Showing papers on "Traumatic memories published in 2016"

Memory and narrative of traumatic events: a literature review

Abstract: This study presents a literature review of 22 studies published since 2004 that use linguistic procedures to evaluate narratives by persons who had suffered any traumatic event. The aim is to analyze the features of traumatic memories and, thus, how individuals construct and integrate their recall of what happened with other autobiographical memories. It uses cognitive theoretical models of posttraumatic stress disorder (PTSD) and their hypotheses about trauma memories as a framework. FINDINGS reveal that trauma narratives are dominated by sensorial/perceptual and emotional details. The study of other narrative aspects (i.e., fragmentation, length, temporal context, and references to self) provides heterogeneous results. RESULTS are discussed in light of the current state of PTSD research, exploring the principal hypotheses that have been proposed in cognitive theories to explain clinical findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Remembering Collective Violence: Broadening the Notion of Traumatic Memory in Post-Conflict Rehabilitation

Abstract: In the aftermath of war and armed conflict, individuals and communities face the challenge of dealing with recollections of violence and atrocity. This article aims to contribute to a better understanding of processes of remembering and forgetting histories of violence in post-conflict communities and to reflect on related implications for trauma rehabilitation in post-conflict settings. Starting from the observation that memory operates at the core of PTSD symptomatology, we more closely explore how this notion of traumatic memory is conceptualized within PTSD-centered research and interventions. Subsequently, we aim to broaden this understanding of traumatic memory and post-trauma care by connecting to findings from social memory studies and transcultural trauma research. Drawing on an analysis of scholarly literature, this analysis develops into a perspective on memory that moves beyond a symptomatic framing toward an understanding of memory that emphasizes its relational, political, moral, and cultural nature. Post-conflict memory is presented as inextricably embedded in communal relations, involving ongoing trade-offs between individual and collective responses to trauma and a complex negotiation of speech and silence. In a concluding discussion, we develop implications of this broadened understanding for post-conflict trauma-focused rehabilitation.

The effects of cognitive reappraisal following retrieval-procedures designed to destabilize alcohol memories in high-risk drinkers.

Abstract: Rationale Addiction is a disorder of motivational learning and memory. Maladaptive motivational memories linking drug-associated stimuli to drug seeking are formed over hundreds of reinforcement trials and accompanied by aberrant neuroadaptation in the mesocorticolimbic reward system. Such memories are resistant to extinction. However, the discovery of retrieval-dependent memory plasticity has opened up the possibility of permanent modification of established (long-term) memories during ‘reconsolidation’.

Intrusive memories to traumatic footage: the neural basis of their encoding and involuntary recall.

Abstract: Background A hallmark symptom after psychological trauma is the presence of intrusive memories. It is unclear why only some moments of trauma become intrusive, and how these memories involuntarily return to mind. Understanding the neural mechanisms involved in the encoding and involuntary recall of intrusive memories may elucidate these questions.

Coherence, disorganization, and fragmentation in traumatic memory reconsidered: A response to Rubin et al. (2016).

Abstract: Although clinical theories of posttraumatic stress disorder (PTSD) claim that in this condition trauma memories tend to be disorganized and fragmented, this has been disputed by some autobiographical memory researchers, such as Rubin, Berntsen, and their colleagues (e.g., Rubin et al., 2016). In this article I review the evidence for and against the fragmentation hypothesis and identify important sources of methodological variability between the studies. This analysis suggests that fragmentation and disorganization are associated with differences in the type of narrative (specifically, with detailed rather than general narratives) and in the focus of the analysis (specifically, with a local focus on sections of text concerned with the worst moments of the trauma rather than with a global focus on the text as a whole). The implication is that apparently discrepant data and discrepant views can be accommodated within a more comprehensive formulation of memory impairment in PTSD. (PsycINFO Database Record

