Category Archives: Coping Strategies And Tips

Signs Of Recovery From Complex-PTSD

According to Peter Levine, an expert on the adverse effects of childhood trauma on our adult lives and the complex post traumatic stress disorder that can result, typically there develops various signs in victims that may indicate the recovery process is underway. The main signs of recovery that Levine identifies are as follows :

1) A REDUCTION IN THE NUMBER, AND INTENSITY, OF EMOTIONAL FLASHBACKS THAT WE EXPERIENCE (an emotional flashback is when an event occurs in our lives that triggers similar painful emotions to those we experienced as a child in relation to our traumatic experiences – such flashbacks may result in regressive behaviour such as extreme, uncontrollable, childlike tantrums. For example, if we had a cold and rejecting father who was always denigrating us, we may over-react when we are criticized by our boss at work).

2) WE BECOME LESS SELF-CRITICAL (those who have suffered childhood trauma very frequently, and erroneously, blame themselves for their terrible childhood experiences and/or internalize the negative view parents/primary carers had of them when they were children – to read my article on how a child can falsely come to see him/herself as ‘bad’ and how this inaccurate self-view may be perpetuated, click here).

3) WE BECOME LESS ‘CATASTROPHIZING’ (many who suffer childhood trauma develop into adults prone to extremes of negative thinking, often referred to as cognitive processing errors.’ One such cognitive processing error is that we may be prone to ‘catastrophizing’ which means we tend to always expect the worst and to interpret situations in their worst possible light. Often, too, we attribute the worst possible intentions and motivations to the behaviour of others. As we begin to recover, this tendency diminishes).

4) WE START TO FIND IT EASIER TO RELAX (one of the worst aspects of my illness was a perpetual, tormenting feeling of the most intense agitation making anything even vaguely approaching relaxation utterly impossible, every medication was tried – and failed; even electro-convulsive shock therapy (ECT) was tried on several different occasions over the years – again, utter failure. When we finally do start to recover, however, the ability to relax gradually returns).

5) WE BECOME LESS DEPENDENT UPON OUR LEARNED DEFENSE MECHANISMS (it is very common for those of us who have experienced childhood trauma to develop into adults who feel very vulnerable to being hurt or exploited by others if we ourselves were hurt and exploited by our parent/s or primary-carer/s during our early lives. In order to protect ourselves, we may have unconsciously learned to develop certain defense mechanisms such as aggression  or avoidance. As we recover, however, we find we become less reliant on these psychological defenses, according to Levine.

6) OUR RELATIONSHIPS WITH OTHERS START TO IMPROVE AND WE BECOME LESS INTIMIDATED BY SOCIAL SITUATIONS (another common outcome of significant childhood trauma is that we can find, in adulthood, that we are quite inept when it comes to forming and maintaining relationships with others. We may, too, find social situations very intimidating, and, even, develop social phobia. A sign of recovery, however, is an easing of such interpersonal difficulties).

 

FOUR MAIN STEPS ALONG THE ROAD TO RECOVERY :

Levine states that the main steps to recovery are as follows :

1) PSYCHOEDUCATION

2) REDUCING SELF-CRITICISM

3) GRIEVING FOR OUR CHILDHOOD LOSSES

4) ADDRESSING ‘ABANDONMENT DEPRESSION’

Let’s look at each of these in turn :

1) The first step, according to Levine, is psycheducation (which is sometimes referred to as ‘bibliotherapy‘. This involves learning about our psychological condition and becoming aware of how it is linked to our adverse childhood experiences. Levine also emphasizes the usefulness of learning about mindfulness).

2) The second step is to, in Levine’s phrase, ‘shrink our inner critic.’  In other words, we need to gradually learn how to stop taking such a negative view of ourselves and of everything we do – one effective therapy which can help us to achieve this is cognitive behavioural therapy (CBT). (To read my related article, entitled :‘How The Child’s View Of Their Own ‘Badness’ Is Perpetuated’, click here).

