Category Archives: Ptsd/cptsd Articles

Types Of Dissociative Amnesia In Complex PTSD

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We have seen how the cumulative effect of repetitive and chronic, traumatic stress during childhood is associated with the later development of complex posttraumatic stress disorder (complex PTSD) and that many of those afflicted by complex PTSD experience symptoms of dissociation (e,g. Freyd, 1996 ; Peclovitz et al., 1997). [Click here to read my previously published post : SYMPTOMS OF DISSOCIATION : MILD AND SEVERE.]

We have also seen how dissociative symptoms may manifest themselves in different ways and that one such way is DISSOCIATIVE AMNESIA.

In this article, I intend to briefly recap on what is meant by the term DISSOCIATIVE AMNESIA, including a short outline of the DIFFERENT TYPES OF DISSOCIATIVE AMNESIA.

WHAT IS DISSOCIATIVE AMNESIA? :

If an individual is suffering from dissociative amnesia, it means that they are unable, for a period of time (usually relatively short periods of time such as minutes, hours or days, but, in mush less frequent cases, months or even years), to remember information about themselves / events in their past (sometimes referred to as autobiographical memory). And, perhaps more surprisingly, they may have periods of time during which they fail to remember a skill or talent that they have learnt (sometimes referred to as semantic memory).

For such memory loss to be diagnosed as dissociative amnesia the memory loss must be far more severe than in ‘normal forgetting’ and not accounted for by another medical condition.

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THE DIFFERENT TYPES OF DISSOCIATIVE AMNESIA :

According to the American Psychiatric Association (APA), dissociative amnesia can be subdivided into the following types :

  • localized
  • selective 
  • generalized
  • systematized

Let’s look at each of these in turn :

1. LOCALIZED :

This involves not being able to remember a specific period of time. Often, this period of time will be the first few hours after the traumatic event has occurred (including the traumatic event itself) and can occur as the result of an isolated traumatic episode.

2. SELECTIVE :

This involves not being able to remember some (but NOT all) of the events that occurred during a specific (traumatizing) period of time (often, this may be the most traumatic aspects of the events which occurred during this time period),

3. GENERALIZED :

This particularly alarming and devastating form of dissociative amnesia occurs when the individual afflicted by it is unable to remember their ENTIRE LIFE including, remarkably, who they are and where they are from. Fortunately, this extreme form of dissociative amnesia is very rare.

4. SYSTEMATIZED :

This type of dissociative amnesia involves being unable to recall information associated with a particular category such as being unable to recall any memories associated with one’s abusive parent or associated with a particular location where one was traumatized. For example, I have virtually no memory of living in my first or second house which incorporated the years between my birth and my being about eight years old when my parents divorced.

 

To learn more about DISSOCIATION, you may wish to read one or more of my other posts on the topic (shown below):

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

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Yoga For Complex PTSD

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Overcoming Trauma Through Yoga: Reclaiming Your Bodyir?t=childhoodtrau 21&l=am2&o=2&a=1556439695 - Yoga For Complex PTSD

 

Studies into the effectiveness of yoga already suggest that it can help to ameliorate both physical and psychological problems including diabetes, arthritis, fibromyalgia, depression and anxiety.

There also now exists evidence (e.g. van der Kolk, 2014, see below)) that it can help to reduce symptoms of Complex posttraumatic stress disorder (Complex PTSD).

