Dynamics of the Transmission of Trauma through three Generations of Slovene Families

In this paper, we will present a study into the dynamics of the transmission of emotional traumatic in three families of victims of World War II and post-war communist oppression. This study is taken from a broader research project in which we investigated the experiences of nonclinical families that managed to survive through three generation, and in which post-traumatic growth is present, i. e. the ability to integrate traumatic experiences and provide greater security for future generations. The main focus will be on how emotional content is transmitted and transformed through generations and how to recognise it in various forms of behaviour, thinking and emotions, that appear in each of the generations. As we follow the transformation of traumatic content, we will also follow the the signs that show how traumatic content has integrated and begun to bring new, deeper emotional and mental insights. The emotional depth of the traumatic experience is what burdens the victim the most and slows down the dynamics of trauma processing. It appears in the form of symptoms of post-traumatic stress syndrome, insecurity and mistrust. This is found even in victims who have articulated the trauma sufficiently to rise above intimidation, managed to develop emotionally strong and connecting interpersonal relationships, maintain faith in the future, and form a coherent narrative of their traumatic past. The most interesting result of the research was that all three families, regardless of their diversity, are similar in term of processing the trauma. They were all able to speak openly about their traumatic experiences. In all three families there there was a great deal of discussion and searching for the social framework and personal truth of historical events, and the desire to present and describe the events that left such deep wounds in such a way that they would be clear, reworked and accessible to future generations as a document of the reality of some tragic and difficult times. Another source of trauma processing was religious faith, which allowed all the participants in this study to look at trauma and life more deeply, through relationships and connections between people and through a deeper understanding of human history embedded in a broader and deeper spiritual flow. Faith helped these families to find the courage to make decisions, to face life’s challenges, and to endure even the most severe of life's trials. A third source that facilitates the processing and integration of a traumatic experience is secure interpersonal relationships and compassionate parenting. Despite the fact that the whole question of parenting was demanding and full of challenges for our interviewees, the quality of parenting has been improved from generation to generation, and sincere affection for children and gratitude for children were present everywhere. The ability to follow the new generation and its initiatives while maintaining a connection to its roots is a dynamic that characterises all three families. There is also a lot of thinking and conscious effort in establishing and maintaining good marital relationships in these families. For the recovery from trauma this study shows the importance of talking about it and also talking about it in a safe relationship until it takes a form that is genuine and at the same time clear, coherent and thus suitable for the general public. That’s when the traumatic story ceases to be traumatizing and becomes a story of courage, perseverance, and truth.

The Role of Satisfaction With Job and Cognitive Trauma Processing in the Occurrence of Secondary Traumatic Stress Symptoms in Medical Providers Working With Trauma Victims

Introduction: As an occupational group, medical providers working with victims of trauma are prone to negative consequences of their work, particularly secondary traumatic stress (STS) symptoms. Various factors affect susceptibility to STS, including work-related and organizational determinants, as well as individual differences. The aim of the study was to establish the mediating role of cognitive trauma processing in the relationship between job satisfaction and STS symptoms among medical providers.Procedure and Participants: Results were obtained from 419 healthcare providers working with victims of trauma (218 nurses and 201 paramedics). Three questionnaires, namely the Secondary Traumatic Stress Inventory, Work Satisfaction Scale, and Cognitive Trauma Processing Scale, were used in the study, as well as a survey developed for this research. Correlational and mediation analyses were applied to assess relations between variables.Results: The results showed significant links between STS symptoms and both job satisfaction and cognitive processing of trauma. Three cognitive coping strategies play the intermediary role in the relationship between job satisfaction and symptoms of secondary traumatic stress. However, this role varies depending on preferred strategies.Conclusion: Nurses and paramedics are significantly exposed to the occurrence of STS. Thus, it is important to engage health care providers in activities aimed at preventing and reducing symptoms of STS.

Refining Sexual Assault Treatment: Recovered Survivors and Expert Therapists Concur on Effective Therapy Components

The goal of the present study was to refine sexual assault therapy through the examination of the level of agreement between survivor and therapist assessments of key recovery-promoting therapeutic interventions. This is the first study to explore the level of agreement between those who partake in the treatment process from either position. Semistructured interviews were conducted in this qualitative study with 10 survivors and 10 experienced therapists. The results document considerable concurrence between them regarding relational and trauma processing treatment components alike. Together, these reports outline key effective interventions, both common and specific in nature, concomitantly supported by both groups.

