The concept of psychical trauma: A bridge in interdisciplinary space1

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post‐Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post‐traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non‐declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.     

抑郁性神经症患者精神创伤的临床调查与分析

通过调查与分析。希望进一步了解导致抑郁性神经症的精神创伤的性质和易感人群的年龄、教育程度和性别等方面的特点。为此类疾病的病因分析及其防治提供客观的依据。结果表明：1．不同的年龄、教育程度和性别均有各自敏感的生活事件,部分生活事件在任何年龄阶段、教育程度、性别的人群中都可构成精神创伤;2．家庭矛盾、个人发展、疾病、失去亲人等生活事件容易构成精神创伤,其中家庭矛盾尤为突出;3．不可控的生活事件是构成抑郁性神经症近、远期精神创伤的重要基础。可见,抑郁性神经症的发病与精神创伤关系密切;不同教育程度、年龄、性别对生活事件的体验及其导致精神创伤的程度不同。     

Children in genocide: Extreme traumatization and the ‘affect propeller’1

The author bases this paper on extensive research concerning children in genocide with a starting point in the Holocaust and in the genocide in Rwanda 1994. She demonstrates indicators for psychological phenomena concerning the child survivors' affect regulating that appeared in life histories presented in videotaped in‐depth interviews. The psychological phenomena concern experiences of persecution and ways of coming to terms with recurring memory images and affects. The interviews that have been analysed in detail form a basis for an emerging conceptual model about trauma‐ and generational‐linking processes within each individual‐the ‘affect propeller’. An overall conclusion from this study is that past traumatic experiences are recovered not as memories in the usual sense of the word, but as affects invading the present. Accordingly, affects seem to tell the story of the past traumatic experiences.     

Intergenerational Transmission of Conflict-Related Trauma in Northern Ireland: A Behavior Analytic Approach

Intergenerational transmission of trauma describes the impact that traumatic events experienced by one generation have for the subsequent generation. In Northern Ireland, violent conflict raged between 1969 and 1998, when a peace process begun. This study explored to what extent (if any) parents’ experiences of the conflict influenced how children perceived life in this society. Parents completed a questionnaire, and their children drew 2 pictures, depicting Northern Ireland now and before they were born. Children’s behaviors and awareness of the conflict were influenced by their parents’ experiences and narratives, their age, gender, and school. Parental narrative about the violence was influenced by individual learning history, the child’s age and gender, and present circumstances. A behavior analytic approach is offered.     

Soziales Trauma

Social traumatization is targeted at entire victim groups and occurs in a societal context. The classification of posttraumatic stress disorders in DSM-5, which intentionally fails to differentiate between different types of traumatic events, ignores the social factors of traumatogenic pathologies. Whereas clinical practice unanimously embraces the thorough exploration of patients’ individual life experiences and history of suffering, taking the relevant social and environmental factors into account, in the classification systems (DSM-5 and ICD-10) it has been decided to address posttraumatic disorders as individual pathologies and not as social phenomena. Even equating social trauma with a disease may foster this partial exclusion, which in turn can contribute to perpetuation of the posttraumatic condition.     

The discourse of being ‘triggered’: Uses and meanings among counselling students

Despite the initial understanding of the word ‘triggered’ as relating to the clinical phenomenon of post-traumatic stress disorder (PTSD), this language has become a common part of the vernacular today, used by many people to apply to a wide variety of experiences and events. Counselling students are particularly sensitised to trauma, as well as identity politics, and are familiar with trigger warnings at college. They themselves have experienced trauma at high rates. Therefore, we were interested to understand how they might be using the word and interpreting the experience of being ‘triggered’, whether different sources of being triggered are related to emotional reactions, and whether a discourse analysis might indicate how and why the term has become useful and for what other experiences it might be serving as a stand-in. In this mixed-methods study, 79 counselling students from around the country shared their definitions and experiences of being ‘triggered’. Participants completed surveys and wrote narratives, which, via thematic qualitative analysis, were coded into five themes. The quantitative analysis focused on the relationship of feelings to themes and the relationship between anger suppression and coping with each theme. Discourse analysis explored how individuals wrote about responsibility and anger. It was discovered that those who wrote about being triggered from a past sexual assault did not discuss anger, nor the responsibility of others to protect them (as those who wrote about microaggressions did), but positioned themselves as overreactors. Results are discussed with regard to training and practice.     