3) The third step, says Levine, is to grieve for our childhood losses. These losses may include our missing out on feelings of safety, security, simple childhood happiness and a care-free state of mind as well as a loss of any self-esteem we may have once had. To read my article about coming to terms with childhood losses, click here). Levine suggests that this process may take up to two years.

4) The final step is to address what Levine calls the core issue, namely our ‘abandonment depression.’ An important part of this step is also to learn how to be self-compassionate. (To read my article about abandonment issues which may we may develop as a result of childhood trauma, click here).

eBook :

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David Hosier BSc Hons; MSc; PGDE(FAHE).

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How To Calm Ourselves At A Sensory, Motor And Cognitive Level

If we have suffered significant childhood trauma, it is extremely common to find that, as adults, we can become emotionally upset as a result of (seemingly) small provocations, we experience particularly intense emotions when we are upset, and we have great difficulty calming ourselves down (‘calming ourselves down’ is often called ‘self-regulating’ by psychologists) once we are upset. This will be particularly true if, in connection with our traumatic early lives, we have gone on to develop, as adults, borderline personality disorder (BPD) or complex post-traumatic stress disorder (cPTSD).

This tendency to feel intense emotions when upset, together with the inability to self-regulate such emotions effectively, stems from a traumatic childhood that deprived us of developing the normal ‘self-soothing skills’ that those who experienced relatively stable upbringings are usually able to develop (as I have discussed at length elsewhere on this site – e.g. in my article entitled The Effects Of Childhood Trauma On The Limbic System).

THE THREE COMPONENTS OF EMOTIONS :

Our emotions are made up of three components :

  1. THE SENSORY COMPONENT
  2. THE MOTOR COMPONENT
  3. THE COGNITIVE COMPONENT

Let’s look at each of these in turn :

1. SENSORY EXPERIENCING :

When we feel an emotion, one component of it involves biological / physiological alterations within the body, such as breathing (when we are anxious it tends to be fast and shallow and we may hyperventilate (to read my article on the bi-directional relationship between anxiety and hyperventilation click here).

Other sensory aspects of the experiencing of emotions include heart-rate, blood pressure and digestion (IBS and stress are often related).

Being aware of such biological / physiological sensations within our body is technically referred to as : interoception.

2. MOTOR ACTIVITY :

At the motor level, emotions such as anxiety may manifest as physical tension of various muscle groups such as the muscles of the face and shoulders.

3. COGNITIVE COMPONENT :

Emotions also interact with our cognitions (i.e. thought processes). A simple example is that constantly thinking the worst will happen is likely to make us feel constantly anxious and fearful.

IMPLICATIONS FOR THERAPY :

It logically follows, therefore, that in accordance with the three components of emotions described above, we may intervene therapeutically in an attempt to ameliorate unpleasant emotions such as anxiety at the three corresponding levels : the sensory level, the motor level and the cognitive level.

Treating our anxiety at all three levels can, therefore, be viewed as a kind of triple-pronged attack.

Examples Of Therapies Specifically Targeting Each Of The Three Levels :

At the sensory level, examples of therapies include breathing exercises, relaxation exercises and visualization/hypnosis

At the motor level, examples of therapies include massage, progressive muscle relaxation and physical exercise

At the cognitive level, examples of therapies include cognitive therapy and  cognitive hypnosis

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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Crying Helps Re-Engagement With Authentic Feelings

As a child, even well into my teens, I cried extremely frequently. Usually this was alone at home, but, on occasion, at my prep school (which I attended until I was eleven) I was removed from the class for crying (there was little compassion on offer from the teachers) when I was particularly upset about what was going on at home.

Once, even, to my acute embarrassment and shame (at the time), I started to cry (or quietly whimper) in a second year (now it would be called Year Eight)  English class at my secondary school when I was about thirteen, desperately trying to conceal this inconvenient outburst of emotion from both my teacher and classmates.

