This qualitative research study explores how racial identity and racial trauma impacts a chaplain's clinical work. In the study, I interviewed eleven professional chaplains who have experienced racial situations either in their past or in their work or both and how those experiences have influenced their professional growth. After evaluating the responses of the interview, I was able to determine a number of findings that I believe would be helpful as chaplains continue to provide spiritual support in the culturally diverse hospice and hospital settings.

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Thesis (MA)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: A century of clinical observations and literature has repeatedly noted that trauma responses occur in across a spectrum and on a continuum of severity. The existing, DSMIV trauma response classifications include Acute Stress Disorder and PTSD as anxiety disorders. Complex PTSD or DESNOS was considered as a proposed, alternative classification during the DSM-IV PTSD Field Trials. It was not included as a separate diagnosis, but briefly mentioned as an associated feature ofPTSD. Subsequent research and replica studies have not proved conclusively whether Complex PTSD should be a separate or associated feature ofPTSD, and the controversy continues to date. Childhood traumatization is strongly associated with adult psychopathology, and various Axis I and Axis II disorders, especially Borderline Personality Disorder, and to a lesser extent, Antisocial Personality Disorder. Prolonged, repeated traumatization during adulthood is also associated with subsequent Axis II pathology, including Borderline, Obsessive-Compulsive and Avoidant Personality Disorders. Chronically traumatized people with Axis II pathology often present with comorbid Axis I disorders including Major Depression, PTSD, Substance Abuse, Somatization Disorder, and Dissociative Disorders. There are divergent views regarding the etiology of personality disorders in chronically traumatized individuals. On the one hand, repeated, prolonged trauma could cause enduring personality dysfunction in individuals despite normal premorbid functioning. On the other hand, genetics, temperament, environmental factors and even a pre-existing stress diathesis in the pre-trauma personality could contribute to the development of post-trauma personality disorders. These two views do not necessary contradict each other, but illustrate the complexity the human stress reaction. Despite the controversy the inclusion of DESNOS into the diagnostic canon, it is a valuable measure of predicting prognosis to existing treatment options. The present main psychological treatment for post-traumatic stress disorders has been a cognitive-behavioral based, exposure intervention. Alternative therapies include psychodynamic approaches, pastoral interventions and more recently, ecological and recovery based models. The Complex PTSD conceptualization contributes to a better understanding of the personality structure of chronically traumatized people. There are three main areas of disturbance. Firstly, a complex symptomatic presentation including somatization, dissociation, and affect dysregulation. Secondly, deep characterological shifts including deformations in concepts of relatedness and identity. Thirdly, and increased vulnerability to harm, either self-inflicted or at the hands of others. The usefulness of integrating these three concepts into the personality conceptualization of chronically traumatized individuals is illustrated a case study. / AFRIKAANSE OPSOMMING: Die literatuur en kliniese waarneming vand die afgelope eeu dui herhaaldelik op trauma reaksies oor 'n spektrum. In die bestaande DSM-IV stelsel, val trauma reaksies net Akute Stress Steuring and Post-Traumatiese Stress Steuring. Hoewel Komplekse PTSD in 1992 voorgestel was as 'n alternatiefin die DSM-IV, is dit nie as aparte diagnose ingesluit is nie, maar wel wel gelys as geassosieerde symptoom van PTSD. Latere navorsing en duplikaat studies het nog nie konklusiefbewys of Komplekse PTSD 'n geassosieerde or aparte simptoom van PTSD is nie, en debat