COVID-19 has affected millions of people around the globe. People's mental health, especially those of nurses, has been primarily affected by the fear of this virus. More focus has been paid to vaccination and treatment of the virus, but less attestation has been given to addressing the mental health of people affected by the virus. Empirical studies show that different external factors are not easily manageable and controllable by the individual. This study preliminarily explores the connection between fear of COVID-19 (...) and secondary traumatic stress in nurses. Further, it examines the moderating effects of occupational self-efficacy on the relationship between fear of COVID-19 and secondary traumatic stress. Data for the study was collected from the nurses of six large hospitals in Karachi, Pakistan. The final analysis was performed on 243 samples. Studies on COVID-19 suggest that increased occupational self-efficacy decreases fear and its impact. This study offers insights for managers to develop stress management programs and provide proper training and counseling sessions to the nurses to motivate them emotionally. Theoretically, this study broadens the understanding of the theory of emotions by using the pandemic as a stressor. Future studies may explore different roles of occupational self-efficacy and study its influential role in managing different kinds of emotions explained by the theory of emotions. Managers at the workplace could design different self-efficacy training for nurses to increase their self-motivation to fight different types of stress they face at the workplace. (shrink)

Introduction: As an occupational group, medical providers working with victims of trauma are prone to negative consequences of their work, particularly secondary traumatic stress symptoms. Various factors affect susceptibility to STS, including work-related and organizational determinants, as well as individual differences. The aim of the study was to establish the mediating role of cognitive trauma processing in the relationship between job satisfaction and STS symptoms among medical providers.Procedure and Participants: Results were obtained from 419 healthcare providers working (...) with victims of trauma. Three questionnaires, namely the Secondary Traumatic Stress Inventory, Work Satisfaction Scale, and Cognitive Trauma Processing Scale, were used in the study, as well as a survey developed for this research. Correlational and mediation analyses were applied to assess relations between variables.Results: The results showed significant links between STS symptoms and both job satisfaction and cognitive processing of trauma. Three cognitive coping strategies play the intermediary role in the relationship between job satisfaction and symptoms of secondary traumatic stress. However, this role varies depending on preferred strategies.Conclusion: Nurses and paramedics are significantly exposed to the occurrence of STS. Thus, it is important to engage health care providers in activities aimed at preventing and reducing symptoms of STS. (shrink)

Background. In some organisations, traumatic events via direct or indirect exposure are routine experiences. A NICE review (2005; updated in December 2018) of Post-Traumatic Stress Disorder (PTSD) management in primary and secondary care did not address early interventions for trauma in emergency response organisations. Aims. This scoping review was designed to identify previous research which evaluated the use of early interventions following exposure to primary or secondary trauma, to report on the effectiveness of early interventions models. (...) Method. A scoping review was conducted to examine early interventions for trauma with staff in roles potentially exposed to trauma including: emergency response, military and humanitarian aid. Relevant data was extracted from included studies and outcomes were assessed using meta-ethnography. Results. Fifty studies of mixed quality met the inclusion criteria for this review. Synthesis of study outcomes found that early interventions help emergency responders to manage post-incident trauma when they: are delivered in a manner that respects distinct organisational culture; are supported by organisations and senior management, and; harness existing social cohesion and peer support systems within teams. Conclusions. This review demonstrates that early interventions support emergency responders following exposure to trauma when: tailored to the needs of the population, are supported by the host organisation, and harness existing social cohesion and peer support processes within a team or unit. We identify a number of recommendations for the delivery and evaluation of early interventions for psychological trauma in emergency response organisations. (shrink)

The following is simultaneously an essay in sociological theory, in cultural sociology, and in the empirical reconstruction of postwar Western history. Per theory, it introduces and specifies a model of cultural trauma - a model that combines a strong cultural program with concern for institutional and power effects - and applies it to large-scale collectivities over extended periods of time. Per cultural sociology, the essay demonstrates that even the most calamitous and biological of social facts - the prototypical evil (...) of genocidal mass murder - can be understood only inside of symbolic codes and narratives; that these frames change substantially depending on social circumstances; and that this culture process is critical to establishing understandings of moral responsibility. Empirically, this essay documents, in social and cultural detail, using both secondary and primary sources, how it was that the `Holocaust' gradually became the dominant symbolic representation of evil in the late twentieth century, and what its consequences have been for the development of a supra-national moral universalism that may restrict genocidal acts in the future. (shrink)

ABSTRACT Recent police brutality has reminded people in the United States of America that racism and discrimination toward Black Americans is still prevalent. Evidence supports the claim that many Black Americans experience racial trauma due to the relatively common occurrence of discriminatory racial encounters in their life. Racial traumas are events of danger related to real or secondary experiences of racial discrimination that may cause psychological, emotional, or physical injury. The goal of this article is to identify the (...) ethical complexities for psychologists in addressing racial trauma among Black Americans. First, the article describes examples of racial traumas for Black Americans and their impact on overall mental health. Second, there is an in-depth analysis of ethical issues for psychologists relevant to racial trauma in areas such as competency, discrimination and harassment, bias, assessment, training programs, and harm. Finally, recommendations for psychologists are provided to address racial trauma among Black American clients, students, supervisees, and colleagues. (shrink)

