DREAMWORK AS A COMPONENT OF POST-TRAUMATIC REHABILITATION OF COMBATANTS SYMBOLIZATION OF COMBATANTS’ MARGINALIZATION IN DREAMS

Abstract

Post-traumatic stress disorder(further – PTSD) is a complex and multi-faceted psychic phenomenon, which is in need of rigorous research. The number of studies done on PTSD is vast, and the number of its treatments – starting with evidence-based exposure therapy and medication and ending with experimental treatments like transcranial magnet stimulation and psychoactive substance use – are very diverse.  Such kind of diversity indicates one thing – we don’t have a sufficient answer to the challenges, which PTSD puts forward. The relevance of the subject in Ukraine, where nowadays hundreds of thousands of people endure the extremely traumatic environment of the front lines, whether taking part in combat or not, is hard to overestimate. Our situation puts us in the position of extreme need for PTSD research, but furthermore – into position of researching it while still enduring the traumatic circumstance itself. For there reasons we need to study PTSD from as many angles, as possible.

Nightmares belong to the essential symptoms of PTSD. Like other symptoms, they are most often viewed in the context of the traumatic event, the memory of which remains in high affectation and devoid of the spatial and temporal isolation, which is specific to the memories, stored in the amygdala. The goal of treatment is to transcribe, so to say, the memory into the hippocampus and to restore the function of temporal lobes, so that  the patient is able to find themselves outside of the place and time of trauma and in here-and-now.  But, trauma is more than an experience of a horrible event – it is also a complex relational phenomenon. It is the relational aspect of PTSD, which became the focus of our attention – specifically the experience of alienation and marginalization of the combatant.

We analyzed relevant literature and also two nightmares in this article. One dream belongs to Dr. Donald Kalsched’s patient, and the second one – to the combatant patient of the Mental Health Center of the First Territorial Medical Union. The content analysis of these cases demonstrates the experience of the patients’ experience of marginalization and the way of its symbolization in the dreams.  This study is a case study, and does not claim finality of its findings.  It is an illustration of a tendency, which has been noticed during clinical work with combatants in rehab, which constitutes the study’s scientific interest. Further, larger-scale research is necessary and will be conducted.