Psychotraumatology is a crucial area of psychology that looks into how people and communities react to traumatic events. It involves studying, treating, and preventing trauma-related disorders such as PTSD and acute stress disorder.
For Psychotraumatology, trauma is not an event or incident: “It is what happens inside you as a result of what happened to you’.
This field also covers the psychological impact of events like wars, natural disasters, and interpersonal violence, aiming to provide effective therapies and policies for trauma prevention. The conventional look of trauma as only events is far away from the neurobiological effects of trauma in the brain and body.
“Trauma is much more than a story about the past that explains why people are frightened, angry or out of control. Trauma is re-experienced in the present, not as a story, but as profoundly disturbing physical sensations and emotions that may not be consciously associated with memories of past trauma.
— Bessel van der Kolk
“Trauma is not the event that inflicted the wound. So, the trauma is not the sexual abuse, the trauma is not the war. Trauma is not the abandonment. The trauma is not the inability of your parents to see you for who you were. Trauma is the wound that you sustained as a result.
— Gabor Maté
Trauma is a dysfunctionally stored memory, – a pathogenic memory.
— Francine Shapiro
When trauma happens, it causes a disruption in our information processing system, leaving any associated sights, sounds, thoughts, or feelings unprocessed and, subsequently, dysfunctionally stored as they are perceived.
“Trauma is an experience we have that overwhelms our capacity to cope.”
— Dan Siegel, MD
“an experience, or pattern of experiences, that impairs the proper functioning of the person’s stress-response system, making it more reactive or sensitive”
Bruce Perry
Trauma originates as a response in the nervous system and does not originate in an event. Trauma is in the nervous system, not in the event. Trauma is not a disorder, it’s not a disease. It’s been called that, but it is a wound. It may not be a physical wound, but it’s a wound to our psyche, to our soul. It leaves us bereft, disconnected from ourselves and disconnected from others.
Peter Levine
“Trauma is threats to life or bodily integrity, and the brain responds to these events by shutting down normal emotional responses and numbing the individual’s psychological experience overwhelming the ordinary human adaptations to life”
Judith Herman
“Trauma is an overwhelming experience that exceeds our capacity to make sense. No matter how resilient we are, the trauma is bigger.”
Janina Fisher
“Any experience that is stressful enough to leave us feeling helpless, frightened, overwhelmed or profoundly unsafe
Pat Ogden
“Trauma disrupts our physiological state. It distorts our social awareness and displaces social engagement with defensive reactions.”
Stephen Porges
Key Takeaways
- Psychotraumatology focuses on understanding and treating trauma-related disorders.
- It studies the neurobiological impact of traumatic events on individuals and communities.
- Critical disorders in this field include Developmental Trauma, PTSD, Complex Trauma (PTSD-C), and dissociative disorders.
- Therapeutic approaches must be conceptualized and evidence-based in treating the neurobiological effects of trauma and the processing of pathogenic memories, not only behavior and thoughts.
- Future directions involve emerging trends, psychotherapy innovations, and global perspectives.
Foundations of Psychotraumatology
Historical Development
Psychotraumatology, a specialized field within psychology, emerged prominently in the 1980s. This was largely due to research on the effects of the Second World War. However, its roots can be traced back to the work of Pierre Janet in the early 20th century. The term itself, combining ‘psycho-‘ and ‘traumatology,’ was coined in 1995 to clarify the field’s focus on psychological trauma.
Core Concepts
At its core, psychotraumatology examines the psychological responses to traumatic events.
Key focus areas include the factors before, during, and after a traumatic event. These factors help in understanding how trauma impacts individuals and communities. The field also emphasizes evidence-based psychotherapy and academic studies to treat psychiatric disorders caused by traumatic experiences.
Key Figures in the Field
Several notable figures have significantly contributed to the development of psychotraumatology. Pierre Janet is often credited as a pioneer, while more modern contributions have come from experts like Judith Herman. More neuroscientific contributions to the field come from Bessel van der Kolk, Lanius, and Yehuda. Psychotherapeutic contributions come from notable work from Levine, Shapiro, Ogden, Fisher, and Schwartz and medical contributions from Maté, Perry, and Siegel.
Their work has helped shape the understanding and treatment of trauma-related disorders.
Psychological Responses to Trauma
Developmental Trauma
Developmental Trauma Disorder (DTD) was proposed almost two decades ago as a diagnosis for children who have been exposed to chronic traumatic stress. The criteria for DTD include prolonged adverse events and significant disruptions in caregiving. These children often experience repeated and severe episodes of interpersonal violence and emotional abuse. They may also face frequent changes in primary caregivers, leading to attachment disruptions.