Also, at about fifteen years of age, I once even rushed upstairs at home after one of my frequent arguments with my family and shut myself in my bedroom wardrobe where I stubbornly and emphatically insisted upon remaining (not that anyone encouraged me to come out), sobbing copiously, for a not inconsiderable period of time. It is quite clear to me, and, presumably, will be to the reader, too, that my emotional development had been arrested at a much younger age.

William Wordsworth, in his poem ‘Ode : Intimations Of Immortality From Reflections On Early Childhood‘, refers to ‘thoughts  that  often lie too deep for tears‘ and, when one is especially afflicted by profound depression and/or traumatized, this line of poetry is often most apposite  – one simply becomes numbed and internally deadened by the sheer intensity of one’s chronic and unrelenting mental suffering. In such a condition, as a psychological defense, all feelings and emotions shut down ; however desperately one wants to cry, one is unable to do so.

Something deep in our soul is blocked or frozen.

Being Finally Able To Cry Can Be A Breakthrough Moment In The Process Of Recovery :

The psychotherapist, Pete Walker, in his excellent book entitled : Complex Trauma – From Surviving To Thriving, explains how finally being able to cry after a long period of emotional numbness (emotional numbness is a key feature of complex post traumatic stress disorder) can signify a major turning point in the recovery process, marking our re-engagement with our long suppressed feelings.

Relevant Research :

There also exists a body of research supporting the idea that crying is beneficial. For example, the biochemist, W. Frey, reports that crying helps to rid the body of chemicals that are produced by stress and, therefore, when we cry, by lowering the concentration of these chemicals within our biological system, we reduce our stress levels ; this not only makes us feel better mentally but also has physical benefits (for example, by lowering our blood pressure).

Also, research carried out by Gracanin et al at the University of  Tilburg in the Netherlands supports the idea that crying can improve mood.

Conclusion :

Unfortunately, males in our society are often discouraged from crying on the erroneous grounds that it is ‘weak’ or ‘unmanly’. In fact, though, crying can be of immense therapeutic value, particularly when one has been feeling emotionally ‘dead inside’ for a long period of time due to having experienced severe trauma.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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Prolonged Exposure Therapy And Posttraumatic Stress Disorder (PTSD)

Major symptom of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (cPTSD)click here to read about the difference between these two conditions – are fear, anxiety and even terror induced by :

– situations related to the traumatic experience

– people related to the traumatic experience

– places related to the traumatic experience

– activities related to the traumatic experience

Prolonged Exposure Therapy Involves Two Specific Types Of Exposure To Trauma-Related Phenomena :

a) In Vivo Exposure

b) Imaginal Exposure

In Vivo Exposure :

Prolonged exposure therapy works by encouraging the individual with PTSD / cPTSD, in a supportive manner, very gradually, to confront these situations / people / places / activities whilst, at the same time, feeling safe, secure and calm. Because this part of the therapy involves exposure to ‘real life’ situations / people / places / activities it is called in vivo exposure.

This is so important because avoiding these situations / people / places / activities, whilst reducing the individual’s anxiety in the short-term, in the longer-term simply perpetuates, and, potentially, intensifies, his/her fear of these things.

Imaginal Exposure:

The therapy also involves the PTSD / cPTSD sufferer talking over details and memories of the traumatic experience in a safe environment and whilst in a relaxed frame of mind (the therapist can help to induce a relaxed frame of mind by teaching the patient/client breathing exercises and/or physical relaxation techniques; hypnosis can also be used to help induce a state of relaxation). Because this part of the therapy ‘only’ involves mental exposure to the trauma (i.e. thinking about it in one’s mind), it is called imaginal exposure and can help alleviate intense emotions connected to the original trauma (e.g. fear and anger).

Both in vivo and imaginal exposure to the trauma-related stimuli are forms of desensitizing and habituating the patient / client to them, thus reducing his/her symptoms of PTSD / cPTSD.

How Effective Is Prolonged Exposure Therapy?

Prolonged exposure therapy is a type of cognitive behavioural therapy (CBT) and research into the treatment of PTSD suggests it is the most effective treatment currently available.

