Table 3.
PS | Organized/disorganized | Reason for maladaptation: Situational or persistent | PS perspective on effective treatment |
---|---|---|---|
Maladaptive PS | Organized PS | Faulty subcortical appraisal of present situation (situational) | Reappraisal through awareness of PS—voluntary re-organization |
Organized PS | Held over from a previous unresolved situation (persistent) | Resolution or release of previous situation | |
Disorganized PS | Overwhelmed by present situation (situational) | Trauma first aid and treatment needed | |
Disorganized PS | Overwhelmed by previous unresolved situation (persistent) | PTSD or DESNOS: Resolution of past trauma needed |
The PS perspective suggests that the four kinds of maladaptive PS (organized/situational, organized/persistent, disorganized/situational, disorganized/persistent) each call for a different therapeutic response. If the PS is well organized and arises in response to the current situation, but is poorly matched, a process of conscious re-organization may be effective. A well-organized but persistent maladaptive PS could be termed a “bad habit”; a resolution through increased awareness of the origins of the PS may help. If the PS is disorganized, and the direct result of the present situation, immediate trauma “first aid” may be very effective. If on the other hand the disorganized PS is the result of past unresolved experiences, PTSD or “disorders of extreme stress not otherwise specified” (DESNOS) may follow, which require specific trauma-oriented therapy. DESNOS is a term from DSM V which covers a variety of trauma sequelae which fail to fall into the category of PTSD. (DESNOS: Disorders of Extreme Stress Not Otherwise Specified)