THE SELF-INJURY TRAUMA (SIT) SCALE: A METHOD FOR QUANTIFYING SURFACE TISSUE DAMAGE CAUSED BY SELF-INJURIOUS BEHAVIOR

A method is described for classifying and quantifying surface tissue damage caused by self-injurious behavior. The Self-Injury Trauma Scale permits differentiation of self-injurious behavior according to topography, location of the injury on the body, type of injury, number of injuries, and estimate of severity. Fifty pairs of independently scored records were subjected to interrater reliability analyses, and the following mean (median) percentage agreement scores were obtained: overall agreement, 97% (98%); location of injury, 99% (100%); type of injury, 96% (100%); number of injuries, 89% (100%); and severity of injury, 94% (100%). Percentage agreement also was calculated for three summary scores: Number Index, 90%; Severity Index, 92%; and Estimate of Current Risk, 100%. Potential applications and limitations of the scale are discussed.     

A pilot study of a Scripture-based trauma healing model for adults in Nicaragua

With the rising attention to global trauma, there is increased interest in utilising effective trauma healing (TH) models, especially those that integrate a spiritual component. This paper examines the effectiveness of a Scripture-based TH model developed by the Trauma Healing Institute utilised in a pilot study with Nicaraguan adults who experienced non-sexualised-related crime, disaster-related trauma, and/or interpersonal violence. An additional focus of this study was on whether increased spiritual well-being would result from this healing model. In this first empirical study on the TH model, initial results indicated that participants (N?=?23) experienced both a reduction in trauma-related symptoms as well as an upward trend in spiritual well-being from pre-test to six-month follow-up. Spearman results also showed an inverse relationship between trauma symptoms and spiritual well-being. Factors that may have impacted results, limitations to this pilot study, and considerations for future studies are discussed.     

Race,religion and a cat in the clinical hour

Racial and religious identities are complex, often mired in dynamics of ‘othering’. Such dynamics easily become a means of distancing the pain, fear and rage of intergenerational traumas, thus undermining ways race and religion can be powerful vehicles for the transference and countertransference. Drawing from a history of race in America as well as Jung's anxiety when meeting the stranger within himself, this paper focuses on 17 years of work between a black female patient and white female clinician (me). Together we encountered themes of hatred, silence, guilt and intimacy in the transference and countertransference, themes eventually symbolized by the presence of my cat which was locked into the bathroom for each session. This cat came to represent a bridge through developmental traumas and wounds of racism.     

Traumatic Stress Among Seriously Delinquent Youth: Considering the Consequences of Neighborhood Circumstance

Myriad factors have been found to have an impact on delinquent behavior and traumatic stress. This study proposes a model that tests the relationship between common predictors of delinquency (neighborhood condition, antisocial peer socialization, and exposure to violence) with traumatic stress. Serial mediation was used to test the relationships between these predictors and traumatic stress. Results indicate the mediation effect between neighborhood conditions and traumatic stress significantly reduces the total effect. Implications for traumatic stress in the context of delinquent behavior are discussed.     

Bidirectional associations between hope,optimism and social support,and trauma-related symptoms among survivors of terrorism and their spouses

The study examined bidirectional relationships between three key resources of resilience: hope, optimism, and social support, and a range of trauma-related symptoms (posttraumatic stress disorder, depression, and anxiety) among injured survivors of terror attacks and their spouses (N = 210). A series of actor-partner interdependence models were used to test the bidirectional dyadic associations. The results demonstrate negative associations between resilience resources of the survivors and their spouses and their trauma-related symptoms. Further, the levels of hope and social support reported by the survivors were negatively associated with the trauma-related symptoms experienced by their spouses, whereas the level of optimism reported by the spouses was negatively associated with the trauma-related symptoms experienced by the survivors. Theoretical and clinical implications are discussed.     

