Category Archives: Coping Strategies And Tips

Childhood Trauma and Self-Harm : How it can be Addressed.

childhood-trauma-fact-sheet

Three key elements to reducing our risk of harming ourselves are:

1) distracting our thoughts away from self-harm
2) reducing the intensity of our emotional arousal to levels which we are able to manage
3) dealing with internal critical ‘voices’ (ie thought processes).

However, as self-harming is often deeply ingrained, we cannot expect instantaneous results. It needs working at.

Let’s look at each of the 3 elements in turn:

1) DISTRACTION: these can be very simple things such as listening to music, watching a movie, going for a walk or a run, reading, calling a friend, browsing the internet, doing something creative like art or craft (eg making a collage), taking a bath, and keeping a journal or diary (including writing down our feelings).

2) REDUCING THE INTENSITY OF OUR EMOTIONAL AROUSAL: one way to do this is to get the painful emotion out. Again, there are simple ways to accomplish this. They include: going for a run, punching a punch bag (or even a pillow), writing a letter to, for example, our parents (without actually sending it), writing out our feelings in a journal, calling a crisis line, going to an online chatline/support group and sharing our feelings, writing poetry about how we feel, playing moving music/crying.

RELEASING ANGER SAFELY:

Sometimes our anger can overwhelm us, so it is important to be able to discharge it in a safe way. Those of us who have experienced childhood trauma have very frequently been taught to blame ourselves. This can result in remaining angry at ‘the child within us’. It is therefore necessary to realize:

a) this child did nothing wrong and does not deserve our anger.
b) the anger needs to be appropriately and safely redirected at those who caused our childhood trauma (in a way which is not destructive to ourselves or them).
c) FEELING angry is not the same as EXPRESSING anger, so does no harm: so we don’t need to fear these angry feelings.
d)we need to stop repressing or misdirecting our anger (at those who do not deserve it – known as DISPLACEMENT in psychodynamic theory) as this can lead to it becoming obsessive.
e) we need to learn to express our anger safely, appropriately and positively. For example, writing a letter we have no intention of sending in order to release our pent up feelings, taking up Judo or a martial art, role playing with a friend or counsellor ( saying to him/her what we would like to say to those who caused our childhood trauma).

SOME DOs AND DON’Ts RELATED TO ANGER:

DO:

A acknowledge anger
N nip it in the bud
G get help for your anger if necessary (eg anger management classes)
E express anger constructively
R release anger appropriately and let it go

DON’T:

A avoid it
N numb it with food/ illicit drugs/alcohol etc
G grin and grit your teeth (ie suppress it as it will just ‘fester’)
E explode
R rationalize it (ie explain it away)

3) DEALING WITH OUR INTERNAL CRITICAL ‘VOICES’: growing up with negative parents leaves many of us with a lot of negative messages running around our heads – we may have had horrible things said about us so often that we have INTERNALIZED them (ie come to see them as true so they form the basis of our self-concept). As adults, we first need to acknowledge that we have these self-lacerating thoughts. This is because the attempt to ignore them can paradoxically make them all the more intense and tenacious.

We may come to notice triggers for these thoughts. For example, if someone is just slightly off-hand with us we may feel we must be a horrible person who everyone will always reject as a matter of course. The root of this may be that we were rejected by one or both of our parents. Being able to trace our self-critical thoughts back to their roots in such a way, and, therefore, understand their triggers, can reduce their intensity of them quite considerably.

In order to retrain the way we think about ourselves, it is helpful, every time we have a negative thought about ourselves, to replace it with a positive one. It can be helpful, too, to write those positive messages down and to keep them somewhere they can easily be retrieved so that we can, on occasion, read through them. It is even possible to make an audio file of them and listen to them occasionally.

As time goes on, it is necessary to let our self-critical messages go and to stop emotionally tormenting ourselves – instead, we need to treat ourselves with compassion.

When individuals come to the point that they are ready to stop hurting themselves with self-critical messages, some make a kind of ritual out of it such as writing down all the negative thoughts they used to have about themselves on a piece of paper and then burning it or tearing it up and throwing it away.

