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Specialist ServicesWorking with Children in Care and Residential Schools (a Whole Service/Systems Approach to Emotion-Regulation)
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Figure 88.1 shows the first stage of contact which is sensation, and in attachment theory this is the activation of the attachment system; this is a sensory experience which could be triggered by thoughts, feelings or other/environment. This is followed by attachment behaviour and how we creatively adjust to internal sensations in relation to other/environment. For example, a child in school may need to go to the toilet, an internal sensation, but the child’s external experience may be that others will shame them so they may adapt to the situation by becoming disruptive in order to leave the classroom. When this process is healthy, contact and withdrawal/attachment and separation are achieved spontaneously and with little effort, but when people have suffered interpersonal trauma they can get stuck at different stages along the cycle.
The Traumatized Couple
Published in Len Sperry, Katherine Helm, Jon Carlson, The Disordered Couple, 2019
Couples who are struggling with PTSD have worldviews that have been shaped by the trauma. The worldview of the trauma partner is that life hurts; the world is scary, unsafe, and uncontrollable. They avoid as many reminders of the traumatic event as possible, which leads them to isolate from even from positive, healing connections to people and places. Even though the trauma partner desperately needs safety and connection with others, trust in and attachment to other people is dangerous (particularly when they have survived an interpersonal trauma). Their self-view and mood are resolutely negative, and they have an inability to experience positive emotions. When their non-PTSD partner provides love and support, they believe they do not deserve it or do not understand why their partner is loving and supporting them. This repeated dynamic continues to isolate the trauma partner from receiving or feeling the love, support, and connection they need to heal and causes the non-PTSD partner to shut down the failed attempts at intimacy. They continuously distort the cause and consequence of the trauma as their own fault, and they might behave recklessly or repeat self-destructive behaviors as a result.
The Ways We Medicate
Published in Mark B. Constantian, Childhood Abuse, Body Shame, and Addictive Plastic Surgery, 2018
Close examination of individual tabulated correlations reveals unexpected findings, at least to me. Emotional abuse was the most common type (as it was in my own patients) and was associated with the most severe internalizing and externalizing symptoms, the lowest quality of life, the least self-worth, the lowest weight-related body esteem, the highest alcohol use, and the greatest family dysfunction compared to other forms of interpersonal trauma. Physical abuse and emotional neglect in combination correlated with internalizing and externalizing symptoms, self-worth, weight-related body esteem, and alcohol abuse. This makes sense. Emotional abuse can be consistent and continuous, unlike physical or sexual abuse. Its biological difference is borne out in treatment successes: At six months, adults treated for single incident trauma had an 83% cure rate. Children with continuous, “complex” trauma had a 30% cure rate. The difference is brain development.48
PTSD symptoms as a potential mediator of associations between military sexual assault and disordered eating
Published in Eating Disorders, 2023
Danielle Sandhu, Elizabeth N. Dougherty, Alissa Haedt-Matt
Sexual assault has been associated with high rates of PTSD (Chen et al., 2010; DiMauro & Renshaw, 2021). Among a sample of women seeking services at a center for rape victims, Elklit and Christiansen (2013) found that 45% of victims endorsed symptoms consistent with a probable PTSD diagnosis and an additional 25% met criteria for subthreshold PTSD. Furthermore, Shakespeare-Finch and Armstrong (2010) found that sexual assault can be more distressing than other traumas. When comparing three types of trauma, individuals who experienced sexual assault had significantly higher levels of PTSD symptoms than individuals who experienced the death of a first-degree relative and individuals who experienced a serious motor vehicle accident (Shakespeare-Finch & Armstrong, 2010). This finding supports research that has demonstrated that interpersonal trauma is associated with greater symptoms of guilt and shame and more likely to result in PTSD compared to noninterpersonal trauma, with survivors of intimate interpersonal trauma being most likely to experience PTSD symptoms (Baker et al., 2021; Forbes et al., 2014).
Dissociation among individuals receiving cancer care: A scoping review
Published in Journal of Psychosocial Oncology, 2022
Lisa S. Panisch, Jen Currin-McCulloch, Elle Covington
Symptoms of interpersonal trauma may lead individuals to avoid or delay cancer screenings or treatment, further exacerbating the situation. Researchers reported more than double the risk of developing breast or gynecological cancer among those exposed to interpersonal trauma,26,27 and trauma-related non-adherence to preventative care may contribute to this risk. Adult women exposed to interpersonal violence were observed to have more than 80% decreased odds of being screened for cervical and breast cancer.28 Screenings and treatments for gynecological cancers often involve invasive procedures among areas of the body vulnerable to victimization, thereby amplifying the risk of retraumatization and leading some individuals to avoid them entirely.29,30 Dissociative symptoms are specifically associated with attenuated treatment adherence in healthcare settings.31
Acceptance and forgiveness therapy for veterans with moral injury: spiritual and psychological collaboration in group treatment
Published in Journal of Health Care Chaplaincy, 2022
Patricia U. Pernicano, Jennifer Wortmann, Kerry Haynes
Group therapy has been used to treat a variety of conditions including but not limited to anxiety, PTSD, depression, and emotional trauma (Malhotra & Baker, 2021; Yalom, 2005) and is also recommended for adult interpersonal trauma survivors (Fritch & Lynch, 2008). Yalom (2005) has identified eleven therapeutic factors which develop in process group psychotherapy and facilitate growth and change: Instillation of hope, universality, imparting information, altruism, the corrective recapitulation of the primary family group, development of socializing techniques, imitative behaviors, interpersonal learning, group cohesiveness, catharsis, and existential factors. Joyce, Piper, and Ogrodniczuk (2007) point to four global therapeutic factors that emerge from Yalom’s model: instillation of hope, secure emotional expression, awareness of relational impact, and social learning as well as the importance of cohesiveness in establishing therapeutic alliance.