Personal attitudes toward time: The relationship between temporal focus,space‐time mappings and real life experiences

What influences how people implicitly associate “past” and “future” with “front” and “back?” Whereas previous research has shown that cultural attitudes toward time play a role in modulating space‐time mappings in people's mental models (de la Fuente, Santiago, Román, Dumitrache & Casasanto, 2014), we investigated real life experiences as potential additional influences on these implicit associations. Participants within the same single culture, who are engaged in different intermediate‐term educational experiences (Study 1), long‐term living experiences (Study 2), and short‐term visiting experiences (Study 3), showed their distinct differences in temporal focus, thereby influencing their implicit spatializations of time. Results across samples suggest that personal attitudes toward time related to real life experiences may influence people's space‐time mappings. The findings we report on shed further light on the high flexibility of human conceptualization system. While culture may exert an important influence on temporal focus, a person's conceptualization of time may be attributed to a culmination of factors.     

Van Gogh and the life chart

Adolf Meyer originally devised the life chart in order to chronologically document a person’s major life events and significant illness experiences over his or her life span. It is the purpose of this report to update Meyer’s life chart through the presentation of the life events and illnesses of the famous artist Vincent Van Gogh. Van Gogh’s life illustrates significant early (predisposing) life stresses, as well as clusterings of stressful (precipitating) life events occurring proximal to the occurrence of his several illnesses. Through the use of a life chart an understanding of why an individual becomes ill at a particular time in their life is enlarged. In addition, a systematic basis for formulating prognosis becomes available.     

Childhood trauma from a patient and a psychoanalyst perspective: linking chronic depression to relational multiple trauma

The relationship between multiple childhood trauma, as well as adversity, and chronic depression has been reported repeatedly. However, there is a lack of clinical differentiations of these findings. We complemented patient self-ratings, using the Childhood Trauma Questionnaire (CTQ), with psychoanalysts’ perspectives in order to provide finer grained clinical differentiations of the trauma behind chronic depression. These differentiations connect the trauma scales with early relational experiences. We developed a bespoke instrument derived from psychoanalytic trauma concepts. A subsample of 52 cases of chronically depressed patients alongside their 24 psychoanalysts was taken from the LAC depression study, in order to complement patient and psychoanalyst ratings. Our results confirm the connection between multiple childhood trauma and chronic depression. Besides relational trauma, the psychoanalysts’ perspective found separation trauma and transgenerational transmission of trauma to be significant. These traumatic relationships seem to precede and accompany adverse life events and/or traumatic experiences. They may even prevent adequate coping and/or processing of such experiences. Patient interview material from study intake and five-year follow-up further provides an insight into the changes the trauma narratives undergo throughout time. These changes emerged due to a joint reconstruction of the meaning of traumatic experiences throughout the course of the psychoanalytic process.     

Les processus de l’intégration psychologique chez un enfant migrant

This article deals with the theoretical model of integration process. The aim is to compare theory with clinic through the study of a migrant child, which present an elective muteness at school. The integration process seeks to highlight how groupals and intersubjectives situations are articulated to psychical reality. This articulation can help to the transitionnalisation of the individual experiences and thus support their integration. But all groups do not have the same potential of transitionnalisation. The family psychic apparatus seems to be the most appropriate agency for resolving in a creative way individual suffering.     

Précis of The Situated Self

The riddle posed by the double nature of the ego certainly lies beyond [the limits of science]. On the one hand, I am a real individual man, born by a mother and destined to carrying out real and psychical acts (far too many, I may think, if boarding a subway during an hour). On the other hand, I am “vision” open to reason, a self‐penetrating light, immanent sense‐giving consciousness, or how ever you may call it, and as such unique. (Weyl, Address, 3)     

