LEVELS OF TRAUMA - A MULTIDIMENSIONAL APPROACH TO THE TREATMENT OF PTSD

THE HISTORICAL course of professional interest in psychological trauma in the 20th century parallels the cycle of intrusion and denial chara cteristic of traumatized individuals, in which periods of recognition and concern alternate with times of forgetfulness and neglect (Glass e t al. 1966; Ingraham et al. 1986). The inclusion of the diagnostic cat egory of posttraumatic stress disorder (PTSD) in the American Psychiat ric Association's Diagnostic and Statistical Manual of Mental Disorder s, 3rd ed. (DSM-III-1980) inescapably confronted the mental health com munity with the problem of psychic trauma and catalyzed the quest for a deeper understanding of the disorder. This has led to a variety of e xplanatory models from such distant fields as neurobiology (Krystal et al. 1989; Pitman 1989; van der Kolk et al. 1985), psychophysiology (K olb 1987), learning theory (Keane et al. 1985), psychoanalysis (Krysta l 1978; Laufer 1988), cognitive psychology (Janoff Bulman 1985), and e xistential-humanistic philosophy (Lifton 1988).