A FUTURELESS MAN: THE INTEGRATION OF A TRAUMATIZED LIFE LOSS OF NARRATIVE SUBJECTIVITY THE DIFFERENCE BETWEEN THE PATIENT S EXPERIENCE OF THE DISEASE AND THE DOCTOR S ATTENTION TO THE DISEASE ERIC C. ARAUZ MLER TRAUMA INSTITUTE OF NEW JERSEY ADJUNCT FACULTY INSTRUCTOR DEPARTMENT OF PSYCHIATRY RUTGERS ROBERT WOOD JOHNSON MEDICAL SCHOOL ARTHUR KLEINMAN, MD PSYCHIATRIST HARVARD MEDICAL SCHOOL PROFESSOR, ANTHROPOLOGY HARVARD UNIVERSITY KLEINMAN, A. 1988. THE ILLNESS NARRATIVES: SUFFERING HEALING AND THE HUMAN CONDITION. NY, NY: BASIC BOOKS. 2 FRACTURING OF GLOBAL IDENTITY: DESTRUCTION OF LINEAR VISCERAL AND COGNITIVE NARRATIVES CHAOS NARRATIVE: NO MAP OR DESTINATION (Frank AW. The Wounded Storyteller: Body, Illness, Ethics. Chicago: University of Chicago Press, 1995, 2013.) STORY OF ATROCITY/LANGUAGE OF ABOMINATION (HERMAN J. TRAUMA AND RECOVERY. NEW YORK: BASIC BOOKS, 1997.) 4 1
TRAUMA-INFORMED STORYTELLING LANGUAGE AS ORGANIZING PARADIGM FOR IMPLICIT AND EXPLICIT MEMORY OF PSYCHOSIS AND TRAUMA EXPLORATORY NARRATIVE PROCESSING AND COHERENT POSITIVE RESOLUTION (Pais, Jennifer L., (2006) Narrative Identity Processing of Difficult Life Experiences: Pathways of Personality Development and Positive Self-Transformation in Adulthood) A FREE ARTIST TO THEMSELVES SELF CHANGE ON THE BASIS OF SELF-OVERHEARING (BLOOM, H. THE WESTERN CANON: THE BOOKS AND SCHOOL OF THE AGES. NEW YORK: RIVERHEAD BOOKS, 1995, 46.) DISEASES OF CONSCIOUSNESS EMOTIVE DISCOURSE SUBCORITCAL GERALD M. EDELMAN MD PHD 1972 NOBEL PRIZE PHYSIOLOGY/MEDICINE SENSATIONS PERCEPTIONS IMAGES MEMORIES THOUGHTS EMOTIONS ACHES PAINS VAGUE FEELINGS (EDELMAN, GERALD. WIDER THAN THE SKY. NEW HAVEN: YALE PRESS, 2004, 8.) 2
9 A FUTURELESS MAN: THE INTEGRATION OF A HUMILIATED LIFE A FUTURELESS MAN: THE INTEGRATION OF A TRAUMATIZED LIFE ERIC C. ARAUZ MLER TRAUMA INSTITUTE OF NEW JERSEY ADJUNCT FACULTY INSTRUCTOR DEPARTMENT OF PSYCHIATRY RUTGERS ROBERTWOODJOHNSONMEDICAL SCHOOL ERIC C. ARAUZ MLER TRAUMA INSTITUTE OF NEW JERSEY ADJUNCT FACULTY INSTRUCTOR DEPARTMENT OF PSYCHIATRY RUTGERS ROBERTWOODJOHNSONMEDICAL SCHOOL 3
ABSOLUTE SHATTERING OF THE SELF PHYSIOLOGICAL COGNITIVE SPIRITUAL SOCIAL FAMILIAL 4
LIKE FATHER, LIKE SON? BIPOLAR 1 DISORDER ADDICTION POSTTRAUMATIC STRESS DISORDER COMPLEX TRAUMA 2 SUICIDE ATTEMPTS 265 POUNDS IN 7 TH GRADE MY SOUL IS LOST, MY FRIEND TELL ME HOW DO I BEGIN AGAIN? MY CITY'S IN RUINS MY CITY'S IN RUINS MY CITY OF RUINS BRUCE SPRINGSTEEN 17 18 MAN CANNOTREMAKE HIMSELF WITHOUT SUFFERING FOR HE ISBOTH THE MARBLE AND THE SCULPTOR. ALEXIS CARREL NOBEL PRIZEPHYSIOLOGY 1912 5