Artistic images, of a universal nature and validated by global culture, are carriers of an emotional potential that can be used for therapeutic purposes in cultural centers as well as in clinical spaces. Esthetic studies reveal the mobilizing power in their contemplation and the capacity to bring out personal stories with healing potential. The general objective of this paper is to design and validate the PROJECTA instrument, consisting of the therapeutic use of artistic images to approach trauma or difficult (...) conditions in therapy, by means of the association between art images and emotions, feelings or states of mind related with a traumatic experience. A mixed approach of investigation with a concurrent triangulation design has been used for the integration of qualitative and quantitative results, where qualitative research outweighs quantitative, but both have been QUAL → quan sequentially developed. The study was carried out in two phases. The first was a systematic review of the literature. The second, divided into five steps, consisted of the validation of artworks and the associated emotions with the participation of students, experts in art therapy, psychologists and educators through focus groups, interviews and an online questionnaire. The analysis techniques were qualitative and quantitative. A set of 220 artistic images linked to emotional states were proposed by experts in education, psychology and art therapy, and validated through an online questionnaire. The respondents included 228 students and professionals and for 64.55% of these images a consensus of over 80% was obtained. These images and their associated emotions were again reviewed by a confirmatory focus group. Finally, 92 artistic works were linked to primary, secondary and tertiary emotions such as love, joy, victory, surprise, balance, sense of humor, anger, sadness, fear, and emptiness. In addition, there are mobilizing images that have not been related to any emotion because of the polysemy of their meanings. It concludes that PROJECTA is a visual art therapy tool that provides professionals with a resource that helps facilitate the identification, expression or demonstration of emotions or feelings related with trauma, and in challenging situations of vulnerability, psychological discomfort or post-traumatic stress. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched (...) an educational video illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

In the trauma surrounding mass disasters, the need to identify victims accurately and as soon as possible is critical. DNA identification testing is increasingly used to identify human bodies and remains where the deceased cannot be identified by traditional means. This form of testing compares DNA taken from the body of the deceased with DNA taken from their personal items or from close biological relatives. DNA identification testing was used to identify the victims of the terrorist attack on the (...) World Trade Center in New York on September 11, 2001, and of the victims of the Tsunami that hit Asia on December 26, 2004. Shortly after the 9/11 attack, police investigators asked the victims' families for personal items belonging to the missing, and for DNA samples from family members themselves. The New York medical examiner's office coordinated the DNA identification testing program; however, some of the identification work was contracted out to private laboratories. (shrink)

Background: Individuals with psychopathic traits demonstrate an attenuated emotional response to aversive stimuli. However, recent evidence suggests heterogeneity in emotional reactivity among individuals with psychopathic or callous-unemotional (CU) traits, the emotional detachment dimension of psychopathy. We hypothesize that primary variants of psychopathy will respond with blunted affect to negatively valenced stimuli, whereas individuals marked with histories of childhood trauma/maltreatment exposure, known as secondary variants, will display heightened emotional reactivity. To test this hypothesis, the present study examined fear-potentiated startle (...) between psychopathy variants while viewing aversive, pleasant, and neutral scenes. Method: 238 incarcerated adolescent (M age = 16.8, SD = 1.11 years) boys completed a picture-startle paradigm and self-report questionnaires assessing CU traits, antisocial-aggressive behavior, and maltreatment. Results: Latent profile analyses identified four classes; primary variants (high CU traits, high aggression, low maltreatment; n = 46), secondary variants (high CU traits, high aggression, high maltreatment; n = 42), and two nonpsychopathic groups differentiated on maltreatment experience (n = 148). Findings from an ANOVA comparing identified groups on startle amplitude difference scores (i.e., aversive-neutral) suggested a main effect for group, F(3,196)=8.91, p<.001, η2 = .12. Primary variants of juvenile psychopathy displayed reduced startle potentiation to aversive images (threat and victim scenes), whereas secondary variants distinguished by high levels of childhood maltreatment did not. Conclusions: Findings add to a rapidly growing body of literature supporting the possibility of multiple developmental pathways to psychopathy (i.e., equifinality), and extend it by finding support for divergent potential biomarkers between primary and secondary psychopathy variants. (shrink)

1. The whole idea that environmental issues1 can be traumatizing may appear as a remote possibility to many. While research on this topic is still sporadic, there is a growing international interes...

Harm, this paper proposes, is a viable teaching objective. Presenting an andragogy of post secondary liberal arts education, this paper explores the relationship between critical thinking and subjective harm, arguing that subjective harm is an inevitable outcome of critical thinking practice. The author situates this teaching methodology within the discourse theory of psychoanalyst Jacques Lacan, positioning this critical thinking andragogy specifically within the Discourse of the Hysteric, which interrogates the institutionalized epistemology present in universities. Defining critical thinking as a (...) subjective cognitive technique adjoined to reflexivity and reflective practice, this paper examines and refutes the university principle of primum non nocere (do no harm), arguing that it represents a logical incoherence in university principles. Semantically and conceptually examining the terminologies involved, the author contends that, to the extent that we accept the definition of “harm” found in the Discourse of the University, any teaching practice that valorizes critical thinking inevitably will, and should, be harmful. (shrink)

In the article, the phenomenon of dual exceptionality is discussed that takes place in the specific situation when a child simultaneously has the characteristics of giftedness and the diseases impairing the learning process at school. Training the child requires from the teacher, on the one hand, the development of giftedness in a particular area, on the other hand - the correction features complicating the learning process. In this group, there more likely includes the left-handed children, children with attention deficit hyperactivity (...) disorder and those who had the syndrome of autistic specter. The methods of the lateral preferences assessment are described. It was discussed that children with mixed lateral parameters had the most severe problems at school. They have the problems with writing and with reading if they have different predominant parameters, for example right leading hand and left leading ear or left leading eye and right leading ear and so on. In this age corpus callosum works poorly and transmits the information from one hemisphere to another badly. In group with the children having the left lateral preferences, there are a lot of children with the autistic specter disorders and children with hyperactivity and attention deficits. The course of this fact is explained with the knowledge that left lateralization has two mechanisms. The first one is genetic one and the second one is connected with the trauma before the birth and during this process. The set of pedagogical and psychological methods are offered for the teachers for the support of all kinds of students. (shrink)

