A Narrative Model of Recovery

Abstract

In this paper I defend the suggestion that narratively understanding her experience of rape can help a survivor in her recovery from the harm that she has suffered. Susan Brison defends a similar suggestion, but, I argue, does not get all of the possible mileage out of narrative understanding because she does not explore what she takes to be the necessary features of a successful narrative itself. I hope to supplement her, primarily relational, account with a richer understanding of narratives themselves, as it is only, I argue, through coming to understand the essential characteristics of a narrative that we are able to grasp the particular explanatory force of narratives and, thereby, all of the potential benefits of narratively understanding her experience for a rape survivor.     

Accessible Spiritual Practices to Aid in Recovery from Moral Injury

Pastoral Psychology - This article is based on the claim that spiritual practices can help sustain and rebuild even deeply wounded human spirits. It introduces simple spiritual practices,...     

Exploring Recovery Perspectives in Individuals Diagnosed with Mental Illness

Using a phenomenological research design with a photovoice method, we aimed to understand the lived experience of eight individuals diagnosed with mental illness and identify factors affecting their recovery. We conducted focus group interviews whereby participants discussed their recovery, shared photographs taken of items symbolizing their recovery, and created personalized photobooks or scrapbooks. Data analysis yielded the following themes: (1) caring relationships, (2) leisure and outings, and (3) relaxation, stress reduction, and coping. Findings revealed factors influencing recovery from mental illness and can be used to develop person-centered and occupation-based interventions to promote recovery in clients with mental health issues.     

Subtle Motor Findings During Recovery from Pediatric Traumatic Brain Injury: A Preliminary Report

Pediatric traumatic brain injury (TBI) is a heterogeneous condition, varying in both severity and sequelae. The long-term motor deficits following severe TBI requiring inpatient rehabilitation are better established than those following milder forms of TBI. The authors examined motor performance 2 and 12 months postinjury in children without overt motor impairment using standard measures of upper limb function and the Physical and Neurological Examination for Subtle Signs (PANESS). The PANESS was sensitive to differences between children with TBI and uninjured children as well as to changes in children with TBI over time. These data suggest that subtle motor deficits are present after milder forms of TBI and, particularly those related to balance and gait, may persist even 12 months postinjury.     

Motivations for Self‐Injury,Affect, and Impulsivity: A Comparison of Individuals with Current Self‐Injury to Individuals with a History of Self‐Injury

Individuals who report nonsuicidal self‐injury (NSSI) are characterized by the tendency to act rashly while experiencing distress (negative urgency), the tendency to act without thinking, and endorsement of both social and affect regulation motives for the behavior. However, very little research has identified characteristics that distinguish current self‐injurers from those with a history of the behavior. The purpose of this study was to compare individuals with current self‐injury to a history of self‐injury on impulsivity‐related personality traits, motives for self‐injury, and distress. Among a sample of 429 undergraduates, 120 reported self‐injury. Among these 120 individuals, 33 endorsed self‐injury within the past month, with a mean frequency of 4.77 acts of NSSI. Within the self‐injury group, current self‐injurers reported higher endorsement of affect regulation motives for NSSI, and higher levels of current negative affect than individuals with a history of self‐injury. There were no differences between current and former self‐injurers on measures of impulsivity, endorsement of social motives for NSSI, or positive affect. We propose that individuals who use NSSI to regulate negative affect may be more likely to repeatedly engage in this behavior over time.     

The Effect of Experience on the Goal-Setting Behavior of Type A and Type B Individuals

The effect of experience on the goal-setting behavior of Type A and Type B individuals was assessed using anagram tasks. Sixty men and 60 women were administered the Jenkins Activity Survey as well as a questionnaire assessing their previous experience with anagram tasks. Before each of three anagram trials, subjects set a performance goal and indicated how certain they were that they could reach that goal. The analyses indicated that Type A men had the largest differences between performance goals and actual performance, even though men, in general, were more certain that they would reach their goals. Differences across trials, however, decreased for all individuals. Men with the most prior self-reported experience were least satisfied with their performance. Of interest was the finding that Type B women had higher difference scores than did Type A women.     

Naturalistic Recovery From Nonsuicidal Self‐Injury: A Phenomenological Inquiry

The authors conducted a phenomenological inquiry of 12 individuals who recovered from nonsuicidal self‐injury without psychotherapeutic or medical intervention. Results indicated that participants’ naturalistic recovery emanated from their recognition of serious physical damage, corrective interpersonal influences, and movement from unhealthy to healthy surroundings. Implications of these findings for clinical practice and future research are discussed.     