duur nog voort. Trauma gedurende kinderjare word sterk geassosieer met volwasse psigopatologie en verskeie As I en As II steurings, veral Grenslyn Persoonlikheids Steuring, en tot In mindere mate, Antisosiale Persoonlikheids Steuring. Langstaande, herhaalde traumatisering gedurende volwassenheid word ook geassosieer met latere As II patologie, insluitende, Grenslyn, Obsessief-Kompulsief en Vermydende Persoonlikheids Steurings, Kronies getraumatiseerde individue met As II patologie presenteer ook dikwels met komorbiede As II steurings insluitende Major Depressie, Post-Traumatiese Stres Steuring, Somatiserings Steuring, and Dissosiatiewe Steurings. Daar is uiteenlopende sienings oor die etiologie van persoonlikheids steurings in kronies getraumatiseerde individue. Aan die een kant, kan langstaande, herhaalde trauma persoonlikheids veranderinge veroorsaak ongeag normale premorbide funksionering. Aan die ander kant, kan genetika, temperament, omgewing en'n pre-morbide stressvatbaarheid almal bydra tot die ontwikkeling van post-trauma persoonlikheids steurings. Hierdie twee sienings weerspreek mekaar nie noodwendig nie, maar dui op die kompleksiteit van die menslike stres reaksie. Ongeag die akademiese debakeloor die insluiting van die Kompleks PTSD konseptualisasie in DSM-IV diagnostiese stelsel, is dit 'n waardevolle praktiese meetinstrument van prognose onder bestaande behandelings opsies. Tot dusver word die primere sielkundige intervensies gebaseer op 'n kognitiewe-gedragsterapie model. Alternatiewe terapieë sluit in psigodinamiese, pastorale en meer onlangse ekologiese en herstel-gebasseerde intervensies. Die Kompleks PTSD konseptualisasie dra by tot beter kennis oor die persoonlikheids struktuur van kronies, getraumatiseerde mense. Daar is drie hoof areas of versteuring. Eerstens, a komplekse simptomatiese presentasie insluitende somatisering, dissosiasie en affek disregulasie. Tweedens, diep veranderings in karakter insluitende versteurings in identiteit en interpersoonlike verhoudings. Derdens, in groter vatbaarheid vir seerkry, of aan hulle eie hande, of aan die hande van ander. Die waarde van die integrasie van hierdie drie konsepte in die persoonlikheids konseptualisasie van kronies getraumatiseerde individue word geillustreer deur 'n gevallestudie.

Orientador: Francisco Hashimoto / Banca: Catarina Satiko Tanaka / Banca: Marlene Castro Waideman / Resumo: A exaltação conferida ao trabalho na sociedade ocidental concedem ao trabalhador uma identidade social, somos aquilo que fazemos e fazemos para um outro (Lei do social) que nos reconheça enquanto sujeitos desejantes, criando-se laços de investimento libidinal entre este sujeito (trabalhador) e o outro. Na relação de trabalho, a organização será este outro social, que assumirá uma função de Lei, uma função paterna, a quem o sujeito se ligará em busca reconhecimento, identificação e de realização de seu Desejo. Mais que isso, as organizações são o lugar de aprisionamento psíquico, recalcamento, sofrimento, criando uma eterna luta do Individual X Coletivo, Sujeito X Organização, Lei X Desejo. Assim sendo, este estudo apreende e analisa o enfrentamento do sujeito com a situação de trabalho, e a constituição subjetiva advinda após este encontro, a que chamamos de sujeito organizacional. Utilizando, em especial, os estudos de Enriquez e Dejours, e a partir de relatos e entrevistas sobre a trajetória profissional de trabalhadores vinculados a uma instituição universitária do estado de São Paulo, foi possível vislumbrar a utilização de mecanismos de defesa individuais e coletivos como forma de aliviar o sofrimento surgido da experiência de trabalho, bem como a construção de representações psíquicas acerca de sujeito, subjetividade, trabalho e sujeito trabalhador, e ainda a constituição/alteração de vivências materiais, sociais e históricas. Tendo como questão que o sentido construído pelo trabalhador em seu projeto de trabalho e projeto de vida faz ressonância com experiências passadas, presentes e expectativas futuras, mesmo que no ato analisador estes elos não se mostrem claramente, é de fundamental importância à clareza de que a arquitetura das