Myths of Trauma : Why Adversity Does Not Necessarily Make Us Sick

Post-traumatic stress disorder (PTSD) is a serious and sometimes debilitating mental disorder. Yet only about one in ten people who are exposed to significant traumatic events develop PTSD. Since its inclusion in the Diagnostic and Statistical Manual (DSM) in 1980, the definition of PTSD has been controversial. Various changes made to the criteria have gradually widened the diagnostic criteria, which now include experiences that may not involve direct exposure to trauma, which in turn has led to PTSD to be over-diagnosed: clinicians may be tempted to seize on traumatic events in a history as an explanation of mental disorders, while patients may automatically receive the diagnosis if they experienced major trauma in the past. Myths of Trauma is a timely and important book that probes the sensitive, emotional, and often controversial subject of trauma, the difficulties associated with its diagnosis, and the over-diagnosis of PTSD. Trauma has become a catch-all for many kinds of adverse experiences, when in reality, people are significantly resilient to traumatic events. The book also explores how responses to trauma develop in the context of multiple interwoven risk factors, ranging from genetic vulnerability effecting sensitivity to the environment, as well as past adversities; how trauma has become a political issue that interferes with unbiased scientific study of its effects; and how trauma narratives can have a darker side when patients use them to justify feelings of victimhood that interfere with their own agency. Integrating and analysing the vast quantities of scientific literature on the topic, Myths of Trauma teaches us not to think about trauma in isolation or as one thing rather than many different things. The experiences of trauma deserve a place in clinical practice, and it is time for PTSD to be viewed through a more complex and multidimensional lens within the broader biopsychosocial context. Cover Myths of Trauma Copyright Contents Foreword Introduction What This Book Is About Why I Have Written This Book The Roots of Resilience Implications for Clinical Practice Acknowledgments 1. Does Trauma Cause Posttraumatic Stress Disorder? Problems in Defining Criteria for Posttraumatic Stress Disorder PTSD and Concept Creep Diagnoses on the Borders of PTSD Acute Stress Disorder Complex PTSD Traumatic and Nontraumatic Risks for PTSD Stressors That Carry a High Risk PTSD Around the World Building a Broader Model of PTSD 2. Individual Differences in Response to Trauma Personality Traits and the Psychological Immune System Behavior Genetics and the Crucial Role of Neuroticism Genes and Susceptibility to PTSD Neuroscience and PTSD Neuroticism, PTSD, and Evolution Previous Exposure to Trauma The Biopsychosocial Model of Psychopathology Applying a BPS Model to PTSD Correlation and Causation 3. Trauma in Historical and Social Perspective Historical Perspectives Sociocultural Perspectives PTSD and the Culture of Trauma The Myth of Trigger Warnings Politics, Identity, and Trauma 4. Risk, Resilience, and Trauma The Ubiquity of Resilience Individual Differences in Resilience Trauma and Resilience Risk and Resilience in Community Populations Follow-​up Studies of Children in the Community The Isle of Wight Study The Hawaii Study The Albany–​Saratoga Study Lifetime Follow-​ups of Adolescents The Grant Study Follow-​ups of Children and Adolescents at Risk Studies of Institutionalized Children Birth Cohort Studies Mechanisms of Resilience Posttraumatic Growth 5. Childhood Trauma and Posttraumatic Stress Disorder Childhood Trauma as a Risk Factor for Psychopathology Childhood Sexual Abuse Other Forms of Childhood Maltreatment Emotional Neglect Attachment, Temperament, and Trauma Are Earlier Experiences More Important Than Later Experiences? 6. Trauma and the Science of Memory The Recovered Memory Movement Suppression, Repression, and Dissociation What Science Tells Us About Memory Lessons from the Recovered Memory Epidemic 7. Posttraumatic Stress Disorder, Personality Disorders, and Complex Posttraumatic Stress Disorder Posttraumatic Stress Disorder in the Context of Personality Personality Traits and Psychological Symptoms Childhood Trauma, PTSD, and Borderline Personality Disorder The Diagnosis of Complex PTSD 8. Treatment for Posttraumatic Stress Disorder Does Posttraumatic Stress Disorder Require Trauma-​Specific Psychotherapy? Pharmacotherapy for PTSD How Therapy Helps—​and Why It Doesn’t Always Help Treating PTSD in the Context of Personality Disorder Psychotherapy, PTSD, and Philosophy Implications for Clinical Practice 9. Summary and Conclusions A Biopsychosocial Model of Posttraumatic Stress Disorder Clinical Implications of a Biopsychosocial Model Myths Versus Evidence About Trauma Recommendations References Index Post-traumatic stress disorder (PTSD) is a serious and sometimes debilitating mental disorder. Yet only about one in ten people who are exposed to significant traumatic events develop PTSD. Since its inclusion in the Diagnostic and Statistical Manual (DSM) in 1980, the definition of PTSD has been controversial. Various changes made to the criteria have gradually widened the diagnostic criteria, which now include experiences that may not involve direct exposure to trauma, which in turn has led to PTSD to be over-diagnosed: clinicians may be tempted to seize on traumatic events in a history as an explanation of mental disorders, while patients may automatically receive the diagnosis if they experienced major trauma in the past.Myths of Trauma is a timely and important book that probes the sensitive, emotional, and often controversial subject of trauma, the difficulties associated with its diagnosis, and the over-diagnosis of PTSD. Trauma has become a catch-all for many kinds of adverse experiences, when in reality, people are significantly resilient to traumatic events. The book also explores how responses to trauma develop in the context of multiple interwoven risk factors, ranging from genetic vulnerability effecting sensitivity to the environment, as well as past adversities; how trauma has become a political issue that interferes with unbiased scientific study of its effects; and how trauma narratives can have a darker side when patients use them to justify feelings of victimhood that interfere with their own agency.Integrating and analysing the vast quantities of scientific literature on the topic, Myths of Trauma teaches us not to think about trauma in isolation or as one thing rather than many different things. The experiences of trauma deserve a place in clinical practice, and it is time for PTSD to be viewed through a more complex and multidimensional lens within the broader biopsychosocial context. Trauma is almost universal in human life, but only a minority of those exposed to adversity develop posttraumatic stress disorder (PTSD). Trauma has become a catchword for many kinds of adverse experiences; this is a construct that needs to be more narrowly and precisely defined. Moreover, most people are resilient to adversity. While exposure is a risk factor for psychopathology, PTSD tends to develop in people with high neuroticism, which describes intense reactions to adversities, based on temperament, and that is a heritable personality trait. The best model of PTSD needs to be biopsychosocial. Moreover, while childhood trauma is a risk factor for many forms of psychopathology, only some of those exposed to early adversity develop mental disorders. Failure to understand the complexity of the pathways to psychopathology can lead to well-meaning but misguided approaches to psychotherapy "Trauma is a term that describes damage to the mind caused by a distressing life event. Traumatic events, in and of themselves, are most certainly not a myth. Some events, such as shootings or rapes, are particularly likely to provoke post-traumatic symptoms. We need not lose sight of the fact that highly adverse life events can trigger serious psychopathology"-- Provided by publisher.