PRENOTES ch21 Trauma

10-13-06

TRAUMA AND GRIEF

From below

“Unresolved trauma or loss leaves the individual with a deep sense of incoherence in autonoetic consciousness, which tries to make sense of the past, organize the present, and chart out the future.  This lack of resolution can produce lasting effects throughout the lifespan and influence self-organization across the generations.  (siegel/tdm/297)”

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below is all one paragraph

“In addition to the influence of repeated patterns of communication within attachment relationships, specific overwhelming events may produce marked effects on the developing mind.  Psychological trauma can overwhelm affect regulation mechanisms, and various forms of adaptation may be required to maintain equilibrium.  (siegel/tdm/294)”

“The flood of stress hormones can produce toxic effects on the develop- (siegel/tdm/294) ment of brain systems responsible for self-regulation.  In this way, early, severe, and chronic trauma may create impairments in a child’s ability to adapt to future stress.  (siegel/tdm/295)”

“The individual’s developmental stage at the time of a trauma – be it loss of a loved one, an abusive experience (especially those involving a sense of betrayal), or the witnessing of a violent event – markedly influences the adaptive responses available.  (siegel/tdm/295)”

“In general, loss or trauma can have a negative impact on a child’s expectations for the future, directly shape his anticipational models and prospective memory, and disrupt his narrative process.  These influences produce impairments to achieving self-regulation and integration of self-states, and in these ways damage the individual’s deepest sense of the self and the ability to regulate the flow of internal states.  (siegel/tdm/295)”

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“If severe trauma occurs early in life, or if a form of divided attention (such as entering a state of intense imagination or trance) is utilized during an overwhelming experience, explicit memory for the traumatic experience(s) may be impaired.  Intense and frightening elements of implicit memory will be encoded and may later be automat- (siegel/tdm/295) ically reactivated, intruding on the traumatized individual’s internal experience and external behaviors without the person’s conscious sense of recollection or knowledge of the source of these intrusions.  (siegel/tdm/296)

[Did this happen to my mother?]

(also see on this page siegel’s discussion on loss and grief of attachment figure)

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“The effects of unresolved loss or trauma in relation to specific overwhelming events can be powerfully disorganizing and often hidden from conscious awareness.  At the most fundamental level, such a lack of resolution involves disturbances in the flow of energy and information in the mind.  As the mind emerges at the interface of neurophysiological processes and interpersonal relationships, such disturbances can be seen within neural pathways and within dyadic communication. (siegel/tdm/296)”

paragraph continues

“Knowledge of impaired resolution of grief or trauma is crucial, given its devastating effects on the individual and its potential to impair attachment with future offspring.  [Allen might disagree with this].  Attachment disturbances in the children of parents with lack of resolution result directly from the impairments to contingent, collaborative communication.  ….the flow of energy and information between parent and child – the essence of attuned relationships – is disturbed in cases of parental unresolved trauma or loss.  (siegel/tdm/296)”

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“Prospective memory allows us to “remember the future.”  In memory-related terms, lack of resolution means that the mind has a tendency to create repeated patterns of disorganizing states, often without conscious awareness of their origin.  These states may be created by sudden and unwanted activations of implicit elements of memory, such as flashbacks of traumatic events or mental models of a deceased attachment figure as if the figure were still alive.  These activations can seriously impair functioning, especially in the realms of response flexibility, emotional modulation, and contingent communication with others.  (siegel/tdm/297)”

“Unresolved trauma or loss leaves the individual with a deep sense of incoherence in autonoetic consciousness, which tries to make sense of the past, organize the present, and chart out the future.  This lack of resolution can produce lasting effects throughout the lifespan and influence self-organization across the generations.  (siegel/tdm/297)”

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later siegel is saying (copied from ch 46 states of mind)

“Self-organization at the level of the mind must involve the integrative processing of these self-states across time and context.  It is at the moments of transition that new self-organizational forms can be constructed.  Indeed, integrating coherence of the mind is about state shifts. Congruity and unity emerge at the interface of how information and energy – the defining elements of the mind – flow across states.  [copied into dissociation notes 6]  As Allan Schore has stated,

The term “self-organization” can be imprecise and misleading, because first, despite the implications of the two words used to describe the process, self-organization occurs in interaction with another self – it is not monadic but dyadic.  And second, the organization of brain systems does not involve a simple pattern of increments but rather large changes in organization.  Development, the process of self-assembly, thus involves both progressive and regressive phenomena, and is best characterized as a sequence of processes of organization, disorganization, and reorganization.

Schore 1997 p 607

Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders

Development and Psychopathology 9, 595 – 631

Integration is about how the mind creates a coherent self-assembly of information and energy flow across time and context.  Integration creates the subjective experience of self.  (siegel/tdm/316)”

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“Making the connection within psychotherapy between these aspects of memory and past experiences allows patients to understand the origins of their disturbances.  Such reflections must take place within the therapeutic attachment setting,

which allows the mind to experience intensely dysregulated states and learn – dyadically at first – how to tolerate them,

then to reflect on their nature,

and eventually to regulate them in a more adaptive manner.

Much of this emotional processing is in its essence nonverbal and is probably mediated via right-hemisphere processes (both within the patient and those between patient and therapist).  (Siegel/tdm/287)”

{Well, this is pretty clean:  MUST take place within the therapeutic attachment setting.  So there’s no hope for anybody who cannot afford to access, or has no access to, such therapy?  Is there no way we can do this ourselves?]

“Bringing conscious reflection to such unresolved reactivations permits the consolidation process of explicit memory to become involved and traumatic experiences to be integrated within autobiographical narrative….this process may allow for cooperative processing in both hemispheres of what may have been only unilateral representations.  The attuned resonant relationship with the therapist allows patients to make left-hemisphere, verbally mediated, interpreter-driven sense out of their right-hemisphere autobiographical representations.  This integrative process probably has direct effects on the right hemisphere’s capacity to regulate primary emotional states.  The patient’s mind is prepared for such a process of the development of a secure attachment with the therapist.

Same paragraph

“Furthermore, the elaboration of autonoetic consciousness permits patients to reflect on the past, understand the present, and help actively shape the future.  Such mentalizing reflective dialogue is also a fundamental component of secure attachments.  Indi- (siegel/tdm/297) viduals with histories of disorganized attachments can thus become freed from the “prison of the present,” in which they were repeatedly trapped when they had no words to reflect on their rapidly enveloping and terrifying states of mind.  (siegel/tdm/298)”  [copied this to prenotes time 8]

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“Such a flexible process…becomes disrupted in childhood trauma and in suboptimal attachment experiences.   (siegel/tdm/306)”

see more on this in brain notes 8 and copied into dissociation notes 6

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see important information under disorganized attachment in prenotes ch 26 attach