Psychological trauma is a type of damage to the mind that occurs as a result of a very sad event. Trauma is often the result of tremendous stress that exceeds a person's ability to overcome, or integrate the emotions involved with that experience. A traumatic event involves a person's experience, or repeating a sealed event that can be deposited in weeks, years, or even decades as a person struggling to cope with immediate circumstances, leading eventually to serious long-term negative consequences.
However, trauma differs between individuals, according to their subjective experience. People will react to similar events differently. In other words, not everyone who has experienced a potentially traumatic event will be a psychological trauma. However, it is possible to develop post-traumatic stress disorder (PTSD) after exposure to potentially traumatic events. This difference in risk level can be attributed to the protective factors that some individuals may have that enable them to overcome the trauma; they are related to temperamental and environmental factors. Some examples are mild exposure to early stress, survival characteristics, and seek active help.
Video Psychological trauma
Definisi
DSM-IV-TR defines trauma as a direct personal experience of an event involving real or threatened death or serious injury; threats to the physical integrity of a person, witnessing events involving the above experience, learning about unexpected death or violence, serious harm, or death threats, or injuries suffered by family members or close associates. Memories related to trauma are implicit, pre-verbal and irrevocable, but can be triggered by stimuli from the in vivo environment. People's response to the nasty details of a traumatic event involves intense fear, helplessness or horror. In children it is manifested as irregular or aggressive behavior.
Trauma can be caused by various events, but there are some common aspects. Often there are violations of people's familiar ideas about the world and their human rights, placing the person in a state of extreme confusion and insecurity. This is seen when institutions rely on survival violating, humiliating, betraying, or causing great harm or separation rather than evoking such aspects as feasible, specialized, safe, new and free.
Psychological traumatic experiences often involve physical trauma that threatens the survival and security of a person. Common causes and hazards of psychological trauma include harassment, embarrassment, neglect, abusive relationships, rejection, mutual dependence, physical assault, sexual harassment, partner battery, work discrimination, police brutality, judicial corruption and offenses, bullying, paternalism, domestic violence, indoctrination, victimization of alcoholic parents, threats or witness to violence (especially in childhood), life-threatening medical conditions, and trauma caused by drugs. Natural disasters such as earthquakes and volcanic eruptions, large-scale transport accidents, house or household fires, motor vehicle accidents, interpersonal violence such as wars, terrorist attacks or other mass torture such as sex trafficking, taken as hostages or kidnapped causing psychological trauma. Long-term exposure to situations such as extreme poverty or milder forms of abuse, such as verbal abuse, exists independently of physical trauma but still produces psychological trauma.
Some theories suggest childhood trauma may increase a person's risk for mental disorders including post-traumatic stress disorder (PTSD), depression, and substance abuse. Childhood difficulties are associated with neuroticism during adulthood. Parts of the brain in growing children develop in sequence and hierarchical order, from the most complex to the most complex. Brain neurons are designed to change in response to constant external signal and stimulation, receiving and storing new information. This allows the brain to constantly respond to its environment and encourage survival. Our five major sensory signals contribute to the development of brain structure and function. Infants and children begin to make internal representations of their external environment, and in particular, key attachment relationships, immediately after birth. Attachment figures who are harassed and sacrificed have an impact on the internal representation of infants and children. The more often the specific pattern of brain neurons is activated, the more permanent the internal representation associated with the pattern. This causes sensitization in the brain to certain neural networks. Because of this sensitization, the nervous pattern can be activated by less reduced external stimuli. Childhood abuse tends to have the most complications with long-term effects of all forms of trauma as it occurs during the most sensitive and critical phases of psychological development. It can also lead to violent behavior, perhaps just as extreme as serial killings. For example, Hickey's Trauma-Control Model shows that "childhood trauma for serial killers can serve as a trigger mechanism that results in an individual's inability to cope with the stress of a particular event."
Often the psychodynamic aspects of trauma are ignored even by healthcare professionals: "If doctors fail to see through the trauma lens and for the concept of a client-related problem may be current or past trauma, they may fail to see that trauma victims, old and young, manage much of life they are around the repetitive patterns of reviving and warding off memories, reminders, and traumatic influences. "
Maps Psychological trauma
Symptoms
People who experience this type of traumatic experience often have certain symptoms and problems afterwards. The severity of these symptoms depends on the person, the type of trauma involved, and the emotional support they receive from others. Reactions and symptoms of trauma can be broad and varied, and vary in person to person severity. Individuals who experience trauma may experience one or more of them.
After a traumatic experience, a person may experience physical and mental trauma, then a trauma reminder, also called a trigger, can become uncomfortable and even painful. This can undermine the sense of security, self-efficacy, and the ability to manage emotions and direct relationships with others. They may turn to psychoactive substances including alcohol to try to escape or dampen feelings. These triggers cause a flashback, which is a dissociative experience in which the person feels as if the event is happening again. They can range from distraction to completion of dissociation or loss of awareness of the current context. Re-experiencing symptoms is a sign that the body and mind are actively struggling to cope with traumatic experiences.
