Trauma and War

Self and time

This article explores the meaning of subjective time and its implications for the understanding of the nature of the self in psychoanalytic terms. Subjective time, the time experience of intrapsychic life, is distinguished from objective time. Its development and evolution in the course of the life cycle are examined, and various aspects of its phenomenology explored. Implications for the understanding of the structure and functioning of the self, especially the combined influence of physiological and environmental processes reflecting the integration of body-mind in the time experience and self-organization are discussed. Some implications for the engagement of the self in the analytic process are suggested, particularly the focusing of therapeutic interaction in the present moment and the implications of the meaning of structural change in reference to the modification of the self-concept through the revision and integration of memory systems in the present interaction between analyst and analysand.

Conducting analysis after September 11: implications for psychoanalytic technique

The September 11, 2001, terrorist attack on the World Trade Center profoundly affected the population of New York City, including analysts and analysands. To study the effect of this event on the technique of psychoanalysts conducting ongoing analysis during the weeks after 9/11, confidential questionnaires were sent to all candidates and faculty at the Columbia University Center for Psychoanalytic Training and Research. Respondents indicated that in the days and weeks following 9/11 they initiated phone calls to their analysands, asked about their analysands' families, gave advice when it was requested, offered reassurance, and answered personal questions. They did not initiate physical contact, discontinue use of the couch, or give unsolicited advice. These responses suggest that these analysts made decisions to alter their technique in certain ways in the wake of a catastrophic event shared by the community.

Healing after Columbine: reflections of psychoanalytic responders to community trauma

Following the shootings at Columbine High School on April 20, 1999, the Denver Psychoanalytic Society provided both immediate and long-term interventions to those closely impacted by the tragedy. In this effort, analytically trained volunteers faced many personal challenges and role adjustments. To address these issues a reflective study group was formed twenty months after the traumatic event. Group discussions revealed a surprising number of residual symptoms from secondary trauma, as well as opportunities for shared coping among analysts. Little has been written about the very human and subjective responses of analysts in such circumstances. These experiences may be helpful to others in today's world of terrorism and unexpected violent events.

Therapeutic work with a traumatized toddler

This case report describes the psychotherapeutic treatment of a three- year-old boy. At the age of twenty-one months the child was attacked by a dog in the facial area. Symptoms of posttraumatic stress disorder consistent with patterns seen in older children and adults and significant developmental disruptions had persisted up to the time of the treatment. The therapeutic work illustrates the unique contributions that psychoanalytic approaches can make to the treatment of posttraumatic stress disorders in children. It appears to have contributed significantly to resolution of the overwhelming feelings evoked by the trauma, such that the child's development could resume its normal course. The case material highlights a number of therapeutic principles relevant to work with traumatized children and frames a discussion of several current issues in the field. A conceptual framework that delineates the effects of trauma on children according to seven different levels of impact is presented utilizing a psychoanalytically based developmental perspective.

Levels of trauma: a multidimensional approach to the treatment of PTSD

The historical course of professional interest in psychological trauma in the 20th century parallels the cycle of intrusion and denial characteristic of traumatized individuals, in which periods of recognition and concern alternate with times of forgetfulness and neglect (Glass et al. 1966; Ingraham et al. 1986). The inclusion of the diagnostic category of posttraumatic stress disorder (PTSD) in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III-1980) inescapably confronted the mental health community with the problem of psychic trauma and catalyzed the quest for a deeper understanding of the disorder. This has led to a variety of explanatory models from such distant fields as neurobiology (Krystal et al. 1989; Pitman 1989; van der Kolk et al. 1985), psychophysiology (Kolb 1987), learning theory (Keane et al. 1985), psychoanalysis (Krystal 1978; Laufer 1988), cognitive psychology (Janoff Bulman 1985), and existential-humanistic philosophy (Lifton 1988).