The Special Problem of Interpretation in the Treatment of Traumatized Patients

Abstract: Trauma is not an unambiguously defined concept. After a discussion of various definitions and different types of trauma, a description is given of short- and long-term outcomes of traumatic experiences. For the treatment of traumatized individuals, and above all, for the interpretation of this kind of experience it is important to note that traumatic memories are subject to some specific psychic transformations. The traumatized self-states are not completely dissociated from the mind’s associative network. Specific interpretive strategies are described that focus on the irreparable break in basic trust, the need to control relationships, the importance of the reconstruction of the trauma, the restoring of the paralyzed agency of the traumatized self, and the particular attention that must be paid to enactments in the treatment. In the final part, a new understanding of memory in so-called Embodied Cognitive Science is described. Memory is no longer a retrieval of stored knowledge in the brain, but a funct...

The Dynamic Therapy Model in Treating Complex Trauma Syndrome

Abstract: Severe trauma such as the war combat, being taken as a hostage, brutal or repeated rape, affects all structures of the victim’s personality—one’s image of the body and sense of self; and one’s values and ideals—and leads to a sense that coherence and continuity of the self is systematically broken down. Severe trauma overwhelms the ordinary human adaptation and resistance as it usually involves the threat to life or bodily integrity and confronts the victim with the extremities of the helplessness, hopelessness, and terror, and evokes the response of catastrophe. In this paper, we describe how effectively the complex trauma is treated using the Dynamic Therapy model. We recognised five major alterations of the self as the aftermaths of severe trauma that should be targeted during treatment: (a) regulation of affected impulses; (b) attention and consciousness; (c) self-perception; (d) perception of the perpetrator; and (e) relation to others. The Dynamic Therapy model is the three-phase oriented treatment which applies to holotropic integration of the distorted self into a whole: (a) Impulse containment; Engagement; Safety; (b) Understanding; Recalling traumatic memories; (c) Self-conception; Enhancing daily living; Relapse prevention; Independency; Steps forward. The main concept of Dynamic Therapy model includes three treatment goals: (a) restoration of a form of the relatedness ( “Interconnectivity” ); (b) restoration of a sense of the aliveness/vitality ( “Dynamism” ); and (c) restoration of an awareness of self and inner events ( “Insight” ).

Activating Attachments Reduces Memories of Traumatic Images.

Abstract: Emotional memories, and especially intrusive memories, are a common feature of many psychological disorders, and are overconsolidated by stress. Attachment theory posits that activation of mental representations of attachment figures can reduce stress and boost coping. This study tested the proposition that attachment activation would reduce consolidation of emotional and intrusive memories. Sixty-seven undergraduate students viewed subliminal presentations of traumatic and neutral images, which were preceded by subliminal presentations of either attachment-related images or non-attachment-related images; free recall and intrusive memories were assessed two days later. Participants with low avoidant attachment tendencies who received the attachment primes recalled fewer memories and reported fewer intrusions than those who received the non-attachment primes. Unexpectedly, those with high anxious attachment tendencies reported fewer memories. These findings generally accord with attachment theory, and suggest that consolidation of emotional memories can be moderated by activation of attachment representations.

Degrading traumatic memories with eye movements: a pilot functional MRI study in PTSD

