Common Characteristic Of Dual Trauma Couples example essay topic

Journal of Marital and Family Therapy The interpersonal dynamics and treatment of dual trauma couples, Vol. 22, No. 4, 1996,431-442. Dennis Balcom NARRATIVE: The author of this article explores the complex and intense challenges for couples and marital therapists dealing with trauma survival dyads. These unique challenges in organizing and implementing treatment are experienced by therapists treating both partners in a couple who are survivors of trauma. Therapists are often faced with complications from "interpersonal reactivity, transference, emotional withdrawal, and associated responses".

They must often deal with an abundance of difficulties. One partner may be in crises while the other is stable. When both partners are in crises at the same time treatment will be the most challenging. The author, Balcom, recommends that therapists develop an understanding of the major dynamics presented by dual trauma couples. "Overall case management and coordination of the various treatments, to active intervention in the enactment of trauma responses in the couples therapy, to the resolution of other issues unrelated to trauma" will have to be tended to by the therapist. There is a need for interpersonal relationship improvement among these clients, however, the individual and / or group treatments may exacerbate conflicts between the partners since the treatment is centralized on individual progress.

The focus typically "ignores the interpersonal dyad in favor of the individual progress". One partner's progress may inadvertently delay individual or group treatment progresses, according to Balcom. The author presents a system formulation for "couples in which both partners are survivors of trauma" and offers a "systemic perspective of treatment". His primary purpose is to explain the types of interaction and "dynamic characteristic of these couples from family systems orientation". Dual Trauma Couple is used in this context to describe "couples in which both partners have experienced a trauma, or multiple traumas, which continue to impact their individual and relationship functioning".

Balcom explains that the traumas "could have occurred prior to the beginning of the relationship or at any time during the relationship". The author gives an overview of the development of the dual trauma couple concept. He explains and explores various types of trauma - psychological as well as physical - that occur "through accidents, human actions (incest, war, kidnapping), and natural disasters (hurricanes, earthquakes) (Baum & Fleming, 1993). Balcom uses vignettes and case histories to illustrate In a discussion of interpersonal dynamics, the author focuses on a crucial factor that distinguishes these couples from single survivor and couples that are nontraumatized: "the high probability that both partners will simultaneously exhibit trauma responses or reactivity". These simultaneous responses arise for duel trauma couples in the routine process of couples therapy. Triggering (whereby one individual is set off by witnessing the other's trauma responses) and retraumatization can inadvertently occur without warning between the partners or be evoked by interactions with the therapist.

Balcom recognizes some common themes among dual trauma couples: lack of comprehension of the partner's experience due to the fact that it is different from one's own experience or over identification because the experiences seem identical; competition about whose trauma or symptoms are worse or who has the most useful style of coping; authentic, but perhaps misguided efforts to cope with distress, which result in an increase instead of a decrease in problems; "caregiver fatigue" - when one partner or both partners experience a serious exhaustion of personal well-being due to efforts to care for either the partner or the self; guilt over surviving and / or causing the trauma; either an actual failure or the belief that one has failed in an attempt to do enough to recover from the trauma; resentment and anger about the need to have to help the partner recover; lack of availability (sexually, emotionally, or physical) for the partner; misunderstanding of responses connected to holidays and anniversaries of the traumatic event; and for couples with children, there is the possibility of "triangulation or detouring (Minuchin, 1974) the trauma-based problems". There are also common characteristic of dual trauma couples: either too extreme or too fluid boundaries; intense emotional reactivity; normal emotional processes and relationship skills (communication, nurturance, problem solving, and conflict resolution skills that are underdeveloped) may be sabotaged by trauma; problems developing and sustaining intimacy; and learned helplessness. Each of the above characteristics are representative of the impact and continued influence of the trauma on the survivors. Balcom discusses treatment guidelines for the therapeutic interventions. Systemic intervention aims to "help each partner with his / her acute distress; challenge or change the dysfunctional interpersonal dynamics / exchanges ; distinguish the past trauma from the current relationship issues; and build empathy and compassion for self and partner. : According to the author, change occurs when any of the dual trauma couple's "typical recursive cycles are interrupted at any point".

He says this often takes place when one partner is able to develop and convey an increased empathy or understanding of the other partner's experience. SUMMARY OF AUTHOR'S CONCLUSIONS AND RECOMMENDATIONS: Balcom recommends an approach in which therapists employ a wide range of techniques including identifying and attending to specific patterns and selecting suitable interventions from his / her "existing repertoire". It is the author's belief that couples therapists are in an excellent "position to act as overall case managers for these couples based on their systemic viewpoint and direct experience of the couple's interaction and dynamics". He says that dual trauma couples essentially have the same range of conflicts and issues that nontraumatized clients or single trauma clients have in addition to their unique issues and interpersonal dynamics. Attention is important to interventions aimed at helping each partner in the identification of and aid for acute distress, the challenge of the dysfunctional interpersonal dynamics of the couple, the ability to distinguish the past trauma from current issues of the relationship, and the development of empathy and compassion for self and partner. CRITICAL ANALYSIS OF ARTICLE: Dennis Balcom does an interesting job of defining and explaining the problems facing therapists whose clients are dual trauma couples.

His approach is thorough and well-organized. The paper is not repetitive ad nauseum and provides insight into the types of problems dual trauma couples face with his use of the case studies as examples. These examples are helpful in getting a feel for dynamics involved in relationships with such couples. The Summary and Conclusion section of the article is somewhat short, however, Balcom covers material quite adequately throughout the paper. Due to the straightforward and thorough presentation throughout the article, the theme is quite clear.