The given case study identifies Sylvia as the victim who loses her two children after going into a coma due to the abuse of cocaine. From the case study, Sylvia has been a victim of a domestic violence and break up from her first marriage. The first husband, who is described to be dominant, had to divorce her due to her drug addiction. Sylvia was too much into cocaine that she had to exploit her family members and friends to get money to buy the drugs. Because of her addiction, her husband who was later arrested assaulted her using a hairbrush while she was taken to the hospital.
According to Feliciano, Mattox and Moore (2008) Complex trauma is the type of trauma that occurs cumulatively, repeatedly and increases over a period which can include issues with the family members due to violence and constant abuse. Simple trauma, like complex trauma, takes place repeatedly in a cumulative manner but does not go over an extended period. The potentially traumatic event, on the other hand, is a great incident, which is upsetting and persistently intrudes into people’s daily lives. Traumatic events are life threatening experiences people encounter and usually pose significant threats to their physical conditions and their psychological wellbeing. In the Case Study, Sylvia can be said to be undergoing a complex trauma due to her prolonged suffering from the breakups, addictions and losing her children.
The Case Study introduces Sylvia as a sober woman from a cocaine abuse for over five years. During these five years, she was assaulted then later divorced by her first husband who was the father of two of her three children. She was taken to the hospital as a result. After coming out of the hospital, she got into a due coma overdose of the cocaine; this forced her kids to go out in search of shelter. Being that Sylvia had been separated from her family members and friends due her husband’s behavior and her addiction to drugs, the children had nowhere to go or no one to turn to. The children had to be placed in the custody of Pennsylvania State.
A person undergoing a complex trauma experiences a vast range of symptoms. These symptoms include changes in the attention and awareness, which entails the removal of the entire events from memory. This situation may make the victim feel disconnected from their natural self-identities and forget their regular scheduled. Sylvia had to alienate herself from her friends and family members due to Clients suffering from complex trauma often experience physical pains or complaints that are not related to any physiological effects. In Sylvia’s case, she went into a coma due to the stress she had from the assaults by her husband and the overdose of the cocaine she had taken. Complex trauma is also symbolized by the change in the relationship with others. Sylvia had to divorce her first husband who used to abuse her.
People with complex trauma always experience changes in their aggressors characterized by a feeling that they deserve what they go through. Sylvia exhibited this when she let her first husband dominate her without reporting him to the authorities. Instead, she went ahead to take cocaine whenever she experienced such problems. Complex trauma also causes changes in one’s self-image where they tend to feel embarrassed or guilty (Courtois, 2008). These people always feel divested and shattered beyond repair. Sylvia took an overdose of cocaine, which sent her into a coma for one week due to the embarrassment and guilt she felt after breaking up with her first husband.
There are three major factors that affect the recovery of the client after an attack by trauma. These factors include personal factors, medical care factors, and environmental factors. Environmental factors that would affect the recovery of Sylvia from the compound trauma include mechanism of injury, multiple TBI’s, polytrauma and severity of harm. Mechanism of damage in Sylvia case was emotional; she was subjected to assault, which was followed by divorce by her first husband. She had also lost all her friends and family members who could support her when she was in trouble. She was further affected when she came out of a coma and found out that her children had been taken into custody by the state. Sylvia from the assaults by her husband could have received multiple Traumatic Brain Injuries in her struggles with her husband. Other environmental factors that would have significantly contributed to her trauma are the deployment and post-deployment of stressors. Transportation access, social support from the family members and friends, family function, during this time she was not in good terms with her family members and her marriage too was not going on well her husband mistreated her and her children had no place to go ending up in the custody of the state.
As trauma informed person, I would advise her to employ John Briere’s principles in managing the trauma. John Briere did extensive research on complex trauma and how it can be treated. John notes that the individual and unique modes through which trauma can be processed has an enormous impact on the clients when retelling the traumatic experiences (Briere & Scott, 2006). John developed a model, which have been used for assessing and manipulating the intensity of trauma in individual clients making it remain within the therapeutic window thus not retraumatized. Retraumatized individuals tend to revert to their original ways of dealing with trauma. People respond in different ways when dealing with traumatic materials. Some regress, some dissociate while others rely on addictions as Sylvia did with her addiction to cocaine. Briere’s principles can be measured in three different levels taking into consideration the intensity of the in session trauma exposure.
The first level through which Sylvia can be taken through is making her demonstrate minimum emotional stimulation. In this level, the individual will appear to be numb exhibiting a calm tone with nonverbal behavior not matching the content of trauma being described. The second level the individual demonstrates affective stimulation but is not out of control. The nonverbal behavior exhibited in this stage is an appropriate measure of the traumatic content but cannot show the degree by which a person appears to be re-experiencing the trauma. In the last level, the client gets stimulated with the intensity, which is closer to the original response to the trauma. The clients tend to show more of regression to the trauma through behaviors like thumb sucking, crying uncontrollably, displaying younger behaviors, and gasping for breath (Briere & Scott, 2006). The client will dissociate the given session and start demonstrating an increase in addictive or self-destructive behaviors between the sessions. The clients tend to terminate the sessions prematurely due to getting overwhelmed with the trauma materials.
Sylvia can get her kids back through following the due process of the law. There are various factors that must be considered by the court before granting her custody of her children. These includes her present, and past life must be looked into to find out whether she is fit to safeguard the interests of her children and availability of her extended family (Mason, 1999). The relationship that is exhibited between the siblings, the preference of the children, any attempts that the parents have made on the child in their bid to turn the child against each other, the residential places, the history of drug abuse which will adversely affect Sylvia and her mental and physical conditions are also some of the very important factors.
Healing from cocaine addiction takes time. Thus Sylvia should be made to undergo therapy and rehabilitation to help her stop using drugs. The abrupt stop in the use of the drug can have various side effects to her body (Meyer, 1972). Thus, it should be started from her mind through serious canceling on the adverse effects of the drug and the various activities she can undertake to help her get rid of the drug. Her rehabilitation from addiction should also include lessons on how to live without the drugs, working on problems with the drugs, interacting with people and making new friends while trying to make up for her family members and treatments to any health problems that may occur.
Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment. Thousand Oaks, Calif: Sage Publications.
Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment.
Espejo, R. (2002). Drug abuse. San Diego, CA: Greenhaven Press
Feliciano, D. V., Mattox, K. L., & Moore, E. E. (2008). Trauma. New York: McGraw-Hill Medical.
Mason, M. A. (1999). The custody wars: Why children are losing the legal battle and what we can do about it. New York: Basic Books.
Meyer, R. E. (1972). Guide to drug rehabilitation: A public health approach. Boston: Beacon Press.
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