Diagnosis and treatment of stress response syndromes : General principles

Clinical assessment of persons exposed to external stress events requires careful inquiry into both kinds of deflection from a homeostatic (or homeokinetic) state: extreme warding-off of the stress event and its implications, resulting in ideational denial and emotional numbing; and intrusive repetitiousness of memories and associations to the stress event, with pangs of painful feeling. Across groups of persons, there is a general tendency to denial first and the intrusion, in a progression of phasic responses to stress. Individuals will vary in the order of entry into such phases, time spent in a phase, degree of ascillation between phases, and specific manifestations during any phase. Treatment, in addition to orientation according to individual personality, should be phase-specific (AU)