Category Archives: Ptsd/cptsd Articles

What Is ‘The Trauma Model’ Of Mental Disorders?

trauma model of mental disorders

The Trauma Model Of Mental Disorders :

According to the trauma model of mental disorders (also sometimes referred to as the trauma model of psychopathology), many professionals involved with the treatment of psychiatric disorders (such as psychiatrists) have been excessively preoccupied by the medical model of mental disorders (the medical model stresses the importance of physical factors that may underlie mental disorders such as a person’s genes and/or neurochemistry ; in line with this hypothesis, those who adhere to the medical model of mental disorders focus primarily on psychoactive medication – such as anti-depressants and major tranquilizers – or physical therapies – such as electro-convulsive therapy – as primary treatment choices) at the expense of taking into account the individual’s history of traumatic experience, especially severe and protracted trauma in early childhood.

According to the trauma model, too, significant problems relating to bonding and to the building a healthy, loving, nurturing, dependable relationship between the child and primary caregiver (most frequently the mother) are particularly predictive of such a child developing serious mental health difficulties in later life. However, childhood trauma leading to psychiatric problems in later can also take the form of physical, sexual and emotional abuse (the potentially catastrophic effects of significant and protracted emotional abuse have only recently started to be fully understood).

Significant Psychologists / Psychiatrists Who Have Adopted A Trauma Model Perspective Of Mental Disorders (Past And Present) :

Past psychologists / psychiatrists who have adhered to the trauma model of mental disorders include Arieti, Freud, Lidz, Bowlby, R.D. Laing and Colin Ross (see below for further, brief details) :

 

  • Arieti (1914-1981) advocated the treatment of those suffering from schizophrenia using psychotherapy
  • Freud’s (1856-1939) enormously influential work can be seen as representing the start of the academic discipline of child psychology and compelled society to acknowledge the profound relationship between a person’s childhood experiences and his/her mental health in later life.
  • Lidz (1910-2001) emphasized the severe psychological damage parents who ‘constantly undermine the child’s conception of himself’ do to their off-spring; he considered such treatment of the child by the parents as so serious because such psychological abuse can constitute a sustained and catastrophic attack on his (the child’s) ‘inner self’, which, in turn, so Lintz proposed, could lead to the disintegration of the child’s personality and the subsequent development of schizophrenia.
  • Bowlby (1907-1990) theorized that when the primary carer fails to healthily, emotionally bond (or, in Bowlby’s terminology attach‘) with the baby / young child the latter is put at high risk of developing mental health problems in later life.
  • R.D. Laing (1927-1989) proposed that schizophrenia is the result of the individual who develops it having grown up in a severely dysfunctional family.
  • Colin Ross (contemporary  psychiatrist) the most recent, significant proponent of the trauma model, emphasizes the harm done by abusive parenting by drawing attention to the fact the perpetrators of the abuse are the very people to whom the ‘child had to attach for survival.’ And he also states : ‘the basic conflict, the deepest pain, and the deepest source of symptoms is the fact that mom and dad’s behavior hurts, did not fit together, and did not make sense.’

eBook :

 

effects of childhood trauma ebook

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David Hosier BSc ; MSc; PGDE(FAHE)

 

 

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How Trauma Can Seriously Adversely Affect The Nervous System

how trauma can adversely affect the nervous system

Peter Levine, an expert on the effects of trauma on the body, states that as a result of severe and prolonged trauma, the functioning of our nervous systems can become seriously disrupted. More specifically, traumatized individuals can suffer from dysregulation of the autonomic nervous system.

What Is The Autonomic Nervous System?

The autonomic nervous system operates below the level of conscious awareness (i.e. it functions involuntarily) and consists of two sub-systems : the sympathetic nervous system and the parasympathetic nervous system.

What Are The Sympathetic And Parasympathetic Sub-Systems?

The Sympathetic Sub-System :

This sub-system of the autonomic nervous system is ‘switched on’ when we are faced with threat/danger/emergencies in order to mobilize extra energy that the body may require for fight/flight.