análises, assim como o próprio objeto a ser analisado, é marcado pela singularidade e pelo subjetivo, permitindo diferentes exames e abordagens. / Abstract: The exaltation affixed to the act of working in the western world grants the working person a social identity, that is to say, people are whatever they do, and they do so for another (Social Law) who can recognize them as desiring subjects, consequently creates ties of libidinal investment between the party offering his/her services (worker) and the other party desiring to hire him/her. . Through labor relationship, an organization will show its other side, which will take up a function of law, a paternal function, which the subject will be connected to in search of recognition, identification and fulfillment of his/her Desires. Furthermore, organizations are a place of psychic imprisonment, repression, and suffer feeding the eternal clash between the Individual and the Social; the Subject and The Organization; the Law and the Desire. Thus, this study aims at analyzing the clashes of workers within their job situation and the subjective constitution originating as a consequence of these clashes, which we call organizational subject. By making use of previous studies, especially those by Enriquez and Dejours, and by interviewing a diverse range of individuals, it was possible to gain an overview of individual and collective self-defense mechanisms as a means of relieving the pain brought about by the experience of work, and the construction of psychic representations on the subject, subjectivity, work, working subject, and yet the construction/alteration of material, social and historical experiences. Bearing in mind that the meanings a working person sets on his/her work and life project echoes both present and past experiences as well as expectations - even when these can not be seen clearly at the time of analysis. Therefore it is essential to understand that the architecture of analysis as well as the subject to be analyzed is highly marked by the singularity and subjectivity, allowing different examinations and approaches. / Mestre

Thesis (M.A.)--Brigham Young University. Dept. of English, 2005. / Includes bibliographical references (p. 73-74).

D.Phil. / Profound psychological trauma, which may lead to Post Traumatic Stress Disorder (PTSD) can continue to negatively impact the lives of its victims for years after its occurrence. Psychological trauma is seen across cultures in people of all ages, the world over, and South Africa’s high levels of crime and violence, HIV and AIDS, and road accidents, make the topic especially pertinent. The symptom clusters of PTSD, included in the Diagnostic and Statistical Manual of Mental Disorders 4th Edition – text revised (DSM-IV-TR; American Psychiatric Association, 2000), namely Re-experiencing, Avoidance and numbing, and Increased Arousal can lead to significant distress and may interfere with all facets of life, including social functioning, career goals, romantic relationships, leisure activities, and mental wellbeing. The effects of trauma in childhood may be different than when it occurs in adulthood, due to developmental processes occurring on physical, emotional, and cognitive levels (e.g. Drell, Siegel, & Gaensbauer, 1993; Perrin, Smith, & Yule, 2000). As such it is clearly important to understand the effects of trauma specific to children. A fair amount of literature is available which discusses the emotional and psychological consequences of trauma in children. Similar studies with regard to PTSD are also available. However, a holistic picture of either psychological trauma, or PTSD in childhood should also include neuropsychological aspects, functions such as attention and concentration, planning, organisation, psychomotor speed, and memory in which dysfunction may interfere with children’s development and futures. Although the field of neuropsychology has traditionally investigated how the brain responds to physical trauma or disease processes, recent decades of technological advancement have made it possible to understand that psychological trauma may actually result in neurobiological abnormalities.