Human time and dreaming

One characteristic of massive trauma is a persistent feeling that time is frozen, i.e., an experience impossible to integrate into a psychic reality. In this paper, the author sets out to explore the dimension of time in the psychoanalytical situation in an effort to shed light on this question. The infant acquires an immediate sense of time through the rhythm of frustration and satisfaction, and out of these encounters, a fundamental dialogue evolves. This primary dialogue is internalised and is regarded as an indispensable structure for psychic life. The child's existence is impregnated by unconscious desires or beliefs of the adult world—enigmatic messages that will constitute an unconscious source of the child's own psychic reality. Timeless desires and enigmatic messages urge on a dreaming in attempts to carry over the psychical sense of time and the implacable time of existence. When we infuse a time dimension through our dreaming and our narratives, we give shape to our timeless wishes. The psychoanalytic situation arouses the primary dialogue and an elementary experience of time. Traumatic experiences are tantamount to the absence of the primary object and thereby the death of time. Dreaming becomes an endeavour to create a psychic space, the aim of which is to restore the primary dialogue. If circumstances obliterate all hope of re-establishing the bond to the primary object, the sense of time is destroyed as well. The author concludes that the experience of time and elaboration of traumatic experiences are closely connected.     

Trauma,causality and time: Some reflections: EPISTEMOLOGY STUDY GROUP,PORTO ALEGRE PSYCHOANALYTICAL SOCIETY1

Based on the studies and discussions of the Epistemology Study Group of the Porto Alegre Psychoanalytical Society, the authors aim to connect the notions of psychical determinism with the concept of trauma and temporality, from a perspective of the mind as a complex system. Following consideration of the concept of psychical determinism, they attempt to expand the discussion on causality. They propose that trauma be situated in the body of contemporary psychoanalysis, where emotional experience is favoured over factual events, leading to the need to rethink the concept of trauma and its usefulness. In the same way, in the light of recent developments, the authors revisit the Freudian etiologic equation, with a proposal that an i, for imaginary factor, be included, corresponding to an element of complexity. The question of temporality, connected with trauma and the therapeutic action of psychoanalysis, is approached within a vision of irreversible time, characteristic of complex systems, far‐from‐equilibrium‐which is how the authors understand psychical functioning.     

Out of Darkness: Reverberations of Trauma and its Creative Transformations

Traumatic experiences have a ripple effect, which continues throughout life and function as a powerful inner force that draws the survivor like a magnet to situations and events that allow him or her to work through pain; to give it shape, to release it, to express it to others, to make sense of it and to find some meaning in it. Self-expression through the creative arts can be one of the most effective means to healing. By externalizing what is experienced internally as overwhelming and fragmenting, and by fashioning it into a creative product, the artist brings the traumatic experience into the light of day for a new viewing. This enables reflection and integration of what is internally chaotic to be defined, mastered, and integrated into a coherent meaningful narrative. The artistic product, which can be shared with witnessing others, facilitates connection and fosters a healthy narcissism. The transformation of trauma into creative self-expression is illustrated here by an analysis of three generations of survivors—the author, her father, and her daughter—who each turned to the arts as a means of self-healing.     

On Seeing What Is Not Said: The Concrete Mode of Psychic Functioning and the Development of Symbolization

This paper examines the difficulties that arise with patients who experience a compromised capacity in working on a symbolic level when ensnared in specific transference/countertransference entanglements. In these kinds of situations, patients often operate in what is referred to as the concrete mode of psychic functioning in which there is an inability to think psychologically about their own mind, as well as the minds of others. Similarly, the analyst often has trouble thinking with the patient in processing the actions between them, unable to recruit the patient’s mind in becoming a thinking couple together. Having exhausted conventional technique and interventions in trying to observe the enactment with the patient, the author argues that the analyst’s ability to grab hold of fleeting associations and memories that have not been fully processed not only expands his own mind but also facilitates symbolic functioning in the patient’s mind. By using the imagistic and sensorial substrates of these remembrances to further symbolize personal experiences, the analyst may gain entrée into the patient’s mental life.     

The non-symbolic level of psychical reality

Freud introduced the concept of psychical reality as a consequence of abandoning the theory of seduction, and although this meant a turning point in his theoretical thinking he never defined the concept concisely and systematically. Thus it is possible to delineate at least two meanings of psychical reality that run through Freud´s writings as well as the writings of contemporary analysts. On the one hand psychical reality encompasses the whole field of subjective experiences. On the other, it is understood more narrowly as a transformation of experiences in the unconscious.

Substituting the idea of different meanings ascribed to Freud´s concept this article proposes to differentiate between levels in the psyche with the main focus on the unconscious level of the dream and of phantasy and the real unconscious. Starting from the most superficial level of subjective reality the text moves to that of fantasy formation illustrated by primarily Freud´s text on `A child is being beaten´. Adding Laplanche´s translational model the article ends up at the deepest level represented by the late Lacan and his concept of the real Unconscious.