Complex PTSD Gives Rise To Both Psychological And Physical Symptoms :

We have already seen how the cumulative effects of exposure to ongoing and repetitive trauma can result in the development of Complex PTSD and that the condition adversely affects the body’s physiology leading to impaired functioning of the autonomic nervous system and associated physical problems that can manifest in various ways including :

Furthermore, such symptoms are, in individuals with Complex PTSD, if not ongoing (though they can be : my own hyperventilation and physical agitation went on for years and the former continues to be set off by what most others would consider to be trivial anxieties, whilst my resting heart rate is still, worryingly, running at over one hundred beats per minute), very easily triggered by even relatively minor stressors ; this is because the individual’s capacity to tolerate stress is dramatically compromised, especially in relation to stressors that are linked (on either a conscious or unconscious level) to memories of the original traumatic experiences.

yoga - Yoga For Complex PTSD

Severe Physical Symptoms Of Complex PTSD May Prevent Or Impair Talk-Based Psychotherapy :

If such physical symptoms of Complex PTSD are severe and remain unaddressed there is potential for them to prevent or impair talk-based psychotherapy. For example, in my own case my physical symptoms were so bad that I frequently either could not attend therapy sessions (as I was unable to leave my flat), or, if I did manage to attend, was unable to focus or concentrate properly.

How Can Yoga Help Those Suffering From Complex PTSD?

Yoga that incorporates physical exercises, breathing exercises and mindfulness can be a more effective treatment of the physiological symptoms of Complex PTSD that talk-based psychotherapy because of the fact that it DIRECTLY ADDRESSES SUCH SYMPTOMS THROUGH BREATHING TECHNIQUES AND BODY WORK. Indeed, recent research supports the effectiveness of yoga in this regard – for example, van der Kolk’s study (2014), which I briefly outline below :

The Study :

  • The participants in the study were adult females with Complex PTSD who had not responded to the intervention of traditional psychotherapy
  • These same females were then randomly allocated to one of two groups as shown below :

GROUP ONE : The females who were randomly allocated to GROUP ONE underwent a TEN WEEK COURSE IN TRAUMA SENSITIVE YOGA (a special form of yoga that was developed at the Boston Trauma Center in the U.S.)

GROUP TWO : The females who were randomly allocated to GROUP TWO did NOT undergo this course.

The Results Of The Study :

The main findings of the study were as follows :

At the end of the ten week period :

  • Those in the treatment group (GROUP ONE) were significantly less likely still to meet the diagnostic criteria for Complex PTSD than those in the non-treatment group (GROUP TWO).
  • Furthermore, those in the treatment group (GROUP ONE) showed a significant reduction in depression and self-harm

Longer term studies have found similar results (e.g. Rhodes, 2014).

CONCLUSION :

Yoga may be an effective complementary treatment option to be used in conjunction with talk-based psychotherapies particularly when physical symptoms of Complex PTSD are so severe that they interfere with talk-based psychotherapies, as in my own case (see above).

A major benefit of yoga for the treatment of the physical symptoms of Complex PTSD is that it addresses such problems directly.

 

If you would like to read my related article : ‘TRAUMA RELEASE EXERCISES’, please click here.

 

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David Hosier Bsc Hons; MSc; PGDE(FAHE) Read More →

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What Are The Differences Between BPD And Complex PTSD? : A Study

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Because there is a considerable overlap in symptoms between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic disorder (complex PTSD) , those with the latter condition can be misdiagnosed as suffering from the former condition (you can read my article about this by clicking here).

In order to help clarify the differences between the two conditions and help show how they are distinct from one another, this article is about a research study which sought to delineate these two very serious psychiatric conditions.

What Are The Differences In Symptoms Between Those Suffering From Borderline Personality Disorder (BPD) And Those Suffering From Complex Posttraumatic Stress Disorder (Complex PTSD)?

A study into the different symptoms displayed by sufferers of borderline personality disorder (BPD) and complex posttraumatic stress disorder (complex PTSD) involving the study of two hundred at eighty adult women who had experienced abuse during their childhoods and published in the European Journal of Psychotraumatology in 2014 compared the symptoms of those suffering from BPD with those suffering from complex PTSD.