Social scientists who conduct qualitative research frequently use emotional engagement to gather information about participants’ thoughts, feelings, and behaviours in relation to a particularly research question. When the subject under investigation is related to trauma, listening to, or being exposed to personal accounts of participants’ traumatic experiences can carry a significant emotional cost for researchers. This may place them at risk of secondary trauma. In this article, I examine these issues from the context of my doctoral field (...) research in South Africa, which focused on intergenerational trauma amongst descendants of victims of apartheid-era gross human rights violations. I reflect on my positionality as both an insider and outsider and feelings of guilt that emanated from my sense of being privileged and an imposter. I also reflect on the emotional turmoil brought about by my engagement with the trauma of participants and their families. I conclude by sharing the lessons I have learnt, and that have enabled me to sustain my scholarly engagement with intergenerational trauma. Ultimately, this article gives insight into, and raises awareness about, the emotional consequences of conducting trauma research. It offers practical suggestions to help researchers navigate the emotional minefield involved in conducting trauma research. (shrink)

1. Academics as a profession is traditionally viewed as stress-free due to high levels of academic freedom, clarity of job description and performance indicators, and tenure protected positions (Th...

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

Compassion fatigue, a secondary traumatic stress [STS] disorder with similar symptoms as post-traumatic stress disorder, is a recognised workplace hazard, particularly for those working in trauma exposed occupations. Here, and by drawing on Australian codes of ethical practice for nurses, social workers and youth workers, we explore how these codes might inform the practice of these Australian health and human services practitioners with respect to compassion fatigue. Drawing on Nikolas Rose’s ideas about responsibilisation and the death of the (...) social, we argue that these codes tacitly reflect a broader research and organisational impetus to responsibilise individuals to prevent compassion fatigue and maintain compassion satisfaction, and we situate this in a broader neoliberal socio-political context also framed by ‘responsibilisation’ in the context of a ‘decaying social’ and by a health and human service sector shaped by new public management. Finally, we begin to explore a preliminary conceptual case for an ecological lens through which to understand ethical responsibility for self-care, maintaining practitioner health and mitigating compassion fatigue. We argue that this lens brings into focus the need for codes to more clearly articulate broader and collective responsibilities for these elements. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dwelling in the GapsGalen SanderlinHave you ever wondered what it would be like to be a mythical being? As a hermaphrodite, I exist in a culture that sees only male or female. Those of us who don’t fit into the rigid sex binary are left out of many of the protections offered to our cousins who more neatly fit the two categories. This leaves an enormous gap in cultural (...) definitions and societal acceptance of my fundamental being.My journey has three main threads: 1) My personal and often rocky self–development, as I have come to understand and accept what it means to be a hermaphrodite, and finding others of my tribe; 2) recognizing the harm done by my medical treatment and actively seeking to change how the medical system treats hermaphrodites, starting from birth onwards; and 3) identifying what was done to me as a human rights violation.I was born in January of 1975. No genetic test was done at the time. My body looked male and my assigned sex/gender was male. As a child, I gravitated toward “male” toys. In 1989, a rural– MD noted that I was not experiencing puberty like my peers and she recommended that my parents take me to a teaching hospital in Seattle for tests. A pediatrician referred me to the adolescent medical division, and from there I was referred to an endocrinologist. After conducting many invasive tests, including drawing blood and comparing my testicles to a bead ring of ersatz testicles, the endocrinologist diagnosed me with Klinefelter’s Syndrome and a karyotype of 47,XXY. I was prescribed testosterone injections to affirm and strengthen the male identity I was assigned at birth and to prevent my body from developing secondary female sex characteristics (breasts and hips).Soon after the shots started I bulked up, adding muscle and hair everywhere. I also became dangerously aggressive and moody. I began to have serious self–esteem issues and a drastic increase in risk–taking behavior as my body was subjected to medical intervention that my parents innocently followed.The prescribed hormone treatment fractured my psyche—what I know now to be a common defense mechanism experienced in trauma survivors. The portion of my consciousness that existed prior to testosterone became deeply buried to prevent harm, and I experienced the emergence of a new “entity.” With each change in prescription, new fractures occurred: testosterone cypionate to enanthate shots, to patches, to gels.The physicians did not consider my feelings or preferences during recommendations or treatment. I feel I was forced into a “male” body based on a medical emergency they created to ease societal concerns.Last February I decided to stop hiding. Tearing the mask off has brought a flood of emotions hidden behind old traumas. I’d been living openly as an intersex person, but still deeply closeted, if not from the public—worse, from myself.Here is the writing that came pouring out of me as I’ve been accessing my repressed memories:I felt the first stirrings of my existence in August of 1989, like a fleeting visage of a long lost lover passing just out of view. The timing of the universe—Out of the infinite we are born, but in this case the body we are to occupy was already housing many other souls. Is this some mistake? Asked to be patient I waited... Late in the year of 1989 I was borne on testosterone wings into an imaginary masculine role/body.Molded in the image of Adonis, Hermes was forced to submit. No longer sexless or ageless—lost in a sea of supposed pressures and roles. My assumed gender [End Page E10] was male. Why!?! Screaming, thrashing, and damaging all around me, no way to express the horror of being so brutally manhandled.My guide Galen/Juniper were excised from our psyche—lost behind a barrier. The only solace was a shared beat: 1,2,3,4 over and over. Was this the pounding of our heart? Thank god for our love of music least we lose ourselves entirely.Why do they insist on calling me Galen? I no longer knew who this was. I... (shrink)

