E-Book, Englisch, 220 Seiten
Schauer / Neuner / Elbert Narrative Exposure Therapy (NET) For Survivors of Traumatic Stress
3rd Auflage 2025
ISBN: 978-1-61334-595-5
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 220 Seiten
ISBN: 978-1-61334-595-5
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Extensive evidence shows that six to twelve sessions of Narrative Exposure Therapy (NET) can be sufficient to provide considerable relief from events such as organized violence, torture, war, rape, and childhood abuse. The new manual is clearly structured and easy to follow, and includes new figures that help illustrate and guide the reader through the steps of NET. The theoretical sections offer a solid basis for carrying out the therapeutic intervention. The reader will learn the NET approach step by step, with robust and straightforward practical advice and tools, including how to deal with challenging situations, e.g., how to go deeper when faced with the challenging dynamics of remembering trauma, and how to manage dissociation, avoidance, strong emotions, lost memories, or the sudden emergence of unexpected recollections from the past. NET therapy conversations and resulting narrations from trauma scenes demonstrate the level of Narrative Exposure details required. Finally, the importance of reading back the testimony to the individual is explained.
A new section on the variations of NET details how to offer KIDNET for children and young people, FORNET for victims of trauma who are perpetrators of violence, NETfacts for communities, and ElderNET for older adults as well as online NET (eNET). Experienced therapists also get an idea of how NET is typically trained and how to facilitate NET exercises. Downloadable resources for use in clinical practice include handouts, examples of narrations, and a checklist for adverse life events.
This book is an invaluable resource for clinical psychologists, psychotherapists, psychiatrists, counselors, crisis workers, social workers, health workers, and physicians.
Zielgruppe
Clinical psychologists, psychiatrists, psychotherapists, counselors, crisis workers, health workers, social workers, and physicians.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
|1|1 Introduction: Voices of Victims
Experiencing or witnessing a threat to one’s life and integrity is considered a traumatic event because it has a lasting impact on the survivor’s body and mind. Survivors are often overwhelmed by traumatic memories with frequent exposure to traumatizing experiences, resulting in pervasive fear and distress long after the danger has passed. Individuals who have experienced psychological trauma may feel as though their body and mind are under constant threat, leading to confusion between past and present dangers. Intrusive memories of traumatic events can create a distorted perception of reality, making it difficult for survivors to feel safe in the present moment. This detachment from the present and future can result in feelings of alienation and a disconnection from one’s body and soul. Natural disasters and life-threatening accidents are events that can happen to anyone. Therefore, scientists have long believed that survivors do not perceive disasters as a personal attack. However, humans tend to interpret even natural coincidences as personal, trying to link them to some reason or cause as a form of punishment for their actions. Intentionally inflicting severe pain and harm violates humanity. Trauma destroys the essence of human interaction within a social setting, including communication, speech, autobiographical memory, dignity, peace, and freedom. It also isolates survivors and halts the natural flow of their personal narrative. In this introduction, we want the voices of those who have survived violent acts and childhood abuse and neglect, as well as torture, terror, and suffering, to be heard. Primo Levi, an Italian Jew born in Turin in 1919, who was deported to the concentration camp Auschwitz in 1943, wrote one of the most significant documents about the horrors of the concentration camp. In If This Is A Man, he demonstrated that the dehumanization and degradation of the victims that precedes physical murder is even more terrible than the murder itself. A dream full of horror has not stopped visiting me, at sometimes frequent, sometimes longer, intervals: I am sitting in a peaceful relaxed environment, apparently without tension or affliction; yet I feel a deep and subtle anguish, the definite sensation of an impending threat. And, in fact, as the dream proceeds, slowly and brutally, each time in a different way, everything collapses and disintegrates around me, the scenery, the walls, the people, while the anguish becomes more intense and more precise. Now everything has changed into chaos; I am alone in the center of a grey and turbid nothing, and now I know what this thing means, and I also know that I have always known it; I am in the Lager once more, and nothing is true outside the Lager. All the rest was a brief pause, a deception of the senses, a dream.... I have fallen into a rather serious depression. I ask you as a “proper doctor,” what should I do? I feel the need for help but I do