Continuous traumatic stress: Conceptual conversations in contexts of global conflict, violence and trauma.

Abstract

In the last 6 decades, large sections of the global population have been exposed to ongoing dangers in circumstances of pervasive conflict, violence and trauma. In this article, we revisit the concept of continuous traumatic stress, originally proposed by South African researcher-practitioners to characterize mental health conditions and challenges under apartheid, and explore its viability as an alternative and supplementary framework for understanding and addressing exposure to situations of ongoing threat. The article highlights the political and mental health limitations associated with the dominance of posttraumatic stress conceptualizations of these forms of human suffering and distress, and calls for more nuanced and complex understandings of such complicated psychosocial conditions and their effects. It concludes by foregrounding several critical debates related to continuous traumatic stress, namely, the importance of understanding contexts of ongoing exposure to danger as both political and psychological (psychopolitical) in nature; of developing socially relevant clinical and conceptual models that can meaningfully account for the varied impacts of, and responses to, these conditions of continuous threat; and the need to extend our intervention practices to include culturally and contextually appropriate intervention strategies that are both clinical and psychosocial in orientation.

Shattered worlds: political trauma amongst young activists in post-revolutionary Egypt

“…CTS was developed by psychologists in apartheid South Africa and refers to ongoing traumatic experiences in contexts of structural violence, including repressive state violence or pervasive community violence (Straker 2013). Rather than perceiving expressions of trauma -such as anxiety, fear, withdrawal, somatisation, aggression, sleeping problems and nightmares -through the medicalised lens of pathology, CTS regards them as normal human reactions to severe traumatic stress resulting from dangerous political contexts Stevens et al 2013). CTS thus places the roots of traumatic stress not within the malfunctioning of the brain, but firmly within violent social and political contexts that shatter the safety of one's world, rendering trauma both an individual and a social phenomenon.…”

Chronic pain as a human rights issue: setting an agenda for preventative action

“…Stevens et al [24] trace the history of the development of PTSD, illustrating how historically it has dominated the research on trauma, reflecting the experience of high-income countries, to the exclusion of other forms of trauma which may be part of life for people in low-income countries, countries which are in the midst of civil conflict, or societies in which there is ongoing poverty, community violence, scarcity of resources, or political oppression [14]. …”

Interventions for Posttraumatic Stress With Children Exposed to Violence: Factors Associated With Treatment Success

“…It should be noted, however, that the method whereby trauma history is assessed, especially in contexts of sociopolitical violence, does not fully describe the far‐reaching and long‐lasting violence exposure that may have been present in some of these children's lives; these samples may have had more chronic and ongoing exposure to violence throughout and after treatment (e.g., Thabet et al., ). Notably, several psychologists have recently revisited the concept of “Continuous Traumatic Stress,” arguing that it more accurately captures the dynamics of ongoing exposure to sociopolitical violence than PTSD (Stevens, Eagle, Kaminer, & Higson‐Smith, ). It may be useful to consider the treatment implications of this different conceptual approach to sociopolitical or other forms of ongoing violence.…”