Psychotherapy and Recovery from Schizophrenia: A Model of Treatment as Informed by a Dialogical Model of the Self Experience in Psychosis

Since the term schizophrenia was coined, the disorder has been linked to experiences of self-diminishment. This link calls for theoretical work that helps us understand experiences of diminishment wherein persons find themselves less than they once were but nevertheless able to recognize and describe their diminishment. In response this paper describes how dialogical psychology may help us both understand this feature of schizophrenia and inform the practice of psychotherapy. In particular, we suggest that some alterations in sense of self in schizophrenia may proceed from a range of losses in a person’s ability to sustain intrapersonal and interpersonal dialogues. Moreover, we suggest that these losses lead to at least three different forms of disturbed self experience: barren, monological and cacophonous selves. We then explore the unique challenges each poses to psychotherapy and suggest that attention to dialogical deficits may enrich self-experience if it attends to aspects of self-experience that emerge within session.     

A Comparison of Help Giving to Individuals Versus Humanitarian Organizations1

The theories of social conduct, seriousness of need, and similarity; cost–benefit models; and individual differences in ideology are used to predict self‐reported help giving that is interpersonal or through humanitarian organizations. The results indicate that persons tend to be more helpful interpersonally than through organizations, are more responsive to characteristics of the needy when helping interpersonally than through organizations, and have stronger affective responses toward individuals than toward individuals represented by organizations. For both interpersonal and organization‐mediated assistance, perceived benefit to the donor strongly predicts help giving. Relatively conservative persons report less helpfulness, both interpersonally and through humanitarian organizations. Collectively, these findings offer an integrative approach to help giving and have implications for fundraising in the humanitarian sector.     

Malingering,Perceptions of Illness,and Compensation Seeking in Whiplash Injury: A Comparison of Illness Beliefs Between Individuals in Simulated Compensation Scenarios and Litigation Claimants1

This paper compares beliefs about whiplash injury between individuals in simulated compensation/no compensation scenarios and actual litigant claimants. Comparisons between simulators and the clinical sample revealed that chronic patients reported significantly more symptoms than all simulator groups. The beliefs of the real compensation claimants in the acute phase of the condition were similar to those in the ‘injury only’ simulator group. The analyses identified a trend towards beliefs in the expected timeline of the illness becoming more negative with time, whilst feelings of control over the symptoms improve. The paper discusses indicators of malingering behavior and the possible involvement of litigation and treatment processes in the transition to a chronic state of ill health.     

Rethinking Traumatic Brain Injury from Intimate Partner Violence: A Theoretical Model of the Cycle of Transmission

ABSTRACT

Despite growing evidence of the repeated nature of traumatic brain injury (TBI) in women experiencing intimate partner violence (IPV), there is no theoretical model depicting TBIs as a cyclical process throughout a lifetime. Situational analysis methodology was used on interviews with 10 women who self-reported passing out from being hit in the head during an episode of IPV to create a theoretical model depicting the cycle of transmission of TBI. We define the cycle of transmission of TBI as the way that women experience multiple TBIs over the course of their lifetime and how TBI can be perpetuated in a family or community. The cycle begins in childhood or adolescence, when women receive a TBI from abuse, sports, or motor vehicle accident. They enter into abusive relationships with men who are also described as living with a TBI and the women receive other TBIs during this relationship. With repeating head trauma, women described increasing TBI symptoms: problems with memory, cognition, executive functioning, depression, and concentration. If they do seek help, they must choose between healthcare and protective shelter. With either choice, the element of instability could be introduced and the cycle of transmission continues. This theoretical model shows that it is necessary to move beyond individual behaviors to think about how TBIs are transmitted through communities and how untreated symptoms can impact help-seeking behavior and perpetuate other risk factors for receiving a TBI.     

Prayer: A Helpful Aid in Recovery from Depression

Depression is a growing issue within the field of medicine. It negatively impacts individuals’ lives and the people they are most connected to. For decades, medical professionals have been searching for solutions to assist those who are suffering from this illness. The use of drugs has not been a sufficient means of treatment to alleviate depression and its symptoms. There is a dire need to expand therapeutic interventions that can attribute meaningful recovery for victims of depression. One means of positive treatment is the use of prayer. Prayer, one of the most ancient forms of meditation, aligns and relaxes the mental state of the mind. The uses of drugs are limited by physiological focus, but prayer is a mechanism that brings human beings into a unique state of oneness. Oneness comprises the holistic nature of a human being and asserts the triad of well-being: mind, body, and spirit. As the emergence of humanities and holism continues in medicine, centering/meditative prayer and similar practices like mindfulness-based cognitive therapy can be useful therapeutic interventions specifically for major depressed patients.     