The Parasympathetic Sub-System :

This sub-system of the autonomic nervous system is ‘switched on’ when we are in a state of relaxation.

 

How Does The Autonomic Nervous System Become Dysregulated And What Effect Does Such Dysregulation Have On The Individual?

Trauma can cause the autonomic nervous system to become dysregulated in two main ways :

  1. The sympathetic sub-system can become ‘stuck’ / ‘locked on’
  2. The parasympathetic sub-system can become ‘stuck’ / ‘locked on’

A traumatized individual, whose traumatic experiences remain unprocessed, may become ‘stuck’ / ‘locked into’ one of the above two extremes or may oscillate back and forth between the them ; their is a loss of homeostasis (i.e. healthy balance between the two systems). In the absence of effective therapy, such dysregulation can persist for months, or, as in my own case, for years. I briefly outline the effects of these two types of dysregulation of the autonomic nervous system below :

trauma adverse effect on nervous system

Above : Effects of the activation of each of the two sub-systems on heart rate. Other effects of the two sub-systems shown below :

 

EFFECTS OF THE SYMPATHETIC SUB-SYSTEM BEING ‘LOCKED ON’ :

 

  • increased heart rate
  • fear
  • anxiety
  • panic
  • hypervigilance
  • insomnia
  • mania
  • anger / rage / hostility
  • chronic pain
  • emotional flooding
  • digestion inhibited
  • adrenal glands secrete epinephrine and norepinephrine
  • bronchioles are dilated

EFFECTS OF THE PARASYMPATHETIC SUB-SYSTEM BEING ‘LOCKED ON’ :

NB. The normal function of the parasympathetic sub-system is to facilitate rest and recovery after the sympathetic sub-system has been activated and the danger has passed – however, severe trauma can lead to the body ‘shutting down’ too much leading to symptoms such as those shown above.

THERAPY :

A therapy that has been specifically designed for individuals who have experienced trauma leading to dysregulation of the autonomic nervous system (as described above) is called SOMATIC EXPERIENCING THERAPY.

 

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

 

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3 Ways To Classify Trauma

3 ways to classify trauma

Terr (1991) in an article published in the American Journal Of Psychiatry, proposes three classifications of trauma. These are as follows :

Terr’s 3 Classifications Of Trauma :

  1. ACUTE TRAUMA (Type I Trauma)
  2. COMPLEX TRAUMA (Type II Trauma)
  3. CROSSOVER TRAUMA (Type III Trauma)

Below, I briefly define and provide examples of these three classifications of trauma :

  1. ACUTE TRAUMA (Type I Trauma): this results from an individual being exposed to a single, overwhelming traumatic event such as the death of a parent during one’s childhood. According to Terr, chief characteristics of acute trauma include detailed memories relating to the traumatic event, an exaggerated startle response, hypervigilance, emotional overreactions and misperceptions.
  2. COMPLEX TRAUMA (Type II Trauma): this results from protracted exposure to traumatizing situations and events such as years of emotional abuse by one’s parents during childhood. According to Terr, chief characteristics of complex trauma include dissociation, psychological numbing, rage, social withdrawal, and a sense of a foreshortened future.
  3. CROSSOVER TRAUMA (Type III Trauma): like acute trauma (see above), crossover trauma also results from a single, overwhelming event ; however, in the case of crossover trauma, the traumatic event is so devastating that the adverse psychological effects of the trauma are long-term. An example of this type of trauma is being involved in a car crash in which other family members are killed. Terr states that chief characteristics of crossover trauma include extended mourning/depression, chronic pain,  sleep disturbances (such as insomnia and nightmares), difficulties concentrating and irritability.

types of trauma

The above forms of trauma are types of DIRECT traumatic experience. However, it is also possible to experience trauma INDIRECTLY. The indirect experience of trauma is also sometimes referred to as SECONDARY TRAUMA or VICARIOUS TRAUMA :

What Is Meant By Secondary / Vicarious Trauma, Who Does It Affect And What Are The Symptoms?

