When The Past Is Always Present
When The Past Is Always Present
Routledge Routledge
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Ruden, Ronald A.
When the past is always present : emotional traumatization, causes, and cures
/ Ronald A. Ruden. -- 1st ed.
p. cm. -- (Psychosocial stress series)
Includes bibliographical references and index.
ISBN 978-0-415-87564-6 (hardcover : alk. paper)
1. Psychic trauma. I. Title.
BF175.5.P75R83 2010
616.8521--dc22 2010007844
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Contents
S e r i e s E d i t o r s Fo r e w o r d xv
Fo re wo rd xvii
P r e fa c e xxi
Acknowledgments xxv
Au t h o rs N o t e xxvii
C h a p t e r 1 A Th i r d P i l l a r 1
Traumatization Appears to Produce Immutable Feelings,
Thoughts, and Behaviors as if Written in Stone 1
Traumatization Always Involves Intense Emotions 2
The First Pillar: The Psychotherapies 2
The Second Pillar: The Psychopharmacologies 4
The Third Pillar: The Psychosensory Therapies 5
References 7
C h a p t e r 2 Th e R o l e E m o t i o n s P l ay 9
Types of Emotions 9
Emotions Are Stressors 10
The Relationship Between the Aversive and Appetitive
Survival Systems 11
Emotional Awareness 13
Emotions Are Motivating and Aid With Decisions 13
Emotions as Physical Forms of Communication 13
Emotions Involved With Social Bonding 14
Emotions and Memory 14
References 15
ix
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x C o n t en t s
C h a p te r 4 M e m o ry and Emotion 35
Memory Systems 36
The Role of Norepinephrine 38
Norepinephrine in the BLC 38
The Role of Cortisol 39
What Else Is Needed for Traumatization? 39
References 40
Chapter 5 Encoding a Tr au m at i c M e m o r y 41
Requirements for Traumatization 41
The Event 41
Meaning 43
Landscape Needed for Traumatization 45
Neuromodulators and Neurotransmitters 46
A Vulnerable Landscape 47
A Resilient Landscape 48
Inescapability 48
Traumatization 53
Dissociated Traumatic Memories 55
Sensory Input and Emotion 56
Modulation of Response to an Emotional but
Nontraumatizing Event 57
The Traumatization of an Event 58
The Timing of Traumatization 59
References 59
C h a p t e r 6 C au s e s a n d C o n s e q u e n c e s of
Tr au m at i z at i o n 61
Early Events 61
Later-in-Life Causes 65
Cultural Sources 66
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C o n t en t s xi
Consequences of Traumatization 67
Why? 67
Phobias 68
Phobia Generation and Generalization 69
Pattern Recognition and Generalizability 69
Panic Attacks 71
Posttraumatic Stress Disorder (PTSD) 72
Repetition Compulsion 73
Chronic Pain 74
On the Origin of Chronic Psychogenic Pain 75
Pathological Emotions 77
Somatization 78
Other Consequences of Traumatization 78
The Absence of Forgetting 79
References 80
C h a p t e r 8 H av e n i n g 95
A New Approach 95
Case Study 98
Andrades Research 100
Rating of 1: Much Better Results Than With
OtherMethods 101
Rating of 2: Better Results Than With Other Methods 101
Rating of 3: Results Similar to Those Expected With
Other Methods 102
Rating of 4: Worse Results Than Expected With Other
Methods 102
Rating of 5: No Clinical Improvement or
Contraindicated 102
Havening 103
Mechanism of Havening 104
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x ii C o n t en t s
C h a p t e r 10 Tr au m a S t o r i e s and Tr au m a C u r e s 131
Loss of a Loved One 131
Loss of a Loved One 132
September 11, 2001 132
Medical Trauma 133
Public Speaking 134
Fear of Snakes 134
Grief Reduction 135
PTSD 135
Back Pain 135
Back Pain 136
Carrying a Chicken 136
Claustrophobia and Elevators 137
Rats 137
Fear of Falling 138
Nasal Congestion 138
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C o n t en t s xiii
A pp e n d i x A: N o n t o u c h H av e n i n g 139
A pp e n d i x B: C u lt i vat i n g R e s i l i e n c e 141
A pp e n d i x C: A n A n a ly s i s of Fe a r of F ly i n g 145
A pp e n d i x D: N i g h t m a r e s , N i g h t Te r r o r s , J u s t B a d
D r e a m s , a n d H av e n i n g 151
A pp e n d i x E: S u g g e s t i o n s for Tr e at m e n t 155
A pp e n d i x F: Tr a n s d u c t i o n , D e p o t e n t i at i o n , and the
Inde x 195
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7
D isrupting a Traumatization
81
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8 2 W hen t he Pa s t is A lways p re sen t
coeruleus (LC) and inhibit the central nucleus (Ce) from further acti-
vating our physiology. In the LC, serotonin via its effect on GABA
neurons prevents the release of norepinephrine.1 The prefrontal cor-
tex, on perceiving the threat has passed, inhibits the Ce via GABA
interneurons. The amygdala is now quiet and the event fades. But
things are different if an event is encoded as a trauma.
