Healing The Heart Of Trauma And Dissociation Wi...
This is the first in an ongoing series highlighting literature and other resources on healing, trauma, dissociation and dissociative identity disorder. Periodically over the next year I will share books, articles and other resources I find. I also welcome you to share what you have read on these topics as well. This month's selection is the novel Nickels: A Tale of Dissociation by Christine Stark.
Healing the Heart of Trauma and Dissociation wi...
Answer: Writing a novel about dissociation interested me as a survivor, activist, and writer. I wanted to put dissociation at the center of a novel about sexual violence because I want people to get in their gut what it is like to survive chronic trauma and I want people to have insight into what it is like to live with the psychological aftermath. Over two decades of activism, my experience is that whatever kind of sexual exploitation a person has gone through, understanding dissociation is crucial for healing. It's also crucial for advocates, friends, and loved ones to understand the psychological and emotional impact of sexual violence. Also, I wanted to convey that despite the fractured sense of self the protagonist suffers from, she experiences joy, friendship, love, humor, and success in school and athletics.
The activation of the fight or flight response prevents the parts of the brain responsible for creating and retrieving memory from functioning effectively. This is why we can forget what occurred around a traumatic event. In the case of ongoing trauma, such as with childhood abuse, ongoing problems with memory and the related process can occur, leading to what is understood as dissociation.
At the heart of dissociation is memory disruption.At the heart of dissociation is memory disruption. During dissociation, the normally integrated functions of perception, experience, identity, and consciousness are disrupted and do not thread together to form a cohesive sense of self. People with dissociation often experience a sense that things are not real; they can feel disconnected from themselves and the world around them. Their sense of identity can shift, their memories can turn off, and the connection between past and present events can be disrupted.
In understanding the human response to trauma, it is understood that dissociation is a central defense mechanism because it provides a kind of mental escape when physical escape is not possible. This type of defense is often the only kind available for children living in abusive situations. Posttraumatic stress (PTSD) and complex posttraumatic stress (C-PTSD) often go hand in hand with dissociation. In studies investigating the impact of PTSD and memory, researchers have found that people with dissociative symptoms have a greater impairment with both working memory and long-term memory.
To understand the long-term impact of memory impairment due to dissociation, we need to look at the context from which it arises. Dissociation occurs as a result of ongoing trauma which is associated with chronic stress. A chronically stressed brain and nervous system have difficulty learning. The hippocampus, critical for memory formation and consolidation, can become damaged from ongoing exposure to stress hormones. Researchers have found that the hippocampus actually shrinks in people who suffer from major depression. In addition to the emotional impact of chronic stress and abuse, difficulties with learning and memory can occur as well.
Three interesting patterns were evident in the factor analysis. The first one suggests that having many responsibilities as a child makes others see him/her as a potential spirit possession practitioner, and that the person may interpret different signs as evidence of contact with the spirits, perhaps because actual responsible adults are not present. We can wonder whether the early burden of responsibility may not result in a wish to surrender control in the possession experience. It is telling that spiritual signs did not load with either trauma or dissociation variables, although we should bear in mind that there may be a ceiling effect when dealing with a restricted sample, which could obscure a relation between these two types of variables.
And so giving that permission and space. One of the important pieces about dissociation is what some are calling embodied healing. Some people call it somatic healing. And this says that a violation, an abuse, or a trauma affects us holistically. Mind, body, spirit.
I have used CIPOS to reduce the risk of dissociation to strengthen present orientation and then graded exposure to trauma memories. So the threat system is not triggered, and the client becomes confident in going in and out of their trauma memories. I also use the Flash Technique, or the EMDR Bomb, to reduce clients distress, before commencing the standard EMDR protocol. Thus reducing the risk of dissociation. If a client is dissociating, I would use the Back of the head scale, and ask them to indicate where they are on this scale. They have to move their arm snd hand which can be enough to bring them back. I would also ask them to take a breath, and a drink. This stimulates the parasympathetic system, between Bilateral simulation and can soothe clients. If they are dissociating, I would ask them to focus on their senses in the room, or play a game of catch with me, or squeeze a soft stress ball in their hands. We can play the catch game even working remotely.
Suzanne, I am so sorry for the trauma caused to you by the Catholic Church. It is natural you have resentment for these soul destroying experiences. May you continue to move toward the healing of your mind, body and spirit.
