Charles Baxter, in his essay “Dysfunctional Narratives: or: ‘Mistakes Were Made,’” implies that all trauma narrative is synonymous with “dysfunctional narrative,” or narrative that leaves all characters unaccountable. He writes: “In such fiction, people and events are often accused of turning the protagonist into the kind of person the protagonist is, usually an unhappy person. That’s the whole story. When blame has been assigned, the story is over.” For Baxter, trauma narrative lets everyone “off the hook,” so to speak. He would say that we write about our bitter lemonade to make excuses for our poor choices, and “audiences of fellow victims” read our tales, because their lemonade and their choices carry equal bitterness, and they require equal excuses. While trauma narrative can soothe us, as can other narrative genres, we should not dismiss trauma fiction because of a sweeping generalization. Trauma fiction also allows us to explore the missing parts of our autobiographical narratives and to explore the effects of trauma—two endeavors not fully possible without fiction. As explained in more detail later, the human mind requires narrative to formulate an identity. Trauma disrupts this process, because “trauma does not lie in the possession of the individual, to be recounted at will, but rather acts as a haunting or possessive influence which not only insistently and intrusively returns but is, moreover, experienced for the first time only in its belated repetition.” Because literature can speak what “theory cannot say,” we need fiction to speak in otherwise silent spaces. Fiction allows us to express, analyze, and comprehend what we could not otherwise.

Lion in Summer & Other Beasts is an investigation into point of view, place and the fragment. Many of the characters are searching for a sense of home outside of their birthplace, in cities such as New York City, Charleston, Portland and Tel Aviv. Major themes include alienation, love and trauma.

This is a collection of two stories, one fiction and one non-fiction, in communication with one another. Both stories explore how trauma can transform a life. In "Tabula Rasa," Mena is unable to recall her past after being beaten and left for dead. She must choose whether to uncover her past or forget it and move forward with her life. Set in a town run by witches, Mena learns that both choices are dangerous. In "Eternal Second," the narrator recounts the aftermath of her husband's suicide. She explores how trauma invades all aspects of her life. In both stories, women must navigate a new life created by the destruction of the old one.

In the proposed study it is hypothesized that resiliency will moderate the relationship between child abuse and psychiatric outcomes. Secondly, it is expected that shame will mediate the above mentioned relationship. Mediation and moderation effects will be tested via SPSS REGRESSION. Data was collected from 160 women at California State University, San Bernardino. The following measures were used to examine the hypothesis: Childhood Trauma Questionnaire, Brief Symptom Inventory, Experience of Shame Scale, Self-Esteem Inventory, the Life Orientation Test-Revised, and the Social Support Inventory.

Thesis (Ph. D.)--Georgia State University, 2007. / Title from file title page. Gregory J. Jurkovic, Gabriel P. Kuperminc, committee co-chairs; Lisa Armistead, Sarah Cook, committee members. Electronic text (117 p.) : digital, PDF file. Description based on contents viewed June 6, 2008. Includes bibliographical references (p. 72-83).

Thesis (PhD (Psychiatry))--University of Stellenbosch, 2005. / Many gaps remain in our current state of knowledge about the epidemiology, phenomenology, neurobiology, and psychopharmacology of posttraumatic stress disorder (PTSD) in children and adolescents. Empirical evidence, particularly in non-Western settings, is sparse and there is little convergent understanding of the interrelationship of epidemiological factors, PTSD symptom expression, full and partial syndromes, disorders comorbid with PTSD, and pharmacotherapeutic interventions. Clinicians are faced with the difficult task of treating this often complicated and debilitating disorder in youth in the absence of data from well-controlled clinical trials. The studies detailed here are a point of departure for understanding the confluence that exists between epidemiological, phenomenological, and pharmacotherapeutic aspects of adolescent PTSD. Two studies were conducted to investigate the prevalence and effects of violence exposure and PTSD, clinical and functional correlates of full and partial syndromes, and associated gender differences in school and clinic samples, respectively. Two preliminary open-label trials assessed the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) in adolescents with at least moderate severity PTSD. The results indicate that (i) partial PTSD is a common nosological entity in adolescents, (ii) gender-related differences in PTSD, even if not manifest in differences in prevalence (i.e., in the rates of trauma exposure and full and partial PTSD), may well manifest in symptom expression (i.e., higher symptom burden in girls), associated morbidity, and functional impairment, and (iii) SSRIs may be effective in treating core PTSD symptoms in this age group. While not yet demonstrated, the partial subtype may have similar biological underpinnings to full PTSD in adolescents and may benefit from similar pharmacotherapeutic interventions. This is an area deserving of further investigation. Controlled SSRI data are needed to establish if these should be agents of choice for paediatric PTSD.

