Environmental+Factors-+Trauma+Exposure



Another research finding also indicates that the importance of the trauma is relative. Against all expectations, no connection can be found between the objective severity of the traumatic event and the development of psychopathology. This holds true even for long-term physical and sexual abuse of children: “Such research has consistently shown that exposure to child abuse increases the risk for developing a wide range of psychological symptoms, but that only a minority of exposed persons are likely to develop clinically significant psychopathology” (Paris, Andrews, & Valentine, 2000, p. 176).

Whether PTSD develops is not so much determined by the trauma in itself; rather, there must be //mediating factors// of vulnerability and resilience.

There is evidence that traumatic environmental factors themselves are the cause of long-term neurobiological changes (Paris, 2000, pp. 177–178). In other words, it is the ever-complex interplay between nature and nurture that determines the final result.

This interplay brings us to the empirical findings of neuropsychological research (Brewin, 1998; Van der Kolk, 1994; Van der Kolk & Fisler, 1995). Studies on the //memory functioning// of patients with PTSD consistently show that certain representations of the traumatic event cannot be stored in declarative or narrative memory (functioning via the hippocampus); instead they are initially organized only at the sensorimotor and affective levels, in what is called implicit, procedural memory (based in the amygdala). Possible connections between both memory systems are very indirect. The implication is that these representations cannot be remembered as such in a normal, associative way. They can be constructed only retroactively, meaning that a narrative can be built around the traumatic experience, in which the explicit memory is then also involved. This gives a totally different, and much less important, complexion to the discussion of false versus repressed memory. We are left with a catch-22 situation: Anyone who claims to remember a traumatic event hasn’t experienced one; anyone who claims not to remember one may have experienced one (Verhaeghe, 2004).

As we will see, the psychological processing of stressful events happens in early development through the mediation by the Other.1 If this Other, for one reason or another, is not able to provide this mediation, then the processing becomes impossible. A painful illustration in this respect is found in Holocaust survivors. As can be expected, the offspring of survivors of the Holocaust show an increased propensity for developing PTSD when compared with the children of other parents. The curious thing, however, is that these children are also shown to experience //more// posttraumatic stress symptoms than their parents (Yehuda, Schmei- dler, Giller, Siever, & Binder-Brynes, 1998). Is it possible that these parents—victims themselves—function in such a way as to be unable to provide their children with the necessary psychological tools to process traumatic experiences? The question has no easy answers, but studies on the impact of the social environment—the Other as a sociocultural discourse—indicate that the presence or absence of social support clearly influences whether PTSD does or does not develop (Brewin, Andrews, & Valentine, 2000; Lee & Young, 2001, p. 156; Paris, 2000, pp. 179–180).