This chapter focuses on identifying and working with dissociative symptoms and dissociative disorders in a therapeutic context, providing a road map to assist with the pacing and planning of clinical interventions. Rapid eye movement (REM) sleep can be conceptualized as a household strength processor that can accommodate the usual processing requirements of daily life. Posttraumatic stress disorder (PTSD) has been historically defined as requiring a trauma that is outside the range of normal human experience. Hypoarousal and parasympathetic activation that are an intrinsic part of dissociative symptoms are much more difficult to assess. The original painful memories live on in flashbacks and nightmares as well as in reenactments of the unconscious dynamics captured from the family of origin’s enactments of perpetration, victimization, rescuing, and neglect. Excessive sympathetic nervous system activation is easily construed to be an indicator of psychopathology.

This chapter presents a combined creative-corrective approach to working with the bereaved by emphasizing on cognitive assessment as a tool for social workers. It determines how best to facilitate an adaptive grief process with individuals who experience traumatic loss or complicated grief. Cognitive therapies (CT) and cognitive behavior therapies (CBTs) were found suitable with individuals suffering from posttraumatic stress disorder (PTSD), anxiety, and chronic or traumatic grief. Grief as a process of reorganizing one’s life and searching for a meaning following a loss through death is a painful experience. The Adversity Beliefs Consequences (ABC) model is based on a cognitive theoretical model to be applied in treatment of bereaved individuals. Like other cognitive models, rational emotive behavior therapy (REBT) emphasizes the centrality of cognitive processes in understanding emotional disturbance, distinguishing between two sets of cognitions that people construct, rational and irrational ones and their related emotional and behavioral consequences that differ qualitatively.

Sexual trauma includes any type of physical touching or other activity of a sexual nature that is against our will or done without our consent. This chapter defines sexual trauma as anything that occurred or was threatened to occur that was experienced as a violation of a sexual nature. Sexual trauma occurs in many different forms and any sexual trauma can be deeply wounding, requiring new skills for healing. Military sexual trauma (MST) refers to experiences of sexual trauma that occur while a person is serving on active duty military service. The link between MST and homelessness is a perfect example of accumulated symptoms. MST was related to symptoms of posttraumatic stress disorder (PTSD). Forced sex may be viewed as an act of domination to inflate one’s sense of self-importance or power. Psychological symptoms include negative thought patterns such as negative thinking, negative thoughts around trust, safety, and self-blame.

This chapter covers psychiatric diagnoses that might be applied to children seen in primary care: pediatric bipolar disorder, major depression, attention deficit hyperactivity disorder (ADHD), and posttraumatic stress disorder (PTSD). It discusses the diagnoses of the context in the neuroscience explaining the disorder. The chapter reviews the efficacy of current pharmacological treatments along with explanations regarding how they impact physiology, and considers side effects. It also provides alternatives to drugs administered for distress in the children themselves. The profile of adults with bipolar I differs dramatically from the behavioral pattern of children being diagnosed as having pediatric bipolar disorder. The Food and Drug Administration (FDA) has approved fluoxetine/Prozac for the treatment of depression in children. Antidepressants carry an FDA black-box warning for suicidal ideation in children and adolescents. Stimulant drugs are the mainstay of treatment for ADHD. The number of children in foster care receiving antipsychotic drugs is particularly notable.

This chapter helps the reader to understand the justifiable optimism when applying eye movement desensitization and reprocessing (EMDR) therapy to psychosis and to equip clinicians with the skills to identify those people experiencing psychosis who are most suitable for EMDR therapy. The adaptive information processing (AIP) model and the dysfunctional memory network (DMN) are paradigms that have validity beyond posttraumatic stress disorder (PTSD); they are just as valid for addictions, obsessive-compulsive disorder, depression, and psychosis. The chapter explores the people who are suitable for EMDR therapy for psychosis, using the Indicating Cognitions of Negative Networks (ICoNN) model, in two groups: first, people with psychosis who have a clear trauma history or comorbid PTSD; and second, those who meet current criteria for schizophrenia within the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) classification systems in addition to the proposed criteria for dissociative schizophrenia.

This chapter defines emerging disabilities; explores medical, psychosocial, and vocational implications of emerging disabilities that distinguish them from traditional disabilities; and provides demographic characteristics of individuals who are most vulnerable to acquiring emerging disabilities. It examines some social and environmental trends that have contributed to the development of emerging patterns and types of disabilities including advances in medicine and assistive technology, globalization, climate change, poverty, violence and trauma, the aging American populace, and disability legislation. Psychological and physical trauma from warfare, violent crime, intimate partner violence, and youth violence can result in permanent physical, cognitive, and psychiatric disabilities. Diagnostic uncertainties, misdiagnoses, and skepticism on the part of medical providers are frequently associated with emerging disabilities. Women also represent a population that is at an increased risk of acquiring emerging disabilities and chronic illnesses. Rehabilitation systems are still not fully prepared to address the multifaceted needs of individuals with emerging disabilities.

The eye movement desensitization and reprocessing (EMDR) method represents a significant advance in psychotherapy. While most of the empirical research on EMDR demonstrates its efficacy as a treatment for posttraumatic stress disorder (PTSD), including relational traumas. Dysfunctional patterns of relating in the family of origin can imprint themselves on the relational template of adults, only to be reenacted in the contemporary couples relationship. Because EMDR can be effective at transforming these earlier relational traumas, adults can become less reactive, enjoy greater distress tolerance, and have a more resilient ego boundary. Thus, EMDR is an invaluable tool in couples therapy. A 5-step protocol is proposed that can guide therapists to develop an EMDR treatment plan within the context of couples therapy. This protocol can and should be applied to both partners in most cases, but of necessity, the therapist must choose one partner to begin with.

This chapter provides the reader with a working knowledge of the relationship between trauma, schizophrenia, and the other psychoses. Trauma and its consequences have been a part of society for a very long time. The psychological impact of the trauma of war became most widely known as “shell shock” in World War I. Wartime features heavily in the development of the nomenclature of the psychological impact of trauma. Posttraumatic stress disorder (PTSD) is the archetypal response to a traumatic event, and the concept soon expanded from the military to all of society as potential sufferers. The evolution of the diagnosis of schizophrenia was characterized by a move away from a trauma/dissociation model and toward a biological diathesis model, which resulted in schizophrenia’s phenomena being viewed as psychologically incomprehensible. There is no single cause of psychosis, just as there is no single gene.

This chapter focuses on anxiety disorders and deals with a discussion of the physiology of anxiety, including the major structures involved in the creation of a fear memory. It considers the mechanisms for extinction of conditioned anxiety. The chapter discusses the basic physiology of fear conditioning, specific anxiety disorders namely generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), and explains treatments. It then reviews the literature about how clients can talk about their fears to minimize them and how relabeling or reappraising of past events can be helpful. There is evidence suggesting that the basal ganglia, structures associated with the control of movement, are involved in the expression of OCD behaviors in subsets of those with OCD. Cognitive behavioral therapy is effective in the treatment of generalized anxiety. Selective serotonin reuptake inhibitors are also used in the treatment of anxiety disorders.