Severe Traumatic Brain Injury (TBI) remains a major cause of death and disability afflicting mostly young adult males and elderly people, resulting in high economic costs to society. Therapeutic approaches focus on reducing the risk on secondary brain injury. Specific ethical issues pertaining in clinical testing of pharmacological neuroprotective agents in TBI include the emergency nature of the research, the incapacity of the patients to informed consent before inclusion, short therapeutic time windows, and a risk-benefit ratio based on concept (...) that in relation to the severity of the trauma, significant adverse side effects may be acceptable for possible beneficial treatments. Randomized controlled phase III trials investigating the safety and efficacy of agents in TBI with promising benefit, conducted in acute emergency situations with short therapeutic time windows, should allow randomization under deferred consent or waiver of consent. Making progress in knowledge of treatment in acute neurological and other intensive care conditions is only possible if national regulations and legislations allow waiver of consent or deferred consent for clinical trials. (shrink)

Nietzsche’s cardinal ideas - God is Dead, Übermensch and Eternal Return of the Same - are approached here from the perspective of psychiatric phenomenology rather than that of philosophy. A revised diagnosis of the philosopher’s mental illness as manic-depressive psychosis forms the premise for discussion. Nietzsche conceived the above thoughts in close proximity to his first manic psychotic episode, in the summer of 1881, while staying in Sils-Maria (Swiss Alps). It was the anniversary of his father’s death, and also of (...) the break-up of his friendship with Wagner, the most important relationship in his life. Despite having been acquainted with these ideas from reading philosophy and literature, Nietzsche created them de novo and imbued them with very personal meaning. Surprisingly, he never defined or explained his cardinal thoughts in his published writings, perhaps because rationally he could not. A resultant hermeneutic vacuum provoked an avalanche of interpretations in secondary literature. But could these ideas be delusions? A current definition of delusion is challenged, and an attempt is made at a limited comparison between delusion, scientific/philosophical doctrine and poetic creation. It is also argued that psychosis is a way of re-living trauma, and delusions can therefore be seen as a form of reasoning that helps to make sense of the world in a state of psychotic disintegration. Far from being false beliefs, delusions are a true expression of one’s innermost feelings and pain, albeit indirectly. The relationship between early parental loss and repeated trauma, psychosis and creativity is also explored. Indo-Pacific Journal of Phenomenology , Volume 8, Edition 1 May 2008. (shrink)

Hans Baron, Karl Popper, Leo Strauss and Erich Auerbach were among the many German-speaking Jewish intellectuals who fled Continental Europe with the rise of Nazism in the 1930s. Their scholarship, though not normally considered together, is studied here to demonstrate how, despite their different disciplines and distinctive modes of working, they responded polemically in the guise of traditional scholarship to their shared trauma. For each, the political calamity of European fascism was a profound intellectual crisis, requiring an intellectual response (...) which Weinstein and Zakai now contextualize, ideologically and politically. They exemplify just how extensively, and sometimes how subtly, 1930s and 1940s scholarship was used not only to explain, but to fight the political evils that had infected modernity, victimizing so many. An original perspective on a popular area of research, this book draws upon a mass of secondary literature to provide an innovative and valuable contribution to twentieth-century intellectual history. (shrink)

BackgroundThe Supreme Court of Canada removed the prohibition on physicians assisting in patients dying on 6 February 2015. Bill C-14, legalising medical assistance in dying in Canada, was subsequently passed by the House of Commons and the Senate on 17 June 2016. As this remains a divisive issue for physicians, the Canadian Neurosurgical Society has recently published a position statement on MAID.MethodsWe conducted a cross-sectional survey to understand the views and perceptions among CNSS members regarding MAID to inform its position (...) statement on the issue. Data was collected from May to June 2016.ResultsOf the 300 active membes of the CNSS who recevied the survey, 89 respondents completed the survey, 71% of whom were attending neurosurgeons and 29% were neurosurgery residents. Most respondents,74.2%, supported the right of physicians to participate in MAID with 7.8% opposing. 37% had current patients in their practice fitting the criteria for MAID. 23.6% had been asked by patients to assist with MAID, but only 11% would consider personally providing it. 84% of neurosurgeons surveyed supported the physicians’ right to conscientious objection to MAID while 21% thought attending surgeons should be removed from the inquiry and decision-making process. 43.8% agreed that the requirment to refer a patient to a MAID service should be mandatory. Glioblastoma multiforme, quadriplegia/quadriparesis secondary to spinal tumour/trauma and Parkinson’s disease were the most common suggested potential indications for MAID among the neurosurgical population.ConclusionsOur results demonstrate that most neurosurgeons in Canada are generally supportive of MAID in select patients. However, they also strongly support the physicians’ right to conscientious objection. (shrink)

