Correction: Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland

AbstractObjective:The primary objective of this article is to elucidate the significance of psychosocial distress and risk in a sub-population of end-stage cancer patients and their spouse caregivers who present with an especially challenging attachment style and histories of childhood trauma. The case study presented highlights the need to both identify and offer an empirically validated couple–based intervention, along with a multi-disciplinary team approach over the trajectory of the illness and at end of life.Method:A validated marital protocol (emotionally focused couple therapy [EFT]) is modified for this population and conducted by an EFT-trained psychologist as part of a pilot investigation as to the feasibility and effectiveness of EFT for the terminal cancer population. Measures of marital distress, depression, hopelessness, and attachment security are completed at baseline and subsequent intervals, as reported in another publication. Attachment insecurity and the exquisitely intimate relationship with caregiving and care receiving are underscored, given the couple's traumatic childhood history.Results:The couple described herein, followed from diagnosis of metastatic disease to end of life illuminates the potential effectiveness of a modified EFT protocol, and underscores the need to both identify and intervene with a population potentially at significantly high risk for marital distress, suicidality, depression, and hopelessness.Significance of Results:The benefits of a multidisciplinary team is evident as the patient's symptoms of physical distress increased toward end of life and she returned to earlier behaviors, namely suicidal ideation and an attempt to alleviate her experience of suffering. The strength of the marital bond, possibly as a result of the intervention, and the efforts of the multidisciplinary team approach, demonstrate potential to mitigate a catastrophic end of life and a complicated spousal bereavement. This case study adds to the current empirical literature in an area that is currently under-studied and under-reported.

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Considering “Cora”: A Critical Appreciation

Pragmatic Case Studies in Psychotherapy ◽

10.14713/pcsp.v12i3.1978 ◽

2016 ◽

Vol 12 (3) ◽

pp. 215

Author(s):

Alexandra Jessup Altman ◽

Ronald B. Miller

Keyword(s):

Childhood Trauma ◽

Study Methods ◽

Systematic Data ◽

Mixed Study

<p>This discussion examines Halvorsen, Benum, Haavind, and McLeod’s (2016) case study of “Cora,” from a perspective both appreciative and at times critical of certain mixed-study methods it employs. While impressed with the clinical alliance it illustrates between therapist and challenging client, we find the study raises more theoretical questions than it answers in terms of our ability to enumerate the conceptual elements necessary to convey valuable clinical truths. The case study does indeed provide systematic data on the presence of dyadic courage, persistence, and symbolic expressions of trust during treatment from which there is much to be learned. As readers we were left marveling at an account of a therapist’s clinical acumen with a client who had faced unbearable childhood trauma, and at the same time wondering how much more we might have learned about how to actually do such work from a comprehensive narrative written in his own voice.</p>

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Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: A Case Study in Iceland (Preprint)

10.2196/preprints.29873 ◽

2021 ◽

Author(s):

Kristjana Thorarinsdottir ◽

Emily Holmes ◽

Johann Palmar Hardarson ◽

Unnur Hedinsdottir ◽

Marie Kanstrup ◽

...

Keyword(s):

Traumatic Event ◽

Single Case ◽

Psychological Trauma ◽

Cognitive Intervention ◽

Clinical Psychologist ◽

Post Intervention ◽

Intrusive Memories ◽

Intervention Phase

BACKGROUND Additional interventions are needed for survivors of psychological trauma. Case studies can help treatment innovation with an intervention designed to disrupt memory reconsolidation, taking a single symptom approach by focusing on intrusive memories of a traumatic event. OBJECTIVE We aimed to examine a novel brief cognitive intervention to reduce the number of intrusive memories of trauma, in an Icelandic setting and extending previous studies by examining longer-term effects up to 3 months. The intervention comprised a brief memory reminder, then Tetris gameplay with mental rotation, targeting one memory at a time in each session. The intervention was guided by a clinical psychologist and adapted to the Icelandic setting. METHODS This was a single case study in Iceland with a woman in her fifties, with 4 different intrusive memories from childhood. The primary outcome was the change in number of intrusive memories from baseline to intervention phase, and to follow-ups. The number of intrusions was monitored in a daily diary for: 4 weeks preintervention; 8 weeks during intervention; 1 week at 1-month and 3-month follow-ups. Intrusions were targeted one-by-one over 6 intervention sessions, creating 4 repetitions of an AB design (i.e., length of baseline ‘A’ and intervention phase ‘B’ varied for each memory). We examined change in both total number of intrusions (summed across all 4 memories) and individually for each memory. RESULTS The number of total intrusions per week was 12.6 at baseline; 6.1 over the intervention phase (a 52% reduction from baseline); 3.0 at the 1-month follow-up (76% reduction); and 1.0 at the 3-month follow-up (92% reduction). Reductions in symptoms of posttraumatic stress and depression were observed post-intervention. Sleep, concentration, stress and functioning improved. The participant considered the gameplay intervention acceptable, and helpful in that she found the memories disappeared while playing. CONCLUSIONS This guided brief cognitive intervention reduced the number intrusive memories from over the intervention phase and follow-ups. The brief memory reminder was well-tolerated, removing the need to discuss trauma in detail. Next steps require extension to more cases and exploring remote delivery of the intervention. CLINICALTRIAL VSNb2017110046/03.01

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Formulating autism systemically: Part 1 – A review of the published literature and case assessments

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104517713241 ◽

2017 ◽

Vol 22 (3) ◽

pp. 378-389 ◽

Cited By ~ 3

Author(s):

Patricia M Crittenden

Keyword(s):

Literature Review ◽

Childhood Trauma ◽

Reciprocal Relation ◽

Close Attention ◽

Genetic Studies ◽

Neurological Differences ◽

Unexpected Findings ◽

Cultural Causes

Autism is a psychiatric disorder of unknown aetiology. In this article, the literature on genetic, neurological, psychological, relational and cultural causes of autism is reviewed, beginning with the 2014 review of Crittenden, Dallos, Landini et al. (pp. 64–70) up to and including recent publications in 2017. Some of the findings were unexpected; others led to new questions. The unexpected findings were the minimal contribution of genes to autism, the extremely evident neurological differences, the interpersonal quality of the psychological findings (that lacked evidence of parents’ behaviour), the relational evidence that mothers’ childhood trauma, perinatal stress and marital stress increased the risk of autism, and the reciprocal relation between funding for treatment of autism and diagnoses of autism. Notably, there was an abundance of genetic studies, numerous neurological studies and only scattered psychological, relational and cultural studies, thus rendering those findings speculative. The new questions included whether mothers used postural/gestural signs to signal their children to maintain distance and whether mothers experienced wariness of males as a result of childhood trauma, with their sons possibly experiencing gender confusion. Following the literature review, a small archival set of video-recorded and transcribed assessments of attachment of cases of autism were examined for evidence to corroborate or refute the psychological and relational findings of the literature review. The findings were striking in their support of mothers’ use of postural/gestural communication regarding distance, children’s close attention to mothers’ bodily signals, without looking at mothers’ face, mothers’ greater comfort when they approached their sons than when their sons approached them, one boy’s lack of verbal self-representation and mothers’ childhood triangulation. These became hypotheses regarding what to look for in Part 2 of this article, a prospective, 12-year case study.

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