In summary, then, we need to realize that we have absolutely nothing whatsoever to gain, for either ourselves or others, by constantly emotionally torturing ourselves. It is necessary, instead, to start treating ourselves with the love and compassion which may well have been denied us in childhood. We can give ourselves the love and compassion the child within us deserves.

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Best Wishes,

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Electro-Convulsive Therapy (ECT) And My Experience of It.

left vagus nerve

 

Childhood trauma can lead us to become severely clinically depressed as adults, and this happened to me. Electro-convulsive therapy (ECT) is only used as a last resort on people who are at high risk of suicide and/or are unable to function in even the most basic areas of life.

ECT is, in fact, misunderstood by the vast majority of people – many see it as barbaric and frightening. Such views, in large part, derive from the popular media (eg from films such as ‘One Flew Over the Cockoo’s Nest’).

However, most controlled research suggests that ECT is helpful as a treatment for severe depression (eg Pagnia et al., 2004). It is normally only used when other interventions, such as psychotherapy and drug treatment, have failed.

There are, though, some risks. Approximately 2-10 patients per 100,000 treatments (ie less than 0.01%) die during the procedure – however, this is no higher than the risk of dying from anesthesia alone (patients have a general anesthetic before undergoing ECT).

After the treatment patients might have headaches, aching muscles or nausea. Also, some patients experience some memory loss (but, generally, only mildly) which can last up to six months (Sackeim et al. 2007).

Patients who undergo ECT, however, tend to view it positively. In one study, 98% of patients who received it said they’d undergo it again if their depression recurred (Pettinati et al., 1994).

ect

MY OWN PERSONAL EXPERIENCE OF ELECTRO-CONVULSIVE THERAPY (ECT).

My own depression was so severe and protracted that I underwent ECT sessions (an ECT treatment session normally comprises blocks of 6 individual treatments) on more than one occasion. I was suicidal and almost completely unable to function (not even able to carry out the most basic self-care, such as shaving, brushing my teeth or taking a bath or shower). As I say, these periods went on for several months, or years, at a time.

Frankly, I did not care whether I lived or died (actually, that’s not quite true, I wanted to be dead), nor what happened to me. Thus, when I was hospitalized, my psychiatrist strongly advised me to undergo ECT. I put up no resistance, nor would I have had the energy or will to do so.

Over the years, each time I underwent ECT sessions, the results were pretty much the same, so I’ll just describe the effect of one set of treatments:

The best thing about it was being given the general anesthetic – such was the extreme nature of my mental anguish that I constantly longed to be unconscious (or dead). Unfortunately, however, the treatment is quick so one is only unconscious for a few minutes!

When I awoke, I’d have very bad, pounding headaches and many of my muscle groups would be painful. Sometimes, I’d need to walk with a stick for a few days after the treatment until the muscles in my legs recovered.

Also, and this was frightening, for about the first five or ten minutes after the treatment I would be so disoriented and confused that I did not know where I was, or even WHO I was. It is impossible for one to imagine how disturbing this is until one has experienced the sensation for oneself. Fortunately, as I said, this did not last long.

On the topic of memory, it felt to me that my memory was impaired for a couple of years after the final treatment session (though not severely). I would make the point, however, that severe clinical depression in itself can impair memory so I cannot attribute it to ECT without some equivocation.

Finally, and most importantly, my own ECT did not have any beneficial effect on me whatsoever; my depression was not even slightly ameliorated.

Obviously, overall, my experience of ECT was fairly negative. However, it is necessary to stress that I am, of course, just one patient out of thousands who have received ECT, so not very much can be concluded from my personal experience it. The research I have already quoted suggests that, for the majority, it is beneficial. Indeed, there are many who believe it has saved their life.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

Cognitive Behavioral Therapy: Challenging Our Negative Thoughts.

 

challenge negative thoughts

This article examines how we can use cognitive behavioral therapy to challenge our negative thoughts.

When we have negative thoughts, it is important to ask ourselves:

‘What is the evidence to support this negative thought/belief?’ OFTEN, WILL WILL FIND THERE IS VERY LITTLE OR AT LEAST NOT THE COMPELLING EVIDENCE WE’D ORIGINALLY SUPPOSED.