Affective and Physiological Dysregulation: Children with DTD show impaired abilities to regulate emotions and bodily functions. This includes extreme tantrums, disturbances in sleep and eating, and over-reactivity to sensory inputs. They may also have trouble describing their emotions or bodily states.
Acute Stress Disorder
Acute Stress Disorder (ASD) is a short-term condition that can occur immediately after a traumatic event. Individuals with ASD may experience intense fear, helplessness, or horror. Symptoms often include re-experiencing the trauma through flashbacks or nightmares, avoiding reminders of the event, and heightened arousal. These symptoms typically last from three days to one month following the trauma.
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a more prolonged response to trauma. It shares many symptoms with ASD but persists for longer than one month and can significantly impair daily functioning. People with PTSD may feel constantly on edge, have trouble sleeping, and avoid places or people that remind them of the trauma. They might also experience negative changes in thoughts and mood.
Complex Trauma
The concept of complex trauma was first introduced in the 1990s by Judith Lewis Herman, PhD. Initially, it was recognized that individuals who experienced ongoing traumatic events, such as child abuse, exhibited symptoms that were more varied and severe than those associated with PTSD. This led to the development of the term complex PTSD (C-PTSD) and, later, the proposed diagnosis of developmental trauma disorder (DTD). Over the years, research has expanded our understanding of complex trauma, highlighting its unique characteristics and the need for specialized treatment approaches.
Distinction from Single Incident Trauma
While single-incident trauma refers to a one-time event, such as a car accident or natural disaster, complex trauma involves repeated and prolonged exposure to traumatic events. This distinction is crucial as the impact of complex trauma is more profound and far-reaching. Individuals with complex trauma often struggle with emotional regulation, have a distorted sense of self, and face challenges in forming and maintaining relationships. In contrast, those with single-incident trauma may primarily experience symptoms like flashbacks, anxiety, and avoidance behaviors.
Dissociative Disorders
Dissociative Disorders are another possible response to severe trauma. These disorders involve a disconnection between thoughts, identity, consciousness, and memory. Individuals may feel detached from themselves or their surroundings, a phenomenon known as dissociation. This can manifest in various forms, such as Dissociative Identity Disorder, where a person exhibits multiple distinct identities or personalities.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences.
Research and Methodologies in Psychotraumatology
Qualitative Approaches
Qualitative research in psychotraumatology often involves in-depth interviews and case studies to understand the complex experiences of trauma survivors. These methods allow researchers to gather rich, detailed data that can provide insights into traumatic events’ emotional and psychological impacts. Standard techniques include thematic analysis and grounded theory, which help identify patterns and themes in the data.
Quantitative Approaches
Quantitative research focuses on numerical data to examine the prevalence and effects of trauma. Surveys and experiments are frequently used to collect data, which is then analyzed using statistical methods. This approach helps establish correlations and causations, providing a broader understanding of how trauma affects different populations. For instance, a study published in the European Journal of Psychotraumatology utilized a large sample size to explore the impact of trauma on mental health.
Mixed-Methods Research
Mixed-methods research combines both qualitative and quantitative approaches to provide a comprehensive understanding of trauma. This methodology allows for data triangulation, enhancing the findings’ validity and reliability. Researchers might use qualitative interviews to explore individual experiences and then apply quantitative surveys to measure the prevalence of those experiences in a larger population.
Mixed-methods research is particularly valuable in psychotraumatology as it bridges the gap between numerical data and personal narratives, offering a holistic view of trauma and its effects.
Therapeutic Interventions in Psychotraumatology
Cognitive Behavioral Therapy
Meanwhile, Cognitive Behavioral Therapy and Exposure Therapy (CBT) are widely used approaches in single-event trauma. It only focuses on changing negative thoughts and behaviors. CBT was conceptualized to treat trauma when the Trauma was seen as an event or single-event treatment(PTSD). For clients with complex trauma, trauma-related dissociation, or developmental trauma, CBT is not recommended as the primary treatment model.
CBT does not do memory trauma processing, and it leaves out of the treatment the implicit memory in the body of the client, even when the focus of treatment is a single event.
The Psychotraumatology Guidelines recommends CBT only in the integration phase of treating trauma, but for trauma-specialized therapy model for the processing phase (2), the Guidelines recommend:
1. Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR) is another effective trauma treatment. This method involves recalling traumatic events while performing specific eye movements. EMDR aims to reduce the emotional distress associated with traumatic memories. EMDR has strong evidence in going to the root of the neurobiology that causes a pathogenic memory.
2. Internal Family Systems
In the context of trauma treatment, IFS is particularly influential because it addresses the fragmented and dissociated nature of traumatic memories and experiences. Trauma often results in parts of the self becoming isolated or burdened with extreme roles, such as protectors or exiles. Protectors are parts that try to keep the person safe from harm, often through avoidance or control, while exiles are parts that hold the pain and distress of the trauma. IFS therapy works to unburden these parts by helping individuals access their core Self and develop a compassionate relationship with their inner system. This process allows for the safe exploration and integration of traumatic memories and emotions.
