These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing This intermediate-level course summarizes the theories on understanding trauma from psychological, developmental, and neurobiological perspectives; discusses various forms of trauma treatment; introduces the reader to integrative The two main categories of traumatic experience are public trauma and private trauma. Public trauma refers to traumatic events that occur in the public sector and are visible to and recognized by others. These events include natural disasters or other “acts of God,” war, traffic accidents, terrorist attacks, and the like. Common to these experiences is that the traumatic event is seen and accepted as reality by the general public. No question arises concerning whether the earthquake occurred, the veteran was exposed to sniper fire, or the two cars collided. There are witnesses and, often, pictures or live footage of the events. This is in contrast to private trauma, which includes domestic violence; rape; neglect traumas; medical traumas; the fallout Helplessness and Resilience In the 1960s, Martin Seligman carried out a research study on the concept of learned helplessness (Seligman & Maier, 1967). The researchers caged dogs and subjected them to an electric shock, while thwarting their ability to escape. (This study would not be permitted today due to better controls on animal cruelty in experimentation.) After a number of trials, the dogs had learned that escape from the noxious stimulus was not possible and they stopped trying to avoid the shock, seemingly resigned to their discomfort or pain. At this point, Seligman released the dogs from their confinement, allowing them the option of escaping the shock stimulus. He found that, initially, all of the dogs continued to suffer the shock and did not even try to escape because of the extent of their conditioned response. After several subsequent trials, some of the dogs did relearn that escape was an option and were able to avoid the shock. Others, however, never regained their capacity to avoid the pain and trauma of the shock and remained in place even when shocked. This rather gruesome experiment illustrates the accommodation to trauma that can occur in the face of a perception that no viable alternative option exists. Although this experiment is often offered as an example of learned helplessness (e.g., some dogs never acted in self-protection after the option became available), it is crucial that attention be placed on the dogs that did relearn to avoid pain and trauma because it is that ability to relearn a temporarily lost capacity that informs treatment orientations and helps to offer hope to those who suffer. The second group of dogs presents an example of the positive counterpoint to learned helplessness by illuminating the concept of resilience. When humans do not cause traumatic events, it is much easier to bear witness and offer aid to the victims. However, when humans do perpetrate traumatic acts against other human beings, the observer is forced to confront the capacity for evil in the world (Herman, 1992). Often, the witnesses, bystanders, or receivers of the disclosure are, in effect, asked to make the excruciating decision of whether to believe the victims. The perpetrators usually do everything in their power to preserve secrecy. In cases
healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
INTRODUCTION
approaches to healing that reflect a holistic perspective; and explains practitioner self-care and the prevention of secondary or vicarious traumatization. Case vignettes throughout highlight key learning concepts. TRAUMATOLOGY AND POSTTRAUMATIC STRESS DISORDER: A HISTORIC OVERVIEW
from growing up in addictive and dysfunctional family systems; and childhood physical, sexual, and emotional abuse. Typically, in private trauma there are no witnesses, and it is often the perpetrator’s word against the victim’s word (van der Kolk, 2014). Often the victim bears the added burden of invisible wounds and the experience of having the disclosure of the abuse or maltreatment met by disbelief from caretakers and professionals. These experiences add an additional layer of trauma to the events—that of entrapment (the sense of feeling tricked or duped by the disbelief of family or caretakers and denial of the events by the offenders) and what is known as “learned helplessness.” in which they are more credible and articulate than their victims, they are more easily believed. Thus, the victims of private abuse or trauma are often left to suffer in silence and isolation (Herman, 1992). Despite the human capacity for resilience, public and private trauma can overwhelm the victims’ coping capacities, possibly resulting in acute or chronic maladaptive responses. Some psychological adaptations are useful for short-term coping; however, if they persist or become generalized to people, places, and things not related to the immediate traumatic events, they can become maladaptive and later interfere significantly with a person’s life. It is important to note that the majority of individuals who have been exposed to trauma do not necessarily go on to develop posttraumatic stress disorder (PTSD) because the human capacity for healing and resilience emerges, much as an individual heals from a physical wound. Persons with compromised immune systems may need additional supports or medical interventions to heal from relatively simple injuries, but the majority will heal on their own. This is the same for psychological healing. People with a strong premorbid constitution can heal on their own, with natural supports from their communities and families, and may not go on to develop a posttrauma syndrome. Individuals who are exposed to complex multiple traumas, or those who have a history of previous traumatic life events that have not yet been addressed or resolved, are the individuals more likely to experience complications, that is, to develop PTSD. (This situation will be discussed in further detail later in the course.) Both public and private trauma can interfere with the psychological, social, and biological balance of the individual (van der Kolk, 2014). The memories of one past event, or a series of events, may severely compromise an individual’s ability to live life fully in the present. A cornerstone of treatment is to help these individuals become able to internalize the concept of “that was then, and this is now” and have the memory of past trauma be truly a memory in the past instead of hijacking their present capacity for joy, connection, and fulfillment in life.
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Book Code: PYCA2725
EliteLearning.com/Psychology
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