Thesis (MA)--University of Stellenbosch, 2008. / ENGLISH ABSTRACT: Sometimes it is not entirely clear why certain clients improve. Critical clinical ingredients which may have led to this improvement or recovery are hard to identify and describe and decisions about therapeutic interventions often appear to be intuitive rather than following a strict modus operandi. This is true particularly if refractory or chronic cases start to improve and maintain this improvement. Refractory and chronic cases are the norm amongst clients suffering from complex, chronic trauma, also termed complex PTSD. Complex trauma is a multi-facetted, often multi-layered condition. It includes damage to the individuals’ self and to her ability to interpersonally relate, additionally to the DSM IV TR diagnosis of PTSD. Due to the manifold unique presentations of the syndrome, particular after long-term exposure and confounded by co-morbidities and rigid defenses, it is difficult to diagnose and treat the condition effectively. This study focuses on one such complex trauma case with an initially very poor prognosis, which improved significantly over a treatment period of eighteen months. The therapeutic intervention and progression of the case are closely examined, using the phenomenological method, with the aim of discerning and describing themes and patterns that could assist in understanding the healing process of this client during therapy and to promote further research in this regard. Integration of psychodynamic conceptualization, particularly self-psychology and intersubjectivity, and person-centered, supportive therapeutic methods were found helpful in the treatment of this case. The common factor to these approaches is their emphasis on the relationship between client and therapist. This therapeutic relationship was concluded to be the determining factor in the successful treatment of this client, because it addressed damage to self and to her relational ability. The research took place concurrent to the therapy with the client and this process led to a degree of integration on three levels: integration of the client’s self and interpersonal functioning, integration of the abovementioned approaches to form a creative synthesis in the therapist’s individual approach to trauma clients, and the integration of a phenomenological methodology with a psychodynamically conceptualized case study. It is noted that the theoretical explorations and therapeutic procedures described and explored in this study are but one way to conceptualize and treat complex trauma. / AFRIKAANSE OPSOMMING: Somtyds is dit nie duidelik hoekom sekere kliente se toestand verbeter nie. Dit is soms moeilik om die kritiese bestanddele wat tot hierdie verbetering of herstel gelei het, te identifiseer en te beskryf. Besluite met betrekking op therapeutiese intervensies blyk dikwels eerder intuitief, as die gevolg van ‘n streng modus operandi, te wees. Dit is spesifiek die geval wanneer chroniese en hardnekkige gevalle begin om te verbeter en die verbetering volhou. Hardnekkige en chroniese gevalle is nie ongewoon by kliente wat aan komplekse, chroniese trauma - ook genoem komplekse post-traumatiese stressversteuring - ly nie. Komplekse trauma is ‘n multi-fasettige toestand, wat dikwels ‘n verskeidenheid lae of vlakke van versteuring opwys. Dit sluit skade tot die individu se self in, asook verlies aan vaardigheid om met ander mense suksesvolle interpersoonlike verhoudings op te bou. Hierdie kenmerke is toevoegings tot die diagnose van die sindroom soos uitgevoer in die DSM IV TR. As gevolg van die meervoudige unieke voorstellings van die sindroom - in besonder na langtermyn blootstelling en verwarring deur co-ongesteldhede en rigiede verdedigings - is dit moeilik om die toestand korrek te diagnoseer en efektief te behandel. Hierdie studie fokus op die soort geval wat aanvanklik ‘n baie swak prognose gehad het, maar vervolgens oor ‘n tydperk van 18 maande ‘n beduidende verbetering getoon het. Die terapeutiese intervensie en die progressie van die geval is in hierdie studie noukeurig ondersoek, deur gebruik te maak van fenomenologiese ondersoekmetodes, met die doel om temas en patrone vas te stel en te beskryf wat die begrip van die genesingsproses van die klient gedurende terapie moontlik kan bevorder, en wat verdere navorsing op hierdie gebied kan stimuleer. Integrasie van psigodinamiese konseptualisering (spesifiek self-sielkunde en intersubjektiwiteit) asook persoongesentreerde, ondersteunende beradingsmetodes, is as waardevol bevind in die behandeling van hierdie geval . Die gemeenskaplike faktor tot hierdie benaderings is die klem op die verhouding tussen klient and terapeut. Die gevolgtrekking is gemaak dat hierdie terapeutiese verhouding die bepalende faktor in die sukkesvolle behandeling van hierdie klient was, omdat dit sowel die skade aan die self as die verlies aan die vaardigheid om verhoudings te bou, aangespreek het. Die navorsing en die terapeutiese intervensie met die klient het terselftertyd plaasgevind, en die proses het ten slotte tot ‘n mate van integrasie op drie vlakke gelei: integrasie van die klient se self en herstelling van interpersoonlike funksionering, integrasie van die bogenoemde benaderings wat tot ‘n kreatiewe sintese in die berader se benadering tot trauma behandeling gelei het, en die integrasie van fenomenologiese metodes en psigodinamies konseptualisering in ‘n gevallestudie. Dit is belangrik om in gedagte te hou dat die teoretiese navorsing en praktiese prosedures wat in hierdie studie beskryf en uiteengesit is, net een manier is om komplekse trauma te konseptualiseer en te behandel.

