An Ecological Community-Based Approach for Dealing with Traumatic Stress

Abstract

This article presents our ecological approach toward building community resilience in the aftermath of a traumatic event and its application in the case of a terror attack on a Kibbutz. It delineates the various principles guiding our framework, outlines the phases of our community intervention, describes the intervention processes, and addresses some dilemmas relevant for such interventions.     

Increasing Couple Intimacy Using Virginia Satir's Temperature Reading

SUMMARY

This article describes the process of using Virginia Satir's Temperature Reading, a communication tool, to increase intimacy with couples. It presents a rationale and theory for using a daiiy couple Temperature Reading to develop communication skills for learning how to share intimately in relationships. Temperature Reading provides a safe environment where each member of the couple can learn to share personal information and can practice listening to the other in a supportive and cooperative manner. Therapists and couples alike can utilize this process as described here.     

Journeys in the labyrinth: Some difficulties in the psychotherapy of a severely traumatized adolescent

This paper explores the long-term sequelae of chronic early trauma as expressed by an adolescent in intensive psychotherapy. In particular, attention is given to the ways in which intolerable early experience may block subsequent identificatory ego growth by means of a radical defensive detachment from any potential source of help. Healthy maturation is replaced by an elaborate structure of defences aimed at obliterating awareness of unfulfilled attachment needs and providing a constantly available inner sanctum filled with exciting but profoundly unsatisfying sadomasochistic distractions. The technical importance of careful attention to the therapist's countertransference experiences is underlined. It is suggested that the presence of hatred in this area may represent one of the few undistorted communications from the patient, implying hatred of torture and cruelty. As such, when carefully metabolized by the psychotherapist, it may herald the recovery of hope and serve to protect hidden, bullied aspects of the patient's self which are still on the side of life and development.     

Meaning making,adversity, and regulatory flexibility

Despite the widely accepted belief that meaning making is essential for mental health following adversity, the available research continues to provide mixed findings: meaning making is sometimes evident, sometimes not, and more frequently than we would expect associated with poor health outcomes. The papers that comprise this special issue of Memory put flesh to those bones by approaching the question from a narrative memory perspective. Meaning making, these studies demonstrate, is a multi-faceted phenomenon and whether it is necessary or adaptive depends on which particular form of meaning making is considered and on the context and timing in which it occurs. To situate these insights in a broader framework I consider parallels with the emergent literature on regulatory flexibility and briefly review recent research and theory on that construct as it has been applied in the literatures on coping and emotion regulation. Finally, I close by suggesting a basic framework, informed by the flexibility construct, that might guide future research on meaning making.     

Training service providers working with traumatized children in South Africa: The navigations of a trainer

In South Africa, counselling training poses two related difficulties: working in a situation of ubiquitous, ongoing violence, and offering training to people who have minimal or no qualifications and are often overwhelmed by enormous workload. In this context, there is a temptation either to give up hope in the face of the enormity of the task, or defensively to package counselling as a set of techniques which can be taught without much self-reflection. In this article we discuss, by contrast, an intervention which used psychodynamic principles to develop learner-centred training drawing on trainees' own experiences. We consider the benefits of this approach even in a context of violence and meagre resources.     

A psychodynamic perspective on early childhood trauma in an adult: A case study

Abstract

This paper uses a long-term case to illustrate, from a psychodynamic perspective, a number of issues arising in working with an adult survivor of early childhood trauma. The paper takes an overview of the case study, identifying issues which are inextricably interwoven in the client's experience of trauma, and which impact on the working alliance. The therapeutic relationship forged with the client is discussed in terms of its intrinsic successes and failures together with the implications of early traumatic experiences for the termination of counselling.     

The centrality of event scale: a measure of integrating a trauma into one's identity and its relation to post-traumatic stress disorder symptoms

We introduce a new scale that measures how central an event is to a person's identity and life story. For the most stressful or traumatic event in a person's life, the full 20-item Centrality of Event Scale (CES) and the short 7-item scale are reliable (alpha's of .94 and .88, respectively) in a sample of 707 undergraduates. The scale correlates .38 with PTSD symptom severity and .23 with depression. The present findings are discussed in relation to previous work on individual differences related to PTSD symptoms. Possible connections between the CES and measures of maladaptive attributions and rumination are considered along with suggestions for future research.     

The effect of arousal on memory for emotionally-relevant information: a study of skydivers

The aim of the present study was to test memory for information under conditions of extreme arousal in an analogue design to mimic hyperarousal during trauma exposure. Prior to their skydive, 70 novice skydivers were administered measures of fear, heart rate, and anxiety sensitivity. Half the participants learnt a list of words that varied in both relevance to their skydive and valence (irrelevant/relevant, negative/neutral) on the plane (skydivers), and remaining participants learnt an identical list of words on the ground (delayed controls). Following the skydive, participants completed free recall and recognition tasks; heart rate, dissociation, and subjective arousal were also measured. Consistent with an attentional narrowing hypothesis, skydivers recalled comparable a comparable number of relevant words as delayed controls, but significantly less irrelevant words. In terms of recognition performance, skydivers displayed better recognition of relevant words but poorer recognition of irrelevant words than delayed controls. Valence of words did not alter the pattern of results. The implications of the findings are discussed in the context of understanding memory processes under conditions of high threat.     

Trauma narratives and emotional processing

The present study examined the relations between indicators of emotional processing (e.g. trauma narratives), posttraumatic stress symptoms, and psychological distress in two military samples (N = 120) exposed to significant training accidents. Trauma narratives were collected at 2-3 weeks, while outcome measures (e.g. IES-15, PTSS-10, and GHQ-30) were collected at 2-3 weeks, and 4 months after the accidents. Emotional processing was indexed by the content of positive and negative emotional expressions in the trauma narratives. The results showed that positive emotional expressions were associated with lower levels of psychological distress, whereas negative emotional expressions were linked to trauma specific symptoms and psychological distress at 2-3 weeks. Negative emotional expressions explained between 6-8% of the variance in trauma specific symptoms at 2-3 weeks, and 11% of the variance in psychological distress symptoms at 4 months after the traumatic event.