Some studies indicate that dissociation occurs in approximately two to three percent of the general population. Other studies have estimated a prevalence rate of 10% for all dissociative disorders in the general population (e.g., Loewenstein, 1994). Dissociation may exist in either acute or chronic forms. Immediately following severe trauma, the incidence of dissociative phenomena is remarkably high. Approximately 73% of individuals exposed to a traumatic incident will experience dissociative states during the incident or in the hours, days and weeks following.. However, for most people these dissociative experiences will subside on their own within a few weeks after the traumatic incident subsides (International Society for the Study of Dissociation, 2002; Martinez-Toboas & Guillermo, 2000; Saxe, van der Kolk, Berkowitz, Chinman, Hall, Lieberg & Schwartz, 1993).SOME PREVALENCE RATES HAVE BEEN CALCULATED INDIVIDUALLY FOR THE FOUR TYPES OF DISSOCIATIVE DISORDERS:Dissociative Amnesia: No exact prevalence rates have been empirically demonstrated for Dissociative Amnesia (Maldonado et al., 2002; Putnam, 1985).Dissociative Fugue: Prevalence rate of 0.2% in the general population (American Psychiatric Association, 2000; Maldonado et al., 2002). The prevalence is thought to be higher during periods of extreme stress (Maldonado et al., 2002).Dissociative Identity Disorder: Prevalence rates of .01 (Coons, 1984) to 1% in the general population. Studies have indicated a prevalence rate of .5 to 1.0% in psychiatric settings (Maldonado et al., 2002).Depersonalization Disorder: Exact prevalence is unknown (Maldonado et al., 2002). Some researchers have suggested that Depersonalization Disorder is the third most common psychological disorder following depression and anxiety (Guralnik et al., 2001).
The International Society for the Study of Trauma and Dissociation is an international non-profit, professional association organized to develop and promote comprehensive, clinically-effective and empirically-based resources and responses to trauma and dissociation and to address its relevance to other theoretical constructs.
Acute stress disorder (ASD), according to the DSM-5, involves a traumatic stress reaction that occurs within 1 month of trauma exposure and includes at least nine symptoms from any of the five categories (intrusion, negative mood, dissociation, avoidance, and arousal; APA, 2013). To receive this diagnosis, the individual also has to display a reaction that causes significant distress or impairment in social, occupational, or other important areas of functioning. ASD can occur at the time of the trauma exposure or any time within 4 weeks of that event As Roberts, Kitchiner, Kendardy, and Bisson (2010) observed, there is a large degree of overlap between ASD and PTSD symptoms, but what distinguishes them is the timing of those symptoms relative to trauma exposure. Cardeña and Carlson (2011) provided a history of the ASD diagnosis and discussed the validity of the diagnostic criteria. ASD can develop into PTSD if the symptoms extend beyond 1 month.
Pole and colleagues (2008) reviewed possible explanations for why Latinos have elevated PTSD rates. Two explanations appear to have the greatest support: culturally defined differences in coping styles (Latinos appear to engage more in self-blame coping and wishful thinking coping, generally related to religious beliefs) and increased likelihood of experiencing peritraumatic dissociation, a possible PTSD risk factor that appears to be a more common reaction to trauma for individuals with greater adherence to Latino cultural norms.
Research generally indicates that women are more likely than men to seek treatment for behavioral health disorders (McLean & Anderson, 2009). Therefore, women are also significantly more likely to receive treatment for PTSD. According to NESARC data, women are approximately 34 percent more likely to be treated for PTSD than men (Roberts et al., 2011). Women often respond differently to trauma than do men, which may contribute to higher PTSD rates among women. For example, women are more likely to report dissociation immediately after or in the few weeks following trauma exposure (Cardeña & Carlson, 2011). Women also tend to report more intense emotional responses and more dissociation following trauma exposure (see review by Olff et al., 2007). Research conducted with survivors of serious vehicular accidents indicates that women are significantly more likely than men are to experience certain PTSD symptoms 1 month after the accident (e.g., distress in similar situations, physical reactions to memories, hypervigilance, trouble sleeping, avoidance of thoughts/feelings/activities/places, exaggerated startle response; Fullerton et al., 2001). 041b061a72