Navigating post-trauma realities in family systems: Applying social constructivism and systems theory to youth and family trauma

Trauma affecting youth and families takes a variety of forms, from random one-time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma-focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family-based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non-linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta-theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family-based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family-based treatment: (a) post-trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma.     

Visual mediation of critical illness: an autobiographical account of nearly dying and nearly living1

This article is concerned with the portrayal of the impact of critical illness on the author's life. An autobiographical approach is used to illustrate how imagery mediates personal trauma. A personal journey over a four‐year period, from the onset of illness towards recovery, is portrayed in the form of snapshots of critical events. Running parallel to the visual dimension is the application of mountain climbing as a metaphor for first understanding critical illness and then as a vehicle to aid recuperation. The journey is described in a narrative style that represents one reality.     

Resiliency in the Aftermath of Repetitious Violence in the Workplace

Summary

The definition and occurrence of traumatic events is expanding and impacts everyone's lives in some way. The degree to which a violent event impacts an individual, a group, a workplace or the community varies. Unfortunately violent events are all too common. Businesses are realizing the significance of violence as a workplace problem and the varying degrees of trauma that has a devastating impact on employee retention, workplace functionality and personal well-being. The events can include industrial or natural disasters; worksite accidents; organizational changes; suicide; homicides; robbery; assault; threats of violence and even terrorism. How prepared an organization is varies and may be correlated with how resilient individuals and the entire workplace are after workplace violence/trauma. This article focuses on what workplace violence and trauma includes, the effects of repeat events, how resilient people are while trying to prevent additional events if possible in the workplace.     

Errors of Logic and Scholarship Concerning Dissociative Identity Disorder

The author reviewed a two-part critique of dissociative identity disorder published in the Canadian Journal of Psychiatry. The two papers contain errors of logic and scholarship. Contrary to the conclusions in the critique, dissociative identity disorder has established diagnostic reliability and concurrent validity, the trauma histories of affected individuals can be corroborated, and the existing prospective treatment outcome literature demonstrates improvement in individuals receiving psychotherapy for the disorder. The available evidence supports the inclusion of dissociative identity disorder in future editions of the Diagnostic and Statistical Manual of Mental Disorders.     

Self-deception facilitates interpersonal persuasion

Self-deception is both commonplace and costly, which raises the question of what purpose it might serve. According to the dominant explanation in psychology and economics, self-deception is an intrapersonal process that fortifies and protects the self from threatening information. An alternative possibility is that self-deception evolved as an interpersonal strategy to persuade others. To investigate interpersonal aspects of self-deception, we gave people a persuasive task and measured their information processing biases and their persuasiveness. Results revealed that people who were financially motivated to persuade another person in a particular direction demonstrated a self-deceptive information processing bias consistent with their persuasive goals. This information processing bias led people to convince themselves of the veracity of their persuasive goal, and subsequently to be more persuasive to others. These findings suggest that self-deception has interpersonal benefits that offset its costs.     

What We Can Learn of Resilience from Older African-American Women: Interviews with Women Who Worked as Maids in the Deep South

Resilience theory is increasingly informed by an in-depth study of personal narratives and story telling by survivors of personal trauma and cultural hardship. From the perspective of risk and resilience theory, this study examines the personal narratives of three older African-American women who engaged in domestic service from childhood. Collectively, their autobiographical memories describe experiences coping with the forces of an oppressive social and economic system. Our analysis of these personable narratives reveals how these women not only endured the cruelties of segregation and racism but somehow prevailed over them.     

Traumatic symptomatology characteristics of adult children of alcoholics

Traumatic experience symptomatology, resiliency factors, and stress among young adults who had experienced alcoholism within their family of origin were assessed in comparison to adults who as children experienced traumatic life events other than alcoholism and those who indicated neither problem (parental alcoholism or traumatic life event) during their childhood. These three groups were compared on self-report measures of stress, resiliency, depressive symptomatology, and trauma symptoms. Results indicated adult children of alcoholics (ACOA) had more self-reported stress, more difficulty initiating the use of mediating factors in response to life events, and more symptoms of personal dysfunction than the control group. Results suggest ACOAs may develop less effective stress management strategies and present more clinically at-risk patterns of responses than their counterparts.     

