Working with severely traumatized,chronically depressed analysands

Surprisingly often in the psychoanalyses of chronically depressed patients, depression represents an unconscious attempt to psychically cope with unbearable psychic pain following severe traumatisation: dissociative states, a chronified psychic state of shock, a disappearance of emotions, an emptying of the self and the object relationships, as well as a disappearance of the psyche in the body are among the possible consequences. The treatment of these difficult groups of analysands can also frequently bring analysts to the limits of the endurable. Often related to this is the repeated danger of denying the trauma, and a re‐traumatisation of the analysand in the analytic situation. The lecture discusses the fact that in comparison with other therapeutic approaches, psychoanalysis has a highly differentiated conceptualisation of the psychic determinants and the treatment of chronic depression at his disposal. However, in order to retain its creativity and innovation as a scientific discipline and to be thus perceived in the non‐psychoanalytic world, it must constantly further develop its conceptualization by way of systematic and extra‐clinical research – as is witnessed in the insufficient conceptual account of severe traumatisation during the genesis of chronic depression. In this connection, several exemplary examples from extra‐clinical studies in the sphere of psychotherapeutic research, neurobiology, epigenetics and embodied cognitive science will be accounted for. As will be treated in the final part of this paper, of no less importance are the conceptualizations in clinical research on psychoanalysis, which are based on meticulous, careful analyses of trauma reactivation in the transference, and understanding and working through them in the analytic relationship.     

Why Seemingly Trivial Events Sometimes Evoke Strong Emotional Reactions: The Role of Social Exchange Rule Violations

People sometimes display strong emotional reactions to events that appear disproportionate to the tangible magnitude of the event. Although previous work has addressed the role that perceived disrespect and unfairness have on such reactions, this study examined the role of perceived social exchange rule violations more broadly. Participants (N = 179) rated the effects of another person’s behavior on important personal outcomes, the degree to which the other person had violated fundamental rules of social exchange, and their reactions to the event. Results showed that perceptions of social exchange rule violations accounted for more variance in participants’ reactions than the tangible consequences of the event. The findings support the hypothesis that responses that appear disproportionate to the seriousness of the eliciting event are often fueled by perceived rule violations that may not be obvious to others.     

Coping responses in the midst of terror: The July 22 terror attack at Utøya Island in Norway

This study examined the peri‐trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri‐trauma coping responses and their relation to subsequent post‐traumatic stress (PTS) reactions. Respondents were interviewed face‐to‐face 4–5 months after the shooting, and most were interviewed at their homes. Peri‐trauma coping was assessed using ten selected items from the “How I Cope Under Pressure Scale” (HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem‐solving strategies, whereas women reported more emotion‐focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events.     

Moving attractive virtual agent improves interpersonal coordination stability

Interpersonal motor coordination is influenced not only by biomechanical factors such as coordination pattern, oscillating frequency, and individual differences, but also by psychosocial factor such as likability and social competences. Based on the social stereotype of “what is beautiful is good”, the present study aimed at investigating whether people coordinate differently with physically attractive people compared to less attractive people. 34 participants were engaged in an interpersonal coordination task with different looking (virtual) agents while performing at the same time a reaction time task. Results showed that participants had more stable motor coordination with the moving attractive than with the less attractive agent, and that the difference in motor coordination could not be interpreted by a specific attention allocation strategy. Our findings provide the evidence that physical attractiveness genuinely affects how people interact with another person, and that the temporal-spatial coordinated movement varies with the partner’s psychosocial characteristics. The study broadens the perspective of exploring the effect of additional psychosocial factors on social motor coordination.     

Seeing ‘the dark passenger’ – Reflections on the emotional trauma of conducting post-disaster research

This paper acknowledges ‘the [my] dark passenger’ of emotional vicarious trauma associated with conducting post-disaster research. Post-disaster research is tightly bounded by ethics and professional codes of conduct requiring us to be vigilant about the impact of our work on our participants. However, as a disaster researcher, I have been affected by vicarious trauma. ‘Direct personal’ vicarious trauma is where I experienced trauma associated with witnessing devastation making a professional separation from my objective subjects impossible. ‘Indirect professional’ vicarious trauma occurred when PhD students and others under my supervision that I sent to disaster affected places, experienced significant negative emotional responses and trauma as they interviewed their participants. In these situations, I became traumatised by my lack of training and reflected on how the emphasis on the participants came at the expense of the researcher in my care. Limited literature exists that focuses on the vicarious trauma experienced by researchers, and their supervisors working in post-disaster places and this paper is a contribution to that body of scholarship. In acknowledging and exploring the emotions and vicarious trauma of researchers embedded in landscapes of disaster, it becomes possible for future researchers to pre-empt this phenomenon and to consider ways that they might manage this.     

“Tears of joy” & “smiles of joy” prompt distinct patterns of interpersonal emotion regulation

Close relationship partners often respond to happiness expressed through smiles with capitalization, i.e. they join in attempting to up-regulate and prolong the individual’s positive emotion, and they often respond to crying with interpersonal down-regulation of negative emotions, attempting to dampen the negative emotions. We investigated how people responded when happiness was expressed through tears, an expression termed dimorphous. We hypothesised that the physical expression of crying would prompt interpersonal down-regulation of emotion when the onlooker perceived that the expresser was experiencing negative or positive emotions. When participants were asked how they would behave when faced with smiles of joy, we expected capitalization responses, and when faced with tears of joy, we expected down-regulation responses. In six experimental studies using video and photographic stimuli, we found support for our hypotheses. Throughout our investigations we test and discuss boundaries of and possible mechanisms for such responsiveness.     

Psychosoma in crisis: an autoethnographic study of medically unexplained symptoms and their diverse contexts

In this study, we examine autoethnographic data from three critical incidents as experienced by the first author demonstrating the importance of context in understanding medically unexplained symptoms, their incidence and underlying patterns. We make the case for ethnographies as a crucial research strand in discerning the finer aspects of the patient or client experience; aspects that might be missed where people are directed along protocolised pathways of care. The article describes care as fragmented and depersonalising, leading to disembodied exchanges, as reflected in other autoethnographic studies, particularly those that highlight the complex relationship and controversies surrounding diagnostic uncertainty. We observe that psychological therapists, given the quality of the therapeutic relationship and sustained attention to the person’s experience, are well placed to assist in the necessary processes of re-contextualisation and re-embodiment.     

Terror as Usual: The Role of the Model Minority Myth in Asian American Women’s Suicidality

ABSTRACT

This article examines the influence of the model minority myth on the formation of suicidal tendencies among Asian American women. These women experience fractured realities under the myth as a form of everyday trauma, or “terror as usual,” which may influence their suicidal thinking or attempts. Using interview data collected from 44 Asian American women suicide survivors, this study employs narrative analyses of the interviews, drawing from the theoretical frameworks of women of color feminism, critical race studies, postmodern psychology, and critical anthropology. The first part of this article deconstructs the model minority thesis as a problematic framework for understanding Asian American achievement. The second part examines how these pressures are experienced by Asian American women as destructive material and psychic constraints. Specifically, the model minority myth contributes to Asian American women’s suicidality in three major ways: (a) the pressure to succeed creates unbearable stress for individuals as they try to live up to the stereotypical image of Asian American success; (b) the dissimulation of the myth as a social fact influences Asian American women to internalize model minority expectations and thus blame themselves if they are unable to succeed; and (c) the image of model success contributes to Asian American women becoming over-looked in the distribution of needed help and resources, further exacerbating their suicidal conditions. The article concludes with a discussion of implications of this study for both clinical and nonclinical practices needed to create social conditions for Asian American women’s mental wellness.