abstract: This project began as an interreligious exercise during Lent, a Christian season of increased spiritual practice. What resulted, in part, is this work, a translation and commentary on the Dhammapada (included here: the introduction and translations of three chapters with chapter commentaries). Like the Sermon on the Mount to Christians and the Bhagavad Gita to Hindus, the Dhammapada is considered the heart of Buddhist teaching. Ultimately, this work is a secondary translation or popular interpretation, akin to Thomas Merton's (...) translations of Chuang Tzu and Coleman Bark's translations of Rumi's poetry. And rather than a scholarly translation, this work is a spiritual and devotional interpretation. Among the choices I have made in this translation include gender-inclusive and affirming language, often opting for they/ them pronouns. In chapter intros, I have included resources, brief commentary, and cultural and academic notes that have helped to shape this translation. Such influencers of this translation include Ella Baker, Kendrick Lamar, Bessel van der Kolk, Lama Rod Owens, and others. The next choice I have made, instead of translating the words dukkha and samsara to sorrow/suffering and reincarnation, respectively, I have often translated these terms to harm cycles and generational suffering. My hope is that these terms capture the original meanings while also creating expansive language to hold possibilities for new understandings within Gautama Buddha's teaching. As the translator of this text, it is important to name my twenty-first-century context, influences, and identity as a person raised mostly in the Upper Midwest of the United States and who has lived in Brooklyn, New York, for the past twenty years. This translation is filtered through the lenses of my lived experience, education, social-familial position, economic status, ethnic-cultural and gender identity (as a cis male of Scandinavian-Hutterite descent, who is identified as white ), and multiple other influences. My sources include peace studies, trauma/resilience studies, liberation theology, and more than fifteen years of experience as a spiritual teacher and minister in the Anabaptist tradition (i.e., the historic peace church) of Christianity. It is through these lived experiences that this translation emerges. And, specifically, what has emerged, at least in part, is a trauma aware, liberationist interpretation of the Dhammapada. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical CommentaryTor Phern Chern, Associate ConsultantThe case scenario describes a difficult clinical and ethical challenge of a psychiatric patient refusing treatment in the context of a treatment-resistant condition that may be affecting her capacity to refuse treatment.The patient described in the case scenario displayed partial treatment refusal as evidenced by her refusal of ECT and adherence with medication and her voluntary hospital admission. Partial treatment refusal is generally more (...) common than absolute treatment refusal1 and can be sporadic, time-limited, periodic or continuous. It is important for the medical team to clarify which category of treatment refusal this patient’s refusal falls under. These broad categories include the doctor-patient relationship, religion, secondary gain, treatment- or illness-based refusals.2 The proper identification of category of treatment refusal will guide subsequent management.Refusal of treatments may be in response to reality-based transference issues like fear, distrust or pressure from the patient’s family. In this particular case, there is little data about her relationship with her treating psychiatrist, but the lack of a trusting doctor-patient relationship could be a factor for treatment refusal. The treating psychiatrist at the inpatient setting could be different from the patient’s routine outpatient psychiatrist and this could result in the lack of a trusting doctor-patient relationship. The remedy for this would be to develop a trusting relationship between her treating psychiatrist and the patient via understanding the patient’s needs and concerns. A useful adjunct would be to identify someone with whom the patient has a trusting relationship and recruit that person to help develop trust in the doctor-patient relationship. On this point, it is interesting to note that the patient’s family was noted to be highly supportive and influential in previous treatment decisions, agreed [End Page 235] with the treating psychiatrist’s treatment recommendation and yet both the treating psychiatrist and the patient’s family were unable to convince her to accept ECT. One possibility is that the patient may see her family’s support of the treating psychiatrist’s recommendation as one reason to refuse treatment. This possibility warrants deeper explorations of her premorbid underlying cultural and religious beliefs and attitudes towards her family and her perceived role in her community.Religion-based refusals of treatment (e.g. blood transfusions for Jehovah’s Witnesses) are less prominent in psychiatry than in general medicine but may manifest in treatment refusal due to advice from religious leaders on the need for spiritual solutions to the patient’s challenges. Religion-based refusals need to be distinguished from an illness-based refusal but if truly present will require the support of appropriate religious leaders to allow the patient more management options other than spiritual support for her psychiatric disorder. There is no specific information about the patient’s religion and religion-based refusals of ECT are not particularly common so this is unlikely to be a major reason for treatment refusal in this case.Treatment-based refusals of care are related to the specific treatment modality being offered and are often motivated by concerns about the side effects of treatment or past traumas that the treatment elicits. In this particular case, the patient has demonstrated some degree of treatment resistance as evidenced by the relapse of her bipolar disorder despite adherence to medication, and a change in management is certainly warranted. However, a change in medication management may be possible before proceeding to ECT in view of the patient’s acceptance of medication and no clear evidence of violent or disturbed behaviour in the ward. The occasional refusal of food and water is worrying, but if the patient can be coaxed to continue oral nutrition, there is no absolute indication to have ECT for rapid treatment response. Other options that may be acceptable to the patient are to optimise the dosage of current medications, switch medications or add augmenting pharmacological agents before proceeding to ECT. A change in pharmacotherapy must take into account her past treatment response and side effects to individual medications. Psychotherapy may also be considered to augment treatment response before ECT is considered.3Illness-based refusals are the most challenging category and... (shrink)

