دانلود پایان نامه

unsafe in their bodies and also in relation to other people. The strategies of therapy must address the patience’s safety concerns in all of these domains. Bodily issues include attention to basic health needs, regulation of bodily functioning such as sleep, eating, and exercise, control of self-destructive behaviors and post-traumatic symptoms. Issues of environment include the establishment of a safe living situation, financial security, a plan for self-protection that encompasses the full range of the patient’s daily life.

In the second stage of recovery which is called remembrance and mourning, the survivor tells the story of the trauma completely, in depth and in detail. This reconstruction transforms the traumatic memory, wordless and static memory that neither develops in time nor reveals the story teller’s feelings or interpretation of events, into the survivor’s life story. Reconstructing of the trauma story begins with a review of the patient’s life before the trauma and the event as well as the important relationships, ideals, dreams, struggles and conflicts prior to the event. This provides a context in which the particular meaning of the trauma can be understood. Apart from the event the narrative also includes the survivor’s responses to it. The patient finds it more and more difficult to use words as the narrative closes in on the most unbearable moments. The patient may switch to nonverbal methods of communication, such as drawing or painting. Creating pictures may represent the most effective initial approach to the indelible images, given the iconic visual nature of traumatic memories. Jessica Wolf describes her approach with combat veterans: “we have them reel it off in great detail, as though they were watching a movie, and with all the senses included. We ask them what they are seeing, what they are hearing, what they are smelling, what they are feeling, and what they are thinking” (qtd. in Herman, 177). Terence Keane also stresses the importance of bodily sensations in reconstructing a complete memory.
A narrative without the traumatic imagery and bodily sensation is incomplete since the ultimate goal is to put the story, including its imagery, into words. The patient’s first attempts may be partially dissociated; the story might be written in an altered state of consciousness, the patient may hide it, throw it away or forget what has been written. He must be reminded by the therapist the main goal, which is to bring the story into the room, where it can be spoken and heard. However the recitation of facts without the accompanying emotions is sterile. By exploring the feelings the patient might become either agitated or withdrawn since it is not simply describing what happened in the past, but reliving those feelings in the present. The patient moves back and forth in time, re-experiencing the feelings in all their intensity.
Reconstructing the story also includes a review of the meaning of the event not only to the patient, but also to the important people in his life. The survivor articulates the beliefs that were once valued but were destroyed by the trauma. Survivors of every age and culture come to a point where all questions are reduced to one: why? The answer is beyond human understanding. There is also another question that the survivor confronts: why me? The survivor must examine the moral question of guilt and responsibility and reconstruct a system of belief that makes sense of the undeserved feeling and to develop a full understanding of the trauma story. Meaning cannot be constructed by thought alone; it requires action; the survivor must decide what is to be done. Resolving these questions brings the survivor into conflict with important people in his life. He must rebuild his own shattered assumptions about, meaning, justice and order; also find a way to resolve his differences with those whose beliefs he can no longer share.
As trauma brings loss, even those who escape physically unscathed lose the internal psychological structures of a self securely attached to others. Telling the trauma story thus plunges the survivor into profound grief, since so many of the losses are invisible or unrecognized, the customary rituals of mourning provide little consolation. It is the most necessary and dreaded task of this stage of recovery. However the survivors often resist it, not only out of fear, but also out of pride. Resistance to mourning is probably the most common cause of stagnation in the second stage of recovery.
For the survivors who have themselves harmed others, taking responsibility has an additional meaning. A common example is the combat veterans who have committed atrocities; they might feel that they no longer belong in a civilized community. The survivor may come to understand that these incidents occurred under extreme circumstances, thus this understanding does not fully resolve the profound feelings of guilt and shame. What the survivor needs, is to mourn for the loss of the moral integrity and to find a way to atone for what cannot be undone. This restitution reaffirms the survivors’ claim to moral choice in the present.
The second stage of recovery has a timeless quality; the reconstruction of the trauma requires immersion in a past experience of frozen time and descent into mourning feels like surrender into tears that are endless. Finally the moment comes when the telling of the trauma story no longer arouses such intense feelings. The survivor will never forget the trauma and will think of the trauma every day as long as he lives. The reconstruction is never entirely completed; new conflicts and challenges of life will reawaken the trauma. However time starts to move again; when the action of telling a story has come to its conclusion, the traumatic experience truly belongs to the past. This is the time when the survivor faces the tasks of rebuilding life in the present and pursuing aspirations for the future.