Triggers and cues act as reminders of trauma, and can cause anxiety and other related emotions. Often the person is completely unaware of what this trigger is. In many cases this can cause a person suffering from a traumatic disorder to engage in destructive or self-destructive coping mechanisms, often without being fully aware of the nature or cause of their own actions. Panic attacks are an example of a psychosomatic response to such emotional triggers.
As a result, intense anger may often arise, sometimes in inappropriate or unexpected situations, because the danger may always appear to be present, as much as it actually is and experienced from past events. Diminished memory such as images, thoughts, or flashbacks can haunt a person, and nightmares may occur frequently. Insomnia can occur because fear and insecurity keep people alert and alert to danger, whether day or night. Trauma not only causes changes in everyday functions but can also cause morphological changes. Such epigenetic changes can be passed on to the next generation, thus making genetics one of the components of psychological trauma. However, some people are born with or subsequently develop protective factors such as genetics and sex that help lower the risk of psychological trauma.
The person may not remember what really happened, while the emotions experienced during the trauma can be re-experienced without a person who understands why (see Repressed memory). This can cause a traumatic event that is constantly experienced as if it were happening in the present, preventing the subject from gaining perspective on the experience. This can produce a long period pattern of acute arousal interspersed by periods of physical and mental exhaustion. This can lead to mental health disorders such as acute stress and anxiety disorders, traumatic sadness, undifferentiated somatoform disorders, conversion disorders, short psychotic disorders, personality threshold disorders, adjustment disorders, etc.
In time, emotional fatigue can occur, which causes disruption, and clear thinking may be difficult or impossible. Emotional detachment, as well as dissociation or "numbness", can often occur. Associating from painful emotions involves turning off all emotions, and the person may seem flat emotionally, busy, distant, or cold. Dissociation includes depersonalization disorders, dissociative amnesia, dissociative fugue, dissociative identity disorder, etc. Repeated exposure and trauma can cause neurophysiological changes such as myelinated lateness, abnormalities in synapses pruning, shrinking of the hippocampus, cognitive and affective disorders. This is significant in brain scanning studies that are conducted on the assessment of higher order functions with children and adolescents in vulnerable environments.
Some people who experience trauma may feel permanent damage when the symptoms of trauma do not go away and they do not believe the situation will improve. This can lead to feelings of despair, transient paranoid ideology, loss of self-esteem, deep vacancy, suicide, and often depression. If important aspects of one's self-understanding and one's world have been violated, that person can call their own identity into question. Often in spite of their best efforts, traumatized parents may have difficulty assisting their child with emotional regulation, attribution of meaning, and post-traumatic fear retention behind the child's trauma, leading to adverse consequences for the child. In such case, it is in the interest of parent and child for the parent (s) to seek consultation and for their child to receive appropriate mental health services.
Assessment
As "trauma" adopts a wider scope, traumatology as a field develops a more interdisciplinary approach. This is partly due to the diverse professional representations in the field including: psychologists, medical professionals, and lawyers. As a result, findings in this field are tailored for various applications, from individual psychiatric care to large-scale sociological trauma management. However, the novel field requires a new methodology. While the field has adopted a number of diverse methodological approaches, many have proposed their own limitations in practical applications.
The experiences and outcomes of psychological trauma can be assessed in several ways. In the context of a clinical interview, the risk of impending danger to self or others is important to address but not the focus of the assessment. In many cases, there is no need to involve emergency services (eg, medical, psychiatric, law enforcement) to ensure individual safety; members of individual social support networks are much more important.
Understanding and accepting an individual's psychological state is paramount. There are many misconceptions about what it means for an individual who is traumatized in a crisis or 'psychosis'. These are the times when an individual experiences a great deal of pain and can not console themselves, if treated with humanity and respectfully they will not reach a state where they are a danger. In such situations, it is best to provide a supportive and caring environment and communicate with the individual that no matter what the circumstances will be taken seriously and not just as sick and delusional individuals. It is important for the assessor to understand that what happens to the head of a traumatized person is valid and real. If appropriate, the assessor may proceed by inquiring about traumatic events and outcomes (eg, post traumatic symptoms, dissociation, substance abuse, somatic symptoms, psychotic reactions). Such an inquiry takes place within the context of established and completed relationships in an empathetic, sensitive, and supportive manner. Doctors may also inquire about possible relational disturbances, such as vigilance against interpersonal hazards, neglect problems, and the need for self-protection through interpersonal control. Through discussions of interpersonal relationships, doctors are better able to assess an individual's ability to enter and maintain a clinical relationship.
