: *.,,,. Herman 3. Terr DSM-5.,.. * 2015. (Corresponding Author): / / 3 204 / Tel: 053-600-5702 / E-mail: euna@snu.ac.kr
(Society of Clinical Psychology, 2015) (Post-Traumatic Stress Disorder: PTSD)., (Present-Centered Therapy; Schnurr et al., 2003), (Cognitive Processing Therapy, CPT; Resick & Schnicke, 1993), (Seeking Safety; Najavits, 2002), EMDR(Shapiro, 1995), (Debriefing) (Society of Clinical Psychology, 2015). DSM- -TR(APA, 2000) PTSD.,., (Courtois, 2008).,,, /,.,, (Preventive Counseling),, (Bronfenbrenner, 1979),.,, ( ), (psychological healing) (recovery),.,, / / / (safety; Herman, 1997) (reconnection)., DSM- -TR(APA, 2000) PTSD,., (Multiple Trauma),. PTSD,., (multiple trauma), CPTSD(Complex PTSD; Herman, 1992) PTSD (APA, 2013) /, PTSD (Rothschild, 2000)., PTSD, PTSD.,
, (67%), PTSD (59%), (31%) (Cloitre et al., 2005)., CPTSD PTSD,.., PTSD.,.,., PTSD,. (Dialectical behavioral therapy, DBT; Linehan, 1993) (Linehan, 1993). DBT PTSD, Linehan /., DBT PTSD,,..,. PTSD (Courtois, 2008)., PTSD, 1 (Type ) (Type )., Type (Rothschild, 2000)., EMDR,,,.,.,,. (critical period), / PTSD., /.,,.,. 50 80%. PTSD (20 50%),
PTSD PTSD.,.,. (cohort) 100%,., PTSD,.,,,... (RISS),,,, PTSD, trauma counseling technique, PTSD counseling, PTSD treatment,.,., (2015) strong research support.,, EMDR,,.,. (Somatic Experiencing; SE; Levine, 1997, 2008, 2010), (Sensorimotor Psychotherapy; SP; Ogden, 2009),,,,.,., MBCT,, (Imago Therapy; Hendrix et al., 2005).,, Brainspotting(Grand, 2013), OEI (Bradshaw, Cook, & McDonald, 2011), (Primal Therapy; Karle, Corriere, & Hart, 1973).,,, (Survival circuits; LeDoux, 2002), (Window of Tolerance; Siegel, 1999),
(The polyvagal perspective; Porges, 2007).,,. Herman(1992, 1997) 3 1, 3., (psychoeducation) (advocacy), (referral), PTSD outreach,. (2002).. J. Herman 3 Herman(1992, 1997), (Courtois, 2008). 1. (Safety) / ( / )., /,,,,. 2,,. 3. Herman (2 ) / (1 ) (3 ). 1 3.,,. (3 ) PTSD.. 3, / /. Herman 3,. Herman., Herman 1, 3
,. Terr(1991) (Trauma),., Type 1,, (Everly & Mitchell, 2000). Type, (Siegel, 1999) (Society of Clinical Psychology, 2014)., Type,, 3, (Rothschild, 2000; Schore, 1996). DSM-5(Diagnostic and Statistical Manual of Mental Disorders; APA, 2013). DSM-5, PTSD (Trauma and Stressor Related Disorders),. (Dissociative subtype) CPTSD (Friedman, 2013). 6 PTSD (Preschool subtype)., Type 1 (,, ) PTSD Type / / /,,, :,,
.,. (Survival circuits; LeDoux, 2002).,., ; (survival-in-the-moment states; LeDoux, 2002).,.,,, PTSD.,. ( / )., - (tend-and-befriend), /. (General adaptation syndrome) 3 :,,. 3 (,, ).,..,,. (The Polyvagal perspective).,,,., (fight-flight reaction),., Porges(2007) 3 (myelinated vagus),, (nucleus ambiguus: ) (Sympathetic nervous system) ( ) spinal cord (unmyelinated vagus) (immobilization:, ),
. 1 (immobilization:, ).,, ( ) 1. 2. 3,, ( ) (myelinated vagus) ( 2 ). (immobilization:, ) 1.,,, 1.,,., 2 ( ) 1 ( ) (Ogden, 2009). PTSD (Dissociative Disorder)/ (Dissociated memory disorder) (APA, 2013; Van der Kolk et al., 1996)., (implicit or procedural memory), (dissociated memory) PTSD, (Shapiro, 1995; Levine, 2010; Ogden, 2009). (Window of Tolerance; WT). (WT) / (Siegel, 1999). Siegel, Ogden(2009) (The Window of Affect Tolerance) ( 2)., WT / (, ). WT, WT,
WT WT. WT,. (empowerment)., 1 WT. Bromberg(2006) Ogden(2009) WT., WT,,., WT,. WT 2, (Najavits, 2002). ( 3 ). J. Herman 3 (Herman, 1997), Terr(1991) DSM-5.., ( PTSD ), / /.,,.,...,,.. 3. 1 : (Safety) (Surviving) Herman(1997) 3, (Safety). / /.,., (response) (trauma event),
( ) / / / / / / / / / / / (Stabilization) & ( ) / / (Positive reframing) (Ritual).,. / /,,. (Out reach) & (Advocacy).. 10 (practitioners) (Vera & Speight, 2003)., / /., (, 2015). (,,,, ),., /.,.,, / / 1. (trigger), ( ).
