scispace - formally typeset
Search or ask a question
Journal ArticleDOI

The psychological processing of traumatic experience: Rorschach patterns in PTSD

01 Jul 1989-Journal of Traumatic Stress (John Wiley & Sons, Ltd)-Vol. 2, Iss: 3, pp 259-274
TL;DR: In this paper, the Rorschach records of 13 Vietnam veterans with PTSD were compared with 11 matched combat controls and were analyzed for both content and structural features, revealing the biphasic cognitive processing of traumatic experiences of rigidly defended, affective numbing versus overwhelmed intrusive reliving.
Abstract: The Rorschach records of 13 Vietnam veterans with PTSD were compared with 11 matched combat controls and were analyzed for both content and structural features. These Rorschachs showed an unmodified reliving of traumatic material and revealed the biphasic cognitive processing of traumatic experiences of rigidly defended, affective numbing versus overwhelmed intrusive reliving. They demonstrated how trauma and its concomitant affects persist with little modification over time and confirm the clinical impression that people with severe PTSD have an impaired capacity for affect modulation. The lack of integration of the traumatic experience accounts for extreme reactivity to environmental stimuli: the initially overwhelming external event, through lack of assimilation, is perpetuated internally and continues to exert disorganizing effects on the psyche. The authors discuss the claims that the presence of mute, unsymbolized, and unintegrated experiences causes reenactment of the trauma, until the victim learns to put into words both the associated facts and the feelings.
Citations
More filters
Journal ArticleDOI
TL;DR: For instance, this article found that failure of declarative memory may lead to organization of the trauma on a somatosensory level (as visual images or physical sensations) that is relatively impervious to change.
Abstract: Ever since people's responses to overwhelming experiences have been systematically explored, researchers have noted that a trauma is stored in somatic memory and expressed as changes in the biological stress response. Intense emotions at the time of the trauma initiate the long-term conditional responses to reminders of the event, which are associated both with chronic alterations in the physiological stress response and with the amnesias and hypermnesias characteristic of posttraumatic stress disorder (PTSD). Continued physiological hyperarousal and altered stress hormone secretion affect the ongoing evaluation of sensory stimuli as well. Although memory is ordinarily an active and constructive process, in PTSD failure of declarative memory may lead to organization of the trauma on a somatosensory level (as visual images or physical sensations) that is relatively impervious to change. The inability of people with PTSD to integrate traumatic experiences and their tendency, instead, to continuously relive ...

1,135 citations

Journal ArticleDOI
TL;DR: The results suggest that emotions associated with the PTSD symptomatic state are mediated by the limbic and paralimbic systems within the right hemisphere.
Abstract: Background: Previous studies have used symptom provocation and positron emission tomography to delineate the brain systems that mediate various anxiety states. Using an analogous approach, the goal of this study was to measure regional cerebral blood flow changes associated with posttraumatic stress disorder (PTSD) symptoms. Methods: Eight patients with PTSD, screened as physiologically responsive to a script-driven imagery symptom provocation paradigm, were exposed sequentially to audiotaped traumatic and neutral scripts in conjunction with positron emission tomography. Heart rate and subjective measures of emotional state were obtained for each condition. Statistical mapping techniques were used to determine locations of significant brain activation. Results: Increases in normalized blood flow were found for the traumatic as compared with control conditions in rightsided limbic, paralimbic, and visual areas; decreases were found in left inferior frontal and middle temporal cortex. Conclusions: The results suggest that emotions associated with the PTSD symptomatic state are mediated by the limbic and paralimbic systems within the right hemisphere. Activation of visual cortex may correspond to the visual component of PTSD reexperiencing phenomena.

956 citations

Journal ArticleDOI
TL;DR: In this article, a systematic exploratory study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of sensory and affective elements of the traumatic experience: as visual, olfactory, affective, auditory, and kinesthetic experiences.
Abstract: Since trauma arises from an inescapable stressful event that overwhelms people's coping mechanisms, it is uncertain to what degree the results of laboratory studies of ordinary events are relevant to the understanding of traumatic memories. This paper reviews the literature on differences between recollections of stressful and of traumatic events. It then reviews the evidence implicating dissociation as the central pathogenic mechanism that gives rise to posttraumatic stress disorder (PTSD). A systematic exploratory study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of sensory and affective elements of the traumatic experience: as visual, olfactory, affective, auditory, and kinesthetic experiences. Over time, subjects reported the gradual emergence of a personal narrative that can be properly referred to as “explicit memory.” The implications of these findings for understanding the nature of traumatic memories are discussed.

938 citations


Cites background from "The psychological processing of tra..."

  • ...This failure to process information on a symbolic level following trauma is at the very core of the pathology of PTSD ( van der Kolk & Ducey, 1989 )....

    [...]

Journal ArticleDOI
TL;DR: The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided.
Abstract: The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.

296 citations

Journal ArticleDOI
TL;DR: Exposure to intrafamilial violence and other chronic trauma results in pervasive psychological and biological deficits, which needs to address issues of safety, stabilise impulsive aggression against self and others, promote mastery experiences, compensate for specific developmental deficits, and judiciously process both the traumatic memories and trauma-related expectations.
Abstract: Objective: This review examines the clinical outcomes associated with exposure to chronic intrafamilial trauma and explores the treatment of the psychological, biological and cognitive sequelae. Method: The existing research literature on the subject was collected, using Index Medicus/MEDLINE, Psychological Abstracts and the PILOTS database. The research findings were supplemented with clinical observations by the authors and other clinical writings on this topic. Results: Children with histories of exposure to multiple traumatic experiences within their families or in medical settings usually meet criteria for numerous clinical diagnoses, none of which capture the complexity of their biological, emotional and cognitive problems. These are expressed in a multitude of psychological, cognitive, somatic and behavioural problems, ranging from learning disabilities to aggression against self and others. Conclusions: Exposure to intrafamilial violence and other chronic trauma results in pervasive psychological and biological deficits. Treatment needs to address issues of safety, stabilise impulsive aggression against self and others, promote mastery experiences, compensate for specific developmental deficits, and judiciously process both the traumatic memories and trauma-related expectations.

