Psychotraumatology

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Psychotraumatology is the study of the consequences of psychological trauma . It deals with the research and treatment of the effects of traumatic events on the experience and behavior of individuals and social systems.

The term traumatology was used worldwide for the first time in this context in 1990 and goes back to the child psychiatrist Donovan, who wanted to expand the existing term of medical traumatology to include psychological injuries. However, this transdisciplinary approach was not adopted by science and instead the field of psychotraumatology developed separately from medical traumatology.

History of Psychotraumatology

Traumatic experiences have always been a basic human experience. In myths , religious writings, literary and philosophical depictions, wars and catastrophes and their emotional consequences were discussed. The painful losses and emotional shocks resulting from these events led to numerous attempts to alleviate the negative emotional consequences of these events with intuitive methods.

The scientific study of psychotraumas began around the second half of the 19th century, but was initially only the research area of ​​a few scattered specialists. In today's literature reference is made to Jean-Martin Charcot and his research into hysteria in Paris in 1867. In modern psychotraumatology, however, the explanatory concepts of memory disorders in traumatized people ( dissociation ) are recognized by Pierre Janet (1889) as a pioneering achievement, which has largely been forgotten for almost 100 years. In the public perception, on the other hand, the lecture by the lecturer Sigmund Freud on April 21, 1896 on the etiology of hysteria is usually seen as the origin of modern psychotraumatology. In this lecture, Freud described the connection between hysteria and child sexual abuse.

The scientific discourse on the subject of the consequences of traumatization was subject to a changing rhythm of rediscovery and suppression. The topic became particularly topical at the time of the world wars. War neuroses were at the Tavistock Institute explored by Bion was there group analysis developed. In the 1970s, trauma research and, following it, trauma therapy received a new boost from the Vietnam war veterans. Impetus for further development also came from dealing with the long-term consequences and cross-generational consequences of the Holocaust and from the women's movement on the topics of sexual abuse , rape and domestic violence . Further impulses came from the psychosocial centers for refugees on the consequences of torture , political persecution, (civil) war and forced prostitution .

Since the mid-1990s, there has been rapid development in the field of trauma research and the further training of psychotherapists. The psychologist and psychotherapist Gottfried Fischer ( multi-dimensional psychodynamic trauma therapy ) is considered the founder of psychotraumatology in Germany . Another German protagonist of psychotraumatology and trauma therapy is Luise Reddemann , to whom psychodynamic imaginative trauma therapy ( PITT , 1985) goes back. Internationally significant contributions to the development of therapeutic procedures come from a. by John Watkins and Helen Watkins ( Ego State Therapy , 1980) and Francine Shapiro ( Eye Movement Desensitization and Reprocessing = EMDR , 1988).

Areas of psychotraumatology

Psychotraumatology is interdisciplinary, whereby theory and practice are closely linked. It can be divided into different fields and areas:

Theory and research

  • Classification - classification of trauma-related disorders using diagnostic and screening methods
  • Epidemiology - examines the incidence of various trauma and trauma-related disorders
  • Etiology - examines the causes of trauma-related disorders
  • Salutogenesis - examines the factors that can prevent the development of trauma-related disorders
  • Risk groups - investigation of risk groups (e.g. firefighters, soldiers, etc.)
  • Effectiveness - Evaluation of the effectiveness of the interventions, therapy methods and stabilization measures used

practice

  • Intervention - emergency psychological help and prevention of secondary psychological disorders immediately after the traumatic event
  • Trauma therapy - treatment and elimination of trauma-related disorders and symptoms
  • Rehabilitation and reintegration - concepts for reintegration into working life
  • Information and training - training for risk groups (e.g. firefighters, soldiers, etc.)
  • Mental hygiene - protection of the health of professional helpers who have contact with traumatized people

trauma

A psychotrauma is an emotional wound that goes back to one or more events in which the individual's ability to cope with being in a state of extreme fear and helplessness was overwhelmed. Such a traumatic event leads to post-traumatic stress disorder in around 20% of those affected . Post-traumatic stress disorder is a long-known and well-described clinical picture. Posttraumatic stress disorder has only been diagnosed since 1980, when it was included in the 3rd version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The three diagnostic criteria are:

  • Break-ins of trauma material into everyday life ( intrusions ),
  • Avoidance and
  • Overexcitation (hyperarousal).