The following results from the study were obtained :

SYMPTOMS SHARED APPROXIMATELY EQUALLY BETWEEN THOSE SUFFERING FROM BPD AND THOSE SUFFERING FROM COMPLEX PTSD :

Some symptoms were found to be shared approximately equally between those suffering from  borderline personality disorder (BPD) and those suffering from complex posttraumatic stress disorder (complex PTSD). The symptoms that fell into this category were as follows :

  • AFFECTIVE DYSREGULATION (ANGER) i.e. frequent feelings of intense rage that the individual cannot control (regulate)
  • VERY LOW FEELINGS OF SELF-WORTH
  • AFFECTIVE DYSREGULATION (SENSITIVE) i.e. feelings of hypersensitivity that cannot be controlled (regulated)
  • INTENSE FEELINGS OF GUILT
  • INTERPERSONAL DETACHMENT / ALONENESS i.e. feeling cut-off and alienated from others, isolated and apart
  • FEELINGS OF EMPTINESS

However, some symptoms were found to be significantly more prevalent amongst those suffering from borderline personality disorder (BPD) than amongst those suffering from complex posttraumatic stress disorder (complex PTSD) as shown below :

SYMPTOMS THAT WERE FOUND TO BE SIGNIFICANTLY MORE PREVALENT AMONGST THOSE SUFFERING FROM BORDERLINE PERSONALITY DISORDER (BPD) THAN AMONGST THOSE SUFFERING FROM COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) :

 

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

 

 

 

 

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Neurocounseling And Its Relevance To Treating Complex-PTSD

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The term neurocounseling refers to a form of therapies that seek to take advantage of the relatively recent neuroscientific discovery that the human brain has far more NEUROPLASTICITY than was previously believed to be the case.

What Is Neuroplasticity?

The brain’s quality of neuroplasticity can be defined as its capacity to be physically changed, not only during childhood, but over the whole life-span ; it is only relatively recently that the extent to which the adult brain can be physically altered (both in terms of its structure and its pattern of neuro-pathways) has been discovered.

Why Is The Brain’s Neuroplasticity, And Therefore Neurocounseling, Relevant To The Treatment Of Complex-PTSD Resulting From Childhood Trauma?

Neurocounseling and the phenomenon of neuroplasticity have important implications for the treatment of post traumatic stress disorder (PTSD) and   complex-PTSD as sufferers of both types often have incurred damage to certain brain regions as a result of their traumatic experiences.

These brain injuries can include a shrunken hippocampus ( the hippocampus is a brain region involved in the processing of memories, including differentiation between past and present memories); increased activity in the amygadala ( a region of the brain involved in the processing of emotions and that is intimately related to the fear response); and a shrunken ventromedial prefrontal cortex (this region of the brain processes negative emotions that occur in response to exposure to specific stimuli).

Neurocounseling :

Neurocounseling is founded upon the premise that that symptoms of psychiatric conditions (both psychological and behavioral) are underpinned by maladaptive, neurological structures and functions and that these neurological structures and functions can be beneficial altered due to the quality of the brain known as neuroplasticity. It combines neuroscience with counseling techniques and, in this way, the individual receiving treatment is helped to learn new skills and new ways of thinking in an attempt to help correct the maladaptive physical development of the brain that has occurred in response to the person’s traumatic past experiences. Examples of neurocounseling techniques include :

  • incorporating biofeedback into the treatment plan ; this can help to treat emotional dysregulation – emotional dysregulation is a major symptom of PTSD and complex-PTSD and is linked to damage to the amygdala (see above)
  • incorporating neurofeedback into the treatment plan
  • mindfulness meditation training (one study found that this can alter the actual physical structure of the brain in just eight weeks)

Additionally, studies have shown that interpersonal psychotherapy and compassion focused therapy can lead to beneficial alterations to the brain.

Furthermore, research shows that neurocounseling can also be successfully employed to treat a range of addiction issues (including prevention of relapse and recovery management), sleep difficulties, ADHD, chronic fatigue syndrome and problems relating to aggression (all of which, potentially, can be linked to childhood trauma).