Elevating the Voices of Girls in Custody for Improved Treatment and Systemic Change in the Juvenile Justice System

The U.S. juvenile justice system does not meet the needs of girls in custody, and often fails to address girls’ symptoms of trauma and high rates of sexual exploitation histories. As the system shifts away from punitive detention to a trauma‐informed approach with community‐based services, community psychologists and other helping professionals can help center the needs and experiences of girls in custody. As part of a multi‐year collaboration, our research team created a confidential youth advisory process in one juvenile detention center (JDC). We acted as liaisons between the girls in custody and JDC administrators, reporting girls’ feedback to agencies at monthly meetings. Participant confidentiality, safety, and consent were priorities. The girls’ feedback, which was conceptualized within a System Responsiveness and hierarchy of needs framework, led JDC probation and mental health staff to improve services (e.g., better laundry system, longer showers, warmer food), climate (e.g., consistent reward system, confidentiality of grievances), and treatment (e.g., increase focus on gender and culture) to reduce the trauma of incarceration among girls in custody. Girls’ feedback also catalyzed systemic change that led to a reduction in the JDC population in favor of wraparound community‐based services better suited to meet girls’ needs. Implications for community psychology values and the juvenile justice system, including the benefits and challenges of this type of collaboration, are discussed.     

Dreams and COVID-19

This work originates from reflections on the observation of recurring themes in dreams of patients in psychoanalytic treatment during the most restrictive lockdown period in Italy (March - May 2020). The authors focus on the peculiar dialogic state between consciousness and the unconscious that arose following a collective event such as that of the pandemic, which determined the activation of complex personal nuclei, compensatory effects of the unconscious psyche and new perspective functions. These latter aspects are interpreted with reference to the contributions of Erich Neumann, bringing a new psychological vision of the relationship between Man and Nature in relation to catastrophic events.     

Archetypes of the pandemic

This paper attempts to read the psychological and emotional impact of the COVID-19 pandemic through the archetypal images contained in patients’ dreams. In these dreams, symbols related to the power of nature and to extreme danger are paired with feelings of detachment that seem to point to a traumatic dissociation, due to the archetypal experience that erupts in familiar surroundings. Through the humanization of the ineffable experience, dissociation, which in the beginning of the pandemic showed in high levels of anxiety, panic attacks and depersonalization, can be transformed into the overview needed for the search for meaning. The container for this process of transformation is the analyst, the real, virtual or imagined one, and his or her ability to relate and feel.     

Editorial

This paper is a response to William Meredith-Owen’s paper presented at the inaugural joint conference on ‘Alchemy, a bridge to Jung’s objective psyche’, for The Society of Analytical Psychology and the West Midlands Institute of Psychotherapy in autumn 2020. The paper presents a way of understanding the collective unconscious through the functioning of the core self, and thus offers a bridge which addresses the indivisibility of the personal and collective psyche/unconscious, referencing Mary Williams’ (1963) classic paper. Specifically, this is applied to Winnicott’s dream of destruction that he had after reviewing Memories, Dreams, Reflections, as well as to parts of the psyche that were dissociated due to significant early deprivation – the primary narcissistic wounds. Alchemical metaphors are shown to relate to the analytic process, which allows the primitive core self (with its identificatory, participatory, connecting nature), when integrated through relationship, to sink back into the unconscious and function as the Self.     

Islamic Trauma Healing: Integrating Faith and Empirically Supported Principles in a Community-Based Program

Access to adequate, much less state-of-the-art, mental health care is a global problem. Natural disasters, civil war, and terrorist conflict have forcibly displaced millions of Muslims and have resulted in a remarkable level of individual and communitywide trauma exposure. As a result, many are at risk for posttraumatic stress and other trauma-related disorders. Many religiously oriented Muslims traditionally rely on Islamic principles and teachings, as well as their community, to cope with and address trauma-related distress. Islamic Trauma Healing is a six-session, lay-led group intervention developed within a Somali Muslim community that integrates evidence-based trauma-focused cognitive-behavioral therapy principles with cultural and religious practices aimed to enhance uptake and create an easily up-scalable intervention for a wide range of trauma. In sessions, narratives of prophets who have undergone trauma (e.g., Prophet Ayyub, faith during hard times) present Islamic principles and facilitate cognitive shifts. Group members spend individual time turning to Allah in dua (i.e., informal prayer), focused on exposure to trauma memories. Program themes arc across suffering to healing to growth following trauma. This paper describes the core theoretical principles and methods in the Islamic Trauma Healing program. We also describe leader perspectives and the program’s train-the-trainer model, in which lay leaders are trained to further disseminate the program and allow Islamic Trauma Healing to be owned and sustained by the Muslim community.