/ (Psychoeducation). (LeDoux, 2002; Porges, 2007),., (dependence),., / / /.,., ( ). (Phoenix, 2007)., ( ; Society of Clinical Psychology, 2015). (Psychoeducation)., 1) (,, ), 2) ( / ), 3). 1,, (stabilization).,.,.. Type, / (,, EMDR, )., WT (Siegel, 1999).,, (, Grounding) (Najavits, 2002).. EMDR (Levine, 2010; Odgen, 2009)., EMDR,, (Shapiro, 1995).. PTSD (Abnormal Stimulus) (Normal Reaction).
.,., (survival-in-the-moment states; LeDoux, 2002), (Phoenix, 2007). ( ) (set)., 1. (referral),.,.,.,,, PTSD., (,, ) (Rothschild, 2010)., (Sharpless & Barber, 2011). WT,, (SNRI) / / (Society of Clinical Psychology, 2015). : :.., Type,. Type,, (Herman, 1992)., (Trauma Re-enactment; Herman, 1992) (Linehan, 1993).. (, SE, SP ) (, 2015; Levine, 2010; Ogden, 2009).. 2 : 2, /., (distancing). 2 1.,., PTSD
.,...,,,., ( ;, 2015). (SE, SP) (Levine, 2010). (Freeze) ( ). / (Ogden, 2009). Type, / ( ) ( ). - ( ), ( - - ) (Odgen, 2009). MBSR, MBCT, (, SE, SP) (, 2015; Linehan, 1993; Levine, 2010; Ogden, 2009). (Stabilization) : / /., 2 WT..,,., / / (Schore, 1996; Rothschild, 2000, Najavits, 2002). -. Type /, (Rothschild, 2000).. ( ) (Rothschild, 2010).,,,.,
,,,.,,, (Skills Training in Affect and Interpersonal Regulation: STAIR, Cloitre et al., 2002), Narrative Story Telling(NST).. (Prolonged Exposure; PE; Foa, 1997).,,. (CPT). 3 MBCT(Mindfulness Based Cognitive Therapy; Segal, Williams, & Teasdale, 2002), (Acceptance Commitment Therapy; ACT; Hayes, Strosahl, & Wilson, 1999), (Dialectic Behavior Therapy; DBT; Linehan, 1993). / ( ) (Mindfulness) (Linehan, 1993).,. CPTSD (Ford & Courtois, 2014; Linehan, 1993; Van der Kolk, 2002). (Battered Wife s Syndrome). Type (Becker, & Zayfert, 2001). Brainspotting(Grand, 2013), OEI (Observed and Experiential Integration; Bradshaw, Cook, & McDonald, 2011), EMDR(Eye Movement Desensitization and Reprocessing; Shapiro, 1995). (Esterling, L'Abate, & Murray, 1999)., (Pennebaker & Francis, 1996) ( ) ( ).,.. 2 ( ). 2.,,, /,. Type, /., (ritual),,..,
,. 3 : (reconnection), (Ford & Courtois, 2014)..,,. (trigger).,.,,. :..,..,. Frankl(1962),., (Herman, 1997).,. (Ritual):. Frankl... (ritual),, (, ), /., /.., /. / /.
(empowerment). (empowerment).,.. (empowerment),,..,.,.,... (positive reframing;, 2002),,..,,,,. 2,. /.,.,.,.., 1, 3. Herman 3, Herman 1, 3. 1, 3.,. /.,., 1 2, 3.,.
,, 3. /.,. (mass trauma),., PTSD,., 3 PTSD PTSD.,,.,.,., 1. 2 ( ),.. (2015), (1 ),.,.., (couch therapy).,.., 2 PTSD., PTSD.,., PTSD, (mass trauma),
., (critical period),. PTSD (Foa, Keane, Friedman, & Cohen, 2008),,.., PTSD.. Herman,.,.,,. 2. 2., 2 (PTSD ),,,.,.,., 2,.,..,,. 1).,,,,. 2),,,,., CYS-net,...,,,,...., PTSD 3.
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Trauma Counseling Model: Recovery Mechanisms and Techniques in Three Stages Kyungil University This study focused on effective and tangible trauma counseling techniques from the perspectives of growth and extension in counselogy and reviewed the recovery mechanism on three stages of trauma. As the frames to analyse recovery mechanisms, the types of trauma events, neurophysiological studies of trauma response, the principles of affect arousal were reviewed. Specifically, the trauma theory by Herman was used for identifying core techniques in three stages. The classification of trauma events by Terr and DSM-5 diagnostic criteria were used to define the trauma response and main counseling task in stages. In order to explain trauma response in a neurophysiological scope and find the implication of recovery mechanisms and tangibility of techniques, Survival Circuits, General Adaptation Syndrome, The polyvagal perspective, and Window of Tolerance were examined. Based on the analysis, the model of trauma counseling was suggested. Key words : trauma, safety, reconnection, recovery mechanism, counseling technique, counselogy, PTSD