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Current issues in understanding sexual victimization
Published in Rachel E. Lovell, Jennifer Langhinrichsen-Rohling, Sexual Assault Kits and Reforming the Response to Rape, 2023
This is not to say that a victim's memory is fraught with relevant inaccuracies. In fact, stress and arousal may facilitate specific and long-lasting memories for salient and important elements of a traumatic or stressful event (Hoscheidt et al., 2014; Mather & Sutherland, 2011). A victim may remember the subjectively most important details or more details closer to the event while forgetting or never encoding more peripheral or less proximal details. Traumatic memory for salient details can be “burned in” someone's mind, sometimes referred to as a flashbulb memory. For example, a victim may vividly remember the smell of the perpetrator's breath and the feel of his erection against her while forgetting the order of events or what she was wearing. This does not correspond well with the need for chronology, detail, and “facts” that are the focus of a criminal investigation. Often the assumption can be that the victim would or should have access to information as if the memory was a recording. When it is not, the victim can be judged as lying by interviewers.
How East Met West
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
TFT and EFT come from a combination of CBT’s exposure response prevention (ERP) therapy and tapping on acupoints, incorporating a somatic/cognitive/energy approach (Diamond, 1985, 1997; Hawkins, 1995). While ERP therapy works for individuals over time, EMDR and EP techniques can work with only a small segment of the traumatic memory within a fraction of the time of ERP to soothe the hippocampus in the limbic brain through introducing new proteins in the amygdala, allowing for reconsolidation of fear memories and release of the emotional charge to the trauma memories (Argen et al., 2012; Nelms, 2017; Shapiro, 2002). These findings are in line with the findings of a ten-year research study at Harvard Medical School that found that the stimulation of certain acupoints generates deactivation in the amygdala and other areas of the limbic brain (Hui et al., 2005). When the limbic brain is soothed, the higher cognitive functioning of the prefrontal cortex comes back online, and other therapies can be used with greater success in treating co-occurring disorders (Levine, 1997, 2010).
The end of life – people's experiences
Published in Catherine Proot, Michael Yorke, Challenges and Choices for Patient, Carer and Professional at the End of Life, 2021
Catherine Proot, Michael Yorke
When a trauma or something too painful occurs, our survival instinct puts a strategy into place to protect us from that ever happening again. Unfortunately, in doing so, it also prevents us going anywhere near the traumatic memory. Many dying people have been trapped for years in such a complex which, though it helped them survive childhood abuse or trauma, did so at great personal cost. Sometimes their distress as they are dying is so great that their defences crumble and they can no longer contain their childhood pain, which bursts through. The following story, told by a palliative care physician, is an example. An elderly woman, Beth, became very upset on a hospice ward where I was working. When the nurses talked to her they discovered that she had had an illegitimate baby when she was only 15 years old. This had stayed with her, like a cancer gnawing at her mind, all through her life. She came from a working-class family where such an event was considered deeply shameful. The baby was adopted. She had never talked to anybody about it. As Beth lay dying, her defences broke down, and she collapsed in tears, unable to cope with her self-imposed silence anymore. In a sense this was a profoundly healing moment for Beth when she was able to give voice to her shame in a climate of loving acceptance; how much more beneficial for her could it have been to exorcise the pain when she was younger?
Eye movement desensitization and reprocessing for post-stroke post-traumatic stress disorder: Case report using the three-phase approach
Published in Brain Injury, 2022
Virtual EMDR can be done via various platforms that use pre-programmed visual and auditory stimuli. However, the patient had vestibular dysfunction and we were concerned that eye movements would not be well tolerated and could exacerbate symptoms such as dizziness and nausea. Instead, tactile BLS (i.e., tapping) was self-administered under the author’s guidance. Eye movements are often considered the gold standard form of BLS in clinical practice. That said, there is debate in the field about the relative efficacy of eye movements versus other forms of BLS, with some evidence that other forms of BLS such as auditory and tactile can be as effective (38). This is consistent with the contemporary working memory hypothesis of EMDR, that posits that overloading working memory is a key mechanism of action, something that could be feasibly accomplished via any form of BLS (22). In addition, traumatic memory is known to be fragmentary and often encoded in different modalities, such as images, sounds, smells, etc (39). It is common clinically to use tactile BLS in the later stages of processing, when trauma fragments are more often represented as bodily sensations versus visual images. That is, tactile BLS is assumed to overload working memory while being aware of tactile memories of trauma. This may be even more relevant to persons with medical PTSD, where the physical body is the trauma stimulus itself (i.e., somatic sensations are a prominent aspect of the trauma narrative).
Interventions for addressing trauma among people with HIV: a narrative review
Published in AIDS Care, 2022
Hilary Goldhammer, Linda G. Marc, Nicole S. Chavis, Demetrios Psihopaidas, Massah Massaquoi, Sean Cahill, Erin Nortrup, Carol Dawson Rose, Janet Meyers, Kenneth H. Mayer, Stacy M. Cohen, Alex S. Keuroghlian
Our search identified two articles on one study of prolonged exposure (PE) therapy for people with HIV (Junglen et al., 2017; Pacella et al., 2012). PE is a form of cognitive–behavioral therapy that involves repeatedly “re-living” traumatic events through imagining the event and through facing situations and memories that trigger traumatic stress (Jaycox et al., 2002). This process enables a person to emotionally process and normalize the traumatic memory. Research indicates that PE has efficacy in reducing PTSD symptoms in various populations (Powers et al., 2010). Pacella et al. (2012) focused PE therapy on each participant’s most distressing trauma. At three months post intervention, the intervention group reported substantial and significant reductions in posttraumatic stress compared to wait-listed controls. There were no significant changes in substance use. HIV care continuum outcomes were not measured.
Post-traumatic stress in the medical setting
Published in American Journal of Clinical Hypnosis, 2020
Many patients with evidence of PTSD after critical illness have been treated in intensive care units (ICUs). “Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. A high number of these traumatic memories from the ICU has been shown to be a significant risk factor for the later development of PTSD in long-term survivors” (Schelling, 2008, p. 229). Myhren, Ekeberg, Toien, Karlsson, and Stokland (2010) in a study of patients who had been discharged from an ICU a year earlier found that the mean level of posttraumatic symptoms was high amongst this patient population and that one in four patients had marked symptoms. They found that pessimism proved to be a major predictor of posttraumatic stress, anxiety and or depression. Mohta et al. (2003, p. 17) have written about how “the ICU and trauma ward environment, sleep and sensory deprivation, impact of injury on CNS, medications and associated premorbid conditions” can cause some patients to react to these stressors with posttraumatic stress symptoms. They point out how helplessness, pain, humiliation, and threat to body image, as well as steps taken to resuscitate or stabilize the patient, can lead to posttraumatic stress symptoms.