Introduction:
Theory
Welcome to ETM Theory. Overviewing it, this introduction also discusses theoretical and application differences between ETM and other approaches to psychological trauma treatment, management and prevention.
Traumatic Sequelae
When an extraordinary (and depreciating) event occurs, it causes traumatic sequelae (series of related and causal effects) for pertinent individuals and systems.
The sequelae begin with a reduction or loss to identity - values, beliefs, images and other realities retained within memory. That first change initializes a process called "extinction," which while it is occurring separates identity into non integrated (pre- and post-trauma) elements. This extinction-disintegrated identity forms the traumatic sequelae's "etiology." It is a medical term that describes the "source" or "cause" of a disease or problem.
The trauma's etiology then produces emotional, thought and behavioral changes. They are referred to as "grief." When these changes manifest within certain time frames and under specific conditions (described later in this section and also referenced in the Diagnostic and Statistical Manual for mental health disorders), the emotional, thought/behavioral responses to the etiology are usually characterized as post-traumatic "stress," or post-trauma "symptoms." Fully developed, the traumatic sequelae, that is, the etiological-to-symptomatic effects of the trauma, have been (since 1980) formerly referred to as a "disorder": "Post-Traumatic Stress Disorder."
Neurological change underpins the sequelae's (or disorder's) psychological ones.
Helping Methods: Nosotropic and Etiotropic
Depending on philosophy, helping methods responding to the trauma induced changes may focus on certain elements of the sequelae. For example, if the primary problem of trauma is seen by a helping method to be the emotional pain and different - apparently abnormal - thoughts/behavior, then the method will attempt to correct the thoughts and behavior and to ameliorate the emotion, returning the person or group to normal status. If on the other hand the problem is seen to be the changes to identity sundered by the event, the helping response attempts to restore that identity, or to reconstitute another one in a like manner, but with consideration for the real life changes that depreciated the original identity in the first place. Some helping methods posit that they give equal attention to both ends of the sequelae - the etiology and symptomatology.
Helping methods that define trauma as a problem by focusing on the symptomalogical elements of the sequelae are said to be "nosotropic." Methods that define the problem by focusing upon the beginning (etiology) of the sequelae are called "etiotropic."
Methodological Problems: Behavioral (nosotropic)
vs. Psychodynamic (etiotropic)
When applied to trauma-affected individuals, each of these methods has had its problems.
Etiotropic models, often referred to as "psychodynmic," become overwhelmed by an overload of informational processing required to understand the trauma's effects on identity. Moreover, the symptoms cause havoc (described in About/ Theory/ Psychological/ Etiology) for the etiology identification - restoration effort. The symptoms can even prevent the etiology's address (also described).
When viewing the traumatic sequelae from the nosotropic perspective, that is, when using behavioral methods to watch for and then appraise symptoms, and with the intent to stop them, some may not appear or otherwise not be apparent for days, months, or even years. And as symptoms do present, they frequently mimic other mental health problems. Delayed attempts then to understand or define the traumatic sequelae can result not only in confusion, but often in no definition at all.
Meanwhile, the etiology can grow, apparently in the unconscious. After long lapses in time, the event may be forgotten partially or entirely by the trauma-affected individual and also forgotten or in other ways minimized by the surrounding system. Lose memory of the event, lose recognition of the initial assault upon identity, lose the ability to detect the trauma etiology.
Methodological Problems Produce
Cultural Management Ones
Referenced methodological problems (occurring as prospective remedies for psychological trauma) produce sociocultural management incapacitation.
Absent diagnostic certitude, the sequelae becomes speculation and supposition. And when symptomatic behaviors contrast with social norms, consideration of a trauma-fractured identity as a prospective cause of aberrant behaviors can be and often is argued to be an excuse for irresponsible behavior. Taking on an added social dynamic, not only do the individual's symptoms prevent the etiology's address, but so also does the culture. It cannot allow etiology's address to excuse the aberrant and apparently antisocial behavior. The etiology's address is made more difficult, if not prevented outright.
The trauma-affected individual, culture and the helping methods exist within a problems solving dilemma. The etiology can't be identified, much less addressed directly, without invoking the excuse theory. Failure to address the etiology can effect more symptoms, regardless of assiduously and stringently applied behavioral (nosotropic) attempts to quash the antisocial activities.
Conflict between nosotropic- and etiotropic-oriented peoples and methodologies has evolved. The conflicts have a chilling effect on individual and social remedies. It thwarts attempts to understand, treat and manage psychological trauma and its sociocultural influences.
An enigma, that is, not knowing what to do, or if so having to engage dramatic battles in order just to be truly helpful, produces professional management and public attitudes of futility -- perceptions that little or nothing can be done. Social management paradigms are then organized on that premise: futility. Because of it, they function reactively instead of proactively.
ETM Differences
Etiotropic Trauma Management (ETM) approaches the traumatic sequelae differently from either the psychodynamic or nosotropic (behavioral) methods. The underpinning of this "difference" is ETM's structure. It allows an unfettered address of trauma's etiology by dividing it into readily addressable increments; segmentation of tasks makes informational processing (referenced as overwhelming without the segmentation) of the damaged identity logical and sequitur.
The "increments" represent the natural steps that identity goes through in order to complete the extinction of those elements of identity altered by the initial traumatic event. Understanding those steps can lead to their facilitation, which when completed reintegrates pre- and post-traumatic identities into a homogenous one, therein ending the presence of trauma etiology. ETM defines and manages clinical facilitation of those extinction steps as they pertain to each person affected by the event.
In addition, ETM's structure holds off any symptomatic attempts to prevent the etiology's address. Axiomatically, remove trauma etiology and mitigate the long-term - most devastating - emotional consequences and end or preempt symptomatic behavior.
In this approach, ready address of trauma etiology would also preempt the cultural dilemma created by the excuse theory. If the etiology is gone, there can be no symptoms to excuse, making that theory moot. Symptoms cannot exist without an etiology. And non trauma-effected aberrant behavior could not be rationalized by previous traumatic events.
Moreover, removal of trauma etiology and ending of symptoms would also end the cultural enigma as a source of futility. The culture would know how and always expect to win against trauma and its symptoms. That expectation would be built into all systemic management paradigms, allowing attitudes to shift toward the use of proactive methods that preempt the sequelae's full development at both individual and systemic levels. ETM assists organizations to identify and remove trauma etiology at those levels.
Theory Section
This section provides the text version of ETM theory. The
section explains the neurological, psychological, individual, familial, and
organizational management concepts that provide the basis of ETM's structured
identity-based approach to both near- and long-term trauma and their
consequences.
|
|
|
|