This can affect professionals who work with traumatized individuals and refers to the adverse psychological consequences that might be suffered by such professionals as a result of such work – this is also sometimes referred to as compassion fatigue; symptoms of compassion fatigue include exhaustion, emotional numbness, withdrawal and poor concentration (all of which may impair work performance). Professionals who work with traumatized individuals and who have little support or have suffered significant trauma in their own lives are especially at risk of developing secondary trauma / vicarious trauma / compassion fatigue.

 

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

 

 

 

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Controlling Emotions : The Emotional Regulation System

controlling emotions

We have seen from other articles that I have published on this site that if, as children, we experienced, significant and protracted trauma we are at increased risk of developing various psychological difficulties as adults, including an increased risk of developing borderline personality disorder (BPD) and complex posttraumatic  stress disorder.

One of the hallmarks of BPD, as we have also seen from other articles, is that the sufferer of the condition finds it very difficult indeed to control intense and volatile emotions. In effect, the emotional regulation system of individuals diagnosed with BPD is out of kilter and dysfunctional.

What Is The Emotional Regulation System?

The emotional regulation system is fundamentally comprised of three interacting parts of the brain ; these are as follows :

  1. THE THREAT SYSTEM (detects and reacts to threats)
  2. THE DRIVE SYSTEM (motivates us to identify and seek resources)
  3. THE SOOTHING SYSTEM  (helps balance the two systems above and engenders in us a sense of well-being, satisfaction and contentment)

Each of these three systems is neither good nor bad per seas long as they are in balance and interacting in a healthy and functional way. However, each system is vulnerable to becoming dysfunctional (as occurs in the case of those suffering from BPD, for example). TO READ ABOUT WAYS IN WHICH THESE SYSTEMS CAN BECOME DYSFUNCTIONAL AND THERAPIES THAT CAN HELP, YOU MAY LIKE TO READ ANOTHER OF MY POSTS ON THE EMOTIONAL REGULATION SYSTEM BY CLICKING HERE.

how to control emotions

THE ROLE OF NEUROPLASTICITY IN THE DEVELOPMENT OF THE EMOTIONAL REGULATION SYSTEM :

The way in which the brain is shaped and develops depends, to a large degree, upon our early life experiences ; this is because of a quality of the brain known as neuroplasticity which you can read about by clicking here.

Because of the brain’s neuroplasticity, if, when we are young, we are constantly exposed to fear and danger because, for example, of the abusive treatment we receive from a parent or primary care giver, the THREAT SYSTEM is at very high risk of being constantly over-activated in a way that leads it to operate in a dysfunctional manner ; this dysfunction takes the form of the fight/flight/freeze; response becoming hypersensitive, resulting in the affected individual developing grave difficulties keeping related emotions (such as anger, fear and anxiety) in check. Without appropriate therapy, such dysfunction may last well into adulthood or even for an entire lifetime.

On the other hand, if, when we are young, we experience consistent and secure love, care and emotional warmth from our parents / primary caregivers, our SOOTHING SYSTEM is ‘nourished’ and becomes optimally (or close to optimally) developed resulting in us becoming more able to cope with life’s inevitable stressors, less vulnerable to feelings of anxiety and fear, and more able to calm ourselves down and ‘self-sooth’ than those who had who were brought up in an environment in which they were constantly exposed to fear and danger.

However, even if we have had a traumatic early life and have problems regulating our emotions, there are various, simple things we can do to us control our feelings (see below).

 

  • AVOID REACTING IMMEDIATELY / IMPULSIVELY : For example, if someone triggers our anger, rather than making a reflexive response (such as saying something we’ll deeply regret later) it is better to wait until the rage has subsided – this may involve calming physiological symptoms like fast heart rate and tense muscles by using relaxation exercises such as deep breathing and visualization ; we may, therefore, need to remove ourselves for a while (if possible) from the presence of whoever it may be that has upset us.
  • MAKE POSITIVE ALTERATIONS TO THE SITUATION GIVING RISE TO OUR NEGATIVE EMOTIONS (although this will not always be feasible, of course)
  • ALTER FOCUS OF ATTENTION (e.g. undertaking a distracting activity)
  • ALTER WAY IN WHICH WE ARE THINKING ABOUT THE SITUATION : A therapy that can help with this is COGNITIVE BEHAVIORAL THERAPY (CBT).