As understanding of the relationship between the way in which the physical brain operates and symptoms of psychological problems increases, it should be possible, in the future, to be apply neurocounseling more effectively to an expanding range of behavioral and psychological difficulties that have their roots in maladaptive brain biochemistry and physiology.

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Retraumatization Caused By Psychiatric Care Institutions

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Retraumatization :

If the trauma we experienced as children was severe enough, we may, as adults, at one time or another, require residential psychiatric care (such as inpatient treatment on a psychiatric ward in a hospital, as was necessary in my own case on several occasions).

Obviously, the quality of the care we receive in psychiatric facilities can vary very considerably ; unfortunately, this means that, if we are unlucky, we may find ourselves in an environment that not only fails to be therapeutic, but is actively retraumatizing.

In What Ways Can A Psychiatric Facility Retraumatize Us?

According to Fallot and Harris (2001), the ways in which we can be retraumatized in psychiatric institutions can be divided into two main categories ; these are :

1) BY THE SYSTEM (policies, culture, procedures, rules etc). For example :

2) BY THE RELATIONSHIPS WE HAVE WITH THOSE ENTRUSTED WITH OUR CARE (e.g nurses, psychiatrists etc)

Let’s look at each of these in turn :

1)  RETRAUMATIZATION BY THE SYSTEM. Examples of how this may occur include :

– lack of choice regarding treatment ; for example, being prescribed medication when a form of psychotherapy may be more appropriate and more effective.

– not being given the opportunity to give feedback to the professionals caring for us about how we feel in relation to the treatment we are receiving

– being treated impersonally and not as an individual but, instead, according to how one has been ‘labelled’ by one’s diagnosis (two individuals with the same diagnosis may manifest very different symptom and have very different needs. In the case of those who have been diagnosed with borderline personality disorder, such individuals may experience the additional trauma as being regarded as ‘a trouble maker’ due to misinterpretation of the true causes of their behavior.

– constantly having to retell personal details relating to one’s psychological condition.

2)  RETRAUMATIZATION BY THOSE ENTRUSTED WITH OUR CARE.  Examples of how this may occur include :

– betrayal of trust

– feeling one is not being listened to and/or is being rushed when explaining one’s condition

– feeling one’s views are being dismissed /not taken seriously / invalidated

– being spoken to disrespectfully, insultingly or inappropriately

– being subjected to punitive ‘treatment’ methods (e.g. locked in isolation room without toilet or proper bedding)

– lack of communication / collaboration between patient and staff

My Own Experiences :

SECTIONING :  When my illness was at its worst, I was sectioned (despite my ardent protests) because it was felt I was a high suicide risk (which, in truty, I was) ; however, being sectioned accentuated feelings of powerlessness, humiliation and loss of autonomy

AGGRESSIVE/THREATENING PATIENTS : Unfortunately, some patients one is exposed to in psychiatric wards can be aggressive and intimidating, leading to feelings of being unsafe and constantly under threat

UNPROFESSIONAL STAFF : Sadly, occasionally one comes across staff who are not above behaving unprofessionally ; this can exacerbate feelings of mistrust

ELECTRO-CONVULSIVE SHOCK TREATMENT (ECT) : Because I was so ill – utterly unable to function and, indeed, almost catatonic at times, as well as a very high suicide risk, I was ‘strongly encouraged’ to undergo ECT treatment ‘voluntarily’ on several occasions ; in fact, though, there was no genuine choice as I was told that, if I did not undergo it ‘voluntarily,’ I would be sectioned and the act of sectioning me would, in turn, give the hospital the legal right to administer the treatment even without my consent. Due to the controversial nature of ECT treatment, this was an intimidating, degrading and, quite arguably, dehumanizing position in which to be placed. (To read my article about my experience of ECT, click here.)

COMPULSION TO ABSCOND :  Indeed, I often found the conditions to which I was confined so intolerable that, on three occasions, I absconded (each time with the intention of committing suicide – to read about one such incident, see my article On Being Suicidal (Or, Why I Carried A Rope In A Bag Around London For Three Months ).

