322- Book -PTSD therapy & victims of violence (Ochberg) (2)

After the introductory portion of the book, I now pass to section I Ochbert et al.'s book about PTT and victims of violence. Is it titled Principles of post-traumatic therapy (chapters 2-5. P. 21-110). 

P. 21-23 is an introduction to this section : I assume it is written by the book editor, Mr Ochberg.  




Chapter 2 (P.25- 36), the biological response to psychic trauma, by Bessel A. Van der Kolk, covers explanations about the way the human body reacts after trauma, on the brain and biochemical levels. What the title of this chapter doesn't say, is that Kolk also introduces what W. T Roth shall develop more fully in chapter 3, which is the notion of psychopharmacology treatment for PTSD patients, based in research - his and by others that he references - both on human patients, and on animal research in labs. This part is less interesting to me as I never accepted to use medication myself, nor do I ethically agree with lab experiments, which are luckily not detailed in this section, and only summarized in their lines of "this medication and reaction in humans correlates to what was found in case of animals". 

This chapter ends (p.36-38) in extensive listing of references. 

Chapter 3 (P. 39-56), the role of medication in post-traumatic therapy, explores the rationale reasons for drug treatment, raises the importance of patient consent, and distinguishes between types of medication for specific symptoms aspects of PTSD, as well as at which period after trauma each could be prescribed. 
The chapter discusses termination of medical treatment, and gives a case-study, showing the complexities of treating in individual patients based on known aspects of their trauma and effects on their daily lives, as well as the role of family circles.  
Walton T. Roth lists the references in the last three quarters of P.56, finishing this chapter, which I read partially and skimmed through the rest as it didn't apply to my needs. 

Chapter 4, healing of the whole person, by Mary R. Merwin & Bonnie Smith-Kurtz, explores notions of wholistic healing approaches in post-traumatic therapy. They, logically, affirm that trauma inflicts the person on multiple levels - mental, emotional, spiritual, and where applied, physical. 
They use the original latin meaning of spiritual, that of breathe, or life, or being alive, and distinguish it from religious aspects. However, they do use several faith and religious based aspects throughout the chapter, and thus loose a bit of credibility for me. 
The rest of the chapter deals with various forms of help the therapist can offer a patient in PTT: physical therapy, with examples of activities ; nutrition, with examples of effects by processed foods, sugar and caffeine on the distressed body ; the need to use humour in recovery, with explanations of the effects humour has on the body ; physiology and management of stress, further detailing how stress affects a victim, the importance of balance and reducing distress (= bad stress) while augmenting eustress (the positive kind of stress, that we all need in life). 

They finish the chapters with attitude adjustment,  coping techniques, and references (this latter part in pages 81-82). 

Chapter 5 poses the rationale, the reasons and a method of Post-Traumatic family therapy, in the specific case where a family member was traumatized/victimized from an external source to the family-group. It was written by Charles R. Figley, the same who had discussed the editorial note and who shall close with postscript editorial note. 

This chapter is rather long (P. 83-107 + plus references P. 107-109), and use a case-study of a family where one of its members - the father - was suffering from PTSD after the Vietnam war. This chapter describes purpose and objectives as to why an entire family should seek therapy when one of its members had experienced trauma - especially when a diagnosis of PTSD is made. 

It proposes the theory that a family structure is most often impacted when one of its members have been victimized, and sets the rules for therapists who treat these families, with concrete examples in helping the family throughout stages of detecting the traumatic stress, confronting the trauma, urging recapitulation of the catastrophe, facilitating resolutions of the conflicts, and how these, later, help the family to better cope with the current crisis, and teaches them skills in case of future traumatic events. 

The chapter continues by telling of the "cost of caring", where caring family members may be impacted by caring and not knowing how to help the one member who suffers, and then in turn, can suffer as well.

It further divides the types of effects family members can suffer from : simultaneous (in cases of shared trauma) ; Vicarious (when one suffered, and the others learn about it) ; Chiasmal effects, or the "infection" of family with trauma (when supporting family members take-on the trauma from the victim, and thus become co-sufferers).

The second portion of this chapter deals with the family therapy itself, from the background of such a therapy model, theories that emerged in psychotherapy research, and develops the social aspects of family structures and supportiveness as part of the therapists work to help the family to learn better coping skills and to become more united in the face of adversity. 

The chapter relies heavily on the goal of the therapist to help the family create a "healing theory" for a family to accept in majority, and to heal together as a unit. 

Overall, it's a very interesting chapter to read, but which at times sets only ideals conditions, and doesn't discuss fully enough of the adverse effects of dysfunctional family structures - such as when family members are in denial or lack community and communication. I'll discuss this in another post, for my own family structures.