Abstract: Background : Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, the patient recalls traumatic memories while making eye movements (EMs). Making EMs during recall is associated with decreased vividness and emotionality of traumatic memories, but the underlying mechanism has been unclear. Recent studies support a “working-memory” (WM) theory, which states that the two tasks (recall and EMs) compete for limited capacity of WM resources. However, prior research has mainly relied on self-report measures. Methods : Using functional magnetic resonance imaging, we tested whether “recall with EMs,” relative to a “recall-only” control condition, was associated with reduced activity of primary visual and emotional processing brain regions, associated with vividness and emotionality respectively, and increased activity of the dorsolateral prefrontal cortex (DLPFC), associated with working memory. We used a randomized, controlled, crossover experimental design in eight adult patients with a primary diagnosis of PTSD. A script-driven imagery (SDI) procedure was used to measure responsiveness to an audio-script depicting the participant’s traumatic memory before and after conditions. Results : SDI activated mainly emotional processing-related brain regions (anterior insula, rostral anterior cingulate cortex (ACC), and dorsomedial prefrontal cortex), WM-related (DLPFC), and visual (association) brain regions before both conditions. Although predicted pre- to post-test decrease in amygdala activation after “recall with EMs” was not significant, SDI activated less right amygdala and rostral ACC activity after “recall with EMs” compared to post-“recall-only.” Furthermore, functional connectivity from the right amygdala to the rostral ACC was decreased after “recall with EMs” compared with after “recall-only.” Conclusions : These preliminary results in a small sample suggest that making EMs during recall, which is part of the regular EMDR treatment protocol, might reduce activity and connectivity in emotional processing-related areas. This study warrants replication in a larger sample. Keywords: Posttraumatic stress disorder; eye movement desensitization and reprocessing; working memory; amygdala; functional MRI This paper is part of the Special Issue: The neurobiology of PTSD. More papers from this issue can be found at www.ejpt.net (Published: 29 November 2016) Responsible Editor: Ruth Lanius, Western University of Canada, Canada. For the abstract or full text in other languages, please see Supplementary files in the column to the right (under ‘Article Tools’) Citation: European Journal of Psychotraumatology 2016, 7 : 31371 - http://dx.doi.org/10.3402/ejpt.v7.31371

Early Psychological Therapy in Critical Illness.

Abstract: Survivors of critical illness often experience long-lasting impairments in mental, cognitive, and physical functioning. Acute stress reactions and delusional memories appear to play an important role in psychological morbidity following critical illness, and few interventions exist to address these symptoms. This review elucidates acute psychological stressors experienced by the critically ill. The effects of psychological stress and state of mind on disease are discussed using examples from the non-intensive care unit (ICU) literature, including a review of placebo and nocebo effects. After reviewing the effect of the mind on both psychological and physiological outcomes, we then focus on the role of memories-including their malleable nature and the consequences of false memories. Memory may play a role in the genesis of subsequent psychological trauma. Traumatic memories may begin forming even before the patient arrives in the ICU and during their state of unconsciousness in the ICU. Hence, practical interventions for redirecting patients' thoughts, such as positive suggestion techniques and actively involving patients in the treatment process as early as possible, are worthy of further investigation.

Literature review of post‐traumatic stress disorder in the critical care population

Abstract: Aim To determine which factors relate to the development of posttraumatic stress disorder, in adult patients who are admitted to critical care units. Background Patient survival rates from critical care areas are improving each year and this has led to interest in the long term outcomes for patients who have been discharged from such environments. Patients typically require invasive and extensive treatment, which places a stress on physical and mental health. Prevalence estimates of posttraumatic stress disorder in the critical care discharge population vary from 5-63%, yet it remains unclear what the predisposing factors are. Design. A systematised review Method Subject heading and keyword searches were conducted in MEDLINE, CINAHL, PsycINFO and ScienceDirect, with 23 articles identified that examined the relationship between critical care and the development of posttraumatic stress disorder. Results Three main themes were identified; Critical Care Factors, Patient Factors and Experience Factors. Eight key and 3 potential causative factors were found: younger age, female, previous psychiatric history, length of ICU stay, benzodiazepine sedation, use of stress hormones, delusional memory and traumatic memory, delirium, GCS score of ≤9 on admission & use of mechanical restraint Conclusions Posttraumatic stress reactions can be strongly related to the development and presence of traumatic and delusional memories. Younger patients may exclude themselves from research to avoid their traumatic thoughts. The role of prior psychiatric illness is unknown. Distinction between ‘factual’ and ‘false’ or delusional memory as occurs in the literature maybe unhelpful in understanding trauma reactions. Relevance to clinical practice There are around 38,000 occupied critical care beds each year in England. The scale of the issue is therefore substantial. Risk factors can be isolated from available evidence and provide a rudimentary risk assessment tool to inform practice development in this area.