This dissertation is about how the concept of harm, damage or wound is applied as a metaphor to a site often called the self or the soul. This is the social space of the individual subject, which is, paradoxically, placed by our language and culture in a person’s interior – a place where we are all said to be vulnerable and endangered by a potentially hostile environment. The thesis consists of a series of studies which are designed to show how the concept of harm to an inner life emerges from different discursive contexts, and how it does so in distinctly variable versions: psychological, emotional, neurological or social, in more or less stable hybrid forms. Using primary sources which are mostly documentary, supported by some interviews, the studies range from a look at the psychiatric history of post traumatic stress disorder (PTSD) and at the story of its rewriting in English tort law; the recent reprised popularity of attachment theory and its marriage to neurology and a look at the career of the concept of the emotional abuse of children as a social problem category in the legal/administrative processes of Child Protection. These are introduced by a first chapter which concentrates on the metaphoric content of invisible wounds or psychic trauma and the way it produces particular forms of the self. The studies which follow this are clustered around the literature and practices of the psychiatric, psychological, psycho-analytic, social work and legal professions, in order to show how the work of these professionals makes the concept of a psychic injury visible, discussible, treatable, administrable and justiciable. Through their efforts, it is argued, the concept moves from being a metaphor, hooked onto the palpable reality of a physical wound, to acquire a ‘facticity’ of its own; it becomes a reality through its achieved status as a social problem category and an ever present risk to self and self regulation at the turn of the 21st century.

<p>Hur går ett företag tillväga när de tar sig ut på den internationella spelplanen. Vilka problem</p><p>blir de tvungna att hantera. I studien som följer har danska livsmedelskedjan Netto studerats,</p><p>deras inträde på den svenska marknaden, det sätt de har gått tillväga på .</p><p>Syftet med uppsatsen är således att studera hur Netto har gått tillväga vid inträdet på den</p><p>svenska livsmedelsvaruhusmarknaden och hur de kulturella skillnaderna mellan hemlandet</p><p>och värdlandet har påverkat detta.</p><p>Upplägget för studien har varit att genom en kvalitativ metod studera såväl primära som</p><p>sekundära källor utifrån aktuell teoribildning, genom att bland annat haft kontakt med en</p><p>förhandlingschef på Netto Marknad Sverige. Men också sätt till sekundära källor för att få en</p><p>uppfattning i vilket sammanhang Netto verkar.</p><p>Studiens visar på att Netto tagit sig in på den svenska marknaden på ett sätt som i många</p><p>fall går rakt emot den rådande teoribildningen inom området. Genom att ingå i ett joint</p><p>venture med ICA har Danska Netto gått in på den svenska marknaden som om det rörde sig</p><p>om en mycket okänd och avlägsen marknad. En viktig orsak till detta beteende är den hårda</p><p>bransch-situation som råden på den svenska livsmedelsmarknaden, med starka aktörer som</p><p>ICA och COOP, samt vår bristande tradition av lågprisaktörer.</p><p>Slutsatsen av denna studie är att det är branschen och inte landet, som avgör hur företaget</p><p>kommer att gå tillväga vid inträdet.</p>

Some of the most interesting facets of Edgar Allan Poe's fiction are his imaginative speculations concerning the metaphysical experiences of the soul, the individual psychic "identity." His interest focuses primarily on three related aspects of the soul's experiences (1) metempsychosis (or reincarnation and transmigration); (2) suspension between "death" and the after-life or states of unconsciousness and consciousness, sleep and waking; and (3) the terrors, real or imagined, of premature burial.