With the much more common complex post-traumatic stress disorders , formally dissociative disorders are added; these are directly related to the three criteria mentioned. So-called flashbacks also fall under intrusions . It comes u. Even decades after the event, there were extremely unpleasant memories of the event, as if it were happening again like in a film. The intrusive symptoms can also be reflected in dreams . Avoidance is characterized by the person consciously and unconsciously avoiding things, situations, issues, and even feelings that are reminiscent of the trauma. Psycho-vegetative overexcitation such as strong fear , anxiety and frightfulness together with physical symptoms belong to the symptom complex Hyperarousal .

In practice, the diagnosis of post-traumatic stress disorder is often more broadly defined than provided for in the current diagnostic classification systems DSM-V or the international statistical classification of diseases and related health problems (ICD-10), since more recent study results show that after a traumatic event such Patients who only partially meet the criteria of a post-traumatic stress disorder, who are suffering from considerable suffering and extensive symptoms and who need treatment. The effects of a traumatic event depend both on the event and on the processing and coping capabilities of the affected individual. Therefore, a wide variety of disruption patterns develop.

In the resilience research is examined what personal protective factors and skills a coping facilitates extreme events. However, it remains clear that certain events represent a threat and excessive demand for almost everyone , which can hardly be processed without symptoms, even with the best mental health. The personal preconditions have a considerable influence on the symptoms as well as the course and prognosis, which normally requires combined trauma and psychodynamic treatment .

Trauma therapy

The term stands for a number of different therapeutic approaches, models and methods. Each major psychotherapy school has developed its own approach to treating traumatic disorders. B. Methods of cognitive behavioral therapy or behavioral therapy , psychotherapy based on depth psychology and psychoanalytic methods.

The thesis that traumatized people have a dynamic and physiology that is significantly different from other psychological disorders has not yet been scientifically proven. However, above all in the context of measures to improve coping with the psychological consequences of military combat missions, methods have been developed that specifically serve trauma treatment. In Berlin, for example, the Center for Psychiatry and Psychotraumatology of the German Armed Forces is dedicated to prevention, treatment and research into psychological damage caused by operations. Ultimately, the common goal is to come to an orderly processing of the trauma or trauma and thereby either limit, control or resolve the trauma-typical symptoms.