The rise of modernity in the 19th century can, among other things, be vividly illustrated by the phenomenal advance of medical profession and, in particular, surgery as its most radical form. In the 20th century, the doctor has already been steadily associated with the phenomenon of power. Medical experiments on human subjects are generally recognized as one of the most extreme manifestations of this discursive nexus. Despite considerable amount of historical research, predominantly dealing with the experiences of Nazi medicine and (...) its patients in concentration camps and some other disciplinary institutions, as well as somewhat gloomy attraction providing for unabated fascination on the part of trivial literature, such experiments have not yet become an established literary topos. The elusive nature of this phenomenon which belongs to the kern of post-war anxiety, but is rarely addressed to, allows me to attest to the fact that human experiments, especially those conducted in Nazi concentration camps, have become a cultural «exclusion zone». Nonetheless, there is a whole range of texts in which attempts has been made to overcome the cultural taboo and to give voice to the victims of human vivisection. Two of them – Friedrich Dürrenmatt’s Suspicion and Marcel Beyers The Flying Foxes – are analyzed in this paper against the backdrop of the so called «intellectual witness» – a concept proposed by Geoffrey Hartman and meaning a distanced witnessing, mostly on behalf of younger generations or, as in case with Dürrenmatt, of those who stayed aside of the World War II. In both novels, the narrative structures of intellectual witnessing serve to surmount the metaphorizing tendency which turns the reality of human experiments into tropes corroborating the author’s idea or concept. Combining documentary elements with the elements of trivial fiction, Dürrenmatt and Beyer make significant strides in deconstructing the naïve «over-identifying» with the victims, as well as their overt fictionalization. As a result, they manage to open the possibility of witness beyond the perspective of eyewitnesses, and at the same time subjugate this rearticulation of the past to the demands of the present situation that facilitates it. This perilous duality reveals the ethical double bind which seems to be inherent to the most reactualizations of utterly traumatic historical experiences, such as human experimentation, transformed into «exclusion zones» and then voiced through intellectual witness and other forms of «secondary witness». In order to become an object of witnessing, those traumatic experiences must correspond to the anxieties of the present originating from them. While triggering the reactualization process, such anxieties, however, also subject the experience of concrete victims to the desiderata of a traumatized «(intellectual) witness» and, in such a way, misuse the tragedy as a means of the witness’s coming to terms with his or her own trauma. (shrink)

This essay places the recent academic fascination with trauma and victimhood in a psycho‐social context within which identifications with pure victimhood hold sway. The essay takes as its starting point Freud's description, in Civilisation and its Discontents, of the formation of the super‐ego via the small child's negotiation of ambivalence towards its first authority figure. It is argued that this process lacks secondary re‐inforcement in western urban postmodernity, where authority has become diffuse, all‐pervasive and unavailable as a point (...) of identification. In this context, aggression becomes harder to acknowledge and manage resulting in a tendency towards Manicheanism and the attenuation of ambivalence. Taking as its case‐study Marianne Hirsch's writings on the ethical aesthetics of postmemorial photography, the essay concludes that recent work on trauma and testimony fails to acknowledge that identifications may straddle victimhood and perpetration. This acknowledgement is only possible where some containment of aggression feels possible. (shrink)

Haunted People Syndrome denotes individuals who recurrently report various “supernatural” encounters in everyday settings ostensibly due to heightened somatic-sensory sensitivities to dis-ease states, which are contextualized by paranormal beliefs and reinforced by perceptual contagion effects. This view helps to explain why these anomalous experiences often appear to be idioms of stress or trauma. We tested the validity and practical utility of the HP-S concept in an empirical study of an active and reportedly intense ghostly episode that was a clinical (...) referral. The case centered on the life story of the primary percipient, a retired female healthcare worker. Secondary percipients included her husband and adult daughter, all of whom reported an array of benign and threatening anomalies across five successive residences. Guided by prior research, we administered the family online measures of transliminality, sensory-processing sensitivity, paranormal belief, locus of control, desirability for control, and a standardized checklist of haunt-type phenomena. The primary percipient also completed a measure of adverse childhood events and supplied an event diary of her anomalous experiences. We found reasonably consistent support for HP-S from a set of quantitative observations that compared five proposed syndrome features against the family members’ psychometric profiles and the structure and contents of their anomalous experiences. Specifically, the reported anomalies both correlated with the family’s scores on transliminality and paranormal belief, as well as elicited attributions and reaction patterns aligned with threat detection. There was also some evidence of perceptual congruency among the family members’ anomalous experiences. Putative psi cannot be ruled out, but we conclude that the family’s ordeal fundamentally involved the symptoms and manifestations of thin mental boundary functioning in the face of unfavorable circumstances or overstimulating environments and subsequently acerbated by poor emotion regulation, histrionic and catastrophizing reactions, and active confirmation biases. (shrink)

BackgroundIn Italy, the COVID-19 pandemic has caused a collective trauma. Post-traumatic growth has been defined as the subjective experience of positive psychological changes as a result of a traumatic event. PTG can involve changes in five psychological main dimensions: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. In the context of national emergencies, those PTG dimensions encompassing changes at the social level can play a role in coping strategies that involve a renewed sense of (...) self and one’s social identities, including national identities, and in turn, foster a stronger sense of trust and connection to others.AimTo investigate how each of the five PTG dimensions mediates the association between the salience of national identity and interpersonal trust in a sample of Italian young adults. Trust in national and European institutions were expected to positively predict the strength of the Italian national identity which in turn was expected to be positively associated with interpersonal trust, and the PTG relating to others dimension to mediate this association.MethodThis study involves the secondary analysis of data from a representative sample of 2,000 Italian young adults. Participants completed a web survey during the peak of the COVID-19 crisis in Italy with measures of trust in EU and national institutions, national identity, interpersonal trust, and the PTG Inventory. Structural equation modeling procedures were employed for key hypotheses tests.ResultsTrust in national institutions positively predicted national identity, which in turn was positively associated with interpersonal trust. Evidence of a full mediation effect of the PTG relating to others dimension on the association between national identity and interpersonal trust was found.DiscussionFindings contribute to clarify the psychological responses to collective traumas. In the context of Italy’s COVID-19 crisis, trust in national institutions reinforced Italian national identity, which was in turn associated with greater interpersonal trust, but only when psychological responses to the trauma involved changes in how individuals perceived and related to others, and not merely a focus on the self. Theoretical and practical implications are discussed. (shrink)

