The influence of a visuospatial grounding task on intrusive images of a traumatic film

Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system.     

Parents' adjustment to late abortion,stillbirth or infant death: the role of causal attributions

The aim of the present study was to explore the attributional processes and the effect of various causal attributions on post-traumatic symptomatology among 110 parents who had lost an infant. The attributional processes were examined with longitudinal data collected over 12 months. One to four weeks post-loss, approximately half of the parents reported that they were never or rarely concerned with attributing responsibility for their baby's death. The importance of attributing responsibility was associated with several post-traumatic symptoms, as was searching for meaning in the death. Attributions to oneself, others, or God were positively and significantly associated with numerous post-traumatic symptoms. The results are discussed with reference to other studies dealing with the effect of attributions on subsequent adjustment among victims of trauma.     

Work potential of road accident survivors with post-traumatic stress disorder

Work potential in adult survivors of road accidents with and without post-traumatic stress disorder (PTSD) was examined at a mean of 8.6 months (SD = 3.77) post-accident. All participants were working prior to their accident. Results showed that survivors with PTSD had significantly less work potential post-accident than survivors without PTSD. Specific barriers to employability for survivors with PTSD identified by this study included high levels of depression, reduced time-management ability, and an over-concern or anxiety with physical injuries. Respondents with PTSD, however, reported significantly greater extrinsic motivation to work than those without PTSD. Early intervention and referral to occupational rehabilitation programs that: (1) help address these barriers to employability and stimulate the existing motivation to return to work, and (2) work alongside clinical treatment programs, may assist in the reduction of poor work outcomes that people with PTSD following road accidents often experience.     

Fewer intrusions after an attentional bias modification training for perceptual reminders of analogue trauma

The present experimental analogue study used computerised attention training to investigate the role of attention bias in the prediction of intrusive memories. After exposure to a trauma film, participants in a training group (n=22) were presented with a variant of the exogenic cueing task (ECT) in which visual film reminders (i.e., stills from the trauma film) were always presented during invalid and neutral control stimuli always during valid trials. The purpose of this cue–location contingency was reinforcing the direction of attention away from film reminders. Control participants (n=23) performed a similar training without such a contingency. Post-training processing bias was assessed with a single target Rapid Serial Visual Presentation (RSVP) task, in which trauma-film reminders served as task-irrelevant distracters appearing shortly before a neutral target. The frequency of film-related intrusions was recorded in a take-home diary and at a follow-up session three days after film viewing. Participants who underwent attention training reported fewer film-related intrusions and showed less interference by visual film distracters than controls. Implications for research on attention bias after real-life trauma are discussed.     

Between Symbol and Antisymbol - The Meaning of Trauma Reconsidered

Within psychoanalysis, it has usually been assumed that what makes an external event traumatic is the personal meaning of the event for that individual, i.e. how it resonates within his/her internal world and in relation to the infantile conflict. Such an assumption, which implies that a trauma operates as a symbol, is compared with the contrasting view that a trauma rather destroys the capacity of symbolization, and discussed in relation to the psyche-soma issue. It is finally maintained that psychic trauma forces upon the victim a vast and difficult transformation, in relation to which the body can be used as an antisymbolic device to resist mental change.     

Trauma Lives in Speech

The author approaches the topic through infant observation. At the age of eight months the baby moves in the borderland between the physical and the symbolic. When the baby hurts herself, she needs the mother's arms to protect her: at the same time, her budding spoken symbol "mama" is comforting in itself, it carries the memory of the mother's arms. Can speech - tone of voice, rhythm, pauses - and the moments of loss, absence, the losing of self also be intertwined? The author discusses the question of how trauma starts to live in speech through two patients. She talks about "a silent language" which speaks in between the words and sentences - changes the rhythm of speech, makes lose words, tears a hole in speech. This "silent language" talks about trauma, reaches for its very essence - a bodily experience and meaning to the wholeness/disruption of self.     

The therapist with her back against the wall

This clinical paper describes once weekly psychotherapy with two boys with traumatic histories. The way in which the trauma enters the consulting room and the relationship with the therapist is explored. Technical issues are discussed, particularly the understanding of the countertransference and its modulation in communication with the patient. The therapist's intense personal anxiety about failure and about management of the difficulties that arise is linked to the impact of trauma.     

'To walk the last bit on my own' - narcissistic independence or identification with good objects: issues of loss for a 13-year-old who had an amputation

This paper describes two years of psychotherapy with Michael, a 13-year-old boy who had undergone a recent emergency amputation of his leg and hip for bone cancer. The work follows Michael's struggle with the enormity of the loss, in the face of his, as well as the system's, use of denial. The amputation as an 'attack' on his physical and emotional autonomy strikes at his early adolescent development. The therapeutic process is aided by his capacity 'to go back to the unhappiness'. The therapy develops from his initial shock, to despair and self-blame, as he struggles with a tendency - in the middle period of the therapy - to lose his mind as well as his leg in a retreat to withdrawal and mindlessness, or to mania. He struggles between an omnipotent, at times self-destructive, wish to 'go it alone', versus a capacity to feel sad and to value life. His capacity to think about the trauma and to find meaning emerges. The paper raises questions about whether some trauma can ever be fully assimilated, and whether, for Michael, the mourning process could lead to a reintegrated sense of self and of a 'psychic intactness', dependent on the survival of his good 'internal couple'. Hospital and ward-based child psychotherapy and its limitations are explored.