It is important for us to get into the habit of challenging negative thoughts in this way because very often the negative thoughts come to us autmatically (due to entrenched negative thinking patterns caused in large part by our traumatic childhoods) without us analysing them and examining them to see if they are actually valid.

So, to repeat, we need to try to get into the habit of CHALLENGING OUR NEGATIVE THOUGHTS AND ASKING OURSELVES IF THERE REALLY IS PROPER EVIDENCE TO SUPPORT THEM.

A SUGGESTED EXERCISE:

1) Think of two or three negative thoughts that you have experienced lately.

2) Ask yourself what evidence you have to support them.

3) Ask yourself how strong this evidence actually is.

4) Now think of evidence AGAINST THE NEGATIVE THOUGHT.

Step 4 above is very important.This is because when we are depressed and have negative thoughts we tend to focus on the (often flimsy) evidence which supports them BUT IGNORE ALL THE EVIDENCE AGAINST THEM (in other words, we give ourselves an ‘unfair hearing’ and , in effect, are prejudiced against ourselves). This is sometimes referred to as CONFIRMATION BIAS.

Challenging our negative thoughts and FINDING EVIDENCE TO REFUTE THEM is a very important part of CBT. It is, therefore, worth us putting in effort to search hard for evidence which weakens or invalidates our automatic negative thoughts/beliefs.

ALTERNATIVE THOUGHTS:

When we have successfully challenged our negative thoughts, and found, by reviewing the evidence, reason not to hold them anymore, it is useful to replace them by MORE REALISTIC APPROPRIATE THOUGHTS.

One way to get into the habit of this is to spend a little time occasionally writing down our automatic negative thoughts. Then, for each thought, we can write beside it:

1) Evidence in support of the negative thought.

2) Evidence against the negative thought.

3) In the light of the analysis carried out above in steps 1 and 2, replace it with a more realistic, valid and positive thought. Here is an example:

Negative Thought: I failed my exam which means I’m stupid and will never get the job I wanted or any other.

1) Evidence in support of negative thought:

‘after a lot of revision, I still didn’t pass.

2) Evidence against negative thought:

‘I only failed by a couple of per cent and was affected by my nerves – failing one exam does not make me stupid’.

3) Alternative, more valid, realistic and positive thought:

I can retake the exam and still get the job. Even if I don’t get my first choice of job, that does not mean there won’t be other jobs I can get, and they may turn out to be better.

Getting into the habit of occasionally writing down negative thoughts, challenging them, and coming up with more positive alternative thoughts will help to ‘reprogram’ the brain not to just passively accept the automatic negative thoughts which come to us without subjecting them to scrutiny and challenging their validity.

 

Self-Help Link :

Ten Steps To Overcoming Negative Thinking. Click here for further information.

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

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Copyright 2013 Child Abuse, Trauma and Recovery

How Cognitive-Behavioural Therapy (CBT) Can Aid Recovery From Childhood Trauma.

WHAT IS COGNITIVE BEHAVIORAL THERAPY (CBT) AND HOW CAN IT AID RECOVERY FROM CHILDHOOD TRAUMA ?

Put simply, CBT works on the basic observation that:

1) how we think about things and interpret events affects how we feel

2) how we behave affects how we feel

therefore:

3) by changing how we think about things, interpret events and behave will CHANGE HOW WE FEEL.

I have over-simplified here but those are the essential three points and my aim in this blog is not to present information in an over-complex way.

RESEARCH

CBT is widely used by therapists to treat survivors of childhood trauma and there is now a solid base of research which supports its effectiveness. I myself underwent a course of CBT some time ago and found it very helpful.

WHAT WE THINK ABOUT THINGS DECIDES HOW WE FEEL

In this post I wish to concentrate on how our thinking styles affect our state of mind and emotions. Survivors of childhood trauma often develop depressive illness and, as a result, thinking styles often become extremely negative:
NEGATIVE THINKING

Depression often gives rise to what is sometimes called a COGNITIVE TRIAD of negative thoughts. These are:

– negative view of self
-negative view of the world
-negative view of the future

I have referred to this NEGATIVE COGNITIVE TRIAD in previous posts, but it is worth revisiting. The aim of CBT is to change these negative thinking patterns into more positive ones. It aims to correct FAULTY THINKING STYLES.

