Volume 5, Issue 4, August 2016, Page: 83-92
Disintegration of the Self-Structure Caused by Severe Trauma
Vito Zepinic, Psychclinic P/L, London, United Kingdom
Received: Jun. 20, 2016;       Published: Jun. 21, 2016
DOI: 10.11648/j.pbs.20160504.12      View  11348      Downloads  1632
Abstract
Severe trauma affects all structures of the self – one's image of the body; the internalized images of the others; and one's values and ideals – and leads to a sense that the self-coherence and self-continuity are invaded, assaulted, and systematically broken down. The traumatic events overwhelm the ordinary human adaptations to life and generally involve threats to life or bodily integrity, confront human beings with the extremities of helplessness and terror, and evoke the response of catastrophe. The vulnerable self-structure of traumatized individuals is evident in the following ways: (a) difficulties in self-regulation (self-esteem maintenance, lower tolerance levels, and the sense of self-discontinuity and personal agency), (b) appearance of the clinical symptomatology (frequent upsurges of anxiety/fear, depression, and specific fears or phobias regarding the external world or one's own bodily integrity), and (c) reliance on primitive or less-developed forms of the self-object relatedness. Severe trauma may lead to de-centering of the self (self-at-worst), loss of groundlessness and a sense of sameness, self-discontinuity and ego-fragility, leaving scars on the one's 'inner agency' of the psyche, fragmentation of the ego-identity resulting in proneness to dissociation.
Keywords
Trauma, Self-Structure, Self-(dis)Continuity, Disintegration of the Self, Inner Conflicts, Dissociation
To cite this article
Vito Zepinic, Disintegration of the Self-Structure Caused by Severe Trauma, Psychology and Behavioral Sciences. Vol. 5, No. 4, 2016, pp. 83-92. doi: 10.11648/j.pbs.20160504.12
Reference
[1]
Zepinic V. The Self and Complex Trauma, Xlibris Corporation, London, 2012
[2]
Gersons BPR, Miranda Off. Coping with the aftermath of trauma, British Medical Journal, 5, 1038-1039, 2005
[3]
van der Hurt O, Nijenhuis E, Steele K. The Haunted Self, WW Norton, New York, 2006
[4]
van der Kolk BA, Fisler. Dissociation and the fragmentary nature of traumatic memories: Overview and explanatory study, Journal of Traumatic Stress, 8, 505-536, 1995
[5]
Wilson JP. The Posttraumatic Self, Routledge, New York, 2006
[6]
Zepinic V. Healing Traumatic Memories: A case study, Dinamische Psychiatrie, 5-6, 279-287, 2008
[7]
Gist R, Devilly GJ. Post-trauma debriefing: the road too frequently travelled, Lancet, 360, 741-742, 2002
[8]
Creamer M, Burges P, McFarlane A. Posttraumatic stress disorder: Findings from the Australian national survey of mental health and well-being, Psychological Medicine, 31, 1237-1247, 2001
[9]
Zepinic V. Persistence of 'Survival Skills' as a Risk Factor for Suicide in Severely Traumatized Individuals, International Journal of Emergency Mental Health and Human Resilience, 2, 552-558, 2015
[10]
Zepinic V. The complexity of treating PTSD symptoms, paper presented at WPA International Conference, Istanbul, 2006
[11]
Zepinic V. Suicidal risk with war-related posttraumatic stress disorder (Chapter 14), In Raphael B, Malak AE, (ed). Diversity and Mental Health in Challenging Times, TCMHC, Sydney, 2001
[12]
Zepinic V. Hidden Scars: Understanding and Treating Complex Trauma, Xlibris Corporation, London 2011
[13]
Schore AN. Affect Dysregulation and Disorders of the Self, WW Norton, New York, 2003
[14]
Ulman RB, Brothers D. The Shattered Self: A Psychoanalytic Study of Trauma, The Analytic Press, Hillsdale, 1988
[15]
Allen JG. Coping with trauma, 2nd ed, American Psychiatric Publishing, Washington DC, 2005
[16]
Courtois AC, Ford JD (ed). Treating Complex Traumatic Stress Disorder, The Guilford Press, New York, 2009
[17]
Herman JL. Trauma and Recovery, Basic Books, New York, 1992
[18]
Horowitz MJ, Zilberg N. Regressive alterations in the self-concept, American Journal of Psychiatry, 140, 284-289, 1983
[19]
Kartal D, Kiropoulos L. Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria, European Journal of Psychotraumatology, 7, 28711, 2016
[20]
van der Kolk BA, McFarlane AC, Weiseath L. Traumatic Stress, The Guilford Press, New York, 1996
[21]
Zepinic V. Treatment Resistant Symptoms of Complex PTSD Caused by Torture During War, Canadian Social Science, 9, 26-32, 2015
[22]
Kuzmanovski B. Foreword, In Zepinic V. Hidden Scars: Understanding and Treating Complex Trauma, Xlibris Corporation, London, 2011
[23]
Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A. Evidence for proposed ICD-11 PTSD: a latent profile analysis, European Journal of Psychotraumatology, 4, 20706, 2013
[24]
Zepinic V. Traumatic memory system, paper presented at WPA International Conference, Istanbul, 2006
[25]
Foa EB, Rothbaum OB. Treating the Trauma of Rape, The Guilford Press, New York, 2000
[26]
Horowitz MJ. Stress Response Syndrome, 4th ed. Jason Aronson Inc., New York, 2001
[27]
Ford JD, Courtois AC, Steele K, van der Hurt O, Nijenhius ERS. Treatment of complex posttraumatic dysregulation, Journal of Traumatic Stress, 5, 437-447, 2005