284 citations

References
More filters
Book
01 Jan 1920
TL;DR: The Standard Edition of the Complete Psychological Works of Sigmund Freud under the general editorship of James Strachey as discussed by the authors was the first English translation of Freud's major works to appear in his lifetime.
Abstract: In reasoned progression he outlined core psychoanalytic concepts, such as repression, free association and libido. Of the various English translations of Freud's major works to appear in his lifetime, only one was authorized by Freud himself: The Standard Edition of the Complete Psychological Works of Sigmund Freud under the general editorship of James Strachey. Freud approved the overall editorial plan, specific renderings of key words and phrases, and the addition of valuable notes, from bibliographical and explanatory. Many of the translations were done by Strachey himself; the rest were prepared under his supervision. The result was to place the Standard Edition in a position of unquestioned supremacy over all other existing versions.Newly designed in a uniform format, each new paperback in the Standard Edition opens with a biographical essay on Freud's life and work -along with a note on the individual volume-by Peter Gay, Sterling Professor of History at Yale.

3,898 citations

01 Jan 1920
TL;DR: The Standard Edition of the Complete Psychological Works of Sigmund Freud under the general editorship of James Strachey as discussed by the authors was the first English translation of Freud's major works to appear in his lifetime.
Abstract: In reasoned progression he outlined core psychoanalytic concepts, such as repression, free association and libido. Of the various English translations of Freud's major works to appear in his lifetime, only one was authorized by Freud himself: The Standard Edition of the Complete Psychological Works of Sigmund Freud under the general editorship of James Strachey. Freud approved the overall editorial plan, specific renderings of key words and phrases, and the addition of valuable notes, from bibliographical and explanatory. Many of the translations were done by Strachey himself; the rest were prepared under his supervision. The result was to place the Standard Edition in a position of unquestioned supremacy over all other existing versions.Newly designed in a uniform format, each new paperback in the Standard Edition opens with a biographical essay on Freud's life and work -along with a note on the individual volume-by Peter Gay, Sterling Professor of History at Yale.

3,544 citations

Book
01 Jan 1933
TL;DR: Freud published his "New Introductory Lectures on Psychoanalysis" in 1933, the year in which the Nazis publicly burned his books in Berlin this paper, and applied his analytical method to such phenomena as telepathy and communism, among a number of indirect relevance to psychoanalysis.
Abstract: Freud published his "New Introductory Lectures on Psychoanalysis" in 1933, the year in which the Nazis publicly burned his books in Berlin. These lectures (though never intended for delivery) are cast in his lively rhetorical manner of speech and in places they recapitulate his established views (as, for instance, about dreams). But Freud also develops his newer concepts of id, ego, and super-ego as elements in the structure of the mind and explains his more recent conclusions about anxiety and the instincts and about the psychology of women. In addition, he applies his analytical method to such phenomena as telepathy and communism, among a number of subjects of indirect relevance to psychoanalysis.

2,803 citations

Journal ArticleDOI
TL;DR: The points to be made in this paper are as follows: i.
Abstract: At first glance, acute grief would not seem to be a medical or psychiatric disorder in the strict sense of the word but rather a normal reaction to a distressing situation. However, the understanding of reactions to traumatic experiences whether or not they represent clear-cut neuroses has become of ever-increasing importance to the psychiatrist. Bereavement or the sudden cessation of social interaction seems to be of special interest because it is often cited among the alleged psychogenic factors in psychosomatic disorders. The enormous increase in grief reactions due to war casualties, furthermore, demands an evaluation of their probable effect on the mental and physical health of our population. The points to be made in this paper are as follows: i. Acute grief is a definite syndrome with psychological and somatic symptomatology. 2. This syndrome may appear immediately after a crisis; it may be delayed; it may be exaggerated or apparently al)sent. 3. In place of the typical syndrome there may appear distorted pictures, each of which represents one special aspect of the grief syndrome. 4. By appropriate techniques these distorted pictures can be successfully transformed into a normal grief reaction with resolution. Our observations comprise tot patients. Included are (i) psychoneurotic patients who lost a relative during the course of treatment, (2) relatives of patients who uied in the hospital, (3) bereaved disaster victims (Cocoanut Grove Fire) and their close relatives, ( ) relatives of members of the armed forces.

2,717 citations

Book
01 Jan 1976
TL;DR: The DSM-III (American Psychiatric Association, 1980) diagnoses for stress-response disorders, and the mutual etiologic effects of stressful life events, psychiatric disorders and preexisting conflicts or functional deficits are discussed in this paper.
Abstract: The signs and symptoms of response to a stressful life event are expressed in two predominant phases: the intrusive state, characterized by unbidden ideas and feelings and even compulsive actions, and the denial state, characterized by emotional numbing and constriction of ideation. In this review of stress-response syndromes, I will outline those phases, discuss the DSM-III (American Psychiatric Association, 1980) diagnoses for stressresponse disorders, and consider the mutual etiologic effects of stressful life events, psychiatric disorders, and preexisting conflicts or functional deficits. Guidelines for brief dynamic psychotherapy for patients who need more than transient support are presented.

2,259 citations