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A FUTURELESS MAN: THE INTEGRATION OF A TRAUMATIZED LIFE

ERIC C. ARAUZ MLER

TRAUMA INSTITUTE OF NEW JERSEY

ADJUNCT FACULTY INSTRUCTOR

DEPARTMENT OF PSYCHIATRY

RUTGERS ROBERT WOOD JOHNSON MEDICAL SCHOOL

LOSS OF NARRATIVE SUBJECTIVITY

“…THE DIFFERENCE BETWEEN THE PATIENT’SEXPERIENCE OF THE DISEASE AND THE DOCTOR’S

ATTENTION TO THE DISEASE…”

ARTHUR KLEINMAN, MDPSYCHIATRIST HARVARD MEDICAL SCHOOL

PROFESSOR, ANTHROPOLOGYHARVARD UNIVERSITY

KLEINMAN, A. 1988. THE ILLNESS NARRATIVES: SUFFERING HEALING AND THE HUMAN CONDITION. NY, NY: BASIC BOOKS. 2

FRACTURING OF GLOBAL

IDENTITY:DESTRUCTION OF LINEAR VISCERAL AND

COGNITIVE NARRATIVES

• CHAOS NARRATIVE: NO MAP ORDESTINATION

(Frank AW. The Wounded Storyteller: Body, Illness, Ethics. Chicago: University of Chicago Press, 1995, 2013.)

• STORY OF ATROCITY/LANGUAGE OFABOMINATION

(HERMAN J. TRAUMA AND RECOVERY. NEW YORK: BASIC BOOKS, 1997.)

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TRAUMA-INFORMED

STORYTELLING

LANGUAGE AS ORGANIZING PARADIGM FOR

IMPLICIT AND EXPLICIT MEMORY OF

PSYCHOSIS AND TRAUMA

EXPLORATORY NARRATIVE PROCESSING AND

COHERENT POSITIVE RESOLUTION(Pais, Jennifer L., (2006) Narrative Identity Processing of Difficult Life Experiences:

Pathways of Personality Development and Positive Self-Transformation in Adulthood)

A FREE ARTIST TO THEMSELVES

…SELF CHANGE ON THE BASIS

OF SELF-OVERHEARING…(BLOOM, H. THE WESTERN CANON: THE BOOKS AND SCHOOL OF THE

AGES. NEW YORK: RIVERHEAD BOOKS, 1995, 46.)

DISEASES OF CONSCIOUSNESS“EMOTIVE DISCOURSE”

SUBCORITCALGERALD M. EDELMAN MD PHD

1972 NOBEL PRIZE PHYSIOLOGY/MEDICINE

SENSATIONS

PERCEPTIONS

IMAGES

MEMORIES

THOUGHTS

EMOTIONS

ACHES

PAINS

VAGUE FEELINGS(EDELMAN, GERALD. WIDER THAN THE SKY. NEW HAVEN: YALE PRESS, 2004, 8.)

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A FUTURELESS MAN: 

THE INTEGRATION OF A HUMILIATED LIFE

ERIC C. ARAUZ MLER

TRAUMA INSTITUTE OF NEW JERSEY

ADJUNCT FACULTY INSTRUCTOR

DEPARTMENT OF PSYCHIATRY

RUTGERS ROBERT WOOD JOHNSON MEDICAL SCHOOL

A FUTURELESS MAN: THE INTEGRATION OF A TRAUMATIZED LIFE

ERIC C. ARAUZ MLER

TRAUMA INSTITUTE OF NEW JERSEY

ADJUNCT FACULTY INSTRUCTOR

DEPARTMENT OF PSYCHIATRY

RUTGERS ROBERT WOOD JOHNSON MEDICAL SCHOOL

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ABSOLUTE SHATTERING OF THE

“SELF”• PHYSIOLOGICAL

• COGNITIVE

• SPIRITUAL

• SOCIAL

• FAMILIAL

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LIKE FATHER, LIKE SON?

• BIPOLAR 1 DISORDER

• ADDICTION

• POSTTRAUMATIC STRESS DISORDER

• COMPLEX TRAUMA

• 2 SUICIDE ATTEMPTS

• 265 POUNDS IN 7TH GRADE

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MY SOUL IS LOST, MY FRIEND

TELL ME HOW DO I BEGIN AGAIN?MY CITY'S IN RUINS

MY CITY'S IN RUINS

MY CITY OF RUINS

BRUCE SPRINGSTEEN

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MAN CANNOT REMAKE HIMSELF

WITHOUT SUFFERING FOR HE IS BOTHTHE MARBLE AND THE SCULPTOR.