The paper concludes that the term real points to something exceeding symbolization and the imaginary—thus escaping comprehension—and yet is absolutely indispensable to the organization of unconscious processes.     

自由基与重度颅脑外伤并发SIRS的原因及治疗研究探讨

就重型颅脑外伤由于过氧化反应后自由基产生的原因、自由基对神经细胞的继发损伤、自由基在重型颅脑外伤状态下诱发或并发全身炎性反应综合征以及两种因素所引起的神经细胞凋亡进行综述。同时就目前学者们在手术抢救、监测血液粘度、持续腰大池置管脑脊液外引流术、亚低温治疗、药物治疗、高压氧与活性氧液治疗、恒定磁场治疗等方面治疗自由基和全身炎性反应综合征对神经细胞的继发损伤进行了讨论。重型颅脑外伤后应重视自由基和全身炎性反应综合征的治疗。     

Cumulative Adversity as a Correlate of Posttraumatic Growth: The Effects of Multiple Traumas,Discrimination, and Sexual Harassment

While trauma is, by definition, a necessary precursor of posttraumatic growth, other aspects of individuals’ life experiences affect their ability to cope with trauma, foster resilience, and grow following adversity. Most research on posttraumatic growth overlooks the accumulation of trauma and sub-trauma stressors as possible predictors of growth. In addition, most research on cumulative adversity omits all but the most extreme examples of discrimination and sexual harassment stressors. This exploratory study of 46 university students with trauma histories used measures of posttraumatic growth, trauma, major (sub-trauma) life events, chronic stressors, sexual harassment, and discrimination to examine the relationship between cumulative adversity and the development of posttraumatic growth. We found that cumulative adversity is positively correlated with posttraumatic growth, and that there are important relationships between gender, race, and cumulative adversity. A hypothesized curvilinear relationship between cumulative adversity and posttraumatic growth was not supported. These findings suggest that successfully coping with some amount of sub-trauma adversity may facilitate the development of posttraumatic growth. Additionally, sexual harassment and discrimination were closely linked to the number of chronic stressors; thus, they need to be included in measures of cumulative adversity to more fully represent the experiences of marginalized groups.     

An interpretation of Babette's Feast as a parable of trauma

In this paper I use the film Babette's Feast as a parable to portray the impasse that often arises out of the experience of complex trauma. The experience of such trauma invokes a crisis of reality. It overflows the boundaries of rational containment. There are no mechanisms with which to apprehend such an event, and consequently it cannot be comprehended; because it cannot be comprehended it cannot be processed. The film Babette's Feast encapsulates the predicament of the individual ensnared in the web of trauma. Although removed from the location and events of her trauma, Babette remains the resident of an austere and colourless environment, her gifts repressed, her brilliance unseen. Healing comes to Babette through her willingness to revisit her true self, a self that has been crushed under the weight of grief and trauma. This revisiting costs her all she has. Yet, it is in this revisiting that she not only frees herself from the austerity of her environment but also engenders purpose and hope within the community who have taken her in. The dissonance of her life is paralleled by the dissonance of the life of the community in which she lives; it is the harmonizing of these dissonances which cannot be spoken that finally gives articulation to the incoherence of Babette's trauma.     

情绪调节灵活性对负性情绪的影响：来自经验取样的证据

情绪调节灵活性是指个体根据不断变化的情境需求灵活部署情绪调节策略的能力。本研究采用经验取样方法,通过拟合个体在日常生活事件(如,未通过考试)和突发公共卫生事件(COVID-19)中的策略使用剖面结构和情境负性程度与策略使用程度的共变关系测量个体的情绪调节灵活性水平,并探讨其对个体后续负性情绪(抑郁和焦虑)的影响。两个独立样本结果表明：单一策略使用偏好(如沉浸偏好和表达抑制偏好)的个体在负性生活事件中和疫情期间经历了更高水平的抑郁和焦虑情绪。此外,当个体随情境负性程度提高使用更多分心策略,而随情境负性程度降低使用更多认知重评策略(意味较高的情绪调节灵活性),其抑郁和焦虑情绪水平更低。以上结果共同证实了情绪调节灵活性有利于减少个体的负性情绪体验。