Therapy for Traumatic Events and Abuse
I work from a transdiagnostic perspective of Trauma (beyond diagnosis). I understand and approach the victims´ psychosocial difficulties as a non-pathological process. Therefore, I believe, Centered Trauma Psychotherapy should be framed within an ethical and paused approach from the therapist. I avoid taking anything for granted, keeping in mind that exposure to trauma redefines the binding characteristics of people and their attachment needs. Trauma derived from violence is complex. Prevention, help and intervention with victims are also complex processes. Since there are different types of people, different types of violence and different types of traumatic experiences, therapeutic approaches should approach each differently and be tailored for each person taking into account his/her situation.Trauma centered therapy helps to overcome unexpected traumatic experiences (i.e. events related to climatology or accidents), a single exposure to intended violence and even sustained poli-victimization by inner circle since childhood. I take into account the specificity details of the traumatic experience and work to develop the trans-diagnostic approach. I understand trauma-centered psychotherapy as a process that tries to signify the traumatic experience. Therefore, psychotherapy will facilitate the integration of the responses to their traumatic experience into self-awareness.
Together we´ll try to promote autonomy to continue enjoying an independent life. Integration of trauma and adaption to the new situation will build a narrative that suggests a life project beyond suffering. We´ll also work on personal/group empowerment to reconstruct the life project. People are subjected to emotions and will express them through our thoughts and actions. That is why therapy should focus on promoting an adaptive integration of trauma that will stabilize and orient the person towards a trauma-free future, with scars, if you may.
My experience in trauma, goes back to 1995, through my DSM American training: a model that proposes detection and intervention protocols; actualized by dynamic thinking (systemic and psychoanalytic approaches) and recently re-framed by social psychology (specifically, Pichon Riviere´s approach): An operative conception of the human being and its groups of reference. I believe violence must be addressed not only from the impact on the individual, but also from the different areas that define the traumatic experience (communities, institutions and groups of reference).
Areas of adjustment and symptoms in the diagnosis of complex trauma
Table 2, table extracted from article “How much violence is too much violence? Evaluation of the poly-victimization in childhood and adolescence “, by Noemi Pereda Beltrán, University of Barcelona, in roles of the psychologist, https://doi.org/10.23923/pap.psicol2019.2892
- Unsafe bonding with the primary caregivers.
- Distrust and suspicion.
- Social isolation.
- Interpersonal difficulties.
- Difficulties in capturing the emotional states of others.
- Difficulties in putting themselves in the other’s place and changing their own perspective.
- Sensory motor development problems.
- Problems in coordination, balance, body tone.
- Medical problems throughout life.
Symptoms related to emotional regulation
- Problems in emotional regulation.
- Problems in the recognition and expression of emotions.
- Problems in the knowledge and description of the internal states.
- Difficulty communicating needs and desires.
Symptoms related to the state of consciousness.
- Depersonalization and Derealization.
Symptoms related to behavioral regulation
- Under impulse control
- Self-destructive behavior
- Aggression to others
- Sleep disorders
- Eating disorders
- Substance abuse
- Compulsive conformity
- Oppositional conduct
- Difficulties in understanding and complying with the rules
- Trauma re-experimentation
Symptoms related to self-concept
- Low self-esteem
- Guilt and shame
- Problems with body image
- Poor sense of individuality
- Difficulties in the attention and the executive function.
- Lack of maintained curiosity.
- Problems processing new information.
- Problems of concentration and to finish the tasks.
- Problems to plan and anticipate.
- Problems to understand one’s own responsibility.
- Learning problems.
- Problems in language development
- Time and space orientation problems
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