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Ethically Treating PTSD Resulting from Terrorism and other Traumas
Ethically Treating PTSD Resulting from Terroism and other Traumas

Section 5
Emotions and Feelings in Trauma Victims

CEU Question 5 | CE Test | Table of Contents | PTSD
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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Ventilating Feelings
Let's next examine impotency and constipated rage of victims taken hostage. If you have worked with a skyjack victim who has been taken hostage, you know it's important in the treatment of acute responses and especially in the treatment of delayed responses, to recognize their need to ventilate. In addition to the normal ventilation toward their captors, the client must be allowed and encouraged to express feelings of hostility toward the individuals involved in negotiations for their release, as well as any feelings of pathological transference they may have toward the terrorist or their captors.

7 Examples of Ecouragement to Vent

If a patient experiences withdrawn behavior and needs encouragement to vent, you may find the following seven examples helpful with some clients.
1. If I could feel what I am most afraid to feel, what would that be?
2. My biggest fears are...
3. I am angry about what...
. I feel anxious when...
5. If I could
say what I really want to say, what would that be?...
. I have been feeling bad about what...
7. Encourage the patient not to judge themselves.

A colleague of mine then suggests they affirm their feelings by saying, “And that’s the way it is now.” According to Ochberg in Victims of Terrorism, during a siege, while the victim is still being held hostage, it is important not to disturb the development of the previously mentioned pathological transference. It must be left alone.

Disturbing pathological transference to the captors while the victim is held hostage only reactivates the victim’s terror and could produce a hopelessness that might result in panic behavior. Because of this transference, rescuers must not expect the victim's cooperation in any escape plans.

Ochberg believes that the persistence of pathological transference in the victim long after his or her release is based on a primal fear that any expression of negative feelings or behavior toward his former captors may bring retaliation. Yet the victim is also aware of the captors’ predatory use of his suffering to obtain their demands. This accounts for the persistent, impotent, or another way to put this is “constipated” rage often experienced in victims of violent crime.

In the past, this rage is common among concentration camp victims who felt that they cannot get revenge, or even reparations, from the Nazis for their suffering. When we work with rape survivors, we have encouraged victims to come to terms with this rage by adopting the attitude that “Survival, and living without fear, is getting even.” Let me repeat that, perhaps for your future reference, we have encouraged victims to come to terms with this rage by adopting the attitude that “Survival, and living without fear, is getting even."

Peer-Reviewed Journal Article References:
Beck, J. G., Reich, C. M., Woodward, M. J., Olsen, S. A., Jones, J. M., & Patton, S. C. (2015). How do negative emotions relate to dysfunctional posttrauma cognitions? An examination of interpersonal trauma survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 3–10. 

Eagle, G., Benn, M., Fletcher, T., & Sibisi, H. (2013). Engaging with intergroup prejudice in victims of violent crime/attack. Peace and Conflict: Journal of Peace Psychology, 19(3), 240–252. 

McGuire, A. P., Frankfurt, S. B., Anderson, L. M., & Connolly, K. M. (2020). Pre- to posttreatment changes in trauma-cued negative emotion mediate improvement in posttraumatic stress disorder, depression, and impulsivity. Traumatology. Advance online publication.

Platt, M., & Freyd, J. (2012). Trauma and negative underlying assumptions in feelings of shame: An exploratory study. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 370–378.

Online Continuing Education QUESTION 5: What could be the result of disturbing pathological transference while the victim is still held hostage? To select and enter your answer go to CE Test.

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Ethically Treating PTSD Resulting from Terrorism and other Traumas

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