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D isru p tin g a T r aum atiz ati o n 83
Working Memory
Central Executive
Figure 7.1 Working memory. (Courtesy of Ronald Ruden and Steve Lampasona.)
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8 4 W hen t he Pa s t is A lways p re sen t
Sonnet 30
When to the sessions of sweet silent thought
I summon up remembrance of things past,
I sigh the lack of many a thing I sought,
And with old woes new wail my dear times waste:
Then can I drown an eye, unused to flow,
For precious friends hid in deaths dateless night,
And weep afresh loves long since cancelled woe,
And moan the expense of many a vanished sight.
Then can I grieve at grievances foregone,
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D isru p tin g a T r aum atiz ati o n 85
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8 6 W hen t he Pa s t is A lways p re sen t
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D isru p tin g a T r aum atiz ati o n 87
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8 8 W hen t he Pa s t is A lways p re sen t
There is a tiger coming after you, Nancy, Run toward that tree;
climb it and escape. To my amazement, Nancys body began to shake
and tremble. Her legs started making running movements. After sev-
eral minutes, she took a few spontaneous breaths. This response, which
was scary for both of us, washed over her in waves for almost an hour.
At the end she experienced a profound calm, saying she felt held in
warm tingly waves.
Nancy reported to me that during this hour she saw mental pictures
of herself at the age of three being held down and given ether anesthesia
for a tonsillectomy. The fear of suffocation she experienced as a child
and that she remembered and revisited during her session with me was-
terrifying. As a child she felt overwhelmed and helpless. After this one
session with me, a whole host of debilitating symptoms improved dra-
matically, and she felt like had herself again.
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D isru p tin g a T r aum atiz ati o n 89
the original event. These are people stuck in their past with no escape,
for whom the past is always present. These memories do not decrease
over time and they elicit responses decades after the event.
Sonia, the daughter of an employee of Homeland Security, heard fright-
ening stories about terrorists and potential threats to the country as she grew
up. After getting married, Sonias husband would be awakened in the night
by her screaming. He would find her curled in a fetal position in a corner
of the room screaming, yet she was asleep. These are called night terrors (see
Appendix D). He couldnt awaken her, and the episode could last several
frightening minutes. She didnt recall those moments. Sonia also found that
she didnt like to leave the house. She would only go for a walk with her new
and very large bulldog. Her life was becoming more and more constricted.
It was clear from her history that she could not find a safe place; chased, she
could not escape.
A potential model for the disrupting an encoded glutamate path-
way comes from Rasolkhani-Kalhorn, Harper, and Drozd, on the
mechanism for the efficacy of EMDR and amygdala de-potentiation
(see Appendix F). These researchers believed that EMDR disrupted
the activated glutamate receptors by a mechanism called de-potenti-
ation. The principal mechanism for depotentiation is the removal, by
internalization, of activated glutamate receptors by the production of
a low-frequency signal produced by eye movement. These receptors,
now internalized within the neuron, cannot transmit a signal and the
pathway is disrupted.
Activated BLC glutamate receptor Eye movements Induction
of low-frequency signal Depotentiation and internalization
of BLC glutamate receptor Inability to transmit a signal
Traumatic memory disrupted
Are there other forms of sensory input that can accomplish this?
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D isru p tin g a T r aum atiz ati o n 91
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9 2 W hen t he Pa s t is A lways p re sen t
References
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(p.159). New York, NY: Regan Books.
4. Callahan, R. (1981a). A rapid treatment for phobias. Collected papers of
international college of applied kinesiology. (ICAK).
5. Shapiro, F. (Ed.)(2002). EMDR as an integrative psychotherapy
approach.Washington, D.C.: American Psychological Association.
6. Levine, P. (1997). Waking the tiger. Healing trauma. Berkeley, CA: North
Atlantic Books.
7. Levine, P. (1997). Waking the tiger. Healing trauma (p. 67). Berkeley, CA:
North Atlantic Books.
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CA: North Atlantic Books.
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10. Van der Kolk, B. A., Weisaeth, L., & van der Hart, O. (2007). The
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D isru p tin g a T r aum atiz ati o n 93
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