See also

literature

  • Savita Dhawan, Ulla-Stina Eriksson Söder: Trauma and psychodrama. In: Birgit Möller, Antonio Morten, Freihart Regner (eds.): Political traumatization: persecution, torture, forced migration and possibilities of therapeutic help. (= Journal for Political Psychology . Vol. 7, No. 1 + 2). 1999, pp. 201-220. ( Online text , PDF file; 75 kB)
  • Christa Diegelmann: Coping with trauma and crisis - psychotherapy with TRUST. Klett-Cotta, Stuttgart ISBN 978-3-608-89042-6 ., 2010.
  • C. Diegelmann, M. Isermann: Power in the crisis - resources against fear. Klett-Cotta, Stuttgart ISBN 978-3-608-86027-6 ., 2011.
  • A. Ehlers: Post-Traumatic Stress Disorder . Hogrefe, Göttingen 1999.
  • H. Fricke: That doesn't stop there. Literature, trauma and empathy. Wallstein, Göttingen 2004.
  • G. Fischer: Multidimensional Psychodynamic Trauma Therapy MPTT. Assanger, Heidelberg, 2000.
  • G. Fischer, R. Nathan: Diagnosis of psychodynamics in disorders with psychotraumatic etiology. In: Psychotraumatology. 1, 2002, p.
  • G. Fischer, Peter Riedesser : Textbook of Psychotraumatology. 3. Edition. Ernst Reinhard, Munich / Basel 2003.
  • Esther Fischer-Homberger: The traumatic neurosis. From somatic to social suffering. Huber, Bern 1975, ISBN 3-456-80123-8 . (also: Psychosozial-Verlag, Giessen 2004, ISBN 3-89806-275-9 )
  • O. van der Hart, ERS Nijenhuis, K. Steele: The persecuted self. Structural dissociation and the treatment of chronic trauma. Junfermann , Paderborn 2008, ISBN 978-3-87387-671-2 .
  • Reinert Hanswille, Annette Pilsenbeck: Systemic trauma therapy - concepts and methods for practice. With prefaces by Ellert Nijenhuis and Gunther Schmidt. 2008, ISBN 978-3-89670-651-5 .
  • C. Hausmann: Introduction to Psychotraumatology. UTB, Vienna 2006.
  • Th. Heedt: Psychotraumatology. Schattauer , Stuttgart 2017.
  • Judith Herman: The Scars of Violence. Understand and overcome traumatic experiences. 2nd Edition. Junfermann, Paderborn 2006, ISBN 3-87387-525-X .
  • A. Hofmann: EMDR in the therapy of psychotraumatic stress syndromes. Thieme, Stuttgart 1999.
  • MJ Horowitz: Stress response syndrome. Aronson, 1976.
  • Michaela Huber: Trauma and its consequences. Trauma and Trauma Treatment, Part 1. 3rd Edition. Junfermann, Paderborn 2007, ISBN 978-3-87387-510-4 .
  • Michaela Huber: Ways of Trauma Treatment. Trauma and Trauma Treatment, Part 2. 3rd Edition. Junfermann, Paderborn 2006, ISBN 3-87387-550-0 .
  • P. Janet: L'automatisme psychologique. Editions Odile Jacobs, Paris 1889.
  • P. Janet: Psychological Healing. Macmillan, New York 1925.
  • H.-P. Kapfhammer: Neurobiology of Post Traumatic Stress Disorder. In: Psychotherapy. 7, 2002, pp. 247-259.
  • H. Krämer: The trauma of violence. Kösel-Verlag, Munich 2003.
  • H. Krämer: Coping with trauma. Orell Füssli, Zurich 2005.
  • Chandler. H .: Whiplash. Orell Füssli, Zurich 2006.
  • Marion Krüsmann, Andreas Müller-Cyran: Trauma and early interventions. 2005.
  • D. Kunzke, F. Güls: Diagnosis of simple and complex post-traumatic disorders in adulthood: An overview for clinical practice. In: Psychotherapist. 48, 2003, pp. 50-70.
  • Peter A. Levine: In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books, 2010, ISBN 978-1-55643-943-8 .
  • Peter A. Levine: Language without words: How our body processes trauma and brings us back into inner balance. Kösel, 2010, ISBN 978-3-466-30918-4 .
  • Peter A. Levine: Trauma Healing. Synthesis, 1998, ISBN 3-922026-91-5 .
  • Peter A. Levine: Get rid of trauma: How to release mental and physical blockages. Kösel, 2007, ISBN 978-3-466-30760-9 .
  • Peter A. Levine, Maggie Kline: Protecting children from emotional harm. Kösel, 2010, ISBN 978-3-466-30837-8 .
  • Peter A. Levine, Maggie Kline: Healing Wounded Children's Souls. Kösel, 2005, ISBN 3-466-30684-1 .
  • HJ Markowitsch: Stress-related memory disorders and their possible brain correlates. In: A. Streeck-Fischer, U. Sachsse, I. Özkan (Ed.): Body, soul, trauma: biology, clinic and practice. Vandenhoeck & Ruprecht, Göttingen 2001, pp. 72–93.
  • Ellert RS Nijenhuis: Somatoforme Dissoziation (Original title: Somatoform dissociation) Junfermann, Paderborn 2006, ISBN 3-87387-623-X .
  • Ibrahim Özkan, Ulrich Sachsse, Annette Streeck-Fischer (eds.): Time does not heal all wounds. Compendium of Psychotraumatology . Vandenhoeck & Ruprecht, Göttingen 2012, ISBN 978-3-525-40186-6 .
  • RS Pynoos, AM Steinberg, A. Goenjian: Traumatic stress in childhood and adolescence. Recent developments and current controversies. In: BA van der Kolk, AC McFarlane, L. Weisaeth (eds.): Traumatic Stress. Basics and treatment approaches . Junfermann, Paderborn 2000, pp. 265-288.
  • L. Reddemann: Imagination as a healing force. To treat the consequences of trauma with resource-oriented procedures. Pfeiffer at Klett-Cotta, Stuttgart 2001.
  • L. Reddemann: Trauma and trauma therapy. In: J. Fengler (Ed.): Handbook of addiction treatment. Advice - therapy - prevention . Ecomed Verlag, Landsberg 2002, pp. 578-584.
  • Babette Rothschild: The body remembers. The psychophysiology of trauma and trauma treatment. Synthesis, 2002, ISBN 3-922026-27-3 .
  • Franz Ruppert: Confused souls. The hidden meaning of psychosis. Basics of a systemic psychotraumatology. Kösel, Munich 2004.
  • Franz Ruppert: Trauma and symbiotic entanglement - from the family to the trauma constellation. In: Journal of Psychotraumatology, Psychotherapy Science, Psychological Medicine. Volume 7, Issue 3, 2009.
  • U. Sachsse: Trauma-centered psychotherapy. Schattauer, Stuttgart 2004.
  • Christiane Sautter: When the soul is injured - trauma - causes and effects . Publishing house for systemic concepts, 2005, ISBN 3-9809936-0-4 .
  • Christiane and Alexander Sautter: Overcoming the dragon - Suggestions for trauma healing. A workbook for those affected and for therapists . Publishing house for systemic concepts, 2008, ISBN 978-3-9809936-5-4 .
  • M. Ruf, M. Schauer, F. Neuner, E. Schauer, C. Catani, T. Elbert: KIDNET- Narrative exposure therapy for children. In: M. Landolt, T. Hensel (Ed.): Traumatherapy with children. Hogrefe, Göttingen 2007.
  • M. Schauer, T. Elbert, S. Gotthardt, B. Rockstroh, M. Odenwald, F. Neuner: Re-experience through psychotherapy modifies mind and brain. In: behavior therapy. 16, 2006, pp. 96-103.
  • M. Schauer, F. Neuner, T. Elbert: Narrative Exposure Therapy (NET). A Short-Term Intervention for Traumatic Stress Disorders after War, Terror, or Torture. Hogrefe & Huber Publishers, Cambridge / Göttingen 2005.
  • Francine Shapiro: EMDR (Eye Movement Desensitization and Reprocessing). Basics and practice. Handbook for the treatment of traumatized people. 2nd Edition. Junfermann, Paderborn, 2005, ISBN 3-87387-360-5 .
  • Onno van der Hart, Ellert Nijenhuis, Kathy Steele: The Pursued Self. Structural dissociation . Junfermann, Paderborn 2008, ISBN 978-3-87387-671-2 .
  • BA van der Kolk, AC McFarlane, L. Weisaeth (eds.): Traumatic Stress. Basics and treatment approaches. Junfermann, Paderborn, 2000, ISBN 3-87387-384-2 .
  • BA van der Kolk: Trauma and Memory. In: BA van der Kolk, AC McFarlane, L. Weisaeth (eds.): Traumatic Stress. Basics and treatment approaches. Junfermann, Paderborn 2000, pp. 221-240.
  • Ralf Vogt: Trauma, State, Setting. Psychosozial-Verlag, Giessen 2007.
  • Martin Zobel (Ed.): Traumatherapy - An introduction . With contributions by Luise Reddemann, Oliver Schubbe etc. Psychiatrie-Verlag, Bonn 2006.

