The Trinity of Trauma: Ignorance, Fragility, and Control (eBook)

Enactive Trauma Therapy

Ellert Nijenhuis (Autor)

eBook Download: PDF

2017 | 1. Auflage
514 Seiten
Vandenhoeck & Ruprecht Unipress (Verlag)
978-3-647-40268-0 (ISBN)

Infos

Enactive trauma therapy is grounded in so-called enactivism, which holds that, like anyone else, traumatized individuals are (1) embrained, embodied, and environmentally embedded; (2) constitute biopsychological organism-environment systems that are essentially interested in preserving their existence; (3) are primarily affective and oriented toward making sense of things. Individuals exhibit a phenomenal self, world, and self-of-the-world through self- and world-oriented actions. They do not act on the basis of knowledge, but possess knowledge on the basis of world-engaged sensorimotor, affect-laden, and goal-oriented actions. Whenever interpersonal traumatization by significant others occurs, individuals may get caught up in affective and relational conflicts they cannot resolve on their own. Their generation and maintenance of a trauma-related dissociation of the personality involves a kind of sense-making that supports their continued existence when their capacity to integrate traumatic experiences is still too low. However, what starts as a courageous effort to navigate a traumatizing life may at some point in time become a serious problem. Enactive trauma therapy comprises the collaboration of two organism-environment systems: the patient and the therapist. Together they spawn new meaning and adequate actions - an interaction that resembles dancing: It takes pacing, mutual attunement, good timing, a sensitivity to balance, movement and rhythm, courage, as well as the ability and willingness to follow and lead.

Ellert R. S. Nijenhuis, Ph. D., ist Psychologe, Psychotherapeut und Forscher. Seit mehr als 30 Jahren diagnostiziert und behandelt er schwer traumatisierter Patienten. Er lehrt und publiziert zu traumabezogener Dissoziation und dissoziativen Störungen. Er ist Forschungsberater der Klinik Littenheid (Schweiz) und arbeitet mit mehreren europäischen Universitäten zusammen. Die International Society for the Study of Trauma und Dissociation hat ihm mehrere Preise verliehen, darunter auch für sein Lebenswerk.

