1. TRAUMA VICARIOUS TRAUMA

2. Trauma is an assault on an unprepared psyche. A traumatic experience impacts the entire person—the way we think, the way we learn, the way we remember things, the way we feel about ourselves, the way we feel about other people, and the way we make sense of the world are all profoundly altered by traumatic experience. (Bloom, 1999)

3. PTSD Criterion A1 Direct personal experience that involves actual or threatened death or serious injury or other threat to one’s physical integrity; witnessing an event that involves death, injury, or a threat to the physical integrity of another; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member. (DSM-IV-TR, 2000, p. 463).

4. PTSD Criterion A2 States that the individual’s response to this event is one of horror, intensive fear and hopelessness

5. PTSD Criterion B Includes re-experiencing the traumatic event one or more of the following ways: intrusive thoughts nightmares dissociative flashbacks psychological distress and reactivity due to exposure that resembles the traumatic event.

6. PTSD Criterion C Involves avoidance numbing behaviors avoiding activities and persons that arouse recollections of the trauma. Also in this category is a sense of despair about the future.

7. PTSD Criterion D Includes increased arousal difficulty sleeping irritability outbursts of anger hyper vigilance an exaggerated startle response

8. PTSD Criteria E and F The durations of symptoms is longer than one month And cause disturbances or distress in social, occupational functioning

9. Type II trauma Type II trauma is different from the DSM-IV or Type I, in that symptoms arise from prolonged, repeated trauma., “Type II trauma includes denial and psychic numbing, self-hypnosis and dissociation, and alternations between extreme passivity and outbursts of rage. (Terr 1991)

10. Stress vs. trauma Regular life stressors, in different areas of human experience, are ordinary and have high expectancy, probability of happening, and controllability. Traumas are the out of ordinary stressors that have low expectancy, probability, and controllability. Kira calls his trauma Type III. (Ibrahim Aref Kira, Ph.D. 2001)

11. Attachment Trauma Attachment or intimacy traumas impact the shared affective exchange with a companionship for the adult or with parents for the infant and child. It affects the feeling of warmth and connectedness for the adult and the feeling of security and trust for the young child who depends on the attachment figure for survival. Early childhood trauma that affects attachment can disturb the whole sequence of child emotional development. (Examples of such traumas are abandonment, death of parents, or kidnapping of a baby, affairs, divorce, and loss of very close significant others.) It can yield avoidant or disordered attachment style, or attachment disorders for infants and children. It can yield relationship and personality disorders for adults. This can shatter his /her assumptions and beliefs about self and objects and impact on emotional and cognitive processing, in the area of object relations.

12. Autonomy/ Identity / Individuation Trauma: The formation of a sense of identity, agency, and self-efficacy is a developmental landmark of late adolescent or early adulthood with positive consequences of individual’s well being. Autonomy or identity trauma can shatter the behavioral and emotional independence of the individual or group or his / their sense of identity and leads to feelings of incompetence, inadequacy, alienation, and loss of control over self and destiny. Examples of such trauma are sexual and physical abuse, domestic violence, rape, slavery, prisoners of war, torture, and genocide. Such traumas in early childhood can disturb the development of a healthy autonomy and identity formation. In adults, feelings of loss of self and helplessness.

13. Interdependence or Disconnectedness Trauma: Social interaction is core to survival. The individual is interlocked within a network of connections that give him emotional, social, and material support. It gives him a sense of social embededness, belonging, and meaning in life. He develops a system of conditioned social contingencies that are rooted physiologically and emotionally and are basic to his feelings of safety, security, and community. Events that threaten these connected network and his embeddedness in it can traumatize the individual. Moving from school to school, or from state to state for a child can be traumatizing in same examples, as it involves losing the long standing relationships and support system. Uprootedness, especially involuntarily uprootedness (e.g., refugees experience) loss of affiliation by suspension or forced out are examples of this kind of trauma.

14. Achievement/ Self-actualization trauma: Tremendous amount of social behavior is motivated by the pursuit of personal goals that are central to the individual’s perceived survival. There is a value-processing component to all goal- directed behavior that include how we influence others. The failure to achieve a target that is perceived essential to survival or progression can be traumatic.

15. Vicarious Trauma Sometimes... we can become emotionally drained by caring so much; we are adversely affected by our efforts. In deed, simply being a member of a family and caring deeply about its members makes us emotionally vulnerable to the catastrophes which impact them. We, too, become ‘victims,’ because of our emotional connection with the victimized family member. (Figley1983)

16. Vicarious Trauma Vicarious traumatization is a process, not an event. It includes our strong feelings and our defenses against those strong feelings. Vicarious traumatization is our strong reactions of grief, rage, and outrage, which grow as we repeatedly hear about and see people’s pain and loss and are forced to recognize human potential for cruelty and indifference, It is our numbing, our protective shell, and our wish not to know, which follow those reactions. These two alternative states of numbness and overwhelming feelings parallel the experience of PTSD. (Pearlman & Saakvitne (1995)

17. Research on vicarious trauma McCann and Pearlman (1990) found that workers’ continued exposure to persons who have experienced trauma lead to shifts in their cognitive schemata. These shifts do not occur over night and in many cases can take years before reaching a point where the helper’s ability to function is significantly impaired

18. Vicarious Trauma presents similar to traditional trauma Hopelessness Helplessness Alters view of the world and self