When Language Meets Traumatic Lacuna: The Metaphoric, the Metonymic, and the Psychotic Modes of Testimony

Abstract: This article traces four modes of traumatic testimony that are distinguished from one another in the degree of the psychic motility they succeed to form in relation to traumatic memories: the metaphoric, the metonymic, the excessive-psychotic, and the Muselmann-psychotic modes of testimony. While the metaphoric mode is characterized by the simultaneous holding of the position of the victim (the experiencing I) and the position of the witness (the narrating I), the other three modes are gradually declining in their capacity to hold the traumatic memories in mind in a way that allows for transformation and healing. These four modes are illustrated through a close reading of various testimonies suggesting that the core of the psychoanalytic treatment of trauma lies in the attempt to enable the crucial shift from the metonymic, the excessive, and the Muselmann modes of testimony to the metaphoric one, which is the only force that can turn the traumatic lacuna into a creative force.

First Time Mothers: Exploring the Relationship between Shame Memories, and Experience of Shame, Compassion and Motherhood

Abstract: Background Shame memories from childhood/adolescence, which operate as traumatic memories and become central to personal identity, have been associated with shame in adulthood. Shame has been reported in the context of motherhood but not yet investigated within Gilbert’s (1998, 2010) biopsychosocial framework. Self-compassion, as an orientation to care for oneself has been found to buffer people against the psychological impact of stressful events, such as the transition to motherhood. Aims Drawing on the biopsychosocial framework, this study aimed firstly to profile the shame memories of first time mothers in the UK and Ireland. Secondly, it aimed to explore the relationships between the traumatic and centrality features of shame memories, shame, compassion, fears of compassion and emotional adjustment to motherhood. Method Drawing on a critical realist epistemological position, this study adopted a crosssectional, quantitative approach. New mothers (N = 133) across the UK and Ireland were recruited on social media forums to complete a series of established self-report questionnaires via an online survey platform. Results The most frequently selected category of shame situation recalled by mothers was ‘exposure of perceived negative personal attributes, characteristics, behaviour to others’ (N = 34). Canonical correlation analysis revealed that shame memories predicted shame, compassion and fears of compassion. Multiple regression analysis revealed self-compassion to be the only significant predictor of emotional adjustment to motherhood in the model. Shame did not moderate this relationship. iii Conclusion Participants experienced shame, fears of receiving compassion and low levels of self-compassion suggesting that they may be experiencing distress with insufficient access to self-soothing skills. Nonetheless, a more selfcompassionate attitude was associated with greater emotional adjustment to motherhood. Perinatal health services are advised to promote the development of compassion at all levels.

Why Do Holocaust Survivors Remember What They Remember

Abstract: Purpose of the study The ability to integrate traumatic memories into a coherent life narrative is one factor associated with the mental health and well-being of Holocaust survivors. In the present study, reminiscences reported by survivors in Israel were collected to identify themes arising in positive and negative memories and experience. Design and methods Participants (M = 80.4 years; SD = 6.87) were asked to describe memories that typify a reminiscence function in which they frequently or very frequently engage. Open-ended responses were collected from 269 Holocaust survivors and thematic analyses were conducted in English (translated) and Hebrew. Results Thematic analyses of these data suggest three overarching themes related to bridging the past and present, rebuilding families and the Jewish state, and the duty to share. These suggest how integral endurance, survival, and resilience were to participants during the war and how these themes defined their choices and understanding of their lives. Implications The results of this study demonstrate how reminiscence serves many functions. Participants appear to have integrated memories of horror and loss as part of coherent life narratives. Resilience and memory are ongoing and intertwined processes whereby survivors juxtapose their early lives to the present.

