Trauma Recovery in the Transgender and Gender Diverse Community: Extensions of the Minority Stress Model for Treatment Planning

Transgender and gender diverse (TGD) populations, including those that do not identify with gender binary constructs (man or woman) are increasingly presenting for treatment of posttrauma sequelae. Providers who offer services for trauma survivors including posttraumatic stress disorder (PTSD) treatment should be knowledgeable about evidence-based care and have some cultural familiarity with TGD experiences. Indeed, the Minority Stress Model suggests that the combination of distal and proximal minority stressors can combine to produce increased mental health symptoms as compared with cisgender peers, though this model has yet to be fully tested. Clients often present with a complicated picture of experiences, which include a variety of minority stressors, microaggressions, discrimination, and traumatic events that can all be related to their identity. However, conceptualizations of trauma treatment in the context of extensive minority stress are lacking. This paper summarizes the existing literature and offers guidance to mental health providers who are well positioned to address stigma, discrimination, violence, and related symptoms that arise from micro-, mezzo- and macro-level spheres of TGD individuals’ experience.     

From individual to social and relational dimensions in asylum-seekers’ narratives: A multidimensional approach

Taking a psychodynamic perspective, the present exploratory study proposes an integrated approach to explore the forced migratory experience, focusing simultaneously on mental health risk and protective factors and on the quality of the subjective experience of migration. We aimed to evaluate trauma and protective factors and to explore in-depth representations and meanings asylum seekers hosted in Italy attribute to their experiences. Levels of trauma and resilience were first evaluated for twenty asylum seekers hosted in two Reception Centres; then, in-depth interviews were administered. Six out of twenty participants presented with symptoms of trauma and all presented with moderately high resilience levels. The interviews were analysed using a quality-quantitative methodology via T-Lab software, and showed four thematic clusters: A godforsaken place; From death to life across the sea; Memories from the past; Searching for a land of care. In line with the identity fracture highlighted in psychodynamic literature, our results show a breakdown between the deeper and original aspects of participants’ identity and their new cultural identity as migrants, which has many social components. Reflections on the implications of the study will be outlined.     

Book Club Groups to Aid Relational Connection and Trust among Addicted Trauma Survivors

This is a secondary analysis of qualitative data from a literacy study, which examines Book Clubs as a creative approach to engage female addicted trauma survivors in developing psychologically safe, trusting therapeutic relationships. This approach is respectful of the participants’ experiences of relational trauma and diverse cultural contexts, in part because book clubs are ‘normal’ experiences in which the client is better able to have control over the level of vulnerability she engages in within the therapeutic milieu. Themes indicating increasing levels of vulnerability and psychological safety include use of book club discussions to identify with text, plot, or characters; to discuss escape coping and aggressive coping; and to discuss self as a victim and as a survivor.     

A Pilot Study Exploring PTSD Symptom Clusters as Mediators between Trauma Exposure and Attachment Behaviors in Married Adults

The purpose of this pilot study was to examine the mediating effect of posttraumatic stress disorder (PTSD) symptom clusters on the association between trauma exposure and attachment behaviors. Results from bootstrapped mediation analyses with a sample of 116 married adults revealed that total PTSD, avoidance, negative alterations in cognition/mood, and arousal symptoms partially mediated the effect of trauma exposure on perceived attachment behaviors in men only; the intrusion symptom cluster was not significant and there were no significant mediation effects for women. Findings shed light on possible gender variant mechanisms by which trauma may threaten secure attachment bonds in couples.     

Sankofa Socialization as a Response to the Soul Trauma of Black Women Activists in Ministry

This article sets out an emerging discourse on defining and repairing the generational spiritual consequences of racism, victimization, marginalization, and isolation experienced by women of African descent, identified in this paper as “soul trauma.” Drawing on the work of W.E.B. Dubois, Joy DeGruy, Iva Carruthers, and others, it establishes the deep and deadly effect of internalized white supremacy and cultural hegemony on the identity and socialization of Black women, an effect that requires substantial work and repair beyond what established human service delivery practices can provide to the essential core of one's being, the soul. This article posits the concept and practice of Sankofa as a form of holistic medicine in the repair of Black souls, specific to the use of Kindezi, a Kikongo education system.     