Obviously, vulnerable patients who find themselves compelled to abscond, as I did, potentially expose themselves to a high level of risk in a multitude of ways.

The Trauma-Informed Environment :

Tailor and Harris (2001) state, based on the main ways in which retraumatization may occur, therapeutic environments that cater for the traumatized (e.g. those suffering from PTSD or complex-PTSD) should be trauma-informed. Trauma-informed environments should :

1) Be calm and comfortable

2) Provide the patient with choice

3) Empower the patient

4) Recognize the strengths and abilities of the patient

5) Involve the patient, as far as possible, in all decision-making processes.

 

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

 

 

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Trauma Triggers : Definition And Examples

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Anger May Operate To Soothe Emotional Pain

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We have seen from other articles published on this site that many forms of childhood abuse/trauma can put as at an increased risk of developing problems controlling our anger as adults, particularly if the abuse/trauma that we have suffered has been serious enough to result in us developing a serious psychological condition such as borderline personality disorder or complex posttraumatic stress disorder.

Steven Stosny, author of the excellent book Treating Attachment Disorder, proposes that the act of getting angry may function, at times, to reduce the level of psychological pain we are feeling (it is known that borderline personality disorder can cause intense mental suffering, even agony).

How Can Anger Alleviate Mental Suffering?

According to Stosny, anger may lessen mental suffering by the chemical changes it produces in the brain, in particular by increasing levels of the neurotransmitter called norepinephrine.

‘Core Hurts’

Stosny further states that the mental pain our anger may help to soothe is pain that is linked to our core hurts‘ ; these are the painful feelings that we carry around with us that are linked to our childhood trauma / abuse and may include those of :

   – rejection

   – worthlessness

   – powerlessness

   – guilt

   – shame

   – being ‘unlovable

   – being an ‘outcast’

Anger As A Kind Of Addictive Drug :

If, then, as Stosny suggests, the act of getting angry, by producing chemical changes in the brain that serve as a psychological analgesic (i.e. pain-killer / self-soothing agent), it is possible that, just as we can become addicted to other pain-killing drugs such as morphine, that some of us may become addicted to anger as a means of coping with unbearable mental anguish.

Any Benefit Of Anger Likely To Be Short-Term :

However, the possible analgesic effect of anger are likely to be ephemeral. This is because, after the initial boost of norepinephrine, we are likely to regret, and feel guilty about, our behavior and find that, in the longer termm it has merely served to compound our already not  inconsiderable problems.

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Trauma Release Exercises

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THE MIND-BODY CONNECTION :

We have seen how the experience of significant and protracted childhood trauma increases our risk of developing both serious psychological and physical problems as adults – e.g. see the Adverse Childhood Experiences (ACE) Study.

Therefore, therapies for those who, as adults, are suffering the effects of childhood trauma – in the most serious cases in the form of  cPTSD (complex posttraumatic stress disorder) – include not only treatments for the mind, but also ones for the body. (And, because the mind and body are interconnnected, treatments for the body will also, to varying degrees) benefit the mind.

THE FIGHT/FLIGHT/FREEZE STATE :

If we have grown up in an environment in which we were frequently made to feel afraid or threatened (physically, psychologically or both) it is possible the early physical development of our brain has been disrupted in such a way that now, as adults, we find ourselves perpetually, tense, anxious and hypervigilant, or, in other words, continuously in the fight/flight/freeze state.

One result of this is that it can cause us to store up a vast amount of physical and muscular tension.

EXCESSIVE AND CHRONIC TENSION IN THE PSOAS (‘Fight or Flight’) MUSCLE :

A main location in the body where muscular tension accumulates is called the PSOAS muscle (sometimes also referred to as the ‘fight or flightmuscle ; it connects the lumber spine to the legs.

It is sometimes called the fight/flight muscle because when we feel threatened, anxious or fearful, or in response to significant loss, it becomes energized in preparation to assist us with the actions of running away or fighting.