USING NEUROPLASTICITY TO OUR ADVANTAGE :

Although the brain’s quality of neuroplasticity can work against us if we experience a traumatic early life, we can also take advantage of it later in life to help reverse any damage that was done to the development of our young and vulnerable brains. In order to learn more about how this may be possible, you may wish read my article MENDING THE MIND : SELF-DIRECTED NEUROPLASTICITY.

DIALECTICAL BEHAVIORAL THERAPY (DBT) :

Dialectical Behavior Therapy (DBT) is a therapy that was designed primarily for those who are suffering from borderline personality disorder (see above). A particularly useful skill taught within this therapy is called DISTRESS TOLERANCE which can be very helpful for those experiencing emotional distress due to intense, negative feelings.

COMPASSION FOCUSED THERAPY (CFT) :

Compassion Focused Therapy (CFT) can also be an effective therapy for those suffering from emotional dysregulation.

 

RESOURCE :

CONTROL YOUR EMOTIONS – SELF-HYPNOSIS DOWNLOAD. Click HERE for

further information.

 

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childhood trauma damages brain ebook

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

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Failure Of Information Processing At Core Of PTSD

failure of information processing at core of PTSD

Research suggests (for examples, see below) that traumatic memories are not stored in the normal way (this theory was initially proposed by the psychologist and philosopher Pierre Janet) but non-linguistically as feelings / emotions and sensations (e.g. images, sounds, smells). This means that they cannot be properly articulated nor integrated into the individual’s personal narrative (story) in a meaningful way. This is why people frequently find trauma  extremely difficult to talk about.

Also, traumatic memories are stored in a fragmentary way (as opposed to in a way that allows them to form a coherent whole) and remain unmodified over time. 

Another feature of traumatic memories, according to Pierre Janet, is that they frequently cannot be remembered at will but are state-dependent (i.e. can only be recalled – in the form of flashbacks, for example – when the individual is in a similar state of consciousness to the one s/he was experiencing at the time of the trauma).

So, as we can see from the above, traumatic memories are not processed in the normal way and it is this lack of normal information processing that lies at the core of post traumatic stress disorder (PTSD). One main theory related to this is that they (i.e. the traumatic memories) are prevented from being properly processed by the EXTREME LEVEL OF AROUSAL the individual feels whilst experiencing the trauma.

Supporting Evidence :

Research (Kolk and Ducey) into flashbacks (a central feature of PTSD) using neuroimaging has revealed that, when these flashbacks occur :

  • there is increased activity in areas of the right hemisphere which are involved with emotional processing
  • there is increased activity in the right visual cortex

These two findings support the theory that traumatic memories (in this case, flashbacks) are processed / stored in the form of emotions and sensations (in the case of the above research visual sensations).

Furthermore, Rauch et al (1995) conducted research showing that individuals experiencing flashbacks simultaneously experienced a decrease in activity in the part of the brain, located in the left hemisphere, called Broca’s area (a brain region involved with language) ; this finding supports the theory that traumatic memories are not stored in linguistic form.

Implications For Therapy :

The above supports the notion that effective therapy for PTSD should involve the individual afflicted by it being helped by the therapist to properly process traumatic memories so that they may be safely integrated into the person’s personal narrative.

RESOURCE :

NHS Advice On Treatments For PTSD – click here.

eBooks :

emotional abuse book   childhood trauma damages brain ebook

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

 

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PTSD And ‘A Sense Of A Foreshortened Future.’

sense of foreshortened future

The DSM 4 (Diagnostic And Statistical Manual Of Mental Illness, 4th Edition) lists one of the symptoms of posttraumatic stress disorder (PTSD) as a ‘sense of a foreshortened future.‘ It is this specific symptom that I wish to concentrate upon in this article.