[28]
Zepinic V. Defining a war-related psychological trauma: Is that one impossible task? The International Journal of Medicine, 3, 376-383, 2010
[29]
Solomon MF, Siegel DJ (ed). Healing Trauma: Attachment, Mind, Body, and Brain, WW Norton, New York, 2003
[30]
Krause ED, Mendelson T, Lynch TR. Childhood emotional and adult psychological distress: The mediating role of emotional inhibition, Child abuse and neglect, 27, 199-213, 2003
[31]
ter Heide FJJ, Mooren TM, Kleber RJ. Complex PTSD and phased treatment in refugees: a debate piece, European Journal of Psychotraumatology, 7, 28687, 2016
[32]
Beck AT, Emery G, Greenberg RL. Anxiety Disorders and Phobias: A Cognitive Perspective, Basic Books, New York, 2005
[33]
Bisson JI, Ehlers A, Matthews R, Pilling S, Richard D, Turner S. Psychological treatments for chronic post-traumatic stress disorder, British Journal of Psychiatry, 190, 97-104, 2007
[34]
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed, APA, Arlington, 2013
[35]
Brewin CR. Memory processes in post-traumatic stress disorder, International Review of Psychiatry, 13, 159-163, 2001
[36]
Rubin DC. The Coherence of Memories for Trauma: Evidence from Posttraumatic Stress Disorder, Consciousness and cognition, 20, 857-865, 2011
[37]
Sleijpen M, Haagen J, Mooren T, Kleber RJ. Growing from experience: an explanatory study of posttraumatic growth in adolescent refugees, European Journal of Psychotraumatology, 7, 28698, 2016
[38]
Bremner JD. Acute and chronic responses to psychological trauma: Where do we go? American Journal of Psychiatry, 156, 349-351, 1999
[39]
Courtois AC. Complex trauma, complex reactions: Assessment and treatment, Psychotherapy: Theory, Research, Practice, Training, 41, 422-425, 2004
[40]
Mikulincer M, Shaver PR. An attachment perspective on psychopathology, World Psychiatry, 11, 11-15, 2012
[41]
Zepinic V. Psychological characteristics of war-related PTSD (Chapter 10), In Ferguson B, Barnes D (ed). Perspectives on Transcultural Mental Health, TCMH, Sydney, 1997
[42]
Wilson JP, Drozdek B (ed). Broken Spirit, Brunner-Routledge, New York, 2004
[43]
Phillips M, Frederick C. Healing the Divided Self, WW Norton, New York, 1995
[44]
Wolfe E. Treating the Self, The Guilford Press, New York, 1999
[45]
Zepinic V. Human Rights Violation and Chronic Symptoms of PTSD, Canadian Social Science, 2, 1-7, 2015
[46]
Zepinic V. Psychopathic Personality (Aetiology, Clinical, and Legal Issues), unpublished manuscript, 2016
[47]
Bremner JD. Trauma, Memory, and Dissociation, American Psychiatric Press, Washington DC, 1997
[48]
Steele K, van der Hurt O, Nijenhuis ERS. Phase oriented treatment of structural dissociation in complex traumatization: Overcoming trauma-related phobias, Journal of trauma and Dissociation, 6, 11-53, 2005
[49]
Herman JL. Complex PTSD: A syndrome in survivors of prolonged and repeated trauma, Journal of Traumatic Stress, 3, 377-391, 1992
[50]
Zepinic V: Treating the war-related complex trauma using Dynamic Therapy, The International Journal of Medicine, 3, 384-390, 2010
[51]
Zlotnick C, Warshaw M, Shea MT, Allsworth J, Pearlstein T, Keller MB. Chronicity in posttraumatic stress disorder (PTSD) and predictors of course of comorbid PTSD in patients with anxiety disorders, Journal of Traumatic Stress, 12, 89-100, 1999
[52]
Duckworth MP, Follete VM (ed). Retraumatisation: Assessment, Treatment, and Prevention, Routledge, New York, 2012
[53]
Goldberg A. The Psychology of the self, International University Press, New York, 1978
[54]
Joscelyne A, McLean S, Drobny J, Bryant RA. Fear of memories: the nature of panic in posttraumatic stress disorder, European Journal of Psychotraumatology, 3, 19084, 2012
[55]
McNally RJ. Remembering Trauma, Harvard University Press, Cambridge, 2003
[56]
Rubin DC, Bernsten D, Johansen MK. A Memory Based Model of Posttraumatic Stress Disorder: Evaluating Basic Assumptions Underlying of the PTSD Diagnosis, Psychology Review, 115, 985-1011, 2008
[57]
van der Kolk, Roth SH, Pelcovitz D, Sunday S, Spinazzola J. Disorder of extreme stress: The empirical foundation of a complex adaptation to trauma, Journal of Traumatic Stress, 18, 389-399, 2005
[58]
Briere J, Spinazzola J. Assessment of the sequelae of complex trauma. In Courtois CA, Ford JD (ed). Treating Complex Traumatic Stress, The Guilford Press, New York, 2009
[59]
Burgess AW, Holstrom L. Rape trauma Syndrome, American Journal of Psychiatry, 131, 981-986, 1974
[60]
Cloitre M. The “one size fits all” approach to trauma treatment: should we be satisfied? European Journal of Psychotraumatology, 6, 27344, 2015
[61]
Cloitre M, Stolbach CB, Herman LJ, van der Kolk BA, et al. A developmental approach to complex PTSD: Childhood and adult cumulative trauma predictors of symptoms complexity, Journal of Traumatic Stress, 5, 399-408, 2009
[62]
Gluck TM, Knefel M, Tran US, Lueger-Schuster B. PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptoms profiles, European Journal of Psychotraumatology, 7, 29700, 2016
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