not know what sort. Primo Levi (February 7, 1963, p. 25; Auschwitz survivor in a letter to his friend and doctor David Mendel.) Primo Levi had experienced even more trauma. As a child, he suffered from frequent chest infections. His father, Cesare, was often away working abroad in Hungary, leaving Primo and his mother alone. Primo was described as thin and shy, and he was severely bullied at school for many years, which he believed was due to his perceived “ugliness” (Thomson, 2019). Undoubtedly, the time spent in concentration camps was a traumatic and inhumane experience of unnameable proportions for victims and witnesses. However, it is important to recognize that other factors, such as experiences of marginalization, lack of attachment figures, physical illness, and more, occurring in contexts of persecution and human rights violations, contribute to the deterioration of mental health amidst organized violence and wars. Levi’s death in 1987 came as a terrible shock to his friends and admirers around the world – his death certificate cites “suicide.” Natalia Ginzburg, a Jewish writer, wrote, “Of those years [in Auschwitz] he must have had terrible memories: a wound he always carried with great fortitude, but which must have been nonetheless atrocious. I think it was the memory of those years which lead him towards his death.” (quote in Gambetta, 1999). The memory of trauma should never be erased. Many survivors believe that denying their experiences is more harmful than the trauma itself. In his account of life as a Moroccan political prisoner, inspired by his own 18 months detainment in an army camp in the late 1960s, Ben Jelloun puts this sentiment into words: |2|Oh, I see, (you) want to destroy the evidence of the horror suffered ... tear down, lie, mask, dance on the ashes of the people. ... Even if the soldiers succeed in erasing the traces of the dungeon, they will never erase the memory of what we have suffered from our memory. Oh, my memory ... You must persevere. Oh, you, my memory, my child, who will carry these words beyond life, beyond the visible. ... Worse than the horror suffered is its denial. Tahar Ben Jelloun (translated from the original by the author, 2001, p. 220) Treatments that help to organize memories of fear and horror are of central importance: They can induce a permanent anchoring of implicit memories in the past, thus preventing the unwanted frequent threat of reactivation of trauma-associated memories by triggers. This integration of traumatic events is particularly important because unresolved trauma memories can influence emotions and actions throughout a person’s life and can be transmitted to the social environment as well as transgenerationally. Equally essential, however, is the testimony so that past violations remain acknowleged. Bearing witness, however, is often prevented by the inherent dynamics of the trauma itself. Inexplicable fear and speechlessness silence survivors. Trauma agents persist due to incomplete memory encoding, preventing conscious recollection of the past. Fleeting traces manage to slip through the gates of attention and trigger vivid and realistic memories of the distressing events, causing immediacy for fear and horror. “As-if” reenactments of the past become a part of the present, but are too terrifying to express vocally. Consequently, terror induces an inability to speak. When I think of this time, fear is rising. In the past, we had to suppress it because of the permanent danger, but today I feel strange, because I only remember fragments. Why is that so? I feel as if a part of me is still hiding. I am staring into the darkness and only now and then something flashes up and lays open, a memory of my previous life. Ervin Staub (1998), child survivor of the Holocaust, whose history of persecution unfolds in multiple events beginning when he was just 6 years old. Survivors of continuous or complex trauma have often endured frequent interpersonal abuse from early childhood. It can take decades for the first clear sensory intrusive memories to surface, despite a lifetime of experiencing symptoms of unknown origin and untold misery. One day I looked in the mirror. On my arms and legs there was hardly any place where I had not cut or burned myself.… I was 30 years old. This time I was hospitalized for 14 weeks. It was my 57th stay as an inpatient in a psychiatric ward. I had suffered from eating disorders, bodily pains, and drug abuse since 16 years old by then. During the 2nd week, I suddenly experienced my first flashback of sexual abuse through my grandfather. I saw him raping me. After this stay, I had panic attacks and nightmares. More and more memories appeared. I realized that my father had done the same thing to me. I felt immense disgust. I slit my wrists; another attempt to die. After that, I stayed again for 5 months on a locked ward. Terrible fractions of memory of a time when I was sold to men in child-prostitution were haunting me. I wished I had succeeded to starve myself to death.… Excerpt from a diagnostic interview at University of Konstanz, held at the Center for Psychiatry Reichenau, Germany (2010) with a person suffering from borderline personality ...
