Quotes

"A cognitive approach has been found to be a suitable framework fortrauma therapy because traumatic experiences usually impede the emotionalprocess by conflicting with pre-existing cognitive schemas (Jaycox, Zoellner,& Foa, 2002). Cognitive dissonance, which occurs when thoughts, memories,and images of trauma cannot be reconciled with current meaning structures,causes distress. The cognitive system is driven by a completion tendency: apsychological need “to match new information with inner models based onolder information, and the revision of both until they agree” (Horowitz,1986, p. 92).The fluctuation between symptoms of hyperarousal and inhibitioncommonly seen among trauma survivors is well described by van der Kolk(1996). During the acute phase of the trauma, in an attempt to comprehendand integrate the traumatic experience, the trauma survivor normallyreplays the event that has been stored in active memory. Each replay,however, distresses the traumatized individual, who may inhibit thoughtprocesses to modulate the active processing of traumatic information. Thisobservable inhibition gives the appearance that the traumatized individualhas disengaged from processing the traumatic memory. Thus, some traumasurvivors, as a result of excessive inhibition, display withdrawn and avoidantbehaviors. However, when an individual is unable to inhibit traumatic thoughts, the intrusive symptoms are expressed in the hyperarousal symp-toms of flashbacks during the waking states and nightmares during sleepstates (van der Kolk, 1996). For this reason, researchers commonly observetrauma survivors as oscillating between denial and numbness, or intrusionand hyperarousal (Lindy, 1996; van der Kolk, McFarlane, & van der Hart,1996). Once clients can reappraise the event and revise the cognitiveschemas they previously held, the completion tendency is served. Thesecommon reactions and cognitive processes seen among trauma survivorscan be explained using the framework of cognitive theory. However, thetherapist’s central focus on the client’s internal cognitive mechanisms andhow the client processes information may result in a neglect of contextualand sociocultural factors in cognitive theory.

---- p. 54, A Practical Approach to Trauma Empowering Interventions, SAGE Publications, Inc, 2007