The psychologists Ratcliffe et al. (2014) suggested, based on their research, that this involved several elements of altered feelings, perceptions and beliefs, some of which I consider (although not exclusively) below.

NEGATIVE VIEW OF THE FUTURE :

An individual suffering from a ‘sense of a foreshortened future’ may have an extremely negative and pessimistic set of beliefs about the future ; these may include :

  • I will die young / soon / prematurely / imminently
  • I will never have a rewarding and successful career
  • I will never find a partner / have a family.

In other words, the individual who is experiencing a ‘sense of a foreshortened future‘ regards the future as bleak, empty a without meaning. 

  • It follows.of course, that the person’s feelings and emotions in relation to the future will also be negative – rather than being hopeful about it, s/he may fear and dread it.

 

ALTERATIONS IN PERCEPTION OF TIME :

Also, such a person may experience severe alterations in his/her perception of how time operates, including :

  • changes in perception of the passage of time and feeling unable to ‘move forward into the future’
  • changes in how PAST, PRESENT and FUTURE are experienced
  • changes in how the relationship between the PAST, PRESENT and FUTURE are experienced
  • the experience of flashbacks (in which the past is experienced as ‘happening now.’
  • a change in perception of the overall structure of experience

FEELING THAT LIFE IS OVER :

Freeman (2000) coined the term ‘narrative foreclosure’ which refers to a strong sense that one’s ‘life story has effectively ended.’ and that there is no further purpose to it, no further meaning that can be derived from it and no possibility that it will contain deep relationships with others or achievement of any kind. The individual affected in this way may also cease to feel s/he cares about anything or can be committed to any cause or project in the future.

In short, a sense of nihilism may prevail.

LOSS OF TRUST :

Also relevant to an individual developing a sense of a foreshortened future is that it is likely to be intertwined with a general loss of trust which may manifest itself through beliefs such as :

  • others cannot be trusted and pose a threat to me
  • the world is a dangerous place that I should interact with as little as possible

THE ‘SHATTERING’ OF ONE’S EXPERIENCE OF WORLD AND OF OTHER PEOPLE :

Greening (1990) puts forward the view that the individual’s ‘relationship with existence itself becomes shattered’. For example, the experience of trauma may leave the individual with a fundamentally altered views about the safety of the world (Herman, 1992) and his/her place within it ; the world seems meaningless, other people undependable and dangerous, and the self of no value.

LOSS OF PREDICTABILITY :

The individual, too, may come to see life as essentially random and unpredictable, feel that s/he can exercise no control over it, and that, therefore, there is no prospect of life unfolding in a dependable, coherent, cohesively structured way – s/he may feel s/he is no longer travelling through life on a reasonably straight set of tracks, but, rather, on tracks that twist and turn at random and from which one may be completely derailed at any time without warning. Indeed, Stolorow (2007) refers to how the individual may lose his/her sense of ‘safety’ and and of any meaningful ‘continuity’ in life.

Such a person may feel that ‘anything can happen at any time’ and that these things will, inevitably, be very bad. Because of this, s/he may feel perpetually trepidatious and vulnerable – alone in a an alien, sinister, hostile and frightening world ; a world in which there is no structure to hold one in place, no coherence and nowhere one can feel safe or a sense of belonging ; it can seem as if the foundations of one’s life are now built on sand rather than on solid ground and, as such, one’s life is liable to collapse at any time and without warning.

foreshortened sense of future

AN UNSHAKABLE SENSE OF IMMINENT DEATH :

Any future goals the individual had may now seem meaningless and pointless – even absurd ; linked to this can be a feeling that one is no longer moving forward in life and that there is no worthwhile direction in which life can go – any direction feels equally futile and devoid of meaning.

