Group therapists and AIDS groups: An exploration of traumatic stress reactions

As the AIDS epidemic continues unabated, there is growing clinical evidence that the catastrophic nature of this disease is creating a second category of trauma casualties. They are the health care practitioners who witness the narratives of those who are living with and dying from AIDS. This article examines how multiple AIDS-related deaths of group members exert a traumatizing effect on group therapists, creating vicarious traumatization. Vignettes are presented that illustrate reactions associated with traumatic stress, including death images, survivors' guilt, psychic numbing, suspicion of counterfeit nurturance, and struggle for meaning. Possible therapeutic interventions for group therapists coping with multiple deaths are also explored.The author wishes to acknowledge the endeavors of the volunteer group therapists and the Clinical Group Services staff of the Gay Men's Health Crisis of New York City, who provide group therapy to over 900 clients a week. This article is written in admiration of their extraordinary effort and dedication.     

Are variations among right-handed individuals in perceptual asymmetries caused by characteristic arousal differences between hemispheres?

We propose that much of the variance among right-handed subjects in perceptual asymmetries on standard behavioral measures of laterality arises from individual differences in characteristic patterns of asymmetric hemispheric arousal. Dextrals with large right-visual-field (RVF) advantages on a tachistoscopic syllable-identification task (assumed to reflect characteristically higher left-hemisphere than right-hemisphere arousal) outperformed those having weak or no visual-field asymmetries (assumed to reflect characteristically higher right-hemisphere than left-hemisphere arousal). The two groups were equal, however, in asymmetries of error patterns that are thought to indicate linguistic or nonlinguistic encoding strategies. For both groups, relations between visual fields in the ability to discriminate the accuracy of performance followed the pattern of syllable identification itself, suggesting that linguistic and metalinguistic processes are based on the same laterally specialized functions. Subjects with strong RVF advantages had a pessimistic bias for rating performance, and those with weak or no asymmetries had an optimistic bias, particularly for the left visual field (LVF). This is concordant with evidence that the arousal level of the right hemisphere is closely related to affective mood. Finally, consistent with the arousal model, leftward asymmetries on a free-vision face-processing task became larger as RVF advantages on the syllable task diminished and as optimistic biases for the LVF, relative to the RVF, increased.