Cognitive Behavioral Conceptualization of Retraumatization
Traumatic events by their nature are not the kinds of life experiences that most people would like to have. Whether childhood abuse, horri¢c accidents, interpersonal assaults, or the violence of war, if we could choose our life experiences, most people would likely choose a life free of trauma. Furthermore, we might expect that those who have already experienced such dreadful events would be even more inclined to avoid them. Indeed, the very purpose of fear learning systems is to teach us to avoid future danger. Yet, a repeated ¢nding in the trauma literature is that individuals exposed to trauma are at risk for additional trauma exposure. Such re-exposure to trauma is perhaps one of the most perplexing of phenomena in the ¢eld of traumatic stress. This is more than just common sense-a vast literature documents that humans are capable of learning fear and avoidance of potentially dangerous stimuli. Posttraumatic stress disorder (PTSD) is understood to be a consequence of such fear learning gone awry. That is, the individual suffering effects of PTSD continues to experience fear and avoidance of trauma-related stimuli well beyond the context when and where such reactions have adaptive value. Even more astounding is that this does not simply happen one or two times beyond the ¢rst traumatic event, but rather evidence suggests that for many trauma survivors, it happens repeatedly.