What Is The Duration Of The Treatment?

The length of time a patient / client spends in treatment varies in accordance with his/her needs and his/her therapist’s particular approach. However, the usual duration of the treatment is between two and four months, comprising weekly sessions of approximately ninety minutes each.

On top of this, the patient / client will need to undertake some therapeutic exercises/activities in his/her own time, set by the therapist as ‘ homework assignments’. These assignments will include listening to recordings of imaginal exposure therapy sessions.

RESOURCES :

The National Center For PTSD has developed a PROLONGED EXPOSURE APP, or PE APP. Click here for further information and download instructions.

eBook :

 

Above eBook now available from Amazon for instant download. Other titles available. Click here for further information.
 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

 

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PTSD, Self-Hypnosis And Positive Recontextualizing Of Intrusive Memories

According to the psychologist, Spiegel, self-hypnosis can be a useful tool to help individuals suffering from posttraumatic stress disorder (PTSD) overcome problems associated with the troubling symptom of disturbing, intrusive memories of the original trauma.

Spiegel states that self-hypnosis may be particularly useful because certain qualities of the hypnotic experience have much in common with qualities of the experience of the symptoms of posttraumatic stress disorder (PTSD), examples of which include :

– a feeling of reliving the traumatic event

– feelings of dissociation (detachment from reality)

– hypersensitivity to stimuli

– a disconnection between cognitive and emotional experience

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Spiegel argues that this similarity between hypnotic phenomena and the symptoms of posttraumatic stress disorder (PTSD) make sufferers of this most serious and disturbing disorder more hypnotizable than the average member of any given randomly selected population.

It follows from this that those suffering from posttraumatic stress disorder (PTSD) may be particularly likely to be helped by the utilization of hypnotic techniques and procedures, particularly ‘coupling access to dissociative traumatic memories with positive restructuring of those memories’ (Spiegel et al., 1990). By this statement, Spiegel is suggesting that hypnosis could help bring traumatic memories more fully into conscious awareness and alter the way in which they are stored in memory by associating / pairing / linking them with feelings of safety (such as the feeling of being safe and protected in the therapist’s consulting room) rather than, as had previously been the case, high levels of distress.

pack-beat-fear-anxiety

In this way, Spiegel suggests, when these previously disturbing memories are recalled in the future, because they are now associated / paired / linked with feelings of safety, they cease to induce distress.

In effect, then, the traumatic memories have become positively recontextualized  and deprived of their previous power to induce feelings of fear, anxiety and terror.

Therapies other than hypnosis and self-hypnosis that are related to the above theoretical ideas include :
1) Eye Movement Desensitization And Restructuring

2) The Rewind Technique

3) Exposure Therapy

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

 

 

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Reducing Amygdala-Based And Cortex-Based Anxiety

If we suffered significant childhood trauma in our youth, we are at increased risk, as adults, of suffering from anxiety – this increased risk can be due to damage the development of our brains incurred as a result of our traumatic childhood experiences.

Two regions of the brain, the development of which can be adversely affected in this way, are :

1) The cortex

2) The amygdala

Both of these brain regions play a central role in generating feelings of anxiety, but they generate this anxiety in different ways which I briefly describe below:

1) Cortex generated feelings of anxiety: feelings of anxiety that ORIGINATE in the cortex are usually due to maladaptive thought processes or distressing images; these include :

  • excessively negative thinking
  • excessive rumination/worry
  • obsessive thinking
  • perfectionist-type thinking
  • excessive self-criticism
  • catastrophization
  • thoughts leading to feelings of excessive shame and guilt
  • jumping to negative conclusions
  • erroneously interpreting neutral situations as negative situations
  • always imagining (sometimes in the form of distressing mental images)/expecting the worst possible outcome (this is sometimes referred to as anticipatory anxiety)

2) Amygdala generated feelings of anxiety : feelings of anxiety yhat ORIGINATE in the amygdala often involve :