Further to the recent handover of the Naval School of Mechanics (ESMA), Argentina’s most notorious centre for the clandestine torture and assassination of leftist militants under the dictatorship of 1976–83, to the city of Buenos Aires, in order to create on the premises a ‘Space for Memory’, debates on the proper commemoration of the recent past have gained momentum. In the course of these, it has become clear that there is currently no consensus among the human rights organizations, let alone (...) Argentine society at large, on how the former sites of state terrorism can be adequately ‘recovered’, or what the purpose and function of such a recovery might be. Rather than as a shortcoming, however, this impossibility of closure, and of the monumentalization of a social consensus about the past in museal forms, might be taken as an opportunity to problematize some of the politics and material poetics underpinning the contemporary ‘memorial museum’. The article therefore analyses the principal arguments and positions voiced in the debate about ESMA with a view to their attitudes (explicit or implicit) towards the museum-form as such, and the conclusions that might be derived from these in the context of contemporary debates about ‘postmemory’, ‘secondary witnessing’ and the politics of empathy at the museum. (shrink)

J.L. Mackie insists that ordinary evaluative thought presents itself as a matter of sensitivity to aspects of the world. And this phenomenological thesis seems correct. When one or another variety of philosophical non-cognitivism claims to capture the truth about what the experience of value is like, or (in a familiar surrogate for phenomenology) about what we mean by our evaluative language, the claim is never based on careful attention to the lived character of evaluative thought or discourse. The idea is, (...) rather, that the very concept of the cognitive or factual rules out the possibility of an undiluted representation of how things are, enjoying, nevertheless, the internal relation to 'attitudes' or the will that would be needed to count as evaluative. On this view the phenomenology of value would involve a mere incoherence, if it were as Mackie says--a possibility that then tends (naturally enough) not to be so much as entertained. But, as Mackie sees, there is no satisfactory justification for supposing that the factual is, by definition, attitudinatively and motivationally neutral. This clears away the only obstacle to accepting his phenomenological claim; and the upshot is that non-cognitivism must offer to correct the phenomenology of value, rather than give an account of it. -/- In Machie's view the correction is called for. In this paper I want to suggest that he attributes an unmerited plausibility to this thesis, by giving a false picture of what one is committed to if one resists it. (shrink)

We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) (...) is systematically sensitive to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners. (shrink)

The relationship between traumatic experiences and subsequent distress is not well understood, and little research focuses on the lived experience of psychological trauma. I draw on Louis Sass’s phenomenological taxonomy to address this lacuna. I present his differentiation between relations of phenomenological causality and implication and demonstrate that his taxonomy can be applied to experiences of trauma. Relations of phenomenological causality and implication can be identified in the genesis and constitution of post-traumatic distress. My adaptation of Sass’s taxonomy (...) will furthermore offer an extension and development of his account, applying it to the study of post-traumatic experiences and elaborating it in the process. I shall demonstrate that whether experiences occur synchronically or diachronically is not essential to their categorization in terms of phenomenological implication and causality, respectively. I will show that an alteration in perception or behavior post trauma might temporally succeed the traumatizing event while, at the same time, being implied in the experience of the event. Thereby, I demonstrate how phenomenology may contribute to a detailed understanding of experiences of trauma. Scrutiny of traumatic experiences furthermore promises to contribute to the philosophical discourse on causality, implication, and temporal experience. (shrink)

This paper addresses the phenomenological experience of precarity and vulnerability in racialized gender-based violence from a structural perspective. Informed by Indigenous social theory and anti-colonial approaches to intergenerational trauma that link settler colonial violence to the modalities of stress-inducing social, institutional, and cultural violences in marginalized women’s lives, I argue that philosophical failures to understand trauma as a functional, organizational tool of settler colonial violence amplify the impact of traumatic experience on specific populations. It is trauma by (...) design. I explore this through the history of the concept of trauma and its connection to tragedy. I give a brief overview of prominent theories of trauma and contrast these with the work of Indigenous feminist scholar Dian Million (2013), who highlights functional complicity of settler colonial institutions in shaping accounts of trauma in the west. I begin the piece with an important illustration of the kinds of lives and experiences that call for a politicized understanding of trauma in anti-colonial feminist theory. I end by offering an expansive notion of structural trauma that is a methodological pivot for conducting trauma-based gender-based violence research in a decolonial context, which calls for an end to narratives of trauma that are severed from the settler colonial project of Native land dispossession and genocide. [Volume 23, no.1]. (shrink)

Trauma-informed care in pediatrics is an organizing principle for health care delivery that is based on the science of toxic stress and the insights of attachment theory. In their groundbreak...

