Healing the Traumatized Self: Consciousness, Neuroscience, Treatment

Abstract

People with severe and chronic trauma-related psychological disorders experience a wide variety of forms of distress and dissociation. Here, Paul Frewen and Ruth Lanius present a new model for parsing the symptoms of trauma-related disorders into non-dissociative distress and properly dissociative "trauma-related altered states of consciousness," or TRASC. Their model, developed with reference to philosophical work in phenomenology and neurophysiological studies of altered states of consciousness, takes a four-dimensional approach toward symptomatology, tracking concurrent disturbances in 1) time-memory, 2) thought, 3) body, and 4) emotion. The forms of TRASC they identify include: 1) flashbacks of trauma memories, 2) voice-hearing, 3) depersonalization, and 4) marked emotional numbing and affective shut-down. The authors delve into the underlying neurophenomenological theory of the 4-D model, and make recommendations for appropriate assessment and treatment of people with trauma-related disorders. At each theoretical step they integrate first-person experience with objective neurophysiological measures, and offer case examples including vignettes, poetry, and artwork. Forewords by field leaders David Spiegel and Bessel van der Kolk set the stage for an account of the four dimensions of posttraumatic experience in Chapter 1. Chapter 2 describes the neurophenomenological method of integrating the study of subjective experience with neuroscience. In Chapters 3 through 6, each of the four dimensions of TRASC is laid out on its own: the distortion or loss of sense of time, as one's experience of the present slows to a crawl and traumas from the past seem to recur; the fragmentation of thought, as voices intrude and narratives break down; the estrangement of the body, as it dissociates from Itself and from its surroundings; and the dysregulation of emotion, as feeling too much and feeling too little intertwine. The text concludes with a word on resilience and recovery: advice for practitioners charged with liberating present selves from their traumatized past. Healing the Traumatized Self is a major step forward in our theoretical understanding of the consciousness of posttraumatic experience and clinical attention to its complex symptomatology. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(jacket)