Inhalt

Cover 1
Title Page 4
Copyright 0
Table of Contents 6
Body 12
Volume III: Enactive Trauma Therapy 12
Preface 14
Ignorance, Fragility, and Control versus Realization 15
Theory: A Navigational Instrument 17
A Player and a Coach: Two Organism-Environment Systems Enacting a Common World 18
The Trinity of Trauma and The Haunted Self 20
The Trinity of Trauma: A Trilogy 22
Clinicians and Therapists 24
Gratitude 24
Introduction: Volume III in Brief 26
Theoretical Basis 26
The Practice of Enactive Trauma Therapy 30
Chapter 22: Consciousness in Trauma 34
A Trinity of Prototypical Dissociative Subsystems of the Personality 34
Consciousness: Cooperation, Coordination, Communication 37
General, Personal, and Subjective (Phenomenal) Consciousness 39
Totalitarian, Corporative, and Communicative Cooperation 40
Interpersonal Traumatization as a Totalitarian Organization 41
Dissociative Parts of the Personality in Trauma: Totalitarian and Corporative 43
Enactive Trauma Clinicians: Corporative and Communicative 45
Being Sentient and Being Conscious 46
Phenomenal and Subjective 48
Chapter 23: Enlightenment, Enlivenment, Enactivism 50
Enlightenment 51
Songs Beyond the Siren of Mechanics 52
Songs Beyond the Siren of Matter 53
Songs Beyond the Siren of Thought 55
Adverse Life: Coincidental Suffering? 55
Enlivenment and Enactivism 56
Parts and Wholes 60
Enactivism: A Viable One System Approach to Life 65
Chapter 24: Embedment, Entanglement, and Conatus 68
A Knotty Ontological Dialectic 68
A Knotty Epistemic Dialectic 70
The Ontological and Epistemic Relativity and Entanglement of Subjects and Objects 71
Embedment and Subject-Object Relativity in Trauma 71
Conatus or Will 73
Summary 77
Chapter 25: Desire, Joy, and Sadness 78
Evaluation as Signification 78
Signs and Sense Making 80
Insignification 81
Signification is Species-Dependent 82
The Power of Action 82
Actions, Passions, and Umwelt 85
Passions and Substitute Actions 86
Adverse, Traumatizing, and Traumatic Events 88
Decomposition and (Re)Composition of the Personality in Trauma 88
Reenactment of Traumatic Memories and Relationships: Seeking Joy, Remaining Stuck in Sadness, Suffocating in Hate 90
Dissociative Intrusions 93
Demoralization: Power of Action Lost 94
Enactivism and Participatory Sense Making 95
Chapter 26: Dissociative Parts of the Personality and Modes of Longing and Striving 98
Dissociative Parts and Action Systems 98
ANPs with ‘EP-like’ Features and EPs with ‘ANP-like’ Features 101
Modes of Longing and Striving 103
Dissociative Parts Include Various Modes of Longing and Striving 108
Lack of Integration and Dissociation: Related but Different Concepts 114
Chapter 27: Traumatized Individuals and Their Dissociative Parts: Autonomous Centers of Action and Passion 118
Autonomous Systems 118
Traumatized Individuals and Their Dissociative Parts: Autonomous Systems 122
Autonomous Systems: Operationally Closed, Environmentally Open 128
Traumatized Individuals and Dissociative Parts as Operationally Closed Systems . 128
Autonomous Systems: Minded 129
Mind, Affectivity, and Perspectivalness in Trauma 134
Conatus and Passions 134
Conatus and Passion in Trauma 136
A Recapitulation 138
Chapter 28: Ego and Socius 142
Ego as Socius 142
Some Perspectival Features of Prenatal Development 144
Ego and Socius in Prenatal and Postnatal Trauma 146
Chapter 29: Conatus, Cognition, and the Body 154
Conatus and Cognition in Trauma 156
Mind, Brain, and Body 157
Chapter 30: Participatory Sense-Making 166
Entering the World of Psychology 167
Paula 168
The Province of Groningen 170
Defrosting a Frozen Lady 173
Making Meaning Together 176
Epilogue 190
Chapter 31: Attunement, Consensus Building, and Sensitive Leading by Utilization 192
Pediatric Hypnotherapy as a Model of Any Form of Psychotherapy 193
The Dance of Enactive Trauma Therapy 198
From Flatland to Spaceland 205
Loss of Control in Trauma and Dissociation 212
Chapter 32: Enactive Assessment of Dissociation and Traumatizing Events 216
Therapeutic Democracy and the Development of Positive Control 217
Standard Assessment 219
Stop Signals 221
Ineke 223
The First Session 223
The Second Session 225
The Path So Far 262
Secrets 263
Epilogue 263
Chapter 33: Uncommon Enactive Assessment 264
Martha 264
Assessment 290
A Therapeutic Plan of Action 301
The Continued Treatment 302
Epilogue 306
Sonja 306
Conclusion 310
Chapter 34: How Water Beats Rocks and Other Metaphors 312
How Water Beats Rocks 313
