Trauma, imagery and the therapeutic relationship : Langu's story
- Karpelowsky, B, Edwards, D J A
- Authors: Karpelowsky, B , Edwards, D J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6268 , http://hdl.handle.net/10962/d1008267
- Description: This paper, a phenomenological case study, describes the psychotherapy of Langu (pseudonym), a 21-year-old student, who presented with Acute Stress Disorder following a series of motor accidents that affected him and his family. Langu's most distressing experience was having to identify his brother's mutilated and severely burned body. Because of the intensity of the intrusive re-experiencing of traumatic imagery and the degree of dissociative numbing, Langu participated in four intensive guided imagery sessions, which involved reliving the incident, and imaginal dialogues with his dead brother. Session records and supervision notes from the therapy process that unfolded over 22 sessions served as the basis for a thematically selective case narrative. Additional material was obtained from several research interviews with Langu over the following months. The narrative highlights the impact of the imagery work as well as relational aspects of the therapy. The case narrative provides a source for examining many aspects of the psychological impact of trauma and the path to healing, as well as the dilemmas and challenges faced by therapists working with traumatised individuals.
- Full Text:
- Date Issued: 2005
- Authors: Karpelowsky, B , Edwards, D J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6268 , http://hdl.handle.net/10962/d1008267
- Description: This paper, a phenomenological case study, describes the psychotherapy of Langu (pseudonym), a 21-year-old student, who presented with Acute Stress Disorder following a series of motor accidents that affected him and his family. Langu's most distressing experience was having to identify his brother's mutilated and severely burned body. Because of the intensity of the intrusive re-experiencing of traumatic imagery and the degree of dissociative numbing, Langu participated in four intensive guided imagery sessions, which involved reliving the incident, and imaginal dialogues with his dead brother. Session records and supervision notes from the therapy process that unfolded over 22 sessions served as the basis for a thematically selective case narrative. Additional material was obtained from several research interviews with Langu over the following months. The narrative highlights the impact of the imagery work as well as relational aspects of the therapy. The case narrative provides a source for examining many aspects of the psychological impact of trauma and the path to healing, as well as the dilemmas and challenges faced by therapists working with traumatised individuals.
- Full Text:
- Date Issued: 2005
Trauma, resilience and vulnerability to PTSD : a review and clinical case analysis
- Edwards, D J A, Sakasa, P, Van Wyk, G
- Authors: Edwards, D J A , Sakasa, P , Van Wyk, G
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6230 , http://hdl.handle.net/10962/d1007780
- Description: This article begins with two case examples of a girl and an adolescent who were raped and developed chronic PTSD. These are used as a basis for understanding the role of a range of factors that are associated with resilience and vulnerability in the face of traumatic events. A literature review examines the proportion of individuals who develop PTSD following trauma and the factors associated with vulnerability and resilience. These include gender, developmental factors, social support and personality factors. Psychological factors associated with maintenance of chronic PTSD are also briefly reviewed. This material is used as a basis for reconsidering the case examples. Each case is formulated within a framework based on sources of vulnerability and qualities of resilience. Approaches to intervention are suggested that could address the range of factors making the individuals vulnerable to chronic psychological problems and support resiliency and recovery.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, D J A , Sakasa, P , Van Wyk, G
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6230 , http://hdl.handle.net/10962/d1007780
- Description: This article begins with two case examples of a girl and an adolescent who were raped and developed chronic PTSD. These are used as a basis for understanding the role of a range of factors that are associated with resilience and vulnerability in the face of traumatic events. A literature review examines the proportion of individuals who develop PTSD following trauma and the factors associated with vulnerability and resilience. These include gender, developmental factors, social support and personality factors. Psychological factors associated with maintenance of chronic PTSD are also briefly reviewed. This material is used as a basis for reconsidering the case examples. Each case is formulated within a framework based on sources of vulnerability and qualities of resilience. Approaches to intervention are suggested that could address the range of factors making the individuals vulnerable to chronic psychological problems and support resiliency and recovery.
- Full Text:
- Date Issued: 2005
Treating PTSD in South African contexts : a theoretical framework and a model for developing evidence-based practice
- Authors: Edwards, D J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, D J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
- Date Issued: 2005
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