From active imagination to active life: at the roots of Jungian social activism

Our traditional Western worldview is often unconsciously based on a polarized, dichotomous perspective. However, many of Jung's ideas hint at a deep interrelation between opposites, such as inside and outside, which are, as the principle of synchronicity shows, rooted in a conceptualization of psyche and matter conceived as intertwined. Another pair of philosophical concepts, traditionally considered as opposites, needs further investigation: that between imagination and reality. If we are lucky in our daily practice as analysts, we can use imagination as a powerful tool to help people discover themselves as individuals and to get in deeper, more lively and responsible touch with reality. This paper explores the difference that Jung outlined between ‘active imagination’ and ‘passive fantasies’, and the transformative power of taking an active part in what imaginatively happens – he called it ‘active participation’ – rather than being passively overwhelmed by invasive fantasies. It is argued that it makes a great difference whether we become the actors and not just the spectators of our lives, and this is linked with the core of the individuation process in which, if individuals discover their particular place and meaning in the universe, they can live an ‘active life’, playing a heartfelt and responsible role in the collective world to which they belong. These ideas are at the heart of Jung's work, and they represent one of the roots of Jungian social activism.     

Disquiet in the consulting room: everything/nothing that is said here is confidential

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require.     

Associations between prenatal substance exposure,prenatal violence victimization,unintended pregnancy,and trauma exposure in childhood in a clinical setting

Given the importance of early prevention and intervention strategies for children exposed to trauma, detection of early risk factors for exposure to traumatic events in childhood is critical. The present study examined associations between three known prenatal risk factors that characterize environmental instability in utero—prenatal substance exposure, prenatal violence victimization, and unintended pregnancy—and child exposure to interparental violence and other adverse experiences in a sample of 198 mother–child dyads (M child age = 44.48 months) referred to a hospital clinic for treatment following exposure to trauma. Prenatal substance and violence exposure were associated with child trauma exposure, and prenatal violence victimization was also associated with maternal severity ratings of traumatic exposures. Unintended pregnancy was not associated with child trauma exposure or severity. These findings expand our understanding of prenatal risk factors for trauma exposure in childhood and, specifically, highlight prenatal substance exposure and violence victimization as risk factors for subsequent exposure to trauma in early childhood. Results suggest that prenatal prevention and intervention programs should target reducing maternal substance use and in-utero exposure to violence.     

The importance of distinguishing between harassment-only and assault military sexual trauma during screening

Extant research demonstrates that a history of military sexual trauma (MST) is associated with PTSD and depression diagnoses as well as heightened risk for suicidal ideation and death by suicide. Past studies of MST and its sequelae typically collapse harassment-only and assault MST screening items into a single response, recorded as positive or negative for a history of MST. It is presently unclear whether assault is associated with poorer mental health outcomes relative to harassment-only MST. Female service members/Veterans (n = 656) completed an online survey assessing history (present, absent) and type (harassment-only, assault) of MST, PTSD, depression, sexual satisfaction and function symptoms, as well as suicidal ideation. Findings revealed that those who reported a history of MST, and assault more specifically, were more likely to report higher PTSD symptoms and probable PTSD diagnosis, higher depression symptoms and probable depression diagnosis, worse sexual function and probable sexual function diagnosis, lower sexual satisfaction, and presence of suicidal ideation. Those who reported harassment-only MST also reported higher PTSD severity and probable PTSD diagnosis, but the magnitude of the association of harassment-only MST and PTSD severity relative to assault MST and PTSD severity was substantially lower. Findings suggest it is critical to distinguish between history and type of MST during screening as a combined screening item loses sensitivity to identify those at heightened risk for distress and dysfunction.