Epilogue 320
Paralinguistics 321
Metaphor Construction and Preparation 325
Sleeping Beauty: A Tale for Young Fragile EPs 326
The Boxer 327
The Jigsaw Puzzle 328
The Long Journey, the First Step 329
Chapter 35: The Meaning of Sirens 330
WWW: From Symptom to Meaning – Who Does What and Why? 331
Discussion 352
A Brutal Confession, the Unveiling of a Final Secret, and the Right to Exist 358
Chapter 36: Hand in Hand 360
Agnes 362
Physical Contact Between Patients and Clinicians 376
Conclusion 386
Chapter 37: Sympathy for The Devil 388
Dissociative Amnesia and Dissociative Hypermnesia 388
Meeting The Helper 390
Meeting The Devil 393
Completion of the Session 406
The Next Session 407
From Totalitarian to Communicative-Egalitarian Relationships 408
Therapeutic Exposure from an Enactive Perspective 411
Twenty Years Later: Sonja’s Reactions to Watching The Devil 415
Chapter 38: 222 Propositions Regarding Enactivism and Enactive Trauma Therapy 418
Enactivism 418
Mind and Matter 418
Relativity of Subject and Object Meaning Making
Morality 419
Organism-Environment Systems and Operationally Autonomous Systems 419
Embrained, Embodied, Embedded 420
Mental and Phenomenal Systems 420
Needs and Desires 420
Modes of Longing and Striving 421
Integration: Synthesis, Personification, Presentification, Symbolization, and Realization 421
Integrative Limitations, Adverse Events, and Traumatic and Traumatizing Events . 422
Dissociation in Trauma and Dissociative Subsystems 423
Prototypical Dissociative Parts 424
Dissociative Parts and Consciousness 425
Enactive Trauma Therapy 426
Enactive Trauma Clinicians 426
Egalitarianism 427
Goals 427
Attunement, Consensus Building, and Leading 428
Enactive Trauma Therapy: Healing Steps 429
Embodiment and the Body in Trauma Treatment 430
Who Does What and Why? 430
Pointland, Lineland, Flatland, and Spaceland 430
Phobias 431
Imaginal Exposure 432
Concretizations 432
Overcoming the Trinity of Trauma in Psychiatry, Psychology, and Psychotherapy . 433
Society and Chronic Childhood Traumatization 434
Appendix 1: Some Notes on the Efficacy of Enactive Trauma Therapy 438
Defining and Using the Concept of ‘Dissociation’ in ContradictoryWays 438
Dissociative Disorders Require a Specific Kind of Treatment 439
Useful (Significant-Good) and Harmful (Significant-Bad) or Useless (Insignificant) Treatment of Complex Dissociative Disorders 440
Community Therapists and Expert Therapists of Complex Dissociative Disorders: What Do They Do? 441
Controlled Group Comparison Outcome Studies and Their Limitations 441
Single-Case Studies 442
Multiple Cases Studies of the Treatment of Complex Dissociative Disorders 443
Appendix 2: The Need for and the Utility of Minimal Constraints on the Concept of Dissociative Parts 445
Concepts are Artificial Constructs 445
Integrative Limitations 447
Phenomenological Interests 448
Clinical Interests 449
Scientific/Empirical Interests 449
Dissociative Parts and Minimal Constraints on Consciousness 451
Minimal Constraints on Self-Consciousness: Phenomenal Self-Conception and Phenomenal Conception of an Intentionality Relationship 454
Dissociative Parts Need Not Be Verbal 456
Minimal Dissociative Parts, Minimal Contents 457
To Have an Autobiographical Memory, Someone Must Remember and Personify It 457
Assessment of Dissociative Disorders and the Accessibility and Assessability of Dissociative Parts 458
Detection of Rudimentary EPs in PTSD (and Other Dissociative Disorders) 459
Appendix 3: The Somatoform Dissociation Questionnaire (SDQ-20) 462
Scoring 462
Scalability 462
Reliability 463
Relationship with Demographic Characteristics 463
Convergent Validity 463
Discriminant Validity 463
Construct Validity 464
Screening Capacity 465
Appendix 4: The Somatoform Dissociation Questionnaire (SDQ-5) 469
Appendix 5: The Traumatic Experiences Checklist (TEC) 473
Scoring Form Traumatic Experiences Checklist (TEC) 479
References 484
Author Index 506
Subject Index 508

Produkt-Details

• Erscheint lt. Verlag: 3.4.2017
• Übersetzer: Evang.-Theol. Seminar
• Zusatzinfo: with 26 figures and 7 tables
• Verlagsort: Göttingen
• Sprache: englisch
• Themenwelt: Geisteswissenschaften
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Schlagworte: Posttraumatische Belastungsstörung • Psychisches Trauma • Psychotraumatologie • Trauma • Traumabewältigung • Trauma-Konzept • Traumatisierung
• ISBN-10: 3-647-40268-0 / 3647402680
• ISBN-13: 978-3-647-40268-0 / 9783647402680