Category Archives: Ptsd/cptsd Articles

Vital Environmental Factors That Can Prevent Recovery From PTSD And BPD

 

borderline personality disorder environmental factors

If, as a result of childhood trauma, we have developed post traumatic stress disorder (PTSD) or borderline personality disorder (BPD) our post-traumatic environment can have an extremely strong impact upon our chances of recovery. I list some particularly important factors below :

  • LACK OF SUPPORT FROM FRIENDS, FAMILY AND THE WIDER COMMUNITY / SOCIETY

If we are not provided with such support, but, instead, are shunned and ignored, it is highly likely that our feelings of worthlessness, vulnerability and isolation will be intensified.

Support needs to be non-judgmental, empathic and validating both of our emotional pain and also of our interpretation of how our adverse experiences have affected us.

Also, those providing the support need to be ’emotionally literate’ (i.e. able and willing to discuss feelings and emotions in a compassionate and understanding manner)

  • NOT BEING BELIEVED

Obviously, if people we talk to about our traumatic experiences don’t believe what we are saying or believe we are exaggerating the seriousness of what happened to us (or the seriousness of the effect it has had upon us) our psychological condition is likely to be severely aggravated : our lack of self-esteem, sense of despair, sense of worthlessness, sense of unlovability, feelings of isolation and any feelings of anger, bitterness and resentment we may have are all likely to be severely intensified.

  •  SECONDARY VICTIMIZATION

We need to avoid those who would cause us secondary victimization. Secondary victimization occurs when those who ought to be helping us instead harm us further. Indeed, the example of not being believed (see above) is one such form of secondary victimization.

Other examples of secondary victimization include :

having a doctor who minimizes / trivializes the seriousness of what has occurred to us and its effects

– being stigmatized by society for having developed a psychiatric condition

– being shunned and ostracized by friends / family due to our condition

– being made to feel ashamed in connection with what has happened to us and its effects

– having the vulnerable nature we have developed as a result of our mental condition exploited by an intimate partner (the risk of this is especially high as those who have suffered significant abuse in their early lives are frequently (on an unconscious level) driven to seek out intimate partners who are likely to abuse them further (this is sometimes referred to as a repetition compulsion).

Above eBook now available from Amazon for immediate download. Click here.

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

 

 

 

Do You Have PTSD?

do you have ptsd/

Those of us who experienced high levels of stress as children are at increased risk of developing PTSD, sometimes referred to as complex post traumatic stress disorder (CPTSD), as adults.

Whilst it is imperative that a diagnosis for PTSD does NOT derive from self-diagnosis but, instead, comes from a relevantly qualified professional (such as a psychiatrist), the symptoms I list below can give an idea of whether or not one may be suffering from it :

These symptoms can be split up into three main categories as follows below:

1) Symptoms related to avoidance behaviour

2) Symptoms related to re-living/ re-experiencing the traumatic events

3) Symptoms related to a person’s biology/physiology/level of physical arousal.

Let’s look at each of these three specific categories of possible PTSD symptoms in turn:

1) Symptoms related to avoidance behaviour :

– avoidance of anything that triggers memories of the traumatic experiences, including people, events, and places

– avoiding people connected to the trauma, or avoiding people in general

– avoidance of talking about one’s traumatic experiences

– avoidance of intimacy (both physical and emotional)

2) Symptoms related re-living/ re-experiencing the traumatic events :

– nightmares

– distressing, intrusive, unwanted thoughts

– flashbacks

– obsessive and uncontrollable thinking about the trauma one has experienced, perhaps to the point that it is hard to think about, or concentrate on, anything else

– constant sense of fear, vulnerability, being under threat and of being in extreme imminent danger

– transient and spontaneous psychotic symptoms (egvisual hallucinations -such as ‘seeing’ past traumatic events happen again, or auditory hallucinations – such as ‘hearing’ sounds or voices connected to the original trauma

3) Symptoms relating to a person’s biology/physiology/level of physical arousal.

– hypervigilance (feeling ‘keyed up’, tense and constantly on guard)

– hyperventilation (rapid, shallow breathing)

– sweating

– shaking/trembling

– extreme irritability

– proneness to outbursts of rage that feel out of control and surface unpredictably

– getting into physical fights, especially if using alcohol to numb feelings of distress/fear

– an over-sensitive startle response

– feeling constantly ‘jittery’ and ‘on-edge’

– inability to relax

– insomnia/frequent waking/unrefreshing sleep

Miscellaneous Other Possible Symptoms:

– despair; feeling life is empty and meaningless; feeling numb and ‘dead inside’; anhedonia (inability to feel pleasure); inability to trust others; loss of motivation; loss of interest in previous hobbies/pursuits; loss of interest in sex; cynical and deeply pessimistic outlook; self-neglect; self-harm; thoughts of suicide/suicide attempts; extreme and chronic fatigue; agoraphobia and phobias related to the original trauma.