FAULTY THINKING STYLES:

Individuals who suffer from this cognitive negative triad of depressive thoughts, as I did for more years than I care to remember, are generally found to have deeply ingrained faulty thinking styles; I provide the most common ones below and give a very brief explanation of each type (if the examples seem a little extreme, it is merely to illustrate the point):

1) GENERALIZATION:

eg. someone is rude to us and we conclude: ‘nobody likes me or ever will’.

So, here, the mistake is vastly over-generalizing from one specific incident.

2) POLARIZED THINKING:

eg. ‘unless I am liked by everyone then I am unpopular’.

This is sometimes referred to as ‘black or white’ thinking ie. seeing things as all good or all bad and ignoring the grey areas.

3) CATASTROPHIZING:

eg. ‘I know for sure this will be an unmitigated disaster and I’ll be utterly unable to cope.’

Here, the mistake is to overestimate how badly something will turn out or to greatly overestimate the odds of something bad happening. It often also involves underestimating our ability to cope in the unlikely event that the worst does actually happen. Also known as ‘WHAT IF…’ style thinking.

4) PERSONALIZATION:

eg. taking an innocent, casual, passing remark to be a deliberate and calculated personal attack. Here, the mistake is thinking everything people do or say is a kind of reaction to us and that people are pre- disposed to wanting to gratuitously hurt us.

5) SELF BLAME

eg. someone says our team has not met its monthly target and we then look for ways to convince ourselves it is specifically and exclusively due to something we have done wrong. With this type of faulty thinking style, we blame ourselves for something for which there is no evidence it is our fault.

6) MINIMIZATION.

eg. ‘I failed one exam out of ten, therefore I’m stupid and a complete failure’.

Here, the positive (passing nine out of ten exams) is pretty much ignored (minimized) and the negative (failing one exam) completely disproportionately affects our view of ourselves. Individuals who minimize the positive tend to also MAXIMIZE (ie. make far too much of) the negative.

CONCLUSION.

What tends to underlie all these faulty thinking styles is that we UNNECESSARILY BELIEVE NEGATIVE THINGS IN SPITE OF THE FACT WE HAVE NO, OR EXTREMELY LIMITED, EVIDENCE FOR SUCH BELIEFS. Therefore, we unnecessarily and irrationally further lower our own sense of self-esteem and self-worth. Because of these faulty thinking styles, we increase our feelings of inadequacy and depression.

In my next post I will look at how we can challenge and correct these faulty thinking styles.

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

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Childhood Trauma: Recovery.

effects-of-childhood-trauma

Research shows those who suffer childhood trauma CAN and DO recover.

Making significant changes in life can be a very daunting prospect, but those who do it in order to aid their own recovery very often find the hard work most rewarding.

Some people find making the necessary changes difficult, whereas others find it enjoyable.

THE DECISION TO CHANGE

Change does not occur instantly. Psychologists have identified the following stages building up to change:

1) not even thinking about it
2) thinking about it
3) planning it
4) starting to do it
5) maintaining the effort to continue doing it

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THE RECOVERY PROCESS

Each individual’s progress in recovery is unique, but, generally, the more support the trauma survivor has, the quicker the recovery is likely to occur.

Often recovery is not a steady progression upwards – there are usually ups and downs (eg two steps forward…one step back…two steps forward etc) but the OVERALL TREND is upwards (if you imagine recovery being represented on the vertical axis of a graph and time by the horizontal). Therefore, it is important not to become disheartened by set-backs along the recovery path. These are normal.

Sometimes, one can even feel one at first is getting worse (usually if traumas, long dormant, are being processed by the mind in a detailed manner for the first time). However, once the trauma has been properly consciously reprocessed, although this is often painful, it enables the trauma survivor to work through what happened and to form a new, far more positive, understanding of him/herself.

Once the trauma has been reworked (ie understanding what happened and how it has affected the survivor’s development) he or she can start to develop a more positive and compassionate view of him/herself (for example, realizing that the abuse was not their fault can relieve strong feelings of guilt and self-criticism).

Once the reworking phase has been passed through, improvement tends to become more consistent and more rapid.

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

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Copyright 2013 Child Abuse, Trauma and Recovery