Nijenhuis The Trinity of Trauma: Ignorance, Fragility, and Control

Enactive Trauma Therapy
1. Auflage 2017
ISBN: 978-3-647-40268-0
Verlag: Vandenhoeck & Ruprecht
Format: PDF
Kopierschutz: 0 - No protection

E-Book, Englisch, 514 Seiten

Enactive trauma therapy is grounded in so-called enactivism, which holds that, like anyone else, traumatized individuals are (1) embrained, embodied, and environmentally embedded; (2) constitute biopsychological organism-environment systems that are essentially interested in preserving their existence; (3) are primarily affective and oriented toward making sense of things. Individuals exhibit a phenomenal self, world, and self-of-the-world through self- and world-oriented actions. They do not act on the basis of knowledge, but possess knowledge on the basis of world-engaged sensorimotor, affect-laden, and goal-oriented actions. Whenever interpersonal traumatization by significant others occurs, individuals may get caught up in affective and relational conflicts they cannot resolve on their own. Their generation and maintenance of a trauma-related dissociation of the personality involves a kind of sense-making that supports their continued existence when their capacity to integrate traumatic experiences is still too low. However, what starts as a courageous effort to navigate a traumatizing life may at some point in time become a serious problem. Enactive trauma therapy comprises the collaboration of two organism-environment systems: the patient and the therapist. Together they spawn new meaning and adequate actions - an interaction that resembles dancing: It takes pacing, mutual attunement, good timing, a sensitivity to balance, movement and rhythm, courage, as well as the ability and willingness to follow and lead.

Ellert R. S. Nijenhuis, Ph. D., ist Psychologe, Psychotherapeut und Forscher. Seit mehr als 30 Jahren diagnostiziert und behandelt er schwer traumatisierter Patienten. Er lehrt und publiziert zu traumabezogener Dissoziation und dissoziativen Störungen. Er ist Forschungsberater der Klinik Littenheid (Schweiz) und arbeitet mit mehreren europäischen Universitäten zusammen. Die International Society for the Study of Trauma und Dissociation hat ihm mehrere Preise verliehen, darunter auch für sein Lebenswerk.

Autoren/Hrsg.

Nijenhuis, Ellert

Weitere Mitwirkende

Seminar, Evang.-Theol.

