Abstract
Background: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. Objective: The purpose of this study was to examine the extent to which soldiers’ PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then). Method: The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS) and two additional measures: the Emotional Distress Inventory (EIBE) and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH) at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT). Results: Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index). A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one’s TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores. Conclusions: For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.
Highlights
The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the Posttraumatic Diagnostic Scale (PDS) scores
For soldiers suffering from specific war-related trauma involving posttraumatic stress disorder (PTSD), the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions
(including positive changes in the way one views the TRAUMATIZED SELF). These findings are in accordance with previously-published studies on the use of imagery rescripting for non-fear emotions [19,39] and builds on the results reported by Alliger-Horn et al [11] in which imagery rescripting and reprocessing therapy (IRRT) was successfully employed with German soldiers
Summary
Clinical research in the field of psychotraumatology has made enormous advances.Today, many published studies are available pertaining to the efficacy of various trauma treatments [1], which has prompted scientific societies to begin recommending standards for the treatment of trauma patients (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) [2]).Numerous studies and meta-analyses on the psychotherapeutic treatment of individuals suffering from posttraumatic stress disorder (PTSD) have examined the efficacy of empirically-established trauma therapies [1,3], as well as the effects of different treatment settings [4,5].Schnyder et al [6] described the central components that are, to a greater or lesser extent, part of all trauma-focused therapy approaches. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. Objective: The purpose of this study was to examine the extent to which soldiers’ PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED. A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one’s TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores
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