Secuelas Psicológicas de la Guerra en Mujeres Forzadas a Desplazarse

Abstract: The psychological after-effects of violence due to the armed conflict have left traumatic memories or indelible stigma in victimized women. Females are overrepresented since they compose more than half of the victims in the Colombian warfare. (Sierra, Calle, and Velez, 2015). Thus, we considered the following research question: What psychological after-effects of war prevail in displaced women? In this research project, we defined psychological after-effects of war as signs, symptoms and psychological disorders based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Moreover, we defined forced migration as the movement of people, families and groups away from their homes to other places. This movement is coerced by a powerful actor or group to expel, harass and uproot a person, group or community. We adopted a social psychological perspective to study the after-effects of war in displaced women. This is a narrative review in which we included manuscripts from academic journals, institutional reports and books. The inclusion criteria were the following: manuscripts published and indexed from 2005 to 2015, and generalizability of the results. We selected the following academic data-bases: Academic Search Complete, Medline, Redalyc, EBSCO, Google Scholar, and Science Direct. We selected 7 out of 50 papers that fulfilled the inclusion criteria. The results showed that displaced women suffer from mood, impulse control and behavioral disorders. These disorders prevail due to the after-effects of war. Whereas fear, helplessness, anger and uprooting are equally conducive to the emotional stability that they experience. We conclude that war directly and indirectly affects the mental health of women forced to emigrate, causing mental disorders and psychological alterations.

We Remember… Elders' Memories and Perceptions of Sleeping Sickness Control Interventions in West Nile, Uganda.

Abstract: The traditional role of African elders and their connection with the community make them important stakeholders in community-based disease control programmes. We explored elders’ memories related to interventions against sleeping sickness to assess whether or not past interventions created any trauma which might hamper future control operations. Using a qualitative research framework, we conducted and analysed twenty-four in-depth interviews with Lugbara elders from north-western Uganda. Participants were selected from the villages inside and outside known historical sleeping sickness foci. Elders’ memories ranged from examinations of lymph nodes conducted in colonial times to more recent active screening and treatment campaigns. Some negative memories dating from the 1990s were associated with diagnostic procedures, treatment duration and treatment side effects, and were combined with memories of negative impacts related to sleeping sickness epidemics particularly in HAT foci. More positive observations from the recent treatment campaigns were reported, especially improvements in treatment. Sleeping sickness interventions in our research area did not create any permanent traumatic memories, but memories remained flexible and open to change. This study however identified that details related to medical procedures can remain captured in a community’s collective memory for decades. We recommend more emphasis on communication between disease control programme planners and communities using detailed and transparent information distribution, which is not one directional but rather a dialogue between both parties.

Depressive, Angst- und posttraumatische Belastungsstörungen als Konsequenzen intensivmedizinischer Behandlung

Abstract: Modern intensive care medicine has led to increased survival rates even after severe life-threatening medical conditions. In self-critical and multidimensional outcome research, however, it must be considered that beyond survival rates treatment on intensive care units (ICU) can also be associated with high long-term rates of depressive, anxiety and posttraumatic stress disorders. Significant correlations with increased somatic morbidity and mortality, persisting cognitive impairments and significant deficits in health-related quality of life must also be taken into consideration. Empirical analysis of the risk factors reveals that a history of premorbid depression, sociodemographic and socioeconomic variables, age, female sex, personality traits, the underlying pathophysiological condition requiring ICU treatment, mode of sedation and analgesia, life support measures, such as mechanical ventilation, manifold traumatic experiences and memories during the stay in the ICU are all of particular pathogenetic importance. In order to reduce principally modifiable risk factors several strategies are illustrated, including well-reflected intensive care sedation and analgesia, special prophylactic medication regarding the major risk of traumatic memories and posttraumatic stress disorder (PTSD), psychological and psychotherapeutic interventions in states of increased acute stress symptoms and aids for personal memories and reorientation.