And, because the individual now sees only emptiness lying ahead of him/her in life this can translate into a perception that future time itself has somehow dissolved and has been replaced by a kind of ‘temporal vacuum’. This, in turn, leads to a feeling that nothing of meaningful substance lies between the present and death. Future time is anticipated as a void and in this sense ceases to be real – therefore, DEATH FEELS ABIDINGLY AND PERPETUALLY IMMINENT ; no buffer of a meaningful, substantive, solid, structured, ‘block of time’ is perceived to lie between NOW and DEATH’S OCCURRENCE ; instead, just a nebulous, indistinct haze of ‘virtual nothingness.’ (This is a difficult concept to relate to, or, even, comprehend  if one has not experienced such an unhappy state of being – or, perhaps more accurately put, non-being – oneself).

To all intents and purposes, therefore, to an individual suffering from a ‘sense of a foreshortened future, it feels as if one’s life is already over. Indeed, Herman (1992) noted that it was not unusual for those who had been affected by the experience of severe trauma reported feeling as if they were dead or as if part of them had died.

RECOVERY :

The psychologist and expert on trauma and its effects, Herman (referred to above), suggests that there are three main stages involved in recovering from PTSD – to read my article on these three stages, click HERE.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Hypervigilance And Complex Posttraumatic Stress Disorder (Complex PTSD).

hypervigilance and complex posttraumatic stress disorder

If we have grown up in a chronically stressful and traumatic environment in which we often experienced anxiety, trepidation, stress and fear we are at high risk of developing a fundamental, core belief (on a conscious and/or unconscious level) that the world is a dangerous place and that we need to be constantly on ‘red-alert’ and ‘on-guard’ in order to protect ourselves from sustaining further psychological injury.

In other words, we GENERALIZE our perception that our childhood environment was a dangerous place (because of the emotional and/or physical harm done to us there) into a perception that everywhere else/the world in general poses an on-going threat to us.

As a result, we may develop a symptom known as HYPERVIGILANCE.

HYPERVIGILANCE is a main symptom of complex PTSD (complex PTSD is a serious psychological disorder strongly associated with childhood trauma which you can read more about by reading my post entitled : Childhood Trauma : Complex Posttraumatic Stress Disorder (With Questionnaire).

hypervigilance

HOW DOES HYPERVIGILANCE MANIFEST ITSELF?

Individuals suffering from hypervigilance may :

  • constantly analyze the behavior (including body language, facial expressions, intonation etc) of those around them in an attempt to determine if they pose a threat (and, frequently, they may perceive a threat to exist when, in reality, it does not)
  • be in a constant state of anxiety, irritation and agitation
  • have an exaggerated startle response to loud, unexpected noises
  • experience excessive concern regarding how they are viewed by others
  • be excessively suspicious of others / expect others to betray them ; this can give rise to paranoid-like states
  • perceive danger everywhere even though this is not objectively justified
  • easily be provoked into aggression (as a means of defending themselves against perceived threats from others ; in other words, such aggressive outbursts are a (primarily unconsciously motivated) DEFENSE MECHANISM.
  • PHYSICAL SYMPTOMS (including elevated heart rate, hyperventilation, trembling and sweating)
  • have false perceptions that others dislike them, are plotting against them or mean them harm
  • see minor set-backs as major disasters (this is a cognitive distortion sometimes referred to as CATASTROPHIZING.
  • frequently experience fear and panic when, objectively speaking, it is not justified
  • experience obsessive worry and rumination that is intrusive and hard to control
  • suffer from sleep problems (including very frequent waking and nightmares)
  • feel constantly exhausted (due to both sleep problems and the sheer debilitating effects of being in a constant state of anxiety)
  • social anxiety / impaired relationships / social isolation

Therapies For The Treatment Of Hypervigilance :

Therapies that may ameliorate symptoms of hypervigilance include :

Some medications, such as beta blockers, may sometimes also be appropriate, but, it is, of course, always necessary to consult a suitably qualified professional before embarking upon such treatment.

 

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David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Types Of Dissociative Amnesia In Complex PTSD

types of dissociative amnesia

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.

dissociative amnesia

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

yoga for complex PTSD

Overcoming Trauma Through Yoga: Reclaiming Your Body

 

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

difference between complex ptsd and bpd

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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