PTSD as an Endothelial Disease: Insights From COVID-19

Graphical Abstract 1Covid-19 triggers endothelial cell (EC) senescence and dysfunction, likely predisposing to PTSD by increasing microvascular permeability that enables the extravasation of stress molecules into the brain trauma-processing networks in amygdala, hippocampus and the medial prefrontal cortex. The virus upregulates host angiotensin II (ANG II) (via S1 antigen), usurps furin/plasmin (via S2 antigen), mitochondria (via ORF9b), and Sigma-1 receptors (Sig-1Rs) via NSP6. These structures, previously associated with PTSD, link the SARS-CoV-2 virus to increased susceptibility for stress related disorders. As ECs are major producers of brain derived neurotrophic factor (BDNF), a neurotrophin altered in PTSD, senescent ECs lower this molecule further, predisposing to stress related disorders.

Introduction and Overview

This chapter provides an introduction to efficacious treatments for posttraumatic stress disorder (PTSD). Despite efficacy of these treatments, many patients do not respond to them or experience persistent symptoms. Efficacious psychotherapies for PTSD used at the Veterans Administration (VA), including prolonged exposure therapy and cognitive processing therapy, are described. While these treatments can be helpful, many patients are avoidant of trauma processing and homework. Furthermore, both treatments tend to focus on one central trauma, to which exposure exercises are targeted, whereas most Veterans experience multiple traumas. An overview of the development and framework of trauma-focused psychodynamic psychotherapy (TFPP), a PTSD-symptom focused brief psychodynamic therapy, is presented. A brief background of psychoanalytic and psychodynamic literature and thinking about trauma is provided to further frame the place of TFPP

A multisensory circuit for gating intense aversive experiences

The ventral hippocampus (vHPC) is critical for both learned and innate fear, but how discrete projections control different types of fear is poorly understood. Here, we report a novel excitatory circuit from a subpopulation of the ventral hippocampus CA1 subfield (vCA1) to the inhibitory peri-paraventricular nucleus of the hypothalamus (pPVN) which then routes to the periaqueductal grey (PAG). We find that vCA1→pPVN projections modulate both learned and innate fear. Fiber photometric calcium recordings reveal that activity in vCA1→pPVN projections increases during the first moments of exposure to an unconditioned threat. Chemogenetic or optogenetic silencing of vCA1→pPVN cell bodies or vCA1→pPVN axon terminals in the pPVN enhances the initial magnitude of both active and passive unconditioned defensive responses, irrespective of the sensory modalities engaged by a particular innate threat. Moreover, silencing produces a dramatic impact on learned fear without affecting milder anxiety-like behaviors. We also show that vCA1→pPVN projections monosynaptically route to the PAG, a key brain region that orchestrates the fear response. Surprisingly, optogenetic silencing of vCA1 terminals in the pPVN titrates the level of c-Fos neural activity in the PAG differently for learned versus innate threats. Together, our results show how a novel vCA1→pPVN circuit modulates neuronal activity in the PAG to regulate both learned and innate fear. These findings have implications for how initial trauma processing may influence maladaptive defensive behaviors across fear and trauma-related disorders.

Healing After Gender-Based Violence: A Qualitative Metasynthesis Using Meta-Ethnography

Gender-based violence (GBV) is a significant violation of human rights, requiring specific understanding of how individuals heal and recover after these experiences. This article reports on findings of a qualitative metasynthesis that examined the nature of healing after GBV through the perspectives of female-identifying survivors. Empirical studies were identified by a search of peer-reviewed articles via electronic databases. Studies were included for review if they were available in the English language, reported on qualitative studies that directly engaged female-identifying survivors of GBV, and were aiming to understand the GBV healing journey, process, or goals. After our initial search, 1,107 articles were reviewed by title and abstract and 47 articles were reviewed for full text. Twenty-six peer-reviewed articles were included for the review and were analyzed using meta-ethnography. Key findings included the recovery journey as a nonlinear, iterative experience that requires active engagement and patience. Healing was composed of (1) trauma processing and reexamination, (2) managing negative states, (3) rebuilding the self, (4) connecting with others, and (5) regaining hope and power. “Shifts” or “turning points” are also mentioned which catalyzed healing prioritization. This article aggregates and examines the scientific literature to date on GBV healing and provides articulation of the limitations, gaps in evidence, and areas for intervention. The article considers implications for future research, policy, and practice and, in particular, focuses our attention on the need to expand our knowledge of alternative recovery pathways and mechanisms for healing.