Virtual Reality Exposure for Trauma and Stress-Related Disorders for City Violence Crime Victims

Abstract: IntroductionIn Mexico crime rates are extremely high: 21.3% of the population over 18 years has suffered from a crime and 86.3% of the population feels unsafe. In recent years, Mexico experienced a dramatic increase in violence. The number of homicides, assaults, kidnappings, threats, disappearances, extortions, and attacks on civilians, journalists, public officials, human rights advocates, and deaths of bystanders increased substantially. The National Survey of Urban Public Safety (1) reported that in the month of September, 2013, 68% of the population over the age of 18 considered that living in their own town is highly unsafe, because in the last three months they have witnessed and/or heard of alcohol consumption on the streets (70%), victims of theft or robbery (66.2%) and urban vandalism (56.1%); on the other hand, there is a wide variety of factors that children, youth and adults are exposed to, which are highly dangerous, and need to be taken into account in order to create preventive or intervention strategies.Accordingly, Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) rates caused by criminal violence such as assault, kidnapping or express kidnapping, are quite high and continue to increase. The violent situation that exists in the country has generated among survivors fear and insecurity, thus increasing the chances of developing acute stress disorder or posttraumatic stress disorder. This has increased the need for intervention programs for this population. Problems and related consequences, lead the population to a hopeless sense of fear and insecurity and their repercussions are associated with the PTSD and ASD. Traditional exposure therapies are often difficult to conduct and financially unavailable to most Mexicans; so this new exposure technique using virtual reality environments (VRE) seems be a potential tool, which permits both patients and therapists more control and yields better results. Based on the effectiveness of participants' preference and acceptance for this innovative intervention in a previous controlled study using virtual reality for the treatment of victims, we conduct a study offering treatment at the School of Psychology in Mexico City (2, 3).The prevalence of PTSD and ASD requires attention because those who suffer from these disorders have elevated degrees of anxiety, fear and avoidance, thereby interfering in personal development and everyday life. Nowadays there are effective cognitive-behavior therapy (CBT) treatments for PTSD and ASD (4). These treatments employ exposure techniques that help patients to overcome the presence of feared objects or situations related to the traumatic event. Prolonged exposure (PE) is the preferred exposure technique for treating PTSD (5). However this technique is poorly used in clinic treatments (6). The low use of these treatments is due to cognitive avoidance of patients to recall traumatic memories and the difficulty for some patients to engage in imaginal exposure.Virtual reality exposure techniques (VRET) can help to overcome some restrictions of traditional exposure therapy (in-vivo or imagined) (7). VRET can simulate the traumatic situation with a high sense of reality; therefore this can help patients regardless of their ability for imaginal engagement. Another benefit is that therapists can control the characteristics of the situation presented to the patient. These aspects could reduce cognitive avoidance in order to increase the emotional engagement during exposure (8).There are several studies supporting the effectiveness of VR for the treatment of PTSD in different populations (9, 10), e.g., survivors of war, active soldiers and victims of terrorism attacks. In Mexico, the development of such systems is non-existent, and its empirical validation is emerging, which gives evidence of the relevance of this study in our socio-cultural context.Based on this socially relevant problem and centered on the efficacy of previous studies for war violence, our research team initiated a project supported by the National Science and Technology Council, and the municipal government of Ciudad Juarez in Mexico, the purpose of which was to evaluate the efficacy of a treatment program for PTSD through virtual reality exposure in criminal violence victims and eyewitnesses in Ciudad Juarez. …

Breaking the silence: traumatised war veterans and oral history

Abstract: In the early 1990s oral history interviews were recorded with nine New Zealand Second World War veterans, all of whom were receiving government War Disablement Pensions for Post Traumatic Stress Disorder. Thirteen years later the three surviving interviewees were revisited and asked to assess the impact on them of disclosing traumatic memories in the earlier interviews. The veterans* responses were largely positive. Each reported a sense of relief after talking about their trauma during an oral history interview. However none opened up further discussion with family or friends and they remain largely silent about their traumatic experiences. The paper considers some of the ethical and professional issues that confront oral historians when working with such interviewees.

