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Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
Lecture for april 9
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Lecture for april 9

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  • Most victims do not pursue legal/criminal avenues, and vets feel judged for political views of war.
  • Transcript

    • 1. SWK 639 Trauma Theory and Treatment in Multicultural Clinical Practice
    • 2. Trauma and Recovery: <ul><li>A Forgotten History
    • 3. Terror
    • 4. Disconnection
    • 5. Captivity
    • 6. Child Abuse </li></ul>
    • 7. A Forgotten History <ul><li>The study of psychological trauma depends on support of political movement. </li><ul><li>Hysteria in women linked to history of trauma. Lack of political context led to Freud withdrawing support of link between history of abuse and adult symptoms in women.
    • 8. Shell shock connected to war experiences, now referred to as Post-Traumatic Stress Disorder.
    • 9. Sexual and domestic violence work driven by feminist movement. After 1980 PTSD applied to survivors of rape, domestic battery, and rape. </li></ul><li>Without context of political movement, it is not possible to advance the study of psychological trauma. Examples? </li></ul>
    • 10. Terror <ul><li>In 1980, PTSD added to Diagnostic Statistical Manual (DSM).
    • 11. Three main categories of PTSD: </li><ul><li>Hyperarousal – a persistent expectation of danger.
    • 12. Intrusion – imprint of trauma.
    • 13. Constriction – numbing response of survivor. </li></ul></ul>
    • 14. Terror, cont&apos;d <ul><li>Hyperarousal: </li><ul><li>Elevated baseline of arousal (body is on alert for danger).
    • 15. Extreme startle response.
    • 16. Intense reaction to stimuli associated with the traumatic event.
    • 17. Difficulty tuning out repetitive stimuli.
    • 18. Sleep disturbance (longer to fall asleep, awaken more easily during the night).
    • 19. Increased irritability. </li></ul></ul>
    • 20. Terror, cont&apos;d <ul><li>Intrusion: </li><ul><li>Relive the event as though it were continually recurring in the present.
    • 21. Flashbacks during waking states and traumatic nightmares during sleep.
    • 22. Resemble memories of young children in that imagery and bodily sensations are primary, and there is frequently an absence of verbal narrative.
    • 23. Trauma can be relived in behavior (children in play therapy; adults in risk taking behavior or therapy – exposure, EMDR, etc.). </li></ul></ul>
    • 24. Terror, cont&apos;d <ul><li>Constriction: </li><ul><li>Keeps traumatic memories out of normal consciousness, split off from awareness.
    • 25. In attempt to avoid reliving trauma – narrow consciousness, withdraw from engagement with others, live a more impoverished life.
    • 26. Frozen watchfulness.
    • 27. Perceptions numbed or distorted.
    • 28. Out of body experience possible.
    • 29. Disassociation (similar to hypnotic trance).
    • 30. May accomplish numbing through use of drugs or alcohol.
    • 31. Traumatized people restrict their lives. </li></ul></ul>
    • 32. Terror, cont&apos;d <ul><li>Dialectic of Trauma: </li><ul><li>Oscillation between intrusion and constriction.
    • 33. Intrusive symptoms can reoccur years later.
    • 34. Numbing and constrictive symptoms dominate as intrusive symptoms diminish.
    • 35. Suicidal thoughts and behavior increase in trauma populations. </li></ul></ul>
    • 36. Disconnection <ul><li>Traumatic events impact family attachments, friendship, love, &amp; community.
    • 37. Traumatic events destroy individual&apos;s assumptions about safety of the world, positive value of self, &amp; meaningful order of creation.
    • 38. Traumatic events thwart initiative &amp; overwhelm competence. Trust shattered, faith destroyed.
    • 39. Feelings of guilt exist when survivor is witness to others hurt or killed (vets, trauma—natural or man-made). Survivor guilt.
    • 40. Survivor experiences feelings of shame &amp; inferiority.
