Prediction of Posttraumatic Stress Disorder From Peritraumatic Dissociation and Distress Among Men and Women Victims of Violent Crimes

This prospective study evaluated the main and interactive effects of peritraumatic reactions with gender on posttraumatic stress disorder (PTSD) onset, independently of known risk factors. Further, 111 adult victims of violent crime completed the Structured Clinical Interview, the Modified PTSD Symptom Scale, the Peritraumatic Dissociative Experience Questionnaire, and the Peritraumatic Distress Inventory. Hierarchical regressions and chi-square tests were conducted for continuous and categorical measures of PTSD. Extremely elevated scores of peritraumatic dissociation (PD) and peritraumatic distress (PDI) were obtained for both sexes. Greater PDI and PD were related to more PTSD symptoms. No significant interaction effects with gender emerged. These results remained when acute stress disorder was controlled for. Analyses on categorical data produced similar results. Victims of violent crimes recall severe peritraumatic reactions. The more severe these are, the more likely they are to develop significant PTSD symptomatology in the months that follow.     

Emotional Reactions During and After Trauma: A Comparison of Trauma Types

Peri- and posttraumatic emotional responses have been understudied, and furthermore, have rarely been compared among trauma types. The current study compared college students' retrospective self-reports of peri- and posttraumatic responses of fear, shame, guilt, anger, and sadness among four types of traumatic events: sexual assault, physical assault, transportation accident, and illness/injury. Overall emotional responding was generally high for all trauma types, and for those in the sexual assault group, emotion increased sharply from the peri- to posttraumatic time point. Generally, fear was higher during the trauma compared to after the trauma, whereas the other emotions tended to remain stable or increase posttrauma. The sexual assault group tended to report higher levels of posttrauma emotion than the other trauma type groups.     

Post-traumatic stress disorder in a Danish population of elderly bereaved

The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.     

The mental representation of living and nonliving things: Differential weighting and interactivity of sensorial and non-sensorial features

Warrington and colleagues (Warrington & McCarthy, 1983, 1987; Warrington & Shallice, 1984) claimed that sensorial and functional-associative (FA) features are differentially important in determining the meaning of living things (LT) and nonliving things (NLT). The first aim of the present study was to evaluate this hypothesis through two different access tasks: feature generation (Experiment 1) and cued recall (Experiment 2). The results of both experiments provided consistent empirical support for Warrington and colleagues' assumption. The second aim of the present study was to test a new differential interactivity hypothesis that combines Warrington and colleagues' assumption with the notion of a higher number of intercorrelations and hence of a stronger connectivity between sensorial and non-sensorial features for LTs than for NLTs. This hypothesis was motivated by previous reports of an uncrossed interaction between domain (LTs vs NLTs) and attribute type (sensorial vs FA) in, for example, a feature verification task (Laws, Humber, Ramsey, & McCarthy, 1995): while FA attributes are verified faster than sensorial attributes for NLTs, no difference is observed for LTs. We replicated and generalised this finding using several feature verification tasks on both written words and pictures (Experiment 3), including in conditions aimed at minimising the intervention of priming biases and strategic or mnemonic processes (Experiment 4). The whole set of results suggests that both privileged relations between features and categories, and the differential importance of intercorrelations between features as a function of category, modulate access to semantic features.     

The relationship between suppression and subsequent intrusions: the mediating role of peritraumatic dissociation and anxiety

Background and objectives: Although previous studies showed that thought and emotion suppression represent risk factors for intrusions development, the mechanisms that explain these relations were less explored. This study aims to examine the relationships between thought and emotion suppression and the symptoms of intrusion following the exposure to a trauma-related event. Moreover, we explored if these relationships would be mediated by peritraumatic state dissociation and state anxiety.

Design and methods: The trauma film paradigm was used and the participants were students (N?=?148) experimentally exposed to an aversive film to model a traumatic experience. Thought and emotion suppression were measured before the trauma exposure. After exposure, the participants completed scales for measuring state dissociation and state anxiety. Intrusive images and thoughts of the film were recorded in the subsequent week using an intrusion diary.

Results: Thought suppression predicted intrusive thoughts frequency, and this effect was mediated by the peritraumatic anxiety. State anxiety predicted both intrusive images and thoughts, while state dissociation only predicted intrusive images.

Conclusions: Intrusive images and intrusive thoughts are different phenomena and they are predicted by different variables. The practical implications of these results for posttraumatic stress disorder treatment and secondary traumatization are discussed.     