(NB : Whilst the above list of symptoms is extensive, it is not exhaustive).

Recommended link:

For more detailed help and advice regarding this serious condition, click here : Advice from MIND on PTSD.

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

Horowitz’s Information Processing Theory, Flashbacks And Nightmares

Information processing theory

According to the psychological researcher Horowitz, some symptoms of post traumatic stress disorder (PTSD) can be understood more clearly with reference to what he termed Information Processing Theory.

What Is Information Processing Theory And How Does It Relate To Post Traumatic Stress Disorder?

Horowitz suggests that if we undergo a very traumatic experience, such as significant and chronic childhood trauma, we develop a powerful unconscious drive to ‘make sense of it’, ‘work through it’ and mentally process it.

In relation to this, Horowitz proposes that we all have an internal mental model of how the world works (mental models are sometimes referred to by psychologists as schemas).

However, when we undergo severe trauma, the experience does not ‘fit’ this internal mental model/schema. This causes us stress and we are unconsciously driven to reconstruct our mental model/schema so that the traumatic experience CAN be fitted into it (ie. mentally integrated).

This process is complex and takes time – especially if the traumatic experience was severe and long – lasting.

Horowitz states that this processing of the traumatic event involves repeatedly, mentally replaying it; this can lead to :

intrusive memories

nightmares

flashbacks

But :

The intensity and frequency of these intrusive memories, nightmares and flashbacks can attain a critical point at which they are so distressing, mentally overwhelming and emotionally exhausting that, to avoid them, we become psychologically numb.

Horowitz suggests that the processing of the traumatic experience can involve vascillating between these two states until a final state of mental equilibrium is reached at which point the trauma has been successfully processed.

Problems arise, of course, if we become ‘stuck’ in the ‘vascillation phase’ and, in such a situation, professional therapy may be considered. Research suggests that two effective therapies are dialectical behavioral therapy and mindfulness meditation.

eBook:

Above eBook now available on Amazon. Click here for further details.

 

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

 

 

Developmental Trauma Disorder

childhood_trauma

Researchers van der Kolk et al. have proposed that children who are significantly psychologically and emotionally disturbed as a result of their traumatic upbringings be diagnosed with Developmental Trauma Disorder  (although the proposed diagnosis is not yet included in the DSM or, to give it its full title, The Diagnostic and Statistical Manual of Mental Illness).

The researchers who propose the diagnosis argue that the various diagnoses disturbed children currently receive, such as Oppositional Defiant Disorder, Reactive Attachment Disorder and anxiety, are too narrow, restricted and limiting and, furthermore, do not recognize or acknowledge the ‘big picture’ (i.e. the full extent and range of the damage that has been done to child’s functioning).

childhood trauma disorder

They also argue that limited and narrow diagnoses like Oppositional Defiant Disorder lead to clinicians focusing too much on correcting the behaviour at the expense of identifying and understanding the underlying cause of it (i.e. the trauma that the child has suffered).

Van der Kolk, in his book The Body Keeps Score (see below) describes Developmental Trauma Disorder as having three prime features; these are as follows:

1) A pervasive pattern of dysregulation:

According to van der Kolk, this may entail dramatic mood swings, outbursts of extreme temper, panic, detachment, flatness, dissociation and the inability to self-sooth

2) Impaired ability to pay attention and concentrate (due to agitation and hyperarousal)

3) Impaired ability to get along with others and, as van der Kolk puts it, ‘a failure to get along with [ oneself ].’

 

Associated Physical Symptoms:

Van der Kolk also draws our attention to the fact that, because the child suffering from Developmental Trauma Disorder is constantly in a state of high stress (and, subsequently, is likely to have an abnormally high level of stress hormones – such as cortisol – coursing through his/her veins) s/he will also be susceptible to various physical symptoms; these include:

– headaches

– sleep disruption

– stomach upsets

– oversensitivity to sounds and tactile experiences

– problems with fine motion movements

Extreme Need To Relieve Stress:

The young person with Developmental Trauma Disorder, in an attempt to alleviate the severe stress s/he perpetually feels, may, also, according to van der Kolk:

– self-harm (e.g. cutting self with razor)

– masturbate excessively

– rock to and fro whilst sitting down

Neediness And Self-Hatred:

If the child has been rejected and/or largely ignored by his/her parents/caregivers this may lead him/her to become extremely ‘needy’ and ‘clingy.’

