Common Factors
The resolution of trauma involves repeated recall, both
intrapersonal and interpersonal, of the traumatic event. Each time a traumatic
event is recalled, it is changed in ways that can help to process or impede the
processing of the traumatic event.
The successful processing of trauma is characterized by the following changes:
1) Movement from a disorganized to a linear narrative: the evolution of the memory from a cloud-like, disorganized set of memories and emotions into a linear narrative, a story with a beginning, middle, and end.
2) Interpersonal processing of trauma: the ability to tell the linear narrative to a trusted, supportive circle who can help one modulate one's emotions during the telling and also reaffirm the present perspective (see 3 below). The retelling in the group regulated context creates a new anxiety reference point that influences the level of anxiety associated with all future revisiting of the trauma. The means by which the group soothes the individual is internalized to some degree and becomes part of the self-soothing. The boundaries between intrapsychic and interpersonal processing of trauma are thus quite blurred.
3) Perspective control: evolution from a memory that pulls one back into the victim perspective to an ability to visit the memory while maintaining a present perspective.
4) Emotional control: evolution from an inability to control the strength and specific emotions associated with a memory to an ability to modulate (choose) the emotions and emotional intensity evoked by the memory.
5) Neuroendocrine control: the evolution from a reflexive neuroendocrine stress response (in its stronger forms, this is called a "fight or flight" response) to a modulated, preferred physical response that does not impair intrapsychic or interpersonal processing.
6) Somatic integration: trauma can create a disconnection between body and sense of self, and if this has occured, the reintegration of these two is part of successful processing.
7) From avoidance to confident revisiting: evolution from fear that the memory is going to be recalled to acceptance and confidence that it can be handled and an ability to decide when and when not to revisit the memory
8) Philosophical and Cognitive Realignment: overcoming cognitive/philosophic dissonance by evolving from a sense that the event is a violation of one's understanding of life to one to a sense that the trauma is not a violation of one's current sense/understanding of the world.
Definition of Trauma Whose Resolution is Blocked
The processing of trauma involves repeated review of an occurrence, a sort of "digestion" of the event. The blocking of any of the changes listed above can interfere with the resolution of trauma.
Severe problems resolving trauma, such as with PTSD, are characterized by a specific breakdown in the resolution process. The resolution of trauma requires repeated recall of the event during which it is processed individually and interactionally. The recall of PTSD linked memories seems to create a "fight/flight/freeze" response that down-regulates the very parts of the brain that are needed to successfully process trauma narratives in favor of parts of the brain that serve fight/flight/freeze responses. This creates a "Catch-22" situation in which the process needed to digest the experience is disrupted by the neuroendocrine response to remembering the event.
The successful processing of trauma is characterized by the following changes:
1) Movement from a disorganized to a linear narrative: the evolution of the memory from a cloud-like, disorganized set of memories and emotions into a linear narrative, a story with a beginning, middle, and end.
2) Interpersonal processing of trauma: the ability to tell the linear narrative to a trusted, supportive circle who can help one modulate one's emotions during the telling and also reaffirm the present perspective (see 3 below). The retelling in the group regulated context creates a new anxiety reference point that influences the level of anxiety associated with all future revisiting of the trauma. The means by which the group soothes the individual is internalized to some degree and becomes part of the self-soothing. The boundaries between intrapsychic and interpersonal processing of trauma are thus quite blurred.
3) Perspective control: evolution from a memory that pulls one back into the victim perspective to an ability to visit the memory while maintaining a present perspective.
4) Emotional control: evolution from an inability to control the strength and specific emotions associated with a memory to an ability to modulate (choose) the emotions and emotional intensity evoked by the memory.
5) Neuroendocrine control: the evolution from a reflexive neuroendocrine stress response (in its stronger forms, this is called a "fight or flight" response) to a modulated, preferred physical response that does not impair intrapsychic or interpersonal processing.
6) Somatic integration: trauma can create a disconnection between body and sense of self, and if this has occured, the reintegration of these two is part of successful processing.
7) From avoidance to confident revisiting: evolution from fear that the memory is going to be recalled to acceptance and confidence that it can be handled and an ability to decide when and when not to revisit the memory
8) Philosophical and Cognitive Realignment: overcoming cognitive/philosophic dissonance by evolving from a sense that the event is a violation of one's understanding of life to one to a sense that the trauma is not a violation of one's current sense/understanding of the world.
Definition of Trauma Whose Resolution is Blocked
The processing of trauma involves repeated review of an occurrence, a sort of "digestion" of the event. The blocking of any of the changes listed above can interfere with the resolution of trauma.
Severe problems resolving trauma, such as with PTSD, are characterized by a specific breakdown in the resolution process. The resolution of trauma requires repeated recall of the event during which it is processed individually and interactionally. The recall of PTSD linked memories seems to create a "fight/flight/freeze" response that down-regulates the very parts of the brain that are needed to successfully process trauma narratives in favor of parts of the brain that serve fight/flight/freeze responses. This creates a "Catch-22" situation in which the process needed to digest the experience is disrupted by the neuroendocrine response to remembering the event.