PTSD易感性人格特质、工作记忆能力和创伤期间认知加工对模拟创伤闪回的影响

基于模拟创伤研究范式, 采用道路交通事故影片对159名健康大学生进行模拟创伤, 考察PTSD易感性人格特质(特质焦虑、特质分离和神经质)、工作记忆能力(注意控制和工作记忆容量)和创伤期间认知加工(数据驱动加工和概念加工)对模拟创伤后不同时段闪回的影响。运用结构方程模型分析数据, 结果发现：(1)数据驱动加工正向预测不同时段闪回(即时闪回、一周闪回和触发闪回)的数量、生动性、痛苦度以及一周侵入频率; (2)神经质正向预测触发闪回痛苦度, 注意控制和工作记忆容量负向预测一周侵入频率; (3)概念加工在注意控制与即时闪回痛苦度之间起中介作用。研究结果提示：数据驱动加工是创伤后不同时段闪回的主要影响因素; 概念加工主要作用于早期急性应激反应, 注意控制是其保护因素; 神经质和工作记忆能力对闪回具有较长期的影响, 且工作记忆能力具有一定的保护作用。     

Profiles of Peritraumatic Emotions

Researchers have identified peritraumatic emotions as important predictors of who will develop posttraumatic stress disorder (PTSD) symptoms. However, such investigations have not examined full profiles of emotions, perhaps because of the typical emphasis on fear or other Criterion A2 emotions. Such an examination could help us identify which peritraumatic emotions are prominent, and how they relate to important posttrauma outcomes. Thus, the aim of this study was to identify distinct profiles of peritraumatic emotions and their correlates using a comprehensive survey of peri- and posttraumatic reactions. We conducted a latent profile analysis of peritraumatic emotions in 398 undergraduate students who reported a DSM–IV A1 trauma and then compared the resulting profiles on trauma type, PTSD, depression, and posttraumatic cognitions. Six distinct profiles emerged: 3 had consistently low, medium, or high levels across the range of emotions, with 3 others primarily characterized by low shame and guilt, high anger and guilt, and low guilt. These profiles significantly differed in terms of trauma type, PTSD, depression, and posttraumatic cognitions. In particular, profiles with high levels of anger, shame, and guilt were consistently related to overall worse functioning. Importantly, fear and associated emotions did not differentiate between profiles. These results have important implications for the phenomenology of posttrauma emotional reactions and strongly suggest that the clinical assessment of traumatic experiences go beyond fear-based conceptualizations.     

Rape: A Trauma of Paralyzing Dehumanization

This study examines the pathogenic role of rape-induced peritraumatic dehumanization, and subsequent humiliation and “freezing.” A theoretical causal model linking these rape-related peritraumatic responses to symptoms is tested while considering the ways in which rape differs from other types of nonsexual trauma in relation to this particular model. Two hundred and fifty-five participants completed self-report questionnaires. Structural path analyses identified dehumanization and humiliation as highly prevalent and almost invariably predictive of a freeze response in rape; and, in turn, of elevated self-blame and post-traumatic stress disorder in its wake while concurrently showing a poor fit for this model in respect to other traumas. In addition, multivariate analysis of variance results indicated that peritraumatic, as well as post-traumatic distress, was considerably more severe among rape survivors as compared to controls.     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.     

Mythological Underpinnings of Feminine Development

In the manner of Oedipus Rex, the myth of Myrrha—a story about a daughter's initiation of sex with her father—promises to divulge insights about feminine development. Given parallels between these two myths, the author asks why Jung identified Electra rather than Myrrha as the feminine counterpart to Oedipus, and revisits Freud's and Jung's differing interpretations of the incest theme in personality development. To break open the metaphor of Myrrha's incest, the author analyzes a similar account of incest in the Old Testament story of Lot and his wife and finds that they share a theme of female bitterness related to wounding of the mother and its arresting effect on the daughter's maturation. The article then considers the Demeter-Persephone myth, a tale not of incest but rape in Persephone's initiation into womanhood. In contrast to Myrrha, Persephone's development unfolds with strong maternal support tempered by the opposing claims on her by the masculine. The article draws these stories together to illuminate the archetypal forces that drive feminine development as well as the human affairs that resist and complicate them. The article concludes with a case study of a client whose developmental “stuckness” follows the contours of the Myrrha myth.     

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.