Intrusion (psychology)

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When intrusion is known in the Psychotraumatology frequently by a key stimulus ( trigger ), uncontrollable recurring, agonizingly into consciousness urgent re- remember and re- experience of traumatic events and situations or dealing with, in related, unexplained painful questions and thoughts that by the deep psychological shock of the trauma or destroyed by basic beliefs have been raised. As a rule , the stressful emotional states associated with this event are also reactivated. Intrusions can also occur unexpectedly and without consciously perceptible ( 'subliminal' ) external key stimuli (triggers) and elude voluntary control. As a result, intrusions are usually emotionally and physiologically very stressful and are associated with vegetative overexcitation ( hyperarousal ) and severe stress , palpitations , often sweating , breathing difficulties, tremors up to panic attacks and angina pectoris .

In contrast to the often imprecise use of the terms intrusion and flashback in common parlance and also in trauma literature, the two terms are precisely defined in psychotraumatology. Unlike one

  • Flashback , which is a particularly violent form of intrusion and suddenly the person concerned and with full force entirely in reliving the traumatic dragged situation and is overwhelmed and she again lived through with all the sensations as if she was about to occur again in real terms , while at times completely loses perception of the environment, responsiveness and reality control,
  • In the event of an intrusion , as it is defined in the strict language of psychotraumatology , the person concerned can usually still maintain a limited perception of the environment, responsiveness and reality control.

Intrusions evade voluntary control and overwhelm the person concerned, who is drawn into the traumatic events again and again and painfully relived them in full or in essential parts with many details. This reliving can include thoughts, images, other sensory perceptions, such as noises, language, screams, smells, taste, pain and other body sensations and perceptions, as well as emotions, whereby the different sensory modalities can be differently pronounced. Children can re-enact the traumatic events in play. The person concerned can only influence the occurrence and course of an intrusion to a very limited extent. Often intrusion and emotional numbness alternate.

Also used to denote intrusive PTSD symptoms

Intrusions include in common parlance besides the

  • Intrusions in the narrower sense (according to psychotraumatological definition), in which the affected person repeats the traumatic event over and over again, sometimes in the form of intrusion loops lasting for hours, etc. U. painfully relived day after day
  • Shorter flashbacks , often lasting only seconds or minutes, but all the more violent, abruptly onset, catapulting the affected person back into the traumatic core event with full intensity of perception, as if he were just experiencing it again for real
  • Nocturnal nightmares , which in rarer cases can also appear in the form of dissociative , nightmarish-like daydreams and relate to the traumatic experience

The following thought and action patterns can also be assigned to the intrusion:

  • negative (memory) images that cannot be controlled voluntarily
  • Stressful thoughts and compulsive preoccupation ( intrusive thoughts ) with the event itself, its consequences for other participants, with future consequences or coping with upcoming tasks (such as coping with life, problems at work, family, social environment, confrontation with perpetrators, criminal prosecution, treatment, insurance, support , Safety precautions)
  • Self- blame , feelings of guilt , feelings of shame and inadequacy, fear , anger , hatred , anger , feelings of powerlessness
  • dealing with agonizing questions about how the traumatic event came about; why it happened to you; whether one could have averted it if one had been more careful, had acted differently or had acted more decisively; whether one is (partly) to blame or was punished
  • Finding out details in order to find explanations for the incomprehensible, to understand and classify it, to evaluate it, to be able to process it better
  • Shocks caused by the trauma in questions of meaning , justice , trust and faith or basic convictions about life, people and the world

Further meanings as a psychiatric term

In addition to the forms of intrusive symptoms, as cardinal symptoms of post-traumatic stress disorder can occur are in psychiatric compulsive usage as intrusions, other forms, uncontrollable awareness urgent or sudden einschießende thoughts and ideas referred (English: intrusive thoughts ), which is also a common symptom u. a. for anxiety disorders , panic attacks , depression and a number of other mental disorders . In the context of other mental disorders, u. a. The term intrusion is also used to describe senseless circles of thought ( compulsion to brood ), obsessive thoughts , obsessions , negative spirals of thought that become independent in anxiety and panic disorders , intrusive delusions , and other psychotic forms ( schizophrenic positive symptoms , thought inspiration , hallucinations, etc.).

Occurrence

Intrusions are a typical symptom of post-traumatic stress disorder (PTSD) , which must be present for diagnosis, but can also occur in obsessive-compulsive disorder , anxiety disorders , panic attacks , as well as depression and various other psychological disorders . Intrusions are mostly triggered by a key stimulus (“trigger”) and usually last a few seconds to minutes; however, intrusion loops can also occur that last for several hours. People suffering from PTSD often avoid triggering situations ( avoidance behavior ).

Individual evidence

  1. Gernot Brauchle: Explanatory models for the development and maintenance of post-traumatic stress disorder. In: Journal of Psychology , Volume 19, No. 3, ISSN  2198-6959 . January 2011, accessed on June 1, 2016 ( PDF; 270 kB ).
  2. Michaela Huber , Luise Reddemann , Onno van der Hart: Trauma and the consequences. Trauma and trauma treatment, part 1. Junfermann Verlag, Paderborn 2003, ISBN 978-3-87387-510-4 .
  3. Andreas Maercker : Post-traumatic stress disorders. 4th edition. Springer, Berlin 2013, ISBN 978-3-642-35067-2 .
  4. Gottfried Fischer , Peter Riedesser : Textbook of Psychotraumatology. 4th edition. Reinhardt, Munich 2009, ISBN 978-3-8252-8165-6 .
  5. ^ Onno van der Hart, Ellert RS Nijenhuis, Kathy Steele: The Pursued Self: Structural Dissociation. Treatment of chronic trauma. Junfermann Verlag, 2008, ISBN 978-3-87387-671-2 .
  6. ^ Günter H. Seidler, Harald J. Freyberger, Andreas Maercker: Handbuch der Psychotraumatologie. Klett-Cotta, Stuttgart 2015, ISBN 3-608-94825-2 .
  7. a b Martin Hautzinger, Gerald C. Davison, John M. Neale: Clinical Psychology (with CD-ROM). Urban & Fischer Verlag / Elsevier GmbH, 2015, ISBN 978-3-437-42528-8 .