ALEXIS CARREL

NOBEL PRIZE PHYSIOLOGY 1912

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PROCESS OF TRANSFORMATION

Ideas vs. Beliefs

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TRAUMA OF PSYCHOSIS

“MORE THAN ONE‐HALF OF THE PARTICIPANTS REPORTED

INTENSE DISTRESS RELATED TO PSYCHOTIC SYMPTOMS OR

TREATMENT EXPERIENCES, WITH 66% MEETING

SYMPTOM CRITERIA FOR THE PTSD SYNDROME (REGARDLESS

OF A1/A2), AND 39% MEETING FULL DIAGNOSTIC

CRITERIA FOR PTSD (INCLUDING A1/A2).” 

MUESER KT, LU W, ROSENBERG SD, WOLFE R. THE TRAUMA OF PSYCHOSIS: POSTTRAUMATIC

STRESS DISORDER AND RECENT ONSET PSYCHOSIS. SCHIZOPHRENIA RESEARCH. 2010;116(2-3): 217-227.

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Shame Pride

MOKROS HB. SUICIDE AND SHAME. AM BEHAV SCI. 1995;38:1091-1103.

SELF STIGMA

“HUMILIATED FURY”HELEN BLOCK LEWIS

CONTINUUM OF IDENTITY23

ADVERSE CHILDHOOD EXPERIENCES

STUDY (ACES)

• Physical abuse by a parent • Emotional abuse by a parent • Sexual abuse by anyone • An alcohol and/or drug

abuser in the household • An incarcerated household

member

• Someone who is chronically depressed, mentally ill, institutionalized, or suicidal

• Domestic violence • Loss of a parent • Emotional neglect • Physical neglect

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Felitti, V. J., Anda, R. F., Nordenberg, D.F., Williamson, D. F., Spitz, A.M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventative Medicine, 14(4), 245-258.

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ACE

BIPOLAR

ALCOHOLISM

DRUGADDICTION

SUICIDE

TRAUMA

CHILDHOODOBESITY

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TRAUMA‐INFORMED STORY TELLING(BERTHA PAPPENHEIM: SIGMUND FREUD AND JOSEF BREUER

STUDIES ON HYSTERIA)

EFFECTIVE TREATMENT IS A MATTER OF HELPINGINDIVIDUALS KEEP THE OBSERVING PREFRONTAL CORTEXONLINE AS IT SIMULTANEOUSLY EXPERIENCES THE RAWPRIMITIVE SENSATIONS GENERATED IN THE ARCHAIC

PORTIONS OF THE BRAIN (THE LIMBIC SYSTEM, HYPOTHALAMUS AND BRAIN STEM.)

(LEVINE, P., IN AN UNSPOKEN VOICE. BERKELEY: NORTH ATLANTIC BOOKS,2010, 71.)

FUNCTIONAL HIERARCHY OF THE BRAIN

• Perry BD. In: Murberg MM (Ed.) Catecholamine Function in Posttraumatic Stress Disorder: Emerging Concepts. Washington, DC: American Psychiatric Press; 1994:253‐276. Perry BD. In: Coffey CE, et al (Eds). Textbook of Pediatric Neuropsychiatry. Washington, DC: American Psychiatric Press; 1998.

Neocortex

Limbic

Diencephalon

Brainstem

Abstract ThoughtConcrete Thought

AffiliationAttachment

Sexual BehaviorEmotional ReactivityMotor Regulation 

“Arousal”Appetite/Satiety

SleepBlood PressureHeart Rate

Body Temperature

COMPLEXITY

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PROCESS

OF

RECOVERY

BIPOLAR

ALCOHOLISM

DRUGADDICTION

SUICIDE

TRAUMA

CHILDHOODOBESITY

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MY VIRGILS

YOU MUST GO ON;

I CAN’T GO ON;

I’LL GO ON.

SAMUEL BECKETTTHE UNAMABLE

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ACE SCORE

FATHER

10SON

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PURPOSE

MISSION

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v

HONOR

cheryl

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ACE SCORE

GRAND DAUGHTER/

DAUGHTER

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