Complex Responses to Toxic Events

The Sanctuary Model

The children and adults who are treated in mental health and social service settings and who have been exposed to adversity, trauma, and/or toxic stress are likely to suffer from complex problems related to the developmental challenges they have faced.

Table: Complex Responses to Toxic Events

Table: Chronic Maladaptive Pathways

Currently, efforts are underway to expand our understanding of the complexity associated with exposure to repetitive and overwhelming stress that usually begins in childhood by using different terms such as “complex PTSD” or “developmental trauma disorder” [1-2]. These terms embrace a wide variety of interactive problems that include: alterations in the ability to manage emotions; alterations of identity and sense of self; alterations in ongoing consciousness and memory; alterations in relations with the perpetrator; alterations in relations with others; alterations in physical and medical status; and alterations in systems of meaning.

van der Kolk and Pynoos Developmental Trauma Disorder

Bloom, S. L. (2010). The Mental Health Aspects of IPV: Survivors, Professionals and Systems. In Giardino AP, Giardino ER (Eds). Intimate Partner Violence, Domestic Violence, and Spousal Abuse: A Resource for Professionals Working With Children and Families. St. Louis, MO: STM Learning (pp.207-250).

Bloom, S. L. (2003) Understanding the impact of sexual assault: The nature of traumatic experience. In A. Giardino, E. Datner and J. Asher (Eds.), Sexual Assault: Victimization Across the Lifespan. Maryland Heights, MO: GW Medical Publishing. (pp. 405-432).

Bloom, S. L. (2000) The Complex Web of Causation: Motor Vehicle Accidents, Comorbidity and PTSD. In E. J. Hickling and E. B. Blanchard (Eds). International Handbook of Road Traffic Accidents and Psychological Trauma: Theory, Treatment and Law. Oxford, England: Elsevier Press.

Bloom, S. L. (1997) Creating Sanctuary: Toward the Evolution of Sane Societies. (1997). New York: Routledge.

References

  1. Van der Kolk, B., Developmental trauma disorder. Psychiatric Annals, 2005. 35(5): p. 401.
  2. Herman, J., Trauma and Recovery. 1992, New York: Basic Books.