During the assessment, the individual may show an activation response in which the reminder of a traumatic event triggers a sudden feeling (eg, distress, anxiety, anger), memories, or thoughts related to the event. Since the individual may not have been able to manage this difficulty, it is necessary to determine how the event can be discussed in such a way that it will not "retraumatize" the individual. It is also important to record such responses, as these responses can assist the physician in determining the intensity and severity of possible post-traumatic stress and the ease with which the response is triggered. Furthermore, it is important to consider the possibility of an avoidance response. Avoidance response may involve the absence of expected activation or emotional reactivity and the use of evasion mechanisms (eg, substance use, avoidance of incidental, dissociation) clues.
In addition to monitoring activation and avoidance responses, physicians carefully observe individual strengths or difficulties with setting influences (ie, affecting tolerance and affecting modulation). Such difficulties can be evidenced by mood swings, brief but intense episodes of depression, or self-mutilation. Information gathered through observations affecting regulation will guide physician decisions regarding individual readiness to take part in a variety of therapeutic activities.
Although psychological trauma assessments can be undertaken in an unstructured manner, the assessment may also involve the use of structured interviews. Such interviews may include PTSD Scale Managed by Doctors (CAPS, Blake et al., 1995), Acute Stress Interference Interference (ASDI Bryant, Harvey, Dang, & Sackville, 1998), Structured Interviews for Extreme Stress Disorder (SITE ; Pelcovitz et al., 1997), Structured Clinical Interviews for DSM-IV Dissociative Disorders- Revisions (SCID-D, Steinberg, 1994), and Short Interviews for Posttraumatic Disorders (BIPD; Briere, 1998).
Finally, psychological trauma assessments may include the use of self-regulated psychological tests. The individual values ​​on the test were compared with the normative data to determine how the level of individual function was compared to the others in the sample of the general population. Psychological tests may include the use of general tests (eg, MMPI-2, MCMI-III, SCL-90-R) to assess specific non-traumatic symptoms as well as personality-related difficulties. In addition, psychological testing may include the use of specific trauma tests to assess post-traumatic outcomes. Such tests may include the Posttraumatic Stress Diagnostic Scale (PDS, Foa, 1995), Davidson Trauma Scale (DTS: Davidson et al., 1997), Posttraumatic Stress Detailed Assessment (DAPS, Briere, 2001), Trauma Symptom Inventory (TSI: Briere , 1995), Trauma Symptom Checklist for Children (TSCC, Briere, 1996), Traumatic Life Event Questionnaire (TLEQ: Kubany et al., 2000), and Trauma-Related Guilt Inventory (TRGI: Kubany et al., 1996 ).
Children are assessed through therapeutic activities and relationships, some of the activities are play genogram, sand world, coloring feeling, Self and Kinetic family images, symbols, dramatic doll-dramas, story telling, TSCC Briere, etc.
Treatment
A number of psychotherapeutic approaches have been designed with trauma care in mind - EMDR, progressive calculation (PC), somatic experience, biofeedback, Internal Family System Therapy, and sensorimotor psychotherapy.
There is a large body of empirical support for the use of cognitive behavioral therapy for the treatment of trauma-related symptoms, including post-traumatic stress disorder. The Institute of Medicine guidelines identify cognitive behavioral therapy as the most effective treatment for PTSD. Two of these cognitive behavioral therapies, prolonged exposure and cognitive processing therapy, are being disseminated nationally by the Department of Veterans Affairs for the treatment of PTSD. Recent studies have shown that combinations of treatments involving dialectical behavioral therapy (DBT), often used for threshold personality disorder, and exposure therapy are very effective in treating psychological trauma. However, if psychological trauma has caused dissociative disorder or PTSD complex, the trauma model approach (also known as phase-oriented treatment of structural dissociation) has been shown to work better than a simple cognitive approach. Pharmaceutical-funded studies also show that drugs such as new anti-depressants are effective when used in combination with other psychological approaches.
Trauma therapy allows trauma-related processing of memories and allows growth toward more adaptive psychological functions. It helps develop positive coping rather than overcoming negatives and allows individuals to integrate disturbing material (thoughts, feelings, and memories) that are internally healed. It also helps the growth of personal skills such as endurance, ego settings, empathy... etc.
The processes involved in trauma therapy are:
- Psycho education: Information dissemination and education in vulnerability and coping mechanisms that can be adopted.
- Emotional rules: Identify, counter discriminative thoughts and emotions, grounded from internal construction to external representation.
- Cognitive processes: Transforming perceptions and negative beliefs become positive about oneself, others, and the environment through reconsideration or cognitive rearrangement. Trauma process: Systematic desensitization, activation of response and back conditioner, titration of extinction of emotional response, deconstruction of difference (emotional state vs. reality), resolution of traumatic material (circumstances in which the trigger does not produce harmful interference and capable of expressing aid.)