Trauma-informed care (TIC) is an approach to service delivery based on the understanding of the prevalence of psychological trauma among service users, knowledge about the impact trauma has on engagement to services, and recognition that service settings can be re-traumatizing. For more than a decade, momentum has been building on this topic. Practitioners are pursuing the knowledge and skills needed to implement trauma-informed service delivery, while organizations are building infrastructure and processes aimed at supporting this approach. Disciplines across many human service sectors are eager to incorporate TIC into policy and practice. Despite this enthusiasm, implementation efforts are slow. Acquiring foundational knowledge about TIC has typically been recommended as a first step when implementing a trauma-informed approach. However, slow progress in implementation suggests knowledge may not be enough. This study investigated the individual characteristics that impact a commitment to TIC, with specific attention to the relationship between foundational knowledge about trauma-informed care and commitment to TIC. Other variables of interest included perceived principal support, TIC self-efficacy, beliefs about trauma and its impact, and organizational strain. Survey data were collected from 118 participants working in mental health, public health, and early childhood. Results from structural equation modeling suggest that foundational knowledge predicts affective commitment to TIC both directly and with the partially mediated paths through principal support, TIC self-efficacy, and beliefs about trauma. Organizational strain does not moderate these effects. However, group differences based on high and low levels of perceived organizational strain were observed and discussed. These findings add to the growing literature on TIC and should be considered as organizations strive to implement TIC.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Both chronic trauma and shame, as well as the relation between them, are understudied phenomena. This is despite particularly high levels of both trauma- and shame-related psychopathology in South Africa (Edwards, 2005). I conducted a qualitative study exploring experiences of trauma, shame, post-traumatic reactions and coping mechanisms in single interviews with 19 South African survivors of chronic trauma (intimate partner violence) using narrative analysis. Results from the categorical content analysis indicated that all but one participant reported a history of physical violence perpetrated by her intimate partner. Sexual and emotional violence were also reported by the majority of the participants. The most significant reported mental health outcomes were persistent fear, depression and suicidality, dissociation and somatic complaints. Coping mechanisms included religion, support from family, counselling and substance misuse. Using smiling as a mask to conceal difficult feelings and keeping occupied were cited as the most effective defenses. Shame was viewed as a social emotion, and often described as humiliation (and sometimes embarrassment), which required the presence of a mocking, hostile audience. This was interpreted in socio-cultural terms. Eleven women presented with a split self – the authentic self who admitted to a great deal of shame when asked indirectly, and the false self who was described in surprisingly positive terms. I analysed this split using categorical content analysis and narrative analysis from a social constructivist point of view at individual (clinical) level, organisational (micro-cultural) level, and broader cultural level. I used Gee’s (1991) categorical form analysis to analyse five long complex shame and trauma narratives with the aim of determining if psychic fragmentation presents at linguistic level. I also analysed three short, compressed trauma and shame narratives. The structure of the short narratives tended to be circular, erratic, disjointed, and interrupted (Scarry, 1985; Simon, 2008). The three short, compressed trauma narratives were characterised by long pauses or silences, hesitations, avoiding eye contact, hunching over, covering the face with clothes, whispering, so making the narrative almost inaudible, crying, and defensive leaning in towards me, and laughing. These women were exceptions – most women expressed an urgency to talk about their experiences in great detail. Although the longer narratives are essentially fractured chaos narratives at linguistic level, they contain predominant trauma- and shame-related themes that are consistent throughout the narratives and that remain intact in spite of the signs of linguistic disruption and fragmentation. They are, in order of narratives, 1) shame/self-blame and deservedness; 2) truth/lies and bearing witness; 3) shame, humiliation and dissociation; 4) the concealed, shame-based self, including amnesiac-like disorientation of place and time; and 5) patterns of cyclical leave-return reflecting perpetrator-instilled abandonment terror, including disorientation of time. I have argued that although language, or narrative structure, continues to mimic and reflect narrative content (fractured narratives vs fractured selves) – there is also the intriguing possibility of a disconnection between form and content; and that thematic coherence or consistency and narrative fracturing can co-occur; co-exist. There are a number of clinical features in the narratives which are either related to, or comprise diagnostic criteria for chronic trauma syndromes such as chronic PTSD and DESNOS, and intersect with shame themes in the narratives I analysed. Consequently, I argue that there is a substantial intersection or co-occurrence between exposure to chronic trauma, and trauma-related clinical symptoms, including shame, which emerge from the narratives, which without exception, demonstrate significant linguistic fracturing. In conclusion, a number of gaps in the literature were identified. Future research should triangulate methods and chronic trauma prevalence and longitudinal studies are needed both internationally and locally. / AFRIKAANSE OPSOMMING: Sowel kroniese trauma as skaamte, en die verhouding tussen die twee, is tot dusver onvoldoende bestudeer – ondanks die besonder algemene voorkoms van trauma- en skaamte-verwante psigopatologie in Suid-Afrika (Edwards, 2005). Ek het ʼn kwalitatiewe studie onderneem en die ervaring van trauma, skaamte, post-traumatiese reaksies en oorlewingsmeganismes ondersoek in indiwiduele onderhoude met 19 Suid-Afrikaanse oorlewendes van kroniese trauma (geweld in intieme verhoudings). In my ondersoek het ek van narratiewe analise gebruik gemaak. Resultate van die kategoriese inhoudsanalise dui aan dat ál die vroue in die bestudeerde groep, behalwe een, ‘n geskiedenis van fisieke geweld gerapporteer het wat deur haar ‘partner’ gepleeg is. Seksuele en emosionele geweld is ook deur die meerderheid van die groep gerapporteer. Die mees betekenisvolle uitkomste in verband met psigiese gesondheid was voortdurende angs, depressie, selfmoordneigings, dissosiasie en somatiese klagtes. Oorlewingsmeganismes was onder andere godsdiens, berading en dwelms. Om ʼn glimlag te gebruik as masker vir die verberging van pynlike emosies, en om besig te bly, is genoem as die effektiefste verdedigingsmeganismes. Skaamte is gesien as ‘n sosiale emosie, en is dikwels ‘vernedering’ genoem (soms ʼn ‘verleentheid’), wat die teenwoordigheid van spottende, vyandige toeskouers impliseer. Skaamte is in die studie in sosio-kulturele terme geïnterpreteer. Elf vroue het 'n gesplete self vertoon – die outentieke self wat 'n groot hoeveelheid skaamte erken het wanneer hulle indirek daaroor uitgevra is, teenoor die valse self wat in verbasend positiewe terme beskryf is. Ek het hierdie gesplete self geanaliseer met gebruikmaking van kategoriale inhoudsanalise en ook van narratiewe analise uit 'n sosiaal-konstruktiewe perspektief – op 'n indiwiduele (kliniese), organisatoriese (mikro-kulturele) en ‘n breër kulturele vlak. Ek het Gee (1991) se kategoriale vorm-analise gebruik om vyf lang, komplekse skaamte- en traumanarratiewe te analiseer om te bepaal of psigiese fragmentering op 'n linguistiese vlak manifesteer. Ek het ook drie kort, gedronge trauma- en skaamtenarratiewe geanaliseer. Die struktuur van die kort narratiewe was geneig om sirkulêr, wisselvallig, onsamehangend en onderbroke te wees (Scarry, 1985; Simon, 2008). Die drie kort, gedronge traumanarratiewe is gekenmerk deur lang stiltes, aarseling, vermyding van oogkontak, vooroor buk, bedekking van die gesig met klere, fluistering (sodat die narratief byna onhoorbaar geword het), gehuil, defensiewe oorleun na my toe, en gelag. Hierdie drie vroue was uitsonderings – die meeste vroue het 'n dringende behoefte laat blyk om in fyn besonderhede oor hulle ervarings te praat. Alhoewel die langer narratiewe op 'n linguistiese vlak wesentlik gefragmenteerde chaos-narratiewe is, bevat hulle dominante trauma- en skaamte-temas wat konsekwent deur die verhale aanwesig bly ondanks die tekens van linguistiese disrupsie en fragmentering. Hulle is, in die volgorde van die narratiewe, 1) skaamte/selfblamering en verdiende loon; 2) waarheid/leuens en getuienis aflê; 3) skaamte, vernedering en dissosiasie; 4) bedekte, skaamte-gebaseerde self, insluitend die amnesieagtige disoriëntering van plek en tyd; en 5) patrone van sikliese vertrek en terugkeer, insluitend 'n disoriëntering van plek en tyd – 'n refleksie van die vrees om alleen gelaat te word, veroorsaak deur die gewelddadige optrede teen haar. Ek het geredeneer dat, alhoewel taal/ narratiewe struktuur geneig is om narratiewe inhoud na te boots en te reflekteer (gefragmenteerde narratiewe naas gefragmenteerde self) – is daar ook die interessante moontlikheid van 'n diskonneksie tussen vorm en inhoud; en dat tematiese samehang of konsekwentheid saam met narratiewe fragmentering kan voorkom. Daar is 'n aantal kliniese kenmerke in die narratiewe wat diagnostiese kriteria bevat vir kroniese trauma-sindrome soos kroniese PTSD en DESNOS, en wat verband hou met skaamtetemas in die betrokke narratiewe. Gevolglik redeneer ek dat daar 'n substansiële oorvleueling of saambestaan is van die blootstelling aan kroniese trauma en trauma-verwante kliniese simptome, insluitend skaamte. Dit kom na vore in die geanaliseerde narratiewe, wat sonder uitsondering deur linguistiese fragmentering gekenmerk word. Ten slotte is ‘n aantal leemtes in die literatuur geïdentifiseer. Toekomstige navorsing behoort metodes en algemeen-voorkomende kroniese trauma te trianguleer en longitudinale studies, plaaslik en internasionaal, word benodig.