And, if, during childhood, we have frequently been in the fight/flight state this muscle may have become perpetually tensed up to the extent we have habituated to this feeling of tension to such a degree that we no longer register it as abnormal; notwithstanding this, it is an indication that we are still being adversely affected by painful emotions linked to our traumatic childhood (if only on an unconscious level).

TRAUMA RELEASE EXERCISES  (TRE) :

Bercelli, PhD, devised six trauma release exercises designed to alleviate this stored muscular tension. The idea is that the tension is released by a ‘muscular shaking process’ known as ‘neurogenic tremors’ and its purpose is rid us of our deep-seated, chronic, early life trauma-related bodily tension.

 

To read my related article : ‘YOGA FOR COMPLEX PTSD’, please click here.

 

RESOURCE : You can learn much more about TRE by visiting Dr Bercelli’s website – click here.

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

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PTSD Nightmares : Typical Content And Symbols

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A major symptom of CPTSD / PTSD is nightmares. I myself have suffered from these and they have led to frequent waking during the night, sheets and pillow cases damp with sweat, thrashing around in my sleep to the extent that I have, on several occasions, knocked the lamp (and several other items, such as piles of books, the alarm clock, cups of cold, unfinished tea etc) off my bedside table with arms wildly flailing about like those of a crazed and demented windmill and, even, falling out of bed a few times. I have also woken myself up shouting and, even, screaming, more than once.

A particular torment of nightmares is, of course, that after a day spent in mental anguish in a state of wakefulness, they prevent one from escaping this mental pain even in sleep so there is no respite from one’s suffering. Indeed, when one has intense and terrible nightmares, one fears going to sleep ; for us, it is not a time of mental recuperation, but of continued psychological torture. This can be so devastating to the morale that one may fear one will go permanently and irrevocably insane.

According to the Harvard psychologist, Dr D Barrett, an expert on dreaming and dream analysis, PTSD nightmares tend to contain the following types of themes / symbols :

The Themes And Symbols Of PTSD Nightmares

– dying

– monsters

– being chased

– being in danger

– being punished

– being isolated

– revenge

– being powerless

– being trapped

– guilt

– shame

– violence

– anger

– filth

– garbage

– physical injury

Nightmares, Suppression, Repression And Dissociation :

If we have extremely painful memories relating to our traumatic childhood then we may, as a means of psychological self-protection, cut off from them mentally.

In order to achieve this we may suppress the memories (i.e. try to put them to ‘the back of our minds’). This takes conscious effort and can be counterproductive – see The Rebound Effect below).

Alternatively, we may repress the memories ; this is an automatic / unconscious process that stores the memories away so deeply in the mind that they become inaccessible to conscious awareness. Mentallly cutting ourselves off from painful memories in such a manner is known as dissociation.

Processing Of Traumatic Memories

However, because these memories are dissociated, they remain unprocessed by the brain and a leading theory as to why dreams/nightmares occur is that they represent the brain’s attempt to process the dissociated memories.

Barrett’s  research has led her to the view that, immediately following traumatic events, a person’s nightmares about them tend to quite closely reflect what actually occurred. However, as the traumatic events that triggered the nightmares recede further and further into the past, the PTSD nightmares relating to them become increasingly symbolic.

What Can We Do To Alleviate Nightmares?

If our nightmares do not result in effective processing of our traumatic memories they can become ‘stuck’ ; this can lead to recurring nightmares that tend to centre upon the same themes.

To alleviate such nightmares, it is necessary to attempt to process the traumatic memories in our waking lives (assuming they have been suppressed rather than repressed – see above).

We can attempt to process the material contained within our nightmares in the following ways :

– by keeping a written record of the nightmares (e.g. by recording our recollections of them or writing these down using a pen and pencil kept by the bed etc)

– by describing our nightmares to another person (who is emotionally supportive, such as a therapist) and trying to work out what their themes and images may represent.