Forgetting Rape: Trauma, Pharmaceuticals and Embodied (In)Justice

Abstract: The discovery that propranolol, a beta-blocker, can reduce the effect of traumatic memory has been a source of great excitement for many, especially those bioethicists committed to the future benefits of new discoveries in medical science. According to this scholarly commentary, the injustice of rape seems to lie in the impact of the traumatic memory; so propranolol is an ideal solution. Injustice, here, is thought to be a problem solely in its production of the pathological state of post-traumatic stress disorder. Yet this characterisation of propranolol relies on a heavily individualised account of memory. Feminist embodiment theory provides a different account of how memory functions. Social norms, shared by other bodies, sediment into the very way that bodies exist in the world, a corporeal memory. Ann J Cahill argues that the shared and implicit memory of rape shapes dominant modes of feminine comportment shaped by caution, uncertainty, vulnerability and distrust. Using this framing exposes t...

Culture, history and traumatic memory: an interpretation

Abstract: Efforts to investigate psychiatric disorders across cultures routinely ignore a pervasive cultural influence, namely the culture of psychiatry. This article focuses on how the culture of psychiatry affects our understanding of posttraumatic stress disorder (PTSD). PTSD is diagnosed by means of standardized symptom criteria and scales. Yet it is a heterogeneous phenomenon. The illusion of homogeneity is fostered by a categorical conception of traumatic memory that homogenizes posttraumatic memories and erects an obstacle to investigating the disorder’s historical nature, clinical phenomenology, and neuro-physiology and neuro-anatomy. I illustrate this process, via an epidemic of PTSD that now affects a quarter of a million American war veterans.

Anticipatory Anxiety in the Treatment of Combat Veterans with Posttraumatic Stress Disorder

Abstract: Combat veterans have experienced a transformational process during war zone deployment, including emotional, cognitive, and sensory processing changes. They also return entrenched in military expectations of conduct and behavior. These changes result in anticipatory anxiety that makes it difficult to reintegrate into the civilian world, and are related to symptoms of posttraumatic stress disorder (PTSD). The PTSD Recovery Program at the McGuire Veterans Affairs Medical Center (VAMC) is a manualized treatment that focuses on the personal and daily experiences of combat veterans rather than exposure to traumatic memories. Program evaluation data demonstrated significant reduction in PTSD symptoms and improvements in general self-efficacy and adaptive behaviors. Results support the PTSD Recovery Program as an effective treatment that enhances readjustment to civilian life.

Simulated War: Remediating Trauma Narratives in Military Psychotherapy

Abstract: How have the politics of therapy been reconfigured during the so-called Global War on Terror? What role have the new virtual reality therapies that so resemble other forms of military simulation played in this reconfiguration? In this article, I draw upon feminist science and technology’s (STS) theorization of human-machine interaction into order to interrogate how contemporary therapies for treating post-traumatic stress disorder (PTSD) reconfigure agency in the practice of healing. Analyzing trauma therapy as a site of reconfiguration, I show how new exposure-based therapies for PTSD—both with and without virtual reality—configure aspects of human subjectivity, such as memory, affect, and behavior, as objects for technological intervention. Through comparative analysis of different modalities of PTSD treatment, I show that the politics of therapy is especially enacted through the therapeutic remediation of trauma narratives: the mediational practices through which a traumatic memory is made available for therapeutic reworking. Therapeutic remediation practices configure therapists, patients, and nonhuman actants as subjects and objects with different forms of agency.

The Role of the Creative Process in Holding and Facilitating Traumatic Experience

Abstract: Dissociative self states related to early traumatic experience may be elicited through the creative act, visual images, dreams, enactments, and affective collisions in the analytic dyad. In the following article, the author will describe her work with a visual artist and how the creative process, along with affect sharing and facilitation, helped open pathways to hold and communicate traumatic memories and self states.