Cognitive Sequelae of Blast-Induced Traumatic Brain Injury: Recovery and Rehabilitation

Blast-related traumatic brain injury (bTBI) poses a significant concern for military personnel engaged in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Given the highly stressful context in which such injury occurs, psychiatric comorbidities are common. This paper provides an overview of mild bTBI and discusses the cognitive sequelae and course of recovery typical of mild TBI (mTBI). Complicating factors that arise in the context of co-morbid posttraumatic stress disorder (PTSD) are considered with regard to diagnosis and treatment. Relatively few studies have evaluated the efficacy of cognitive rehabilitation in civilian mTBI, but we discuss cognitive training approaches that hold promise for addressing mild impairments in executive function and memory, akin to those seen in OEF/OIF veterans with bTBI and PTSD. Further research is needed to address the patient and environmental characteristics associated with optimal treatment outcome.     

Type D Personality: A Five-Factor Model Perspective

This study investigated the position of Type D (high Negative Affectivity and high Social Inhibition) within the Five-Factor Model (FFM) of personality. A sample of 155 healthy subjects were administered the Type D Scale and the NEO-FFI, assessing the FFM traits. Subjects also filled out the General Health Questionnaire and the Job Stress Survey. Negative Affectivity was positively correlated with Neuroticism (0.74) and negatively with Conscientiousness ( m 0.38), Agreeableness ( m 0.37), and Extraversion ( m 0.35). Social Inhibition was negatively correlated with Extraversion ( m 0.61) and Conscientiousness ( m 0.40) and positively with Neuroticism (0.50). Type D subjects reported more somatic distress ( p <0.0001), anxiety ( p <0.0001) and depression ( p <0.01) than non-Type D subjects. An alternative one-dimensional representation of the D-traits was suggested, conceptualized as a dimension ranging from neurotic introversion with relatively low conscientiousness to stable extraversion with relatively high conscientiousness. These findings are discussed in the light of the renewed interest in psychology for type versus dimensional representations of individual differences.     

Nonsuicidal Self‐Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders

Nonsuicidal self‐injury (NSSI) prior to age 18 was evaluated as a risk factor for adulthood suicide attempt (SA). Archival data from 222 mood‐disordered participants were analyzed using multivariate Cox proportional hazards analysis. Participants with a youth SA were excluded. The hazards of SA among adult participants with a history of youth NSSI were twice than those of mood‐disordered participants without youth NSSI (hazard ratio = 2.00, 95% confidence interval = 1.16–3.44, p = .01). Moreover, participants who had both youth and adult NSSI attempted suicide significantly earlier than participants who began NSSI as an adult. Youth NSSI is associated with persistent, elevated SA risk in adulthood.     

Impact of Interpersonal Conflict on Individuals High in Unmitigated Communion1

The current study examined the impact of interpersonal conflict on mood and physical symptoms for individuals who scored high on a personality characteristic called unmitigated communion (UC), as compared to individuals who did not score high in UC. UC is defined as a focus on others to the exclusion of the self. Forty‐one undergraduate students participated in 7 consecutive nightly interviews. Participants described their social interactions, indicated whether the interaction involved interpersonal conflict, and indicated their distress and physical symptoms at the end of the day. Multilevel modeling analysis demonstrated that conflict adversely affected UC and non‐UC individuals similarly on the same day, but had a more negative impact for UC individuals on the following day.     

Spirituality and Recovery from Cardiac Surgery: A Review

A large research literature attests to the positive influence of spirituality on a range of health outcomes. Recently, a growing literature links spirituality to improved recovery from cardiac surgery. Cardiac surgery has become an increasingly common procedure in the United States, so these results may provide a promising indication for improved treatment of patients undergoing surgery. To our knowledge, a comprehensive review of the literature in this area does not exist. Therefore, this paper reviews the literature relevant to the influence of spirituality on recovery from cardiac surgery. In addition, it proposes a conceptual model that attempts to explicate relationships among the variables studied in the research on this topic. Finally, it discusses limitations, suggests directions for future research, and discusses implications for the treatment of patients undergoing cardiac surgery.     

Group Intervention Studies in the Cognitive Rehabilitation of Individuals with Traumatic Brain Injury: Challenges Faced by Researchers

There are many factors to consider in designing and interpreting group studies. These include both analytic considerations, such as the selection of valid and reliable outcome measures, and subjective considerations, such as the selection of outcomes that are perceived to be important to participants and researchers. In this paper, we review key issues to consider in the design of group studies in neurorehabilitation, using problem-solving studies in traumatic brain injury as an example.     

A Little Goes a Long Way: The Impact of Distal Social Support on Community Integration and Recovery of Individuals with Psychiatric Disabilities

Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted—focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.