PROCESS OF TRANSFORMATION Ideas vs. Beliefs TRAUMA OF PSYCHOSIS MORE THAN ONE HALF OF THE PARTICIPANTS REPORTED INTENSE DISTRESS RELATED TO PSYCHOTIC SYMPTOMS OR TREATMENT EXPERIENCES, WITH66% MEETING SYMPTOM CRITERIA FOR THE PTSD SYNDROME (REGARDLESS OF A1/A2), AND 39% MEETING FULL DIAGNOSTIC CRITERIA FOR PTSD (INCLUDING A1/A2). MUESER KT, LU W, ROSENBERG SD, WOLFE R. THE TRAUMA OF PSYCHOSIS: POSTTRAUMATIC STRESS DISORDER AND RECENT ONSET PSYCHOSIS. SCHIZOPHRENIA RESEARCH. 2010;116(2-3): 217-227. 21 22 HUMILIATED FURY HELEN BLOCK LEWIS SELF STIGMA Shame Pride ADVERSE CHILDHOOD EXPERIENCES Physical abuse by a parent Emotional abuse by a parent Sexual abuse by anyone An alcohol and/or drug abuser in the household An incarcerated household member STUDY (ACES) Someone who is chronically depressed, mentally ill, institutionalized, or suicidal Domestic violence Loss of a parent Emotional neglect Physical neglect CONTINUUM OF IDENTITY MOKROS HB. SUICIDE AND SHAME. AM BEHAV SCI. 1995;38:1091-1103. 23 Felitti, V. J., Anda, R. F., Nordenberg, D.F., Williamson, D. F., Spitz, A.M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventative Medicine, 14(4), 245-258. 24 6
BIPOLAR TRAUMA INFORMED STORY TELLING CHILDHOOD OBESITY TRAUMA ACE ALCOHOLISM DRUG ADDICTION (BERTHA PAPPENHEIM: SIGMUND FREUD AND JOSEF BREUER STUDIES ON HYSTERIA) EFFECTIVE TREATMENT IS A MATTER OF HELPING INDIVIDUALS KEEP THE OBSERVING PREFRONTAL CORTEX ONLINE AS IT SIMULTANEOUSLY EXPERIENCES THE RAW PRIMITIVE SENSATIONS GENERATED IN THE ARCHAIC PORTIONS OF THE BRAIN (THE LIMBIC SYSTEM, HYPOTHALAMUS AND BRAIN STEM.) (LEVINE, P., IN AN UNSPOKEN VOICE. BERKELEY: NORTH ATLANTIC BOOKS,2010, 71.) SUICIDE 25 FUNCTIONAL HIERARCHY OF THE BRAIN Neocortex Limbic Diencephalon Brainstem Abstract Thought Concrete Thought Affiliation Attachment Sexual Behavior Emotional Reactivity Motor Regulation Arousal Appetite/Satiety Sleep Blood Pressure Heart Rate Body Temperature C O M P L E X I T Y Perry BD. In: Murberg MM (Ed.) Catecholamine Function in Posttraumatic Stress Disorder: Emerging Concepts. Washington, DC: American Psychiatric Press; 1994:253 276. Perry BD. In: Coffey CE, et al (Eds). Textbook of Pediatric Neuropsychiatry. Washington, DC: American Psychiatric Press; 1998. 7
BIPOLAR MY VIRGILS CHILDHOOD OBESITY PROCESS OF RECOVERY ALCOHOLISM TRAUMA DRUG ADDICTION SUICIDE 29 YOU MUST GO ON; I CAN T GO ON; I LL GO ON. SAMUEL BECKETT THE UNAMABLE 32 8
ACE SCORE FATHER 10 SON 9 PURPOSE MISSION 9
HONOR v cheryl 10
ACE SCORE GRAND DAUGHTER/ DAUGHTER 0 11