Trauma, Transformation, And Healing.

An Integrated Approach To Theory Research & Post Traumatic Therapy

J. P. Wilson

• Éditeur: Routledge
• Année: 2014
• ISBN:
  9781317772545
• Édition: 1
• Sujet: Psicología
• Sous-sujet: Historia y teoría en psicología

First published in 1989. This rich and exciting book draws together a wide range of theoretical conceptualizations, current research, and clinical understanding to provides up-to-date and comprehensive account yet available of traumatic stress and its consequences. John Wilson integrates complex theoretical frameworks from Freud to Seligman, Horowitz to Selye, to paint a powerful explanatory picture of the interaction between trauma, person, and post-trauma environment.

Section II

Empirical Support

4

Stress Sensitivity and Psychopathology

with Ken Prabucki

A person-environment model of human responsivity to stressful life events implicitly recognizes that there are differential stress response thresholds. Traumatically stressful events do not necessarily have a uniform effect on all people, and for this reason theorists have postulated that various psychological processes (e.g., stress appraisal) determine how these experiences are perceived, processed, and integrated into the self-structure.

Antonovsky (1979), for example, has argued that the ability to successfully manage and cope with different types of stressors (i.e., traumatic versus mundane) is contingent on a “sense of coherence” which he defines as “the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one’s internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected” (p. 123). Antonovsky’s concept of a sense of coherence is similar to Kobasa’s concept of the hardy-coper personality type, which characterizes a person who enjoys challenges and handles stressful life events by maintaining an internal locus of control and a sense of commitment to a well-formed value system. Kobasa’s research with her associates (1979, 1981, 1982) has indicated that the hardy coper is resilient to the types of stresses that produce deleterious effects in others. Common to both Antonovsky’s and Kobasa’s concept of stress sensitivity is the idea that there is a complex mind-body relationship which is affected by many factors such as culture, learned patterns of stress management, cognitive coping styles, and autonomic nervous system functioning.

As noted in Chapter 1, many other theorists from Freud to the present have postulated concepts of vulnerability and sensitivity to stressful life events (e.g., Anthony & Koupernick, 1974; Coyne & Lazarus, 1980; Dohrenwend & Dohrenwend, 1974; Garmezy, 1981; Gleser, Green, & Winget, 1981; Lazarus & Folkman, 1984). In an explicit person-environment formulation of stress sensitivity, Appley and Trumbull (1967) state:

It is consistently found that these [stress] reactions vary in intensity from person to person under exposure to the same environmental event. … It has also been noted that, with few exceptions, the kind of situation which arouses a stress response in a particular individual must be related to significant events in that person’s life. Many people have used the terms “ego strength,” “stress tolerance,” and “frustration tolerance.” It is perhaps doubtful that there is such a thing as a general stress-tolerance in people. There is more likely to be a greater or lesser insulation from the effects of certain kinds of stress producers rather than others. … It seems more likely that there are differing thresholds, depending upon the kinds of threats that are encountered and that individuals must be differentially vulnerable to different kinds of stressors. … To know what conditions of the environment are likely to be effective for the particular person the motivational structure and prior history of the individual would have to be taken into account. Where the particular motives are known … what kinds of goals have for him been likely to increase anxiety or lead to aversive or defensive behavior … a reasonable prediction of stress proneness might be made. (pp. 10–11)

In a 19-year update from their original formulation on stress sensitivity, Appley and Trumbull (1986) summarize as follows:

In our view stress vulnerability profiles (cf. Appley, 1962) are determined by underlying motivational patterns that identify particular areas of relatively greater or lesser susceptibility, thus influencing the appraisal processes in different ways for different individuals. (p. 13)

The various conceptions of sensitivity or vulnerability to stress presented above are dynamic explanations that assume that person and environmental variables codetermine whether or not a stressor will produce psychic overloading and distress or be effectively managed by the individual in ways that do not adversely affect adaptive functioning. Clearly, some persons are especially likely to manifest pathological stress response to some stressors which would have little effect on others. Conversely, some stressors (e.g., torture) would produce post-traumatic stress in nearly everyone.

There is, of course, a large literature on the concept of stress vulnerability and stress invulnerability (e.g., Anthony & Koupernik, 1974; Block & Block, 1980; Coelho, Hamburg, & Adams, 1974; Garmezy, 1981; Garmezy & Rutter, 1983; Kahana, Harel, Kahana, & Rosner, 1988). The review of these studies, while important, is beyond the specific scope of this chapter. It is clear from the results of these studies and many others (e.g., Archibald & Tuddenham, 1965; Danieli, 1988; Lindy, 1988; Laufer, Frey-Wouters, & Gallops, 1985; Nefzger, 1970; Ochberg, 1988; Wilson, Harel, & Kahana, 1988) that situations of extreme stress, such as high levels of combat in warfare or prolonged internment in concentration camps (Eitinger & Strom, 1973), produce consequences that diminish some individuals’ ability to tolerate stressors later in ...