Grieving sexual abuse: The therapist's process

Clinicians working in the area of sexual abuse often experience grief as a direct result of the trauma they encounter in their therapeutic endeavors. This article explores the stages of grief that transpire in reaction to treating sexual victimization and examines the behavioral indicators which surface during each phase of the therapist's process. The author's personal account is included as a means of chronicling this experience and offering suggestions as to more effective resolution. As a final note, certain preventative measures which are aimed at diminishing the potential for negative countertransference and personal conflict are presented for consideration.     

Trauma-informed forensic child maltreatment investigations

Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the agency personnel working with these clients. Within the body of trauma-informed literature, little attention has been devoted specifically to the initial investigative response and its role in controlling for system induced trauma to the child, family, and caseworker. Training child protection services (CPS) workers on the impact of trauma in child maltreatment forensic investigations and the worker's role in anticipating and mitigating the effects of trauma during the investigative process is rarely addressed in the trauma-informed literature. This article reports on a training strategy to infuse trauma information into an existing forensic child maltreatment investigation curriculum with the goal of enhancing CPS caseworker's knowledge, skills, and values concerning the importance of viewing investigations and their associated tasks through a trauma lens.     

Creating Foster Care Youth Biographies: A Role for the Internet

ABSTRACT

Large numbers of youth continue to enter foster care despite federal and state efforts to minimize placement. Some youth will experience lengthy tenure in care with multiple placements and be at risk for adverse events. They are also at risk for losing an accurate biography of their childhoods. We suggest a two-tiered approach to help youth develop a personal history. Agencies can establish a digital depository of basic information including pictures that document the life course of the youth. Agencies can help youth procure e-mail accounts. These e-mail accounts are under the control of the youth and can function as an electronic diary. Thus, youth would have a portable life biography and sense of self over time.     

Female Veterans: Navigating Two Identities

Female veterans differ from their male veteran counterparts in terms of ratio of men to women, minority status, economic status, and age. In 2014, female veterans totaled over 2 million; roughly 10% of the veteran population. In addition to balancing personal and professional responsibilities, many female veterans also have to adjust to and cope with the physical and/or mental health conditions they experience post-deployment. The extent to which female veterans succeed in transitioning back to civilian life post-deployment may be determined by biological, psychological, and social factors within their home and community. Circumstances that can support or hinder female veterans’ reintegration process include: (a) availability of gender-specific Veterans Affairs policies and services; (b) access to education and employment; (c) supports specific to mental health and/or military sexual trauma; and (d) social stigmas associated with being a female veteran. Along with other healthcare professionals, social workers have an obligation to promote social justice, and to empower underprivileged populations, including female veterans, whose needs may differ from male veterans and require specific expertise and knowledge.     

Season of light/season of darkness: The effects of burying and remembering traumatic sexual abuse on the sense of self

This paper considers the disruptive effects of defensively forgetting childhood sexual abuse on the sense of self. Defense analysis, leading to access to and control of affects and associated recall of forgotten events is a crucial aspect of understanding and treating the resulting self disorders. The defenses of dissociation, denial and repression will be considered with regard to some of the basic effects on the sense of self which come from employing them. A case discussion illustrates the strengthening of the sense of self of a patient with a profoundly traumatic past when these defenses are systematically disrupted through psychotherapy.This paper was originally presented as the keynote address on the psychoanalytic track at the Federated Societies for Clinical Social Work meeting in Chicago in September of 1991. The author would like to thank the organizers of that conference and, in particular, the members of the program committee of the Committee on Psychoanalysis, chaired by Rosemary Gaeta, for their invitation to present.The author would also like to thank many friends and colleagues for their help in preparing this paper. In particular, Dr. James Masterson, Dr. Eleanor Grayer, Andrea Stone, MSW, Dr. Shelly Nagel, Dr. Stephen Reed and Stewart Clark, took the time and trouble to make many helpful comments. In addition, I would like, in particular, to thank Dr. Candace Orcutt, whose thinking about trauma and dissociative states has had a profound influence upon my work.     