  • sudden, unexpected feelings of aggression
  • sudden, unexpected aggressive acts (e.g. hitting someone ‘before you realize what you’ve done‘)
  • clouded/foggy thinking
  • rapid onset of physiological symptoms (sweating, racing heart-beat etc)

Different Types Of Anxiety Respond To Different Interventions

It is very useful to know whether the anxiety one experiences originates in the cortex or amygdala as some interventions are best for dealing with cortex-based anxiety whilst others are best for dealing with amygdala-based anxiety. I list these different interventions below :

Ways Of Dealing With Cortex-Based Anxiety :

  • distraction (any activity that distracts you from distressing thoughts/images)
  • try not to be concerned about what others think (if you experience anxiety in company you are likely to believe your symptoms are far more apparent to others than, in reality, they are)
  • try not to constantly worry about panic attacks (easier said then done for many, but constantly anticipating one is going to have a panic attack can increase the likelihood of such an occurrence)
  • remind yourself that the bodily sensations of anxiety cannot harm you (some people, whilst experiencing extreme anxiety, feel they are going insane or are going to die – remind yourself that feelings of anxiety can’t harm you in this way)
  • cognitive-behavioural therapy (a therapy that helps correct faulty and maladaptive ways of thinking)

Ways Of Dealing With Amygdala-Based Anxiety :

  • deep breathing exercises
  • physical exercise
  • systematic muscle relaxation exercises
  • mindfulness
  • self-hypnosis

eBooks :

     depression and anxiety

 

Above eBooks now available from Amazon for instant download. Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

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Is Freud Still Relevant To The Understanding Of Effects Of Childhood Trauma?

Sigmund Freud (1856-1939) is the founder of psychodynamic psychotherapy (sometimes called depth therapy). Its most central theory is that our behaviour and feelings are driven by unconscious forces and motivations. In other words, we do not know why we behave and feel as we do (even though we may think we do) because the majority of our mental life goes on in the unconscious and is generally not available to our conscious minds. To provide a simple example:

  • A boy was thrown out of the house of his parents when he was thirteen years old; a few years later he is at a friend’s house with whom he has an argument – this culminates in the friend telling him to get out of his house and the boy who was thrown out by his parents hits him.

The psychodynamic explanation here may be that being told to leave his friend’s house unconsciously triggered the memory and associated pain of having been thrown out of his parents’ house, hence his (seemingly, on the surface) dramatic ‘over-reaction.’

It is true that Freud was unscientific in forming his theories (he himself accepted that much of his work was ‘speculative’). It is also true that very few psychodynamic therapists working today are strict Freudians. However, just because a proportion of his work may well be reasonably rejected as therapeutically unhelpful, this by no means implies that all of his insights should be dismissed.

Indeed, it was Freud who opened society’s eyes to the fact that our early life experiences (and, most especially, our early life relationship with our primary carers) have a dramatic impact upon adult lives.

Above : Sigmund Freud (1856-1939).

Other important ideas he had, which remain useful today include :

  • the repetition compulsion : The theory of the repetition compulsion is that we are unconsciously driven to repeat painful experiences from our childhood (so, for example, a woman who was abused by her father as a child may be unconsciously driven, as an adult, to become repeatedly involved in relationships with abusive men).

Or, to take another example, a man who was rejected by his parents as a child may be unconsciously driven to sabotage all his adult friendships and relationships to a degree that ensures he will continue to be yet further rejected.

On the surface, the idea that we are unconsciously motivated to re-experience painful episodes in our lives seems odd, but you can read about the psychodynamic reasoning behind it by clicking here).

  • the importance of dreams : Freud believed that by analysing the content of our dreams we could gain an insight into our unconscious mental conflicts; in fact, he described dream analysis as ‘the royal road to the unconscious’.
  • early relationships with primary carers heavily influence our view of our adult relationships (e.g. if our parents rejected us we may believe, as adults, that we are completely unlovable and that we will inevitably continue to be rejected by others even though, in reality, this is not the case – psychoanalysts call this phenomenon ‘transference.’

