Trauma,resilience and healthy and unhealthy forms of dissociation

This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years’ experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees’ displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: ‘psychic space’, ‘sense of self’, and the use of a ‘listening other’ and ‘healthy dissociation/resiliency’. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.     

Posttraumatic stress disorder in the emergency room: exploration of a cognitive model

Ehlers and Clark (Behav. Res. Ther., 38 (2000) 319) recently proposed a cognitive model of posttraumatic stress disorder (PTSD). In this study, we examined two facets of this model, appraisal and peritraumatic dissociation, in the context of a hospital emergency room. Fifty-one emergency room personnel completed questionnaires measuring posttraumatic stress symptoms, interpretations of traumatic events experienced while working in the emergency room and subsequent intrusive recollections, and peritraumatic dissociation. Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria. As predicted, both negative appraisals of the trauma and of intrusive recollections were associated with increased PTSD severity. Although peritraumatic dissociation did not correlate with overall PTSD symptom severity, it was associated with the reexperiencing symptom cluster. Discussion focuses on the factors associated with PTSD in emergency room professionals and implications for intervention.     

Undoing trauma: contemporary neuroscience. A Jungian clinical perspective

This paper uses insights from contemporary neuroscience and attachment theory to explore the profound dissociative defences associated with trauma. I discuss the effects of trauma on the emotional, intellectual and imaginative life of the individual and on the development of the self. Based on work with three patients with very different experiences of trauma, the paper offers clinical illustration of 'right brain to right brain' Jungian analysis. I argue that through repeated transference and countertransference experiences dissociative defences may be undone and change brought about.     

Clarifying the Relationship of Dissociative Experiences to Suicide Ideation and Attempts: A Multimethod Examination in Two Samples

Fears of pain, injury, and death may represent key barriers to acting on suicidal thoughts. Dissociation, which involves a disconnection from one’s body, may reduce fears and sensations of pain associated with harming the body, in turn facilitating suicide attempts. This study examined whether dissociation differentiated individuals with a history of suicide attempts from those with a history of suicide ideation, and investigated whether other relevant constructs explain this relationship. Sample 1 included 754 undergraduates (M_age = 21, 79% female) who completed a battery of self-report measures. Sample 2 included 247 undergraduates (M_age = 19, 74% female) who completed a self-report measure of dissociation, a clinical interview regarding suicide history, and four counterbalanced behavioral pain tolerance tasks. In both samples, dissociation was elevated in lifetime attempters compared to ideators (d = 0.28; d = 0.46; ps = 0.01) and slightly elevated in lifetime ideators compared to nonsuicidal individuals (d = 0.19, p = .02; d = 0.24, p = .47), though this effect was non-significant in the latter sample. In Sample 1, dissociation no longer differentiated attempters from ideators after controlling for clinical covariates. In Sample 2, dissociation was unrelated to behavioral pain tolerance tasks, and these tasks did not account for the association between dissociation and attempts. Overall, dissociation differentiated individuals with a history of suicide attempts from those with ideation alone in both samples. Pain tolerance did not explain this association; instead, it is possible that the relationship of dissociation to suicide attempts is due to “third variables” associated with both phenomena, such as symptoms of borderline personality disorder or posttraumatic stress disorder.     

Does Dissociation Among Adolescents Predict Difficulties? A Panel Study in Japan

Dissociation has been reported to be associated with emotive-relational and behavioral difficulties; however, the temporal relationship between dissociation and these difficulties is unclear. Accordingly, this study investigated whether dissociation predicts difficulties (including emotional symptoms, conduct problems, hyperactivity, and peer problems) in adolescents. A two-wave cross-lagged panel study (Time 1: September–November 2016, Time 2: February–March 2017) was conducted among 1,773 Japanese junior high and high school students at two private schools (995 boys and 778 girls; M_age = 14.79 years at Time 1 and 15.09 years at Time 2). Dissociation was assessed using the Japanese version of the Adolescent Dissociative Experiences Scale and perceived difficulties were assessed via the Strengths and Difficulties Questionnaire. A cross-lagged effects model analysis indicated that high dissociation scores at Time 1 predicted high difficulties scores at Time 2. These findings suggest that dissociation could effectively predict difficulties in junior high and high school students. This study expands the field's understanding of the temporal relationship between behavioral problems and dissociation, which could help prevent problem behaviors.     