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie

Inhaltsverzeichnis

1;Cover;1
2;Title Page;4
3;Copyright;0
4;Table of Contents;6
5;Body;12
6;Volume III: Enactive Trauma Therapy;12
6.1;Preface;14
6.1.1;Ignorance, Fragility, and Control versus Realization;15
6.1.2;Theory: A Navigational Instrument;17
6.1.3;A Player and a Coach: Two Organism-Environment Systems Enacting a Common World;18
6.1.4;The Trinity of Trauma and The Haunted Self;20
6.1.5;The Trinity of Trauma: A Trilogy;22
6.1.6;Clinicians and Therapists;24
6.1.7;Gratitude;24
6.2;Introduction: Volume III in Brief;26
6.2.1;Theoretical Basis;26
6.2.2;The Practice of Enactive Trauma Therapy;30
6.3;Chapter 22: Consciousness in Trauma;34
6.3.1;A Trinity of Prototypical Dissociative Subsystems of the Personality;34
6.3.2;Consciousness: Cooperation, Coordination, Communication;37
6.3.3;General, Personal, and Subjective (Phenomenal) Consciousness;39
6.3.4;Totalitarian, Corporative, and Communicative Cooperation;40
6.3.5;Interpersonal Traumatization as a Totalitarian Organization;41
6.3.6;Dissociative Parts of the Personality in Trauma: Totalitarian and Corporative;43
6.3.7;Enactive Trauma Clinicians: Corporative and Communicative;45
6.3.8;Being Sentient and Being Conscious;46
6.3.9;Phenomenal and Subjective;48
6.4;Chapter 23: Enlightenment, Enlivenment, Enactivism;50
6.4.1;Enlightenment;51
6.4.2;Songs Beyond the Siren of Mechanics;52
6.4.3;Songs Beyond the Siren of Matter;53
6.4.4;Songs Beyond the Siren of Thought;55
6.4.5;Adverse Life: Coincidental Suffering?;55
6.4.6;Enlivenment and Enactivism;56
6.4.7;Parts and Wholes;60
6.4.8;Enactivism: A Viable One System Approach to Life;65
6.5;Chapter 24: Embedment, Entanglement, and Conatus;68
6.5.1;A Knotty Ontological Dialectic;68
6.5.2;A Knotty Epistemic Dialectic;70
6.5.3;The Ontological and Epistemic Relativity and Entanglement of Subjects and Objects;71
6.5.4;Embedment and Subject-Object Relativity in Trauma;71
6.5.5;Conatus or Will;73
6.5.6;Summary;77
6.6;Chapter 25: Desire, Joy, and Sadness;78
6.6.1;Evaluation as Signification;78
6.6.2;Signs and Sense Making;80
6.6.3;Insignification;81
6.6.4;Signification is Species-Dependent;82
6.6.5;The Power of Action;82
6.6.6;Actions, Passions, and Umwelt;85
6.6.7;Passions and Substitute Actions;86
6.6.8;Adverse, Traumatizing, and Traumatic Events;88
6.6.9;Decomposition and (Re)Composition of the Personality in Trauma;88
6.6.10;Reenactment of Traumatic Memories and Relationships: Seeking Joy, Remaining Stuck in Sadness, Suffocating in Hate;90
6.6.11;Dissociative Intrusions;93
6.6.12;Demoralization: Power of Action Lost;94
6.6.13;Enactivism and Participatory Sense Making;95
6.7;Chapter 26: Dissociative Parts of the Personality and Modes of Longing and Striving;98
6.7.1;Dissociative Parts and Action Systems;98
6.7.2;ANPs with ‘EP-like’ Features and EPs with ‘ANP-like’ Features;101
6.7.3;Modes of Longing and Striving;103
6.7.4;Dissociative Parts Include Various Modes of Longing and Striving;108
6.7.5;Lack of Integration and Dissociation: Related but Different Concepts;114
6.8;Chapter 27: Traumatized Individuals and Their Dissociative Parts: Autonomous Centers of Action and Passion;118
6.8.1;Autonomous Systems;118
6.8.2;Traumatized Individuals and Their Dissociative Parts: Autonomous Systems;122
6.8.3;Autonomous Systems: Operationally Closed, Environmentally Open;128
6.8.4;Traumatized Individuals and Dissociative Parts as Operationally Closed Systems .;128
6.8.5;Autonomous Systems: Minded;129
6.8.6;Mind, Affectivity, and Perspectivalness in Trauma;134
6.8.7;Conatus and Passions;134
6.8.8;Conatus and Passion in Trauma;136
6.8.9;A Recapitulation;138
6.9;Chapter 28: Ego and Socius;142
6.9.1;Ego as Socius;142
6.9.2;Some Perspectival Features of Prenatal Development;144
6.9.3;Ego and Socius in Prenatal and Postnatal Trauma;146
6.10;Chapter 29: Conatus, Cognition, and the Body;154
6.10.1;Conatus and Cognition in Trauma;156
6.10.2;Mind, Brain, and Body;157
6.11;Chapter 30: Participatory Sense-Making;166
6.11.1;Entering the World of Psychology;167
6.11.2;Paula;168
6.11.3;The Province of Groningen;170
6.11.4;Defrosting a Frozen Lady;173
6.11.5;Making Meaning Together;176
6.11.6;Epilogue;190
6.12;Chapter 31: Attunement, Consensus Building, and Sensitive Leading by Utilization;192
6.12.1;Pediatric Hypnotherapy as a Model of Any Form of Psychotherapy;193
6.12.2;The Dance of Enactive Trauma Therapy;198
6.12.3;From Flatland to Spaceland;205
6.12.4;Loss of Control in Trauma and Dissociation;212
6.13;Chapter 32: Enactive Assessment of Dissociation and Traumatizing Events;216
6.13.1;Therapeutic Democracy and the Development of Positive Control;217
6.13.2;Standard Assessment;219
6.13.3;Stop Signals;221
6.13.4;Ineke;223
6.13.5;The First Session;223
6.13.6;The Second Session;225
6.13.7;The Path So Far;262
6.13.8;Secrets;263
6.13.9;Epilogue;263
6.14;Chapter 33: Uncommon Enactive Assessment;264
6.14.1;Martha;264
6.14.2;Assessment;290
6.14.3;A Therapeutic Plan of Action;301
6.14.4;The Continued Treatment;302
6.14.5;Epilogue;306
6.14.6;Sonja;306
6.14.7;Conclusion;310
