Traumatology

- Trauma is not only about awful events but also about our attachments in the aftermath of
the events.

PTSD modification in DSM-5

- Under Trauma and Stressor-Related Disorders

- Diagnosis of PTSD is based on 8 criteria:
o Exposure
o Intrusion
o Avoidance
o Negative alterations in Mood and Cognition
o Arousal and Reactivity
o Duration
o Significance, and;
o Not substance or medical

Psychoanalysis and Trauma

- Involves recalling the repressed or forgotten details of the traumatic event

- GOAL: to help one become conscious of information that remained hidden in the
unconscious
o It is called “insight” (in-sight or seeing within)
o Can be done through free-association, dream analysis, and interpretation

Medication and Trauma

- Various psychiatric medications are used in treatment of PTSD

- These medications do not cure trauma, but reduced symptoms and in some cases may
improve the effectiveness of psychological treatment
- To remain on medication without psychological treatment is ill-advised
- It must be a combination of therapy and medication

Psychotrauma

- Trauma is the physical or the medical injury or a blow in the head (shock) or other parts
of the body
- Psychotrauma is an extremely distressing experience that causes severe emotional
shock and may have a long lasting psychological effects on the person
- The person’s response to the event must involve:
o Intense fear
o Hopelessness
o Or horror
- In children, response must involve disorganized or agitated behavior
Traumatic Events

- An event or incident that is outside the range of usual human experience and that would
be markedly distressing to almost anyone
- A serious threat to one’s life and of physical integrity, serious threat or harm to one’s
children, spouse, or close relative
- A sudden destruction of one’s home or community
- It involves feeling of helplessness
- It overpowers your ability to cope with the memories and emotions involved.

Examples of Traumatic Events

- Seeing another person who has been injured or killed

- Victims/survivors or witnesses of tragic vehicular accidents
- War or arm conflict
- Natural disasters such as flash flood, devastating typhoons, volcanic eruption, horrifying
earthquake
- Tragic death or sudden loss of loved ones for being close to death
- Chronic or terminal illness
- Exposure to domestic violence or community violence
- Sexual abuse
- Extreme poverty
- Crime/violence
- Fires
- Plane crash
- School shooting

Brain and Trauma

- Severe/prolonged trauma may disrupt and alter brain chemistry

- If exposed to fear, stress, and overwhelming experience, neurochemical responses in
the brain occur
- The goal of therapy is to calm the amygdala and allow the hippocampus to record the
traumatic event as over—as just a memory

Stages of Trauma

1. Sudden occurrence of traumatic event

2. Physical effects
3. Shock or disbelief
4. Destabilization
5. Psychological effects
6. Coping/normalizing
7. Recovery
Psychological Effects of Trauma

1. Anxiety
- Refers to the symptoms such as fear, apprehension or worry.
- It is accompanied by physical sensations.
2. Depression
- Refers to the symptoms of trauma seen as hopelessness, desperation, meaningless life,
the pessism, lack of initiative, slow thought process, disturbances in sleeping and eating
patterns, fatigue, difficulty in concentrating, preoccupation with death or suicide,
decrease sex drive, feelings of worthlessness, and other sad mood after experiencing
physical, sexual abuse, neglect and abandonment.
3. Psychosomatic
- Illness refers to the somatization or the ways the body remembers trauma.
- Survivors frequently have problems with their digestive system, chronic pain.
4. Post-Traumatic Stress Disorder (PTSD)
- Not all persons who were traumatized will have PTSD.
- Some may have trauma symptoms but not necessarily with PTSD.

Trauma Impact Model

Trauma Impacts on Five Areas of Personal and Social Functioning:

- Behavioral
- Affective
- Somatic
- Cognitive
- Spiritual

Survivor Guilt

- It is the guilt that comes from the belief that our actions or non-actions during a traumatic
event may have caused or could have prevented the death, injury, or mistreatment of
others.
- It also occurs if one believes that one should have experience death, injury, or
mistreatment but escaped from it
PTSD Triad of Symptoms

1. Re-experiencing
- Intrusive recollections of the event/re-living of memories
- The unavoidable echo of the event; often vivid
- It is called flashback, nightmare, or hallucination
2. Avoidance of reminders associated with trauma
- Numbing (emotional anesthesia)
- Triggers: place, event, people, and thoughts
- The numbing may protect a person from overwhelming distress between memories
- Most survivors of trauma will consciously avoid reminders
3. Hyper-arousal
- Physiological disturbance: sleep problem, irritability, anger outburst, concentration
problem, hyper-vigilance, startled response
- Unexpected noise can cause the person jumpy. The response is automatic—not
necessarily related to stimuli associated to the original trauma