Freedman Sara A, Tuval Mashiach Rivka
School of Social Work, Bar Ilan University, Ramat Gan, Israel.
Dept. of Psychology, Bar Ilan University, Ramat Gan, Israel.
PLoS One. 2018 Feb 6;13(2):e0191949. doi: 10.1371/journal.pone.0191949. eCollection 2018.
Shared traumatic reality occurs when therapists are doubly exposed to a traumatic event, both through their clients' experience, along with their own direct exposure. Studies have shown that a shared traumatic reality can lead to both positive and negative outcomes for therapists. Most studies have examined these reactions sometime after the end of the traumatic event, and less is known about reactions that occur during a traumatic event. In addition, most studies have assumed, rather than examined, indirect exposure. In this study, we extend this literature by examining direct and indirect exposure of therapists during a war situation, and their psychological reactions.
Over a period of two months in 2014, 70% of the Israeli population was exposed to rocket fire. Geographical areas differed in terms of amount of exposure, and its potential danger. 151 therapists living throughout Israel were assessed via an Internet based survey in the middle of the war, and were assessed for the effects on their professional and personal lives, degree of burnout, ways of coping and symptoms levels of PTSD and psychological distress.
These indicate that significant differences in direct exposure occurred depending on place of residence. PTSD levels were related to higher direct exposure, as well as prior trauma exposure, but not to indirect exposure. Indirect exposure, as measured by increased workload, was related to increased distress and emotional exhaustion.
These data shed light on the effects of direct and indirect exposure to a shared traumatic experience of war amongst therapists. The data support previous studies showing a greater effect of direct exposure on PTSD. Since indirect exposure appears to negatively impact burnout and psychological distress, rather than PTSD, this study shows that symptoms other than PTSD should be the result of in a shared traumatic reality.
当治疗师通过客户的经历以及自身的直接接触双重暴露于创伤事件时,就会出现共同创伤现实。研究表明,共同创伤现实可能给治疗师带来积极和消极的结果。大多数研究是在创伤事件结束后的某个时间点考察这些反应的,而对于创伤事件期间发生的反应了解较少。此外,大多数研究是假定而非考察间接接触。在本研究中,我们通过考察治疗师在战争情况下的直接和间接接触及其心理反应来拓展这方面的文献。
2014年的两个月时间里,70%的以色列人口遭受了火箭弹袭击。不同地理区域在暴露量及其潜在危险方面存在差异。对居住在以色列各地的151名治疗师在战争期间通过基于互联网的调查进行评估,考察这对他们职业和个人生活的影响、倦怠程度、应对方式以及创伤后应激障碍(PTSD)和心理困扰的症状水平。
这些结果表明,直接接触的显著差异取决于居住地点。PTSD水平与更高的直接接触以及先前的创伤暴露有关,但与间接接触无关。以工作量增加衡量的间接接触与痛苦加剧和情绪耗竭有关。
这些数据揭示了治疗师直接和间接接触战争共同创伤经历的影响。这些数据支持了先前的研究,即直接接触对PTSD的影响更大。由于间接接触似乎对倦怠和心理困扰有负面影响,而不是对PTSD有影响,本研究表明,除PTSD之外的症状也应该是共同创伤现实的结果。