 

Modern day psychodynamic psychotherapists/ psychologists place far more importance on the relationship between the patient and therapist than was the case for strictly Freudian psychodynamic psychotherapy (strict Freudians barely interact with their patients, instead spending the majority of treatment sessions silently listening to what their patient says – more modern psychodynamic psychotherapists, on the other hand, are far less aloof and more informal).

Some individuals still opt for treatment by traditional, strict Freudian therapists, although this may involve several sessions per week and go on for years, hence it is extremely expensive. The American actor/writer/director, Woody Allen (now in his eighties) famously spent thirty years in this type of therapy but claimed it did him little good.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

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Resentment : Effects Of Holding Onto It

If we experienced significant childhood trauma, it is quite understandable that we may harbor feelings of deep resentment. However, such feelings can serve only to prolong and intensify the mental pain we feel. Below is a fairly well-known quote that encapsulates this idea :

‘Resentment is like taking poison and waiting for the other person to die’. 

– Malachy McCourt

Feelings of resentment against another usually build up over a long period of time, often years. If we are still in contact with the person we resent, these feelings may be triggered by present events (such as again being let down by the person), perhaps giving rise to anger that seems, objectively, disproportionate to the current provocation but reflects the intensity of the omnipresent, latent, resentful sentiments that underlie this anger.

Indeed, feeling resentful involves constantly replaying and reliving in our minds the wrong that was done to us and so it can potentially give rise to strong emotional and visceral responses.

The reason we feel resentful against another person may be due to acts of commission (what someone did to us) or acts of omission (what someone failed to do for us), or both.

Feelings of resentment can torment us and make it impossible for us to achieve any semblance of peace of mind. We may, too, displace our feelings of resentment onto others, making us cynical, suspicious and incapable of forming meaningful and reparative new relationships.

So why do we hold onto feelings of resentment?

We may hold onto our feelings of resentment out of a sense of ‘moral integrity’ and a conviction that it would somehow be ‘against justice’ to allow our resentful feelings to abate (in other words, we may firmly believe that our feelings of resentment are ‘just’, therefore to jettison such feelings would be ‘unjust’).

Indeed, we may be of the view that to forgive the perpetrator would show us to be weak and make us vulnerable to incurring yet further psychological damage.

Or we may feel that to let go of our resentment would in some way seem to diminish the seriousness with which we feel the offence against us should be taken – rather like saying what we experienced ‘wasn’t that bad after all’ (which would constitute self-invalidation).

Finally, by hanging onto our resentment we may create for ourselves the illusion that we have more control and power over what happened to us than we actually do.

What Can We Do To Free Ourselves From Such Self-Destructive Feelings Of Resentment?

The bottom line is that tenaciously holding onto resentment, like a snarling pit-bull terrier with a cyanide-laced bone, is often extremely self-defeating and can act as an insurmountable obstacle between us and recovery.

To overcome feelings of resentment it can be useful :

1) to remind ourselves that our resentment may be negatively colouring our view of others, the future and the world in general

2) to remind ourselves that we might be displacing our feelings of resentment onto others who do not deserve to be treated badly, spoiling our relationships

3) to view our insistence on clinging onto our feelings of resentment as a kind of addiction or obsession which needs to be overcome

4) to remind ourselves that the stress and mental anguish our resentment causes us is almost certainly not worth it, especially as we cannot change the wrong that was committed against us and that our resentment is likely to be hurting us much more than the person we resent

5) to consider undergoing a therapy such as cognitive behavioural therapy (CBT) to help us think less negatively

6) to remind ourselves that our belief that our feelings of resentment make us more powerful, in control and strong is likely to be an illusion

7) to remind ourselves that staying resentful, in many ways, allows the perpetrator to continue to make us unhappy, thus giving him/her continued power over us

8) to consider forgiving the perpetrator

Resources:

Self-hypnosis MP3s/CDs:

 

LET GO OF THE PAST – click here for more details.

DON’T HOLD GRUDGES – click here for more details.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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