22
loss of a job, and many other stressful conditions. For a child, a
"trauma" might involve neglect, excessive punishment (e.g.
spankings), sexual abuse, emotional abuse (e.g. "you are stupid...
mean... worthless"), sibling abuse or rivalry, serious accidents,
observing domestic violence, bullying and social rejection, and many
other conditions. The "experts" argue about the appropriateness of
PTSD being restricted to life-threatening situations but that is the way
the APA Diagnostic & Statistical Manual-IV reads for now. Other
diagnoses are adequate to describe the psychological disruptions
caused by non-life-threatening events or thoughts. Just keep in mind
that PTSD, as a formal psychiatric diagnosis, involves a very restricted
kind of trauma, but the term PTSD itself is often used casually by
doctors and patients to refer to the aftermath of almost any trauma.
There are other major problems with the idea of trauma causing
single cause, i.e. the tendency to overlook that the victim may have
lacked the adaptive coping skills that were needed to handle the crisis,
i.e. the individual may have had a predisposing vulnerability to some
traumatic situation. Second, the identified traumatic event may have
been merely a part of a complex "sick" environment, as when
childhood sexual abuse occurs in a generally unhealthy family
environment which had failed to provide the child with the confidence
and skills to recognize, confront or avoid the abusive situation or to
deal with it after the abuse was ongoing. Gold (2000) elaborates on
this perspective. This idea is not "blaming the victim" in any way; it is
clarifying the complexity of most situations. Third, as will be discussed
at length in the next section, there are mental, emotional,
physiological, conditioning and other processes at work in the
intervening time between the trauma and the emotional consequences
weeks, months, or years later. It would be foolish to neglect these
psychological or physiological processes; they are crucial in the causal
explanatory chain and in therapy. Labeling one specific trauma as
"the" cause of a disorder is likely to be sloppy thinking that leads to
over-simplification and the perpetuation of ignorance.
Many types of traumas may have major effects on your
psychosocial development (see Table 9.2). Examples: if a child is
neglected or mistreated, the child's need for a safe, nurturing human
attachment is denied, and distrust or withdrawal or irritability may
result. If the neglect or abuse interacts in certain ways with the child's
personality or temperament, a variety of intense emotions may result
at the time of abuse and years or decades later-fears, panic, anger,
shame, guilt, depression, submissive dependency, etc. In turn, such
feelings may have impact on many aspects of life, especially
relationships, both connected and seemingly unconnected with the
trauma. Let's look at some of the other consequences of trauma.
If the trauma involves actions by others (or external events) or if
one's own actions result in fears, rage, shame or other painful
memories, the way some people cope is to unconsciously push the
unpleasant thoughts and feelings "out of mind." This denial or