–  going through the nightmare in our minds when awake but changing its ending to a positive one – then mentally replaying/rehearsing this new, positive ending. It is then helpful to write out what happens in the nightmare, including writing out the new, positive ending. Alternatively, we could draw a series of pictures representing the nightmare, but, again, incorporating the new, positive ending.

– by imagining, when awake, carrying out a simple action in our dream, such as taking a single step, and saying to ourselves : ‘You are completely safe, this is just a dream’. If we then mentally rehearse this before we go to sleep we may find this action, carried out in our dream, will cue the comforting and reassuring thought (the action that is to act as the cue can be anything simple that is likely to recur in the nightmare).

Nightmares And The Rebound Effect

In relation to some of what has been said above, it is useful to look at a psychological phenomenon known as the rebound effect :

If we try very hard not to think about something, this, paradoxically, frequently increases the probability that we will think about it. The classic example that is given to first year psychology undergraduates is the instruction NOT to think about a pink elephant for the next minute. Of course, this instruction is impossible to carry out  (try it if you don’t believe me!).

This is known as the rebound effect and research suggests the phenomenon may apply to nightmares, too. One possible technique to reduce the probability of having a nightmare is, therefore, to actually think about whatever it is the nightmare represents (if this has been inferred from reflection / dream analysis) for a few minutes before going to sleep as trying not do so, because of the rebound effect, may actually increase the chances that the nightmare will occur, however counterintuitive this may sound.

RESOURCE :

Stop Recurring Nightmares / Dreams | Hypnosis Downloads. Click here for more information.

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

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Overcoming Feelings Of Dissociation

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What Is Dissociation?

I have already discussed the phenomenon of dissociation in the article : Always Zoning Out? Dissociation Explained to recap very briefly, dissociation is a biopychological process that operates as a defense mechanism to prevent disturbing thoughts/memories/experiences from penetrating consciousness due to the unbearable burden of stress they would bring about were this mechanism not in place.

In so doing, dissociation can function to protect us from potentially highly potent emotions such as helplessness, fear and shame.

What Does Being In A State Of Dissociation Feel Like?

Feelings of dissociation can be seen as lying on a continuum : relatively mild dissociation involves feeling mentally ‘hazy’,’foggy’ ‘ numb’ and somehow ‘not fully present’ nor fully engaged with reality ; at the other end of the continuum, dissociation can involve complete loss of conscious memory of a highly traumatizing event / series of events / periods of one’s life (I describe my own experiences of dissociation in the article linked to above).

Depersonalization And Derealization :

Two important types of dissociation are :
a) DEPERSONALIZATION : this state involves cutting off from one’s own thoughts and feelings so that they do not feel like one’s own but those of somebody else. Individuals in this state can feel like an ‘observer of themselves’, as if they were watching themselves on a film screen.

b) DEREALIZATION : as the word implies, this refers to a feeling of ‘unreality’ – as if what is going on around one is unreal, surreal or dreamlike even when it is, objectively, ordinary and quotidian.

Overcoming Feelings Of Dissociation :

According to Dr Harold Kushner, author of Healing Dissociation, in order to overcome feelings of dissociation / dissociative disorders it is necessary to :

– gradually, as part of a therapeutic process, to come to terms with, and accept, the reality of one’s traumatic childhood experiences (as opposed to being in denial about this, repressing it or suppressing it)

– firmly recognize the traumatic experiences are now over and in the past

– firmly recognize that because the traumatic experiences are over and in the past, how one feels, behaves, thinks and acts no longer has to be constricted by these experiences – one is free to start making fresh choices and take on a new, more positive approach to life

– come to an acceptance that injustice, pain and suffering are inevitable parts of life and that what is of greatest importance is how one responds adapts to this inescapable fact.

– find meaning in one’s experiences of suffering, such as how it has developed one as a person and how it can lead to posttraumatic growth.

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

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