Post-Traumatic Stress Disorder,Dissociation, and Neuropsychological Performance in Latina Victims of Childhood Sexual Abuse

This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.     

Trauma Symptoms: Relationship With Career Thoughts,Vocational Identity,and Developmental Work Personality

Knowledge of traumatic events and how trauma symptoms relate to social and psychological well‐being continues to grow. One aspect of an individual's functioning that may be affected by exposure to traumatic events is the ability of the individual to engage in career‐ and work‐related activities (D. H. Coursol, J. Lewis, & L. Garrity, 2001). The current study examines the relationship between trauma symptoms and the career development process of 131 college students. Results indicate a significant relationship between higher levels of trauma symptoms and higher levels of dysfunctional career thoughts and lower levels of work personality. Implications for career counselors are discussed.     

Measuring the lifetime experience of domestic violence: application of the life history calendar method

In the absence of a "gold standard," research on domestic violence relies primarily on self-report, the quality of which is known to decline as the length of the recall period increases. Eliciting valid and reliable self-report data is crucial to the development of prevention and intervention policies and services. Nevertheless, existing measures typically do not incorporate devices to facilitate respondents' recall of the lifetime experience of domestic violence. This article describes the application of the Life History Calendar (LHC) method (Freedman, Thornton, Camburn, Alwin, & Young-DeMarco, 1988) to increase a respondent's recall of domestic violence victimization over the lifecourse. The LHC method elicits memorable information of a personal nature (e.g., children's birth dates) and uses this information to facilitate the recall of less memorable events. A recent field test of this LHC measure indicates its utility in assessing domestic violence victimization, which takes place in a complex sequence of episodes and often involves multiple perpetrators over the lifecourse.     

A Theoretical Understanding of Refugee Trauma

The effects of trauma on refugees are long-lasting, both physically and mentally. The primary objective of this paper is to broaden the scope of theoretical knowledge on refugee trauma by building on refugee, Post-Colonial, Trauma and Feminist theories, and emphasizing refugee trauma as a consequence of multiple historical, social and political constraints which are embedded in the personal experiences of refugees. By incorporating these various theories, the author proposes an integrated model to aid service providers in identifying the various trauma factors associated with refugees, as well as to facilitate the development of efficient service delivery mechanisms for this population.     

Psychological vulnerability and problem gambling: an application of Durand Jacobs' general theory of addictions to electronic gaming machine playing in Australia

The aim of this study was to conduct an empirical investigation of the validity of Jacobs' (in J Gambl Behav 2:15-31, 1986) general theory of addictions in relation to gambling problems associated with electronic gaming machines (EGM). Regular EGM gamblers (n?=?190) completed a series of standardised measures relating to psychological and physiological vulnerability, substance use, dissociative experiences, early childhood trauma and abuse and problem gambling (the Problem Gambling Severity Index). Statistical analysis using structural equation modelling revealed clear relationships between childhood trauma and life stressors and psychological vulnerability, dissociative-like experiences and problem gambling. These findings confirm and extend a previous model validated by Gupta and Derevensky (in J Gambl Stud 14: 17-49, 1998) using an adolescent population. The significance of these findings are discussed for existing pathway models of problem gambling, for Jacobs' theory, and for clinicians engaged in assessment and intervention.     

Social mobility and the well‐being of individuals

Several papers published in recent years have revived interest in Sorokin's dissociative thesis: the view that intergenerational social mobility has detrimental effects on the social relationships and wellbeing of individuals. In this paper, I test the dissociative thesis using data from the British Household Panel Survey and Understanding Society. On a wide range of indicators that measure participation in civic associations, contact with parents, close personal relationships, social support, subjective wellbeing, etc. individuals who have achieved long‐range upward mobility (i.e. those who move from working class origin to salariat destination) tend to fare better than those who are immobile in the working class. Those who have experienced long‐range downward mobility (moving from salariat origin to working class destination) do about as well as second‐generation members of the working class. Overall, there is no support for Sorokin's thesis.