Der Beitrag fragt danach, was einem Subjekt durch ein psychisches Trauma angetan wird. In diesem Zusammenhang setzt er sich mit Tendenzen auseinander, die derzeit in der Psychoanalyse im Umgang mit Traumata zu beobachten sind: Steht ein Trauma im Zentrum ihrer Aufmerksamkeit, tendierten Psychoanalytiker dazu, darin ein für ihre klinische Arbeit spezielles oder gar außergewöhnliches Problem zu sehen, das nach »etwas Anderem« als der grundlegenden Methode der Psychoanalyse verlangt. Demgegenüber wird die Auffassung vertreten, dass ein Trauma untrennbar mit (...) dem Seelenleben verwoben ist. So etwas wie eine nichttraumatische Psychopathologie, so der Autor, gibt es nicht. Jede traumatisierte Psyche, unabhängig von der Intensität des Traumas, stehe darum im Grunde vor demselben Problem: Wie lässt sich der grundsätzliche Mechanismus der Wiederholung überwinden und eine ergebnisoffene Symbolisierung erreichen? Um diese Prozesse beschreiben zu können – die auch anhand einer Vignette illustriert werden –, schlägt der Autor die Unterscheidung zwischen »Subjektivität« und »Subjektalität« vor. (shrink)

There is a strong pull to the idea that there is some metaphysically interesting distinction between the fully real, objective, observer‐independent qualities of things as they are in themselves, and the less‐than‐fully‐real, subjective, observer‐dependent qualities of things as they are for us. Call this (putative) distinction the primary/secondary quality distinction. The distinction between primary and secondary qualities is philosophically interesting because it is (a) often quite attractive to draw such a distinction, and (b) incredibly hard to spell it (...) out in any kind of satisfying and sensible way. I attempt such a spelling‐out after first trying to pin down in more detail what we want from the primary/secondary quality distinction, and saying a bit about why that is such a hard thing to get. (shrink)

ArgumentIn this article, we trace shifting narratives of trauma within psychiatric, neuroscience, and environmental epigenetics research. We argue that two contemporary narratives of trauma – each of which concerns questions of time and psychopathology, of the past invading the present – had to be stabilized in order for environmental epigenetics models of suicide risk to be posited. Through an examination of these narratives, we consider how early trauma came to be understood as playing an etiologically significant role (...) in the development of suicide risk. Suicide, in these models, has come to be seen as a behavior that has no significant precipitating event, but rather an exceptional precipitating neurochemical state, whose origins are identified in experiences of early traumatic events. We suggest that this is a part of a broader move within contemporary neurosciences and biopsychiatry to seelife as post: seeing life as specific form of post-traumatic subjectivity. (shrink)

Trauma and Human Existence effectively interweaves two themes central to emotional trauma--the first pertains to the contextuality of emotional life in general, and of the experience of emotional trauma in particular, and the second pertains to the recognition that the possibility of emotional trauma is built into the basic constitution of human existence. This volume traces how both themes interconnect, largely as they crystallize in the author’s personal experience of traumatic loss. As discussed in the book's (...) final chapter, whether or not this constitutive possibility will be brought lastingly into the foreground of our experiential world depends on the relational contexts in which we live. (shrink)

Trauma and traumatization have arguably always been part of the human experience yet have in the last few decades come to occupy a prominent place in various popular and academic contexts. This chapter offers an interdisciplinary and comparative investigation of trauma and traumatization in different historical contexts. More specifically, my aim is to discuss whether the rich bodies of research in trauma and traumatization in Holocaust survivors and their descendants yield relevant insights for post-slavery contexts. It has (...) been shown that children of Holocaust survivors suffer from stress and other symptoms related to their parents’ traumatization which influence the interactions with their environments. Such results made me wonder whether the traumatic impact of chattel slavery—which has been abolished some 160 years ago—might have a similar impact, yet now across several generations. Issues of the transmission and current persistence of trauma are inherently linked to questions of social justice, recognition and reparations. This chapter is meant, however, as an exploration of interdisciplinary connections that should be studied in concert to account for the traumatic impact of historical and present day experiences. It starts by discussing the concepts of trauma and post-traumatic stress disorder. Continuing by exploring the phenomenon of the inter- and transgenerational transmission of trauma, it relies in part on the important body of research conducted on families of Holocaust survivors. I then turn to the much less researched ‘post-traumatic slave syndrome’ (DeGruy) and discuss two factors that might contribute to the transgenerational transmission of trauma in the families of former enslaved: epigenetics and the continuation of traumatization even after the abolition of slavery as articulated in Historical Trauma theory. Drawing upon these insights, I conclude that it is plausible that a continuing transgenerational transmission of trauma might occur in some families of slavery survivors, the knowledge of which might help to break the chains of such traumatization across generations. (shrink)

With my research, I wish to contribute to the discussion of post-traumatic psychopathologies from a phenomenological perspective. The main question I pursue is to what extent PTSD can be understood as an intersubjective psychopathology and which implications this view might have. In this paper, I argue that the mode of perception allowing for intersubjective experience is vulnerable to disruptions through traumatic events. I begin with a short elaboration on what intersubjectivity entails before proceeding to illustrate how it can be impaired. (...) Then, I focus on the concept of empathy as a mode of perception: I propose that due to a disruption of the ability to empathize an individual suffering from PTSD may cease to experience the other as another subject that offers possibilities for interaction. The traumatized individual is thus unable to establish meaningful connections with others. I offer some implications this view might entail for thinking about trauma treatment. (shrink)

In this paper, I enquire into the nature of the influence culture has on the experience of trauma. I begin with a brief elaboration of the dominant conceptualisation of post-traumatic experiences: the diagnostic category of PTSD as it can be found in the DSM. Then, I scrutinise the nature and extent to which cultural factors may influence the phenomenology of the experience of certain events as traumatic and subsequent symptoms of post-traumatic stress. It seems that cultural circumstances alter the (...) way in which trauma is experienced; it is not clear whether there is in fact a core pathology of PTSD, as the DSM assumes, or whether the structure of the experience of trauma is too multifaceted to be summarised in one diagnostic category. Finally, I show that phenomenological enquiry promises to identify the structural similarities that would justify the delineation of a distinct diagnostic category. (shrink)