The lingering burden of seeing a past trauma as central to your identity

How is your doctor and psychologist treating your stroke trauma? My stroke is central to my identity but in a positive way, it focused my life.
http://digest.bps.org.uk/2016/06/the-lingering-burden-of-seeing-past.html
Horrific experiences often cast a pall upon our lives, but for some people it’s worse than others. A new study in Applied Cognitive Psychology explores a key reason for this difference known as “event centrality” – when we consider an experience to be core to our identity, the trauma that follows is typically more serious and longer lasting.

Ines Blix and her colleagues surveyed 259 ministerial employees caught up in a particularly grim piece of Oslo history: the July 2011 far-right terrorist attack upon government ministries. At one, two and three years after the attack, the participants reported the severity of their post-traumatic symptoms, such as feeling jumpy, continually vigilant, or numb and closed off from others. They also reported the degree to which the terrorist attack was central to their lives, for example through their agreement or not with statements like: “This event has become a reference point for the way I understand myself and the world.”

Participants who considered the terrorist event very central to their life one year after the attack experienced higher levels of trauma, both at that time and through the subsequent years. However, they recovered at a faster rate from the trauma, meaning the greater severity of their symptoms compared with the other participants reduced as time went by. This likely reflects the fact that they had more recovery to do. Essentially, seeing a traumatic event as definitive to your life fixes a particular trajectory: Blix’s team characterise this as ‘launching’ the trauma.

It’s not just that event centrality reflected how much the participants were caught up in the carnage – when the researchers controlled for whether the person was injured themselves, had witnessed killings, or seen dead bodies, the association between event centrality and trauma severity held true.

There was also some evidence that trauma and event centrality remain intertwined longer term. The two measures were in general highly correlated and in most participants both eventually declined. This might just be a coincidence and the two factors aren’t linked, but arguing against that, it’s notable that when event centrality increased at the 2013 assessment (two years after the event), trauma recovery also tended to stutter. However, even if the two measures really are linked, we still don’t know whether centrality exacerbates trauma or trauma exacerbates centrality.

These new findings add to previous work, such as an earlier study on post-traumatic stress in Vietnam veterans that found higher rates in those vets who attended the experiment wearing medals and other regalia, suggesting that the war was more central to their identities.

It’s important to to understand how victims think about their traumatic experiences – their  ”mental models” of the event – because these models can be interrogated and changed. For example, in a study published last year, a course of Acceptance and Commitment Therapy successfully helped a group of women who had suffered abuse to reduce both event centrality and traumatic symptoms. This new Norwegian study suggests that it may be better to target such treatment early, to help survivors reject the idea an event is life-definitive and prevent it launching them down a path of greater trauma.

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Blix, I., Birkeland, M., Solberg, Hansen, M., & Heir, T. (2016). The Launching and Ensnaring Effects of Construing a Traumatic Event as Central to One's Identity and Life Story Applied Cognitive Psychology DOI: 10.1002/acp.3224