3. DBR
Deep Brain Reorienting (DBR) is an innovative therapeutic approach designed to treat trauma by directly addressing the neural mechanisms involved in traumatic memory and emotional responses. Developed by Dr. Frank Corrigan, DBR focuses on the brainstem and deep brain structures activated during traumatic experiences. This method aims to help individuals process trauma at a fundamental neurological level, facilitating the reorganization of the brain’s response to traumatic memories.
DBR therapy involves guiding individuals through a structured process that reactivates and reorients the brain’s deep neural circuits associated with trauma. By carefully re-engaging these circuits in a controlled and safe environment, DBR allows the brain to reprocess and integrate traumatic memories to reduce their emotional intensity and associated physiological responses. This can lead to a significant reduction in trauma-related symptoms such as flashbacks, anxiety, and hypervigilance.
Pharmacotherapy
Pharmacotherapy involves the use of medications to manage symptoms of trauma-related disorders. Common medications include antidepressants and anti-anxiety drugs. These medications can help stabilize mood and reduce anxiety, making it easier for individuals to engage in other forms of therapy.
Prevention and Policy in Psychotraumatology
Community-Based Programs
Community-based programs play a crucial role in preventing trauma and supporting those affected by it. These initiatives often involve local organizations and volunteers who work together to create safe environments and provide resources for trauma survivors. Effective community programs can significantly reduce the long-term impact of traumatic events. They may include support groups, educational workshops, and outreach activities to raise awareness about trauma and its effects.
Policy Development
Policy development is essential in addressing the widespread impact of trauma. Governments and institutions must collaborate to create policies that protect individuals and communities from traumatic experiences. This includes implementing laws and regulations that prevent abuse, violence, and other forms of trauma. Additionally, policies should ensure that trauma survivors have access to necessary mental health services and support systems. The Trauma Professionals Association is dedicated to sharing information about the effects of trauma and the discovery and dissemination of effective interventions.
Educational Initiatives
Educational initiatives are vital in spreading awareness and understanding of trauma and its effects. Schools, universities, and community centers can offer programs that educate individuals about the signs of trauma and how to seek help. These initiatives can also train professionals, such as teachers and healthcare providers, to recognize and respond to trauma appropriately. By integrating trauma education into various sectors, we can create a more informed and supportive society for trauma survivors.
Applications of Psychotraumatology
Psychotraumatology is a crucial field in psychology that focuses on understanding and addressing the psychological impact of traumatic events on individuals and communities. It involves evidence-based therapy and academic research to treat mental health disorders resulting from experiences like war, terrorism, disasters, and interpersonal violence. Psychotraumatology plays a significant role in supporting individuals who have experienced trauma and in developing policies to prevent further harm.
Future Directions in Psychotraumatology
Emerging Trends
MDMA-Assisted Psychotherapy for Trauma
The emergence of psychedelics as medicine has led to a surge in new research. MDMA-assisted psychotherapy (MDMA-AP) is at the forefront, with numerous studies exploring its benefits. Currently, the Multidisciplinary Association for Psychedelic Studies (MAPS) is compiling data from 18 Phase 2 and Phase 3 studies. This data will form the basis of a New Drug Application (NDA) submitted to the US Food and Drug Administration (FDA).
Who are some key figures in the field of psychotraumatology?
There are many important people in psychotraumatology. Some of them include researchers and therapists who have developed new ways to treat and understand trauma. Their work has helped shape how we think about and deal with trauma today.
- Judith Herman
- Bessel van der Kolk
- Peter Levine
- Bruce Perry
- Onno van der Haart
- Daniel Siegel
- Gabor Maté
- Janina Fisher
- Pat Ogden
- Ruth Lanius
- Rachel Yehuda
What types of therapy are used in psychotraumatology?
There are several types of therapy used to help people who have experienced trauma. Some common ones include Neurofeedback, Eye Movement Desensitization and Reprocessing (EMDR), Somatic Therapies, and the breakthrough FDA-designated MDMA-Assisted Psychotherapy.
Conclusion
Psychotraumatology is a vital field within psychology that delves into how individuals and communities respond to traumatic events. This discipline not only focuses on understanding and treating conditions like PTSD and ASD but also emphasizes the importance of prevention and early intervention. By studying the factors before, during, and after trauma, psychotraumatologists aim to mitigate the adverse effects of traumatic experiences. As awareness of psychological trauma grows, the research and findings in this field become increasingly accessible, fostering better support and treatment for those affected. Ultimately, psychotraumatology is crucial in helping individuals and communities heal and build resilience against future traumas.
