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Małgorzata Folaron, PhD student: The impact of traumatic events on a change in human functioning.

Nowadays, people tend to describe various unpleasant situations as traumatic. This is due to the specificity of the trauma itself and the difficulties in recognizing and defining it. Which events can be called traumatic and which are no longer traumatic? What does it depend on and what may influence the fact that a specific event is traumatized by "T" for one person, and by "t" for another? In my speech, I will also focus on the crises that may occur as a result of these events, as well as on how a traumatic event can be worked out from the practical side so that it becomes an opportunity to improve the quality of life.

We can describe trauma in two ways, taking into account the essence, the frequency of its occurrence and the accompanying consequences. In a broad sense, these will be all psychological traumas accompanying a person at various stages of life. These include various types of crises, conflicts, chronic somatic and mental diseases, often associated with emotional, cognitive and social disorders. This approach is closer to understanding a stressful situation.

In the narrow sense, trauma is a type of severe stressor causing risk of death or loss of life, serious trauma or sexual violence. Most often it is sudden and uncontrolled. It may concern many people at the same time, as well as a situation in which a person is an eyewitness to traumatic events for other people. One of the most difficult tasks is to recognize childhood traumas. Unresolved losses and traumatic experiences that are repetitive but emotionally significant and difficult in childhood can inhibit the normal processing of memories while disrupting the mechanisms of recording and storage. Some of them may be the result of a single and short-term event, such as kidnapping, witnessing a murder, while others concern long-term, repeated situations, which are exposure to traumatic external factors. The concept of trauma can also include experiences of neglect and abuse that affect the sense of worth, security, the ability to take responsibility for oneself and others, and limit the sense of control or choice. Many studies in which the negative consequences of long-term traumatic events have been observed have shown that with the increase in the number of experienced traumatic events, the probability of post-traumatic stress disorder (PTSD) or depression increases.

Memories of traumatic experiences or events may contribute to the development of pathology or distress in the client. PTSD is a disorder of processing memories and traumatic experiences, most of which should be treated therapeutically, because information related to a traumatic or stressful experience is not always fully processed. During a traumatic event, the direct and inborn biochemical response to the trauma (release of adrenaline, cortisol, etc.) blocks the brain's innate processing system, keeping the information related to the trauma isolated and stagnant. The trauma-related information becomes trapped in the neural network along with the same emotions, beliefs, and physical sensations that were present at the time of the event. An event can be traumatic even when the person's reaction to it is within the normal range and the person has successfully dealt with the stress resulting from the event. The basic principle is the assumption that there is an innate, physiologically oriented, information-processing, self-healing system in humans. Pathology occurs when this system is blocked and the memory of the traumatic event is isolated from the rest of the neural network and not integrated into the innate self-healing system. Raw information is dysfunctionally stored in memory networks, and people often suffer from their memories.

Trauma has a dual structure and includes the occurrence of a traumatic event and a subjectively strong emotional reaction to it. This reaction may or may not develop into a psychopathological state. In practice, the diagnosis of trauma is not easy. This is due to individual differences in the perception of the traumatic nature of events, therefore the subjective feeling of traumaticness of the same event may be, and even is, different in different people.

Trauma-focused therapies should be the psychological treatments for chronic post-traumatic stress disorder. The Federal Substance Abuse and Mental Health Administration (at the U.S. Department of Health) has recognized EMDR (Eye Movement Desensitization and Reprocessing) as an evidence-based treatment for depression, anxiety and PTSD. The World Health Organization (WHO), in its recommendations for the management of stress-specific conditions, indicates trauma-focused CBT (cognitive-behavioral therapy focused on trauma TFCBT) and EMDR as the most effective forms of therapy for treating children, adolescents and adults with PTSD. Like trauma-focused CBT, EMDR aims to reduce subjective distress and strengthen adaptive beliefs associated with a trauma event. Unlike CBT, EMDR does not include a detailed description of the event, direct confrontation of beliefs, prolonged exposure, or therapeutic homework assignments.

As previously mentioned, each of us has an adaptive information processing model that posits that distress is caused by perceptions of past events or events (images of thoughts, beliefs, emotions, sensations, smell sensations) that are physiologically stored in memory networks. Pathology results from unprocessed memories, and their processing will lead to a reduction in the severity or removal of symptoms. Processing a traumatic memory, e.g. with EMDR, often results in desensitization (desensitization) and cognitive change. The client is able to distance themselves from the traumatic event, modify their beliefs about themselves, feel emotions adequate to the original event, and free themselves from disturbing physical feelings. After EMDR sessions, clients still remember the event or experience but perceive it as part of their past. The content of this experience is completely integrated within the adult perspective. In the course of processing, clients gradually experience changes in the cognitive and emotional area until they reach a more mature and constructive perspective. The client is able to spontaneously associate information stored in memory networks with memories without the intervention of the therapist.

The client's reactions to the traumatic event include fear, intense terror, or a sense of vulnerability. Thanks to the development of neuroimaging techniques, we know what really happens in the brain of people experiencing trauma. Studies using SPECT (single photon emission tomography) or high resolution magnetic resonance reveal neurophysiological changes (activation areas in the brain), volumetric (volume) changes, changes in blood flow in the hippocampal, occipito-temporal and visual cortex. Following treatment, e.g. with EMDR, there is a significant change in the activity of certain areas in the limbic regions with high emotional load and the cortical regions associated with mating. The use of this research is the basis for therapeutic treatment and reduction of reactions accompanying traumatic events, so as to remove suffering and associated symptoms. "Resources", or qualities and skills that a person has, turn out to be very important in the face of current challenges. Peterson and Seligman (2004) listed 6 virtues or advantages desired in everyday functioning. These include: thinking (creativity, curiosity, open-mindedness, interest in new points of view), proactivity (courage, steadfastness, honesty and vitality), humanity (ability to love and be loved, generosity, emotional intelligence, empathy), justice (leadership skills , honesty), self-control (forgiveness, modesty, prudence), transcendence (spirituality, appreciation of beauty, gratitude, hope, sense of humor).

The ability to react to stressful events plays a fundamental role in every person's life, especially when psychosocial and genetic vulnerability factors are additionally present, in line with the theory of multifactorial causes of mental disorders. Past, present and future cannot be separated. A healthy adult has the ability to take care of himself and self-regulate, he can feel a whole range of different emotions, is able to interact and connect with others, to set boundaries, feel empathy and create good relationships. He also has a good level of self-esteem and a well-integrated personality with an appropriate level of functioning.

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