- Emotional process: Improper reconstruction of perceptions, beliefs and expectations such as trauma-related fears is activated automatically and habituated in a new life context, providing a crisis card with encoded emotions and appropriate cognition. (This stage only begins in the pre-termination phase of clinical judgment and the assessment of mental health professionals.)
- Experimental processing: Visualization of relief conditions achieved and relaxation methods.
Causal discourse
Situational trauma
Trauma can be caused by man-made disasters, technology and natural disasters, including war, harassment, violence, mechanical accidents (cars, trains, or plane crashes, etc.) or medical emergencies.
Response to psychological trauma: Response to psychological trauma may vary by type of trauma, sociodemography and background factors. There are several common behavioral responses to stress including proactive, reactive, and passive responses. Proactive responses include attempts to cope with and correct stressors before having a noticeable effect on lifestyle. Reactive response occurs after stress and possible trauma has occurred, and is intended to correct or minimize damage from stressful events. Passive responses are often characterized by the emotional numbness or ignorance of a stressor.
Those who are able to be proactive often can cope with stress and are more likely to be able to cope with unexpected situations well. On the other hand, those who are more reactive will often experience more tangible effects of unexpected stressors. In their passive cases, victims of stressful events are more likely to suffer long-term traumatic effects and often do not engage in deliberate coping. This observation may indicate that the degree of trauma associated with the victim is related to independent coping skills.
There is also a difference between the trauma caused by the last situation and the long-term trauma that may have been buried in the unconscious of past situations such as childhood abuse. Trauma is often overcome through healing; in some cases this can be achieved by creating or reviewing the origin of trauma in a psychologically safe state, such as with a therapist.
In psychoanalysis
French neurologist Jean-Martin Charcot argued in the 1890s that psychological trauma is the origin of all instances of mental illness known as hysteria. Charcot's "traumatic hysteria" often manifests as paralysis followed by physical trauma, usually years later after what Charcot describes as an "incubation" period. Sigmund Freud, a student of Charcot and the father of psychoanalysis, examined the concept of psychological trauma throughout his career. Jean Laplanche has given an overview of Freud's understanding of trauma, which varied significantly during Freud's career: "An event in the subject's life, determined by his intensity, by the inability of the subject to respond adequately to it and by the turbulence and long-term effects it engenders in psychic organization ".
French psychoanalyst Jacques Lacan states that what he calls "The Real" has an external traumatic quality for symbolization. As an object of anxiety, Lacan states that The Real is "an important object that is not an object anymore, but this is something that is confronted with all the word stops and all categories fail, anxiety object par excellence i>".
Stress disorder
All psychological trauma comes from stress, a physiological response to an unpleasant stimulus. Long-term stress increases the risk of mental health and poor mental disorder, which can be associated with long-term glucocorticoid secretion. Prolonged exposure causes many physiological dysfunctions such as immune system suppression and elevated blood pressure. It not only affects the body physiologically, but morphological changes in the hippocampus also occur. Studies show that extreme stress early in life can disrupt the normal development of the hippocampus and affect its function in adulthood. Studies certainly show a correlation between the size of the hippocampus and one's susceptibility to stress disorders. In times of warfare, psychological trauma has been known as shell shock or combat stress reactions. Psychological trauma can cause acute stress reactions that can cause post-traumatic stress disorder (PTSD). PTSD emerged as a label for this condition after the Vietnam War in which many veterans returned to their respective countries demoralized, and occasionally, psychoactive substance addictions. PTSD symptoms should last at least one month for diagnosis. The main symptoms of PTSD consist of four main categories: Trauma (ie intense fear), revitalizing (ie flashback), avoidance behavior (ie emotional numbness), and hypervigilance (ie irritability). Research shows that about 60% of the US population is reported to have experienced at least one traumatic symptom in their lives but only a small percentage actually develop PTSD. There is a correlation between the risk of PTSD and whether the action is intentionally perpetrated by the offender. Psychological trauma is treated with therapy and, if indicated, psychotropic drugs.
The term post traumatic stress disorder (CTSD) was introduced into the trauma literature by Gill Straker (1987). It was originally used by South African doctors to describe the effects of exposure to frequent, high-level violence commonly associated with civil conflict and political repression. The term also applies to the effects of exposure to contexts where gang and crime violence are endemic as well as the impact of persistent exposure to life threats in high-risk jobs such as police, fire, and emergency services.
As one treatment process, confrontation with the source of their trauma plays an important role. While the critical incidence of freezing people immediately after the incident has not been proven to reduce the incidence of PTSD, coming alongside people who have been traumatized in a supportive manner has become standard practice.
Vicarious
Source of the article : Wikipedia
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