Thesis (MEdPsych)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: As I engaged in a therapy journey with a single client, the possibilities for research on the integrative use of narrative therapy and EMDR unfolded. I investigated recent literature and realised that much had been written about narrative therapy as single approach to therapy within the postmodern paradigm. There was also extensive writing on EMDR and its integrative use with other therapies in assisting people who struggle with upsetting memories of trauma. Since I was unable to find any literature to date on the integrative use of narrative therapy and EMDR, I realized that there was much to be discovered and learned on such an integrative research journey. The client's experiences and descriptions of overwhelming emotional distress (as the problem in her life) during the process of integration was the main focus of this qualitative case study. During our therapy conversations knowledges were gathered and deconstructed. Video or tape recordings, photographs, work with clay, sketches, letters and other documents were useful in keeping track of the research journey. A reflecting team and the participation of the client's boyfriend contributed and enriched both the therapy and research journeys. / AFRIKAANSE OPSOMMING: Tydens terapeutiese werk met 'n enkele kliënt het die moontlikhede van navorsing oor die integrasie van narratiewe terapie en EMDR vir my 'n werklikheid geword. Ek het onlangse navorsing bestudeer en besef dat narratiewe terapie as 'n enkele benadering tot terapie binne die post-moderne paradigma, al 'n geruime tyd lank nagevors is. Daar bestaan ook literatuur oor EMDR en die integrasie daarvan met ander terapeutiese benaderings in die ondersteuning van persone wat probleme ondervind met ontstellende herinnerings van trauma. Aangesien ek tot op hede geen literatuur oor die integrasie van narratiewe terapie en EMDR kon vind nie, het ek vermoed dat 'n navorsingsreis op hierdie terrein verskeie ontdekkings en die ontginning van nuwe kennis moontlik sou maak. Die fokus van hierdie kwalitatiewe gevallestudie val op die kliënt se belewing en beskrywings van oorweldigende emosies (as probleem in haar lewe) tydens die terapeutiese integrasieproses. Waarhede of kennis is tydens terapiegesprekke versamel en gedekonstrueer. Video- of bandopnames, foto's, kleiwerk, sketse, briewe en ander dokumente was waardevol om die koers van die navorsingsreis aan te dui. Insette en deelname van 'n refekterende span, asook die kliënt se kêrel, het beide die terapie- en navorsingsreise verryk en uitgebrei.