Having come to terms with the traumatic past, the survivors confront the task of creating a future. Having mourned the old self that the trauma destroyed now is the time to develop a new self. The relationships that have been tested or changed by the incident must be developed into new ones. The old beliefs that gave leaning to life, have been challenged and must be renewed. These are the tasks of the third stage of recovery when the survivors reclaim their world. In this stage the issues of the first stage are often revisited; devoting energy to the care of body, environment, needs and relationships. But while the goal in the first stage was to secure a defensive position of basic safety, by the third stage the survivors are ready to engage more activity in the world. Since helplessness and isolation are the core experiences of psychological trauma, empowerment and reconnection are the core experiences of recovery.
The survivors place themself in a position to experience the fight or flight response to danger, electing fight. Therefore a degree of control over bodily and emotional responses is established that reaffirms a sense of power that not all danger is overwhelming; not all fear is terror. The aim is not to obliterate fear, but to learn how to live with it and use it as a sense of energy and enlightenment. By recognizing the socialized assumptions that rendered them vulnerable in the past, they may also identify sources of continued social pressure that keep them confined in a victim role in the present. They must learn to overcome not only inner conflicts but also the external social pressures. While in the first stage of recovery, the survivors deal with social adversity by retreating to a protected environment, in this stage they wish to take the initiative in confronting others. It is at this point that they are ready to reveal their secrets, challenge the indifference or censure of bystanders.
The emblem of the third stage of recovery is the statement “I know I have myself”. In reconciling with oneself, the survivor draws upon those valuab
le aspects from the time before the trauma, the experience itself, and the period of recovery, creating a new self, both ideally and in actuality. This re- creation involves the active exercise of imagination and fantasy, capacities that now have been liberated; An imagination which was limited by a sense of helplessness and futility, a fantasy life dominated by repetitions of the trauma. The survivors, fearing the pain of disappointment, may initially insist doing so, but as they must dare to confront their fears, they must also dare to define their wishes. It is time to rise above the sameness of days and explore the risk of testing abilities.
Furthermore the survivors have gained some capacity for appropriate trust at this stage. They can once more feel trust in others, connect to others but regain the ability to feel autonomous at the same time, maintain their point of views and boundaries while respecting those of others. Now they are ready for greater intimacy. Deepening of intimacy brings the survivor into connection with the next generation and a concern that is linked to the question of prevention; prevent a repetition at all costs. “Never again!” is the survivor’s universal cry. The survivor may consider sharing the trauma story with children, in a manner that is neither secretive nor imposing, and how to draw lessons from this story that will protect children from future dangers. This story is part of the survivor’s legacy that can be passed on when it is fully integrated, as a source of strength and inspiration rather than blight.
While most survivors seek the resolution of their traumatic experiences within the confines of their personal lives, a slight minority feel called upon to engage in a wider world. It is for the sake of a political or religious dimension that they recognize in their misfortune, to transform the meaning of their personal tragedy by making it the basis for social action. Although there is no compensation for an atrocity, there is a way to transcend it; making a gift to others. The trauma is redeemed as it becomes the source of a survivor’s mission.
Social action can take many forms, from concrete engagement with particular individuals to abstract intellectual pursuits; to focus energy on helping others who have been similarly victimized; educational, legal, or political efforts to prevent others from being victimized in the future; or an attempt to bring offenders to justice. Dedication to raising public awareness is the most common effort of all when survivors understand that the natural human response to horrible events is to put them out of mind; something they have done before. However those who forget the past are condemned to repeat it. That is why they select public truth-telling which is the common denominator of all social action. In their belief speaking about the unspeakable in public will help others; they also feel connected to a power larger than themselves. Giving to others is indeed a practice for healing survivors feel recognized, loved, and cared for them (Herman, 156-211).
2.5.3.4 Resolving the Trauma
There is no final resolution for the trauma; recovery is never complete. The impact of the event continues to reverberate throughout the survivor’s lifecycle since issues that were sufficiently resolved at one stage of recovery may be reawakened at new milestones of the survivor’s life. Occasions such as marriage, divorce, a birth or death in the family, illness or retirement may cause resurgence of traumatic memories. For example the fighters and refugees of the Second World War experience a revival of post-traumatic symptoms as they encounter the losses of old age. Although resolution is never complete, it is often sufficient for the survivors to turn their attention from the tasks of recovery to the tasks of ordinary life, to take pleasure in life in the

دیدگاهتان را بنویسید