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Surviving Childhood: An Introduction to the Impact of Trauma


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Lesson 2: The Psychology and Physiology of Trauma
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The Psychology and Physiology of Trauma

The fight-or-flight response is a well-characterized reaction to danger, as we've already discussed. A second common reaction pattern to threat is dissociation. Dissociation is the mental mechanism by which one withdraws attention from the outside world and focuses on the inner world.

It is increasingly clear that responses to threat can vary tremendously from individual to individual. This second major adaptation response to threat involves an entirely different set of physiological and mental changes, yet does not fall under the heading of either fight or flight.

Many common and "normal" mental and emotional states such as anxiety, dissociation, or anger are experienced by most of us to some degree. When any one of these becomes pervasive and ever-present, however, it begins to interfere with the rest of one's life. This can happen with dissociation and anxiety. When it does we characterize this as a disorder.

Figure 2-3: Dissociation.

Because of their small size and limited physical capabilities, young children do not usually have the fight-or-flight option in a threatening situation. When fighting or physically fleeing is not possible, the child may use avoidant and psychological fleeing mechanisms that are categorized as dissociative.

Dissociation due to threat and/or trauma may involve a distorted sense of time or a detached feeling that you are observing something happen to you as if it is unreal -- the sense that you may be watching a movie of your life. In extreme cases, children may withdraw into an elaborate fantasy world where they may assume special powers or strengths.

Like the alarm response, this "defeat" or dissociative response is graded along a continuum. The intensity of the dissociation varies with the intensity and duration of the traumatic event. (Remember that even when we are not threatened, we use dissociative mental mechanisms, such as daydreaming, all of the time.) During a traumatic event, all children and most adults use some degree of dissociation. However, some individuals will use, or experience trauma that induces dissociation as a primary adaptive response.

For most children and adults the adaptive response to an acute trauma involves a mixture of hyperarousal and dissociation. During the actual trauma, the child feels threatened and the arousal systems will activate. With increased threat, the child moves along the arousal continuum. At some point along this continuum, the dissociative response is activated and a host of protective mental (decreased perception of anxiety and pain) and physiological responses (decreased heart rate) occur (see Figure 3-4 below).

Figure 2-4: Differential response to threat.


 


Dissociation is not always a response to threat or trauma. It is often a normal coping mechanism used for excessive boredom or for another purpose. For example, meditation, Lamaze childbirth exercises, daydreaming, and highway hypnosis are all mild forms of dissociation.

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