Alchemical dragons: Winnicott’s reaching towards the objective psyche

This paper was presented to the inaugural joint conference of The Society of Analytical Psychology and the West Midlands Institute of Psychotherapy in the autumn of 2020. It develops the author’s interest (2011, 2015, 2016) in Winnicott’s engagement with Jung by looking at the imagery of Michael Maier’s alchemical work of 1617, Atalanta Fugiens, through the lens of Matte Blanco’s bi-logic.     

When Home Is Where the Harm Is: Family Betrayal and Posttraumatic Outcomes in Young Adulthood

Research on institutional betrayal has found that institutional wrongdoing that fails to prevent or respond supportively to victims of abuse adds to the burden of trauma. In this two-study investigation with young adult university students, we demonstrated parallels between institutional betrayal and ways that families can fail to prevent or respond supportively to child abuse perpetrated by a trusted other, a phenomenon we call family betrayal (FB). In Study 1, psychometric analysis of a new FB questionnaire provided evidence of its internal consistency, unidimensionality, and convergent and discriminant validity. The majority (approximately 72%) of young adults abused in childhood reported a history of FB, with an average of 4.26 FB events (SD = 4.45, range 0–14). Consistent with betrayal trauma theory, Study 2 revealed that FB was 4× more likely to occur in relation to childhood abuse by someone very close to the victim (vs. non-interpersonal victimization), with a particularly strong effect for female participants. FB history predicted significant delay to disclosure of a self-identified worst traumatic event (η_p² = .017) and significant increases in dissociation (?R² = .05) and posttraumatic stress (?R² = .07) symptoms in young adulthood. Moreover, with FB in the regression models, only FB—not child abuse nor recent interpersonal victimization—predicted dissociation and clinically significant elevations in posttraumatic stress. Findings suggest that FB is a prevalent phenomenon among young adults abused as children and that it explains unique, clinically significant variance in posttraumatic distress, warranting increased attention from trauma researchers and clinicians.     

Resource loss,resource gain,PTSD, and dissociation among Ethiopian immigrants in Israel

The aim of this study was to examine the loss and gain of resources, posttraumatic stress disorder (PTSD) and dissociation among Jewish Ethiopian immigrants in Israel following exposure to stressful events occurring pre‐, peri‐, and post‐migration. Resources are defined as objects (e.g., housing), conditions (e.g., employment), personal (e.g., self‐esteem), or energy (e.g., culture). A random sample (N = 478) of three waves of immigrants participated in the research (N1 = 165; N2 = 169; N3 = 144). The data were collected in 2001. Age, loss and gain of resources, traumatic events peri‐migration, post‐migration difficulties, posttraumatic symptoms, and dissociation were assessed. The relationships between the variables were assessed with multiple hierarchical regressions predicting PTSD and dissociation with gain and loss of resources, over and above age, immigration wave, and trauma. A significant relationship was found between PTSD symptoms and loss of self‐esteem resources (r = 0.17 p < 0.001), while dissociation was positively associated with gain of housing resources (r = 0.20, p < 0.001). Both PTSD and dissociation were predicted by younger age. The findings are discussed in light of the conservation of resources (COR) theory (Hobfoll, 1988 ), of resource loss and gain among Ethiopian immigrants.     

Traumatic dissociation of aspects of the feminine: an Asian cultural perspective

The paper explores the impact of the dissociated feminine principle resulting from the trauma of cultural displacement in a young Chinese woman keen to embrace a modern Western identity. A case study illustrates the outcome of the client both consciously and unconsciously rejecting the traditional stereotypical Chinese feminine identity and instead embracing the distorted, yet seductive, image of the Western (Caucasian) woman as independent, intellectual and confident. Her defensive denial of the traditional feminine was dealt with by intellectualising both personal and professional relationships. Then, unconsciously, the dissociated traditional feminine was projected into a separate aspect of her identity that held the traumatised feelings. The intellectualisation was eventually understood as being a necessary defence to cope with the cultural as well as geographical dislocation trauma. And with this realisation a space was created to accept and integrate the denied feminine–in a literal as well as a symbolic manner.     

提供具体信息对学习的影响

本研究采用多重分离程序,对提供具体信息在学习中的作用加以探讨,结果发现：随着指导语外显程度的逐步增高,外显学习效应显著增加,而内隐学习效应无显著变化。