Thesis (MEdPsych (Educational Psychology)--University of Stellenbosch, 2005. / This study demonstrates the use of the transtheoretical model in the context of sexual trauma in middle childhood. Exploring contemporary literature I found that there is no literature in South Africa available on this topic. It was not until 1997 that the transtheoretical model was implemented internationally with regard to sexual abuse. Taking this in consideration, I realised that there was much scope for exploring, discovering and reflecting on the transtheoretical model and its use within the boundaries of childhood sexual trauma. A qualitative case study within the social constructivist/interpretive paradigm, was chosen as research design. The study involved a participant in middle childhood. Elna (pseudonym) was selected from referrals from the Child Protection Unit of the South African Police Services to the Unit for Educational Psychology at Stellenbosch. The reason for referring Elna to the Unit was because of the negative and diverse effects sexual trauma had on her life story. The study explores the transtheoretical model and the appropriateness thereof as alternative treatment model in a case of sexual trauma, as well as insight into progression of the client in the therapeutic process. Data was collected by means of interviews and therapy sessions during which Narrative therapy, EMDR, sandtray therapy (used in a narrative context) and art therapy techniques were used in an integrated manner. The data was analysed by means of interpreting codes, categories and themes. The study concluded with a discussion of the findings and a reflection on the impact the use of the transtheoretical model had on me as a research-therapist-in-training. The literature review and the findings of this research suggest that the transtheoretical model can be applied effectively to a case of sexual trauma in middle childhood. The use of the model also gives insight into progression of the client in the therapeutic process.