Measuring for Etiology Reversal
This chapter:
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Describes what etiology reversal (and "trauma resolution" to the patient)
looks like to the ETM clinician.
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Discusses what the ETM clinicians should expect from TRT's (ETM's)
application.
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Lists the criterion (offers a model) for testing TRT to see if those
expectations are being realized.
About/ Development/ Evaluating for Trauma Resolution
considers industry problems related to evaluating for trauma resolution.
You might read that chapter before reading (or in concert with) this one
so that you may have a development history of ETM's method for measuring
or evaluating for trauma resolution.
ETM Measures Trauma Resolution
ETM's measuring device for trauma resolution is a combination of subjective
and objective methods, but with the application of special criterion that
have evolved out of our observations of the trauma resolution therapy process.
Trauma resolution per these special criterion involves self-reports and
the facilitator's observations.
Self-Report
Numerous self-reports have been taken at the end of the trauma victim's
use of the 5 phase structured psychodynmic process. Virtually in every
case, those people reported that the trauma had been resolved. To them,
"resolved" carried a special meaning; it is described next. Simultaneously,
the facilitator has observed the trauma resolution process, even experienced
it with the patient. Both, the client and the facilitator/observer, combine
to present the following criterion that demonstrates resolution, etiology
reversal.
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The acute emotional pain and loss resulting from the event is addressed
to the extent and degree that the person feels fully "heard" or "finished"
with the experience or that the emotional pain is "completely addressed,
resolved, and reconciled"; further address, resolution, and reconciliation
is unnecessary. In addition, the counselor who has made the journey with
that person also experiences a similar sense of completion from that person.
The individual also explains that if further address of emotion is necessary,
the person would, with confidence, know what to do; the person would know
what was required to address any recurring experience. In our facilitation
of TRT, such additional needs were rare; we have no recollections of an
example of an individual's demonstrating a need to return to, or an interest
in returning to, a discussion of the traumatic event for the purpose of
addressing emotional pain and loss resulting from that event. Nor have
we ever heard of such a requirement by any of the 1000 (at the time of
this writing in 1992-93) professionals trained and certified to administer
TRT.
and
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The person has an understanding of the following (A - D): ("Understanding"
refers to a well grounded intellectual [rational/cognitive] and experiential
[empathic, intuitive, emotional, and for some, spiritual] realization.)
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A. Who the person was prior to the trauma's occurrence.
"Who the person was prior to the trauma's occurrence" means that the person
identifies specific values, beliefs, images, and realities that are considered
to be the essence of those aspects of Self that are recognized as having
comprised the psychological Self that existed before the event occurred.
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B. What happened to the person as a result of the trauma.
"What happened to the person as a result of the trauma" means that the
person recognizes the specific effects that the traumatic event
had on existential and operational aspects of identity. "Specific effects"
refers to those continuums of thought comprising Self images, values, beliefs,
and realities that were interrupted and that as a consequence of the intrusion,
resulted in loss of certain aspects of that Self; the aspects of loss are
also identified with specificity. "Specific effects" also refers to any
reductions in interactions between the individual's use of certain attributes;
for example, reductions in the abilities to manage the system of values,
etc., analyze and plan life processes without encumbrance, and to feel,
empathize and, in some cases, care about one's self and others.
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C. The difference between what the person had to do to survive and
who the person was (during the trauma and the following period).
The reference to "differences between survival thought/behavior and person
hood" means that the individual identifies all changes in behavior and
thought undergone as direct and indirect responses to the trauma-causing
event, and that the responsibility for those changes lie with, and within
the context of, the event itself and the subsequent (that is, the period
in which the trauma was not being addressed, reconciled or resolved) and
unrecognized damage to the existential and operational elements of the
psyche directly caused by the event. "Differences" also refers to the identification
of those survival responses and behaviors as consequences of the damaged
psyche and not of personality traits attending the undamaged psyche --
the person.
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D. Who the person is now that the trauma is resolved.
"Who the person is now that the trauma is resolved" means that the person
has
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appraised the pre-trauma identity, the damage to that identity, and
the survival identity adapted as a response to the trauma, and
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assimilated the elements of those pre-trauma identities that are acceptable
to the ontology of the individual, as that individual exists today; the
person is no longer encumbered by the damage previously sustained as a
response to the trauma-causing event.
When the trauma victim provides a self-report that the trauma has been
resolved, that is, the trauma victim describes his or her understandings
of the trauma and its effects upon the person's life -- the description
is provided within the criterion described in "1" and "2: A,B,C and D"
from the foregoing, the standard for trauma resolution under the ETM definition
has been met: the trauma has been resolved; the etiology created by the
event has been reversed.
Clinician's Observations
Validation of the trauma victim's self-report that the trauma has been
resolved is accompanied by the facilitator's determination through observation
of the therapeutic process that:
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all contradictions to values, beliefs, images and realities, including
both contradictions created by the initial trauma and the survival responses,
have been identified.
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all losses stemming from those contradictions have been resolved; "resolved"
means that they have been identified, experienced, expressed, understood
and accepted.
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all contradicted values, beliefs, images and realities have been reconstituted.
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all grief cycles (described in Part One of the text) related to the
individual's passage through the process of identifying the trauma-causing
event, its damage to existential identity, survival responses that also
damage existential identity, and identification of that specific damage,
and reconciling all such damage described herein have been fully
negotiated. "Fully" means that no elements of the psychological trauma
patterns remain to be addressed.
Test for Resolution
TRT will resolve trauma if:
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external factors (nosotropically-based models like psychotherapy, cognitive
- behavioral/ analytical - interpretive, pharmacological, and ongoing threat
to life by a perpetrator) do not interfere with TRT's application.
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the TRT participant does not use drugs (including the social use of
alcohol) at any time throughout the therapeutic process.
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the therapist does not use drugs (including social use).
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the person does not suffer additional physiologically-based mental
illnesses (for example, manic depression or schizophrenia).
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the patient's prior medical history does not include pharmacological
applications; for example, tranquilizers, anti-depressants, etc.; although
TRT may be able to help these people, the previous applications may alter
neurology (see the theory and bibliographical sections), and the past alterations
could interfere with TRT's application despite their current discontinuance.
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the therapist follows the directions for facilitating TRT; those directions
have been provided in this book and are reiterated through the application
of TRT experience within the professional education and training module
known as the ETM Professional Training School.
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