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• W2092181844 abstract "The modern study of the effects of psychological trauma is relatively recent, beginning only about 30 years ago, as evidenced by the introduction of posttraumatic stress disorder (PTSD) in the DSM-III in 1980. However, much was theorized about trauma and dissociation more than 100 years ago, only to become buried by the widespread acceptance of psychoanalytic theory that minimized the actual occurrence of trauma–particularly childhood sexual abuse–in favor of an emphasis on intrapsychic conflict. This pattern of recognition and subsequent denial may derive from the universal human desire not to have to acknowledge the burden of the human suffering that derives from trauma and to accept some responsibility to ameliorate it. It has only been in the context of societal and political support that such denial was overcome. In recent history, such support has been provided by the need to address traumaissues related to the Vietnam War and the Women's Movement, namely to treat veterans with lasting psychological scars and to combat violence against women and children. Beginning in the 1980s, the reality of high rates of childhood abuse began to be recognized, as were the dynamics of its damaging effects, including posttraumatic and dissociative disorders in psychiatric patients. As such disorders were recognized, a treatment model evolved. The early models emphasized the abreaction of the traumatic experiences early in treatment. However, it soon became clear that many persons with extensive traumatization in childhood not only developed posttraumatic and dissociative disorders, but they also had major deficits in many domains. The chaos and abuse of their early years interfered with learning vital skills, such as the development of basic trust and relational capacity, affect tolerance, impulse control, the ability to tolerate aloneness and to self-soothe, and a positive self-image and sense of self-efficacy. Thus, when faced with the overwhelming dysphoria involved in remembering and reexperiencing childhood trauma, some patients fled into dysfunctional isolation and sometimes destructive behaviors. Moreover, once the dissociative barriers to traumatic memories were breached, patients became yet more overwhelmed as they were flooded by their past experiences. A phase-oriented treatment model evolved that mandated an early phase of enhancing ego functioning and relational skills before directly addressing past trauma. Further evolution of the treatment model for complex PTSD included more sophisticated evaluations of reports of abuse, better differential diagnosis, and treatment focused on patients' complex and multifaceted symptoms and disabilities." @default.
• W2092181844 created "2016-06-24" @default.
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• W2092181844 date "2011-03-28" @default.
• W2092181844 modified "2023-09-24" @default.
• W2092181844 title "Trauma and Dissociation: 30 Years of Study and Lessons Learned Along the Way" @default.
• W2092181844 doi "https://doi.org/10.1002/9781118093146.ch01" @default.
• W2092181844 hasPublicationYear "2011" @default.
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