Web links

Individual evidence

  1. ↑ Gottfried Fischer, Peter Riedesser: Textbook of Psychotraumatology. 4th edition. UTB, p. 18.
  2. ↑ Pierre Janet: L'automatisme psychologique . Félix Alcan, Paris 1889 (Reprint: Société Pierre Janet, Paris 1889/1973).
  3. ↑ Pierre Janet (1904): L'Amnesie et la dissociation des souverirs par l'emotion. Journal Psychol. 4, 417-453.
  4. ^ Gerhard Heim, Karl-Ernst Bühler: The return of the forgotten: To the history of PTSD . In: K. Brücher, M. Poltrum (Ed.) Psychiatrische Diagnostik. On the Critique of Diagnostic Reason. Parodos Verlag, Berlin, pp. 87-104.
  5. ^ Uwe Wolfradt (2006): Pierre Janet and the depersonalization . In: Peter Fiedler (Ed.) Trauma, Dissociation and Personality. Pierre Janet's contributions to modern psychiatry, psychology and psychotherapy. [Volume 1] Lengerich, Berlin, Pabst Science Publishers (pp. 180-193).
  6. ↑ Ursula Gast: Trauma and Dissociation. Published in: Karolina Jeftic, Jean-Baptiste Joly (Ed.): Erinnern und Vergessen. To represent trauma. Stuttgart: edition solitude, 2005, pp. 77-89.
  7. ↑ Ulrich Sachsse: Trauma-centered psychotherapy. Schattauer, 2004, ISBN 3-7945-2738-0 , p. 6.
  8. ↑ asanger.de
  9. ↑ Luise Reddemann .: Psychodynamic Imaginative Traumatherapy: PITT® - The Manual: A Resilience-Oriented Approach in Psychotraumatology. 9th edition. Klett Verlag, Stuttgart, ISBN 3-608-89201-X .
  10. ^ John G. Watkins, Helen H. Watkins .: Ego-States Theory and Therapy: A Handbook. 3rd, unchanged. Edition Carl-Auer-Systeme-Verlag, Heidelberg 2012, ISBN 3-89670-663-2 .
  11. ↑ Francine Shapiro .: EMDR - Basics and Practice Handbook for the Treatment of Traumatized People. 2., revised. Ed. Junfermann, Paderborn 2013, ISBN 3-87387-873-9 .
  12. ↑ Bundeswehr Hospital Berlin: Psychotrauma Center .