6.15;Chapter 34: How Water Beats Rocks and Other Metaphors;312
6.15.1;How Water Beats Rocks;313
6.15.2;Epilogue;320
6.15.3;Paralinguistics;321
6.15.4;Metaphor Construction and Preparation;325
6.15.5;Sleeping Beauty: A Tale for Young Fragile EPs;326
6.15.6;The Boxer;327
6.15.7;The Jigsaw Puzzle;328
6.15.8;The Long Journey, the First Step;329
6.16;Chapter 35: The Meaning of Sirens;330
6.16.1;WWW: From Symptom to Meaning – Who Does What and Why?;331
6.16.2;Discussion;352
6.16.3;A Brutal Confession, the Unveiling of a Final Secret, and the Right to Exist;358
6.17;Chapter 36: Hand in Hand;360
6.17.1;Agnes;362
6.17.2;Physical Contact Between Patients and Clinicians;376
6.17.3;Conclusion;386
6.18;Chapter 37: Sympathy for The Devil;388
6.18.1;Dissociative Amnesia and Dissociative Hypermnesia;388
6.18.2;Meeting The Helper;390
6.18.3;Meeting The Devil;393
6.18.4;Completion of the Session;406
6.18.5;The Next Session;407
6.18.6;From Totalitarian to Communicative-Egalitarian Relationships;408
6.18.7;Therapeutic Exposure from an Enactive Perspective;411
6.18.8;Twenty Years Later: Sonja’s Reactions to Watching The Devil;415
6.19;Chapter 38: 222 Propositions Regarding Enactivism and Enactive Trauma Therapy;418
6.19.1;Enactivism;418
6.19.2;Mind and Matter;418
6.19.3;Relativity of Subject and Object; Meaning Making;418
6.19.4;Morality;419
6.19.5;Organism-Environment Systems and Operationally Autonomous Systems;419
6.19.6;Embrained, Embodied, Embedded;420
6.19.7;Mental and Phenomenal Systems;420
6.19.8;Needs and Desires;420
6.19.9;Modes of Longing and Striving;421
6.19.10;Integration: Synthesis, Personification, Presentification, Symbolization, and Realization;421
6.19.11;Integrative Limitations, Adverse Events, and Traumatic and Traumatizing Events .;422
6.19.12;Dissociation in Trauma and Dissociative Subsystems;423
6.19.13;Prototypical Dissociative Parts;424
6.19.14;Dissociative Parts and Consciousness;425
6.19.15;Enactive Trauma Therapy;426
6.19.16;Enactive Trauma Clinicians;426
6.19.17;Egalitarianism;427
6.19.18;Goals;427
6.19.19;Attunement, Consensus Building, and Leading;428
6.19.20;Enactive Trauma Therapy: Healing Steps;429
6.19.21;Embodiment and the Body in Trauma Treatment;430
6.19.22;Who Does What and Why?;430
6.19.23;Pointland, Lineland, Flatland, and Spaceland;430
6.19.24;Phobias;431
6.19.25;Imaginal Exposure;432
6.19.26;Concretizations;432
6.19.27;Overcoming the Trinity of Trauma in Psychiatry, Psychology, and Psychotherapy .;433
6.19.28;Society and Chronic Childhood Traumatization;434
7;Appendix 1: Some Notes on the Efficacy of Enactive Trauma Therapy;438
7.1;Defining and Using the Concept of ‘Dissociation’ in ContradictoryWays;438
7.2;Dissociative Disorders Require a Specific Kind of Treatment;439
7.3;Useful (Significant-Good) and Harmful (Significant-Bad) or Useless (Insignificant) Treatment of Complex Dissociative Disorders;440
7.4;Community Therapists and Expert Therapists of Complex Dissociative Disorders: What Do They Do?;441
7.5;Controlled Group Comparison Outcome Studies and Their Limitations;441
7.6;Single-Case Studies;442
7.7;Multiple Cases Studies of the Treatment of Complex Dissociative Disorders;443
8;Appendix 2: The Need for and the Utility of Minimal Constraints on the Concept of Dissociative Parts;445
8.1;Concepts are Artificial Constructs;445
8.2;Integrative Limitations;447
8.3;Phenomenological Interests;448
8.4;Clinical Interests;449
8.5;Scientific/Empirical Interests;449
8.6;Dissociative Parts and Minimal Constraints on Consciousness;451
8.7;Minimal Constraints on Self-Consciousness: Phenomenal Self-Conception and Phenomenal Conception of an Intentionality Relationship;454
8.8;Dissociative Parts Need Not Be Verbal;456
8.9;Minimal Dissociative Parts, Minimal Contents;457
8.10;To Have an Autobiographical Memory, Someone Must Remember and Personify It;457
8.11;Assessment of Dissociative Disorders and the Accessibility and Assessability of Dissociative Parts;458
8.12;Detection of Rudimentary EPs in PTSD (and Other Dissociative Disorders);459
9;Appendix 3: The Somatoform Dissociation Questionnaire (SDQ-20);462
9.1;Scoring;462
9.2;Scalability;462
9.3;Reliability;463
9.4;Relationship with Demographic Characteristics;463
9.5;Convergent Validity;463
9.6;Discriminant Validity;463
9.7;Construct Validity;464
9.8;Screening Capacity;465
10;Appendix 4: The Somatoform Dissociation Questionnaire (SDQ-5);469
11;Appendix 5: The Traumatic Experiences Checklist (TEC);473
11.1;Scoring Form Traumatic Experiences Checklist (TEC);479
12;References;484
13;Author Index;506
14;Subject Index;508

Über Autor(innen)

Nijenhuis, Ellert
Ellert R. S. Nijenhuis, Ph. D., ist Psychologe, Psychotherapeut und Forscher. Seit mehr als 30 Jahren diagnostiziert und behandelt er schwer traumatisierter Patienten. Er lehrt und publiziert zu traumabezogener Dissoziation und dissoziativen Störungen. Er ist Forschungsberater der Klinik Littenheid (Schweiz) und arbeitet mit mehreren europäischen Universitäten zusammen. Die International Society for the Study of Trauma und Dissociation hat ihm mehrere Preise verliehen, darunter auch für sein Lebenswerk.