Severe trauma affects all structures of the self – one's image of the body; the internalized images of the others; and one's values and ideals – and leads to a sense that the self-coherence and self-continuity are invaded, assaulted, and systematically broken down.
The traumatic events overwhelm the ordinary human adaptations to life and generally involve threats to life or bodily integrity, confront human beings with the extremities of helplessness and terror, and evoke the response of catastrophe.
The vulnerable self-structure of traumatized individuals is evident in the following ways:
(a) difficulties in self-regulation (self-esteem maintenance, lower tolerance levels, and the sense of self-discontinuity and personal agency),
(b) appearance of the clinical symptomatology (frequent upsurges of anxiety/fear, depression, and specific fears or phobias regarding the external world or one's own bodily integrity), and
(c) reliance on primitive or less-developed forms of the self-object relatedness. Severe trauma may lead to de-centering of the self (self-at-worst), loss of groundlessness and a sense of sameness, self-discontinuity and ego-fragility, leaving scars on the one's 'inner agency' of the psyche, fragmentation of the ego-identity resulting in proneness to dissociation.