Collision Every Night: Treating Nightmares with Trauma-focused Methods: Case Report

Introduction We would like to present the case of a young patient with acute stress disorder and recurrent nightmares following the psychological trauma caused by a severe road traffic accident. The comprehensive therapy carried out at the Department of Traumatology included medication, trauma processing and a psychological method whose aim is to cease the development of nightmares. Case Presentation Psychiatric assessment and treatment was asked for a polytraumatised female patient at the Intensive Care Unit after she had undergone a neurosurgical intervention. Her medicinal treatment was continued at the Department of Traumatology. Besides the antidepressant venlafaxine she was treated in accordance with the EMDR protocol for acute stress disorder, and we also applied imagery rescripting to prevent her from having recurrent (daily) nightmares. As a result of the therapy, her symptoms were fast relieved, the nightmares stopped almost instantly, her mood improved, rumination and anxiety decreased significantly. Conclusions In view of the fast and significant symptomatic improvement, we can expect that the EMDR therapy and its protocol for acute stress disorder have successfully reactivated information processing, and besides the subjective relief we have managed to prevent a mental crisis that could lead to a suicide risk as well as the development of post-traumatic stress disorder. We also hope that the improvement will be long-lasting.

The Mediating Role of Cognitive Trauma Processing in the Relationship Between Empathy and Secondary Traumatic Stress Symptoms Among Female Professionals Working With Victims of Violence

One of the negative consequences of indirect trauma exposure is secondary traumatic stress (STS). Professionals helping victims of violence may be at the risk of STS symptoms development. Both empathy and cognitive processing of trauma seem to be important in this process. The aim of the study was to examine the relationship between empathy, cognitive processing of trauma and symptoms of STS in women working with people who have experienced violence trauma. The mediation role of cognitive coping strategies in the relationship between empathy and STS was also checked. A total of 154 female professionals representing three groups (therapists, social workers, and probation officers) were included in the study. The age of the respondents ranged from 26 to 67 years ( M = 43.98, SD = 10.83). Three standard measurement tools were included in the study: the modified PTSD Checklist for DSM-5 (PCL-5), the Empathic Sensitivity Scale, and the Cognitive Processing of Trauma Scale. Correlational analysis indicated STS to have positive associations (Pearson’s correlation coefficients) with all three aspects of empathy, and three of the five cognitive coping strategies (denial, regret, downward comparison). Mediation analysis performed by the bootstrapping method found strategies of regret and downward comparison to act as mediators in the relationship between STS and empathic concern. The same results were obtained for perspective taking. In addition, the regret and denial strategies mediated the relationship between personal distress and STS. Empathy and cognitive trauma processing may play an important role in STS symptoms development. Preventive programs for professionals helping trauma victims should focus on cognitive processing of trauma and empathy.

Trauma Processing in Israel’s Contemporary Documentary Cinema

This article investigates a new phenomenon in contemporary Israeli documentary cinema: the processing of war trauma. For the first time since the onset of the Second Intifada, films whose heroes suffer from PTSD are dealing with the processing of past experience. Using case studies, the article analyzes films directed by PTSD victims, which deal with the processing of war trauma, including among others One Battle Too Many (Joel Sharon, 2013) and Closed Story (Micha Livne, 2015). The films’ heroes are seeking to free themselves from the amnesia that is concealing the traumatic events deep within their memory. They manage to locate the repressed memory and then weave the traumatic story anew. The films propose various cinematic strategies for processing trauma, strategies that are meant to demarcate both the subjective traumatic past and the objective safe present and to place a defined aesthetic border between them. The films are analyzed by means of close reading of the cinematic aesthetic and the discussion of trauma in the Humanities. The interweaving of unrealistic and realistic symbolization practices dismantles the classic form of documentary cinema and facilitates an encounter between the viewer and the overwhelming nature of trauma.