    • 41. Above fosters withdrawal from close relationships—survivor may go between isolation &amp; clinging to others. </li></ul>
    • 42. Disconnection, cont&apos;d <ul><li>Direct relationship between severity of trauma and its psychological impact.
    • 43. Resilience matters: stress resistant individuals have high sociability (perhaps not in instances involving rape), thoughtful/active coping style, &amp; strong perception of ability to control their destiny (internal locus of control).
    • 44. Highly resilient people able to make use of opportunity for purposeful action w/others vs. being more easily paralyzed/isolated by terror.
    • 45. Support essential, beginning w/building of trust (preserve attachment, assurance of safety &amp; protection essential).
    • 46. Survivors need support to mourn losses.
    • 47. Social attitudes towards victims &amp; vets impact recovery. </li></ul>
    • 48. Captivity <ul><li>Repeated trauma occurs when victim is a prisoner, unable to flee, &amp; under the control of the perpetrator (e.g., prisons, concentration camps, slave labor camps, religious cults, brothels, &amp; families).
    • 49. Political captivity recognized, while domestic captivity is frequently unseen.
    • 50. Two steps in creating captive situations: 1) psychological domination, &amp; 2) total surrender. </li></ul>
    • 51. Captivity, cont&apos;d <ul><li>Psychological Domination </li><ul><li>Systematic, repetitive infliction of psychological trauma.
    • 52. Instill terror &amp; fear, &amp; destroy the victim&apos;s sense of self in relation to others.
    • 53. Generally unnecessary to use violence—threat of death or serious harm sufficient, &amp; threats against others as effective as threats against victim.
    • 54. Destroy victim&apos;s sense of autonomy (create dependency financially and emotionally).
    • 55. Isolate victim from information, material aid, or emotional support. Destruction of attachment with others and internal images of connection to others. </li></ul></ul>
    • 56. Captivity, cont&apos;d <ul><li>Total Surrender </li><ul><li>Occurs when victim forced to violate her own moral principles and to betray her basic human attachments (victim is truly broken).
    • 57. Victim is forced to witness or participate in violence toward others, perhaps particularly someone close to them.
    • 58. Two stages of brokenness: 1) victim relinquishes inner autonomy, world view, moral principles, or connection w/others for sake of survival (reversible), &amp; 2) victim loses the will to live (irreversible). </li></ul></ul>
    • 59. Captivity, cont&apos;d <ul><li>Chronic Trauma Syndrome </li><ul><li>Individuals subjected to prolonged, repeated trauma experience a form of PTSD that erodes the personality (Complex Trauma).
    • 60. Continually hypervigilant, anxious, &amp; agitated.
    • 61. Intrusive symptoms may persist for years.
    • 62. Constriction in relationships, activities, thoughts, memories, emotions, &amp; sensations (adaptive in captivity, needs to be unlearned).
    • 63. Complain of insomnia, agitation, &amp; numerous somatic symptoms.
    • 64. Alter consciousness through dissociation, suppression, minimization, &amp; denial.
    • 65. Perpetrator may be seen as savior or source of life.
    • 66. New identity includes memory of trauma.
    • 67. Preoccupation w/shame, self loathing and sense of failure.
    • 68. PTSD and depression frequently co-exist.
    • 69. Rage can become internalized with increase risk of self harm and suicidality, or external in form of abuse or homicide. </li></ul></ul>
    • 70. Twist of Faith <ul><li>What to look for in film excerpts: </li><ul><li>PTSD symptoms (hyperarousal, intrusion, &amp; constriction).
    • 71. Suicidal ideology
    • 72. Impact on relationships with self, family, &amp; friends
    • 73. Impact on sense of safety in the world
    • 74. Examples of survival guilt
    • 75. Areas of resilience
    • 76. Sources of support
    • 77. Examples of psychological domination and total surrender
    • 78. PTSD vs. depressive symptoms </li></ul></ul>

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