both interventions. Performance gains were also shown to generalize to less structured situations, bringing the clients' level of positive responses into a range established with a social comparison group.