Ramey Rieger (X) Dec 23, 2017:

Subtle messages Yes, the therapist avoids a direct confrontation with issues that may (or may not) be healing for the patient. Taking the idea further, it is the therapist who fears the personal resonance that may arise when directly confronting the patient's trauma. This, in turn, gives the patient an inkling of the therapist's uncertainty - all of which is subtly, non-verbally communicated. The patient, who is depending on the therapist for help, has a wide range of reaction options, which basically boil down to doubting his/her ability to be healed or the therapist's ability to help. Since the patient obviously avoids his/her trauma, it is horribly destabilizing - and not at all healing - when the therapist does the same in the name of stabilizing the patient.

Daniel Arnold (X) Dec 22, 2017:

but actually I think Ramey's suggestion is in the right direction, it sounds like it's about the patient's own appraisal of the situation, or something like that......

Daniel Arnold (X) Dec 22, 2017:

Really hard to tell. I don't think it's about anything "external", like diagnostics criteria. Sounds more like it's about the patient's "paradigm" in interpreting his own situation or action he has to take or something along those lines. Hope you'll figure it out, to me it sounds like "disposition", "paradigm", "mindset", kind of these things..... but I might be wrong, not enough context to make a call.

Susan Welsh (asker) Dec 22, 2017:

context It's not clear to me either! The article argues for a trauma-confrontation approach rather than just "stabilization." The paragraph continues: "Durch die Ankündigung einer sehr ausgedehnten Stabilisierungsphase bzw. die Einschätzung des Therapeuten, dass die konkreten traumatischen Erlebnisse besser nicht thematisiert werden sollten, wird dem Patienten indirekt vermittelt, dass die Auseinandersetzung mit dem Trauma gefährlich oder schädlich sein könnte. Darüber hinaus wiederholen sich damit für den Patienten in der therapeutischen Beziehung Erfahrungen, die die meisten PTBS-Patienten in ihrem sozialen Umfeld vielfältig erlebt haben"

Daniel Arnold (X) Dec 22, 2017:

Would need more context, it's not clear what the Bewertungsmaßstäbe refers to.