Also, s/he is likely to have internalized his/her parents’/caregivers’ negative view of him/her and therefore develop feelings of self-hatred, of being intrinsically unlovable, and of being worthless and of no value to others.

Resources:

To purchase van der Kolk’s book/eBook, click on image below:

 

To purchase Childhood Trauma And Its Link To Borderline Personality Disorder click image below:

 

BPD

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

 

What Is ‘Trauma Informed’ Therapy?

childhood_trauma

Many individuals who seek treatment and therapy for problems such as alcoholism, drug addiction, clinical depression, severe anxiety, anger management issues and eating disorders (or a combination of such problems) often have an underlying problem: they have experienced severe and protracted childhood trauma.

In other words, it is their experience of trauma that has significantly contributed to the existence of such problem as those mentioned above.

Such people are increasingly being said by psychiatric professionals to be suffering from complex posttraumatic stress disorder (CPTSD). However, this diagnosis has yet to be included in the DSM (Diagnostic And Statistical Manual Of Mental Disorders).

In CPTSD sufferers, the problems that go with it such as those listed above (alcoholism, drug addiction etc) are often referred to secondary problems/conditions/diagnoses whilst the the core CPTSD is referred to as the primary problem/condition/diagnosis).

Sadly, all too frequently, the diagnosis of CPTSD is missed due to practitioners focusing exclusively on the secondary problems without taking the time to discover the underlying and primary problem, namely the effects of childhood trauma manifesting as CPTSD.

Unfortunately, it is much harder to treat the secondary problems if their link to the primary problem (the experience of childhood trauma / CPTSD) is not identified. Indeed, in my own case, for years my secondary symptoms were treated without success due in large part due to the fact none of my doctors or psychiatrists I saw (and, believe me, these were numerous) thought to ask me about my childhood.

TRAUMA INFORMED THERAPY:

Trauma informed therapy is treatment which identifies the link between the primary problem (the effects if childhood trauma) and the secondary problems (alcoholism, drug addiction etc…).

Indeed, according to the principles of trauma informed therapy, if the psychiatric professional fails to make this connection and tailor the treatment accordingly, it is much less likely the patient will be able to permanently conquer his/her secondary problems, let alone the primary problem (as it remains unidentified as a causal factor and as a major problem in its own right).

Resource:


 

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

 

PTSD Sufferers More Likely To Be Obese.

childhood_trauma

Currently, in the UK, about 65% of men and 58% of women are clinically classified as being either overweight or obese. In the USA, the figures are similar : approximately 58% of women are clinically defined as overweight or obese, whilst the corresponding statistic for male Americans is 70%.

A study conducted by Bartoli et al. found that those suffering from post-traumatic stress disorder (PTSD) were about one and a half times more likely to suffer from obesity than were the controls (participants who did not have PTSD) who took part in the research.

So, if, as adults, we suffer from PTSD as a result of our highly disturbed childhoods we are at increased risk of also becoming obese compared with the average individual (all else being equal).

Why should this be the case? Well, one explanation is that the depressive symptoms that accompany PTSD can lead to the so-called ‘comfort eating’ phenomenon as well as much decreased levels of physical activity due to lack of motivation (in my own case, I was frequently utterly incapable of getting out of bed); therefore, we are likely to consume more calories each day than we burn up.

Above : The Cookie Monster : Me love cookie…

Also, the severe anxiety that accompanies PTSD can lead to various different compulsions, one of which being compulsive eating.

Furthermore, many PTSD sufferers experience severe insomnia and intense, terrifying nightmares (as I know from my own bitter experiences). This can lead (as it did in my own case) to getting out of bed frequently in the night for the purpose of consuming self-medicating (i.e. mentally soothing), nocturnal feasts (especially carbohydrates, which help many to feel slightly calmer, temporarily).

A Psychodynamic Theory Of Why Some Individuals May Become Obese:

Psychodynamic theory suggests that if we suffered severe childhood trauma and frequently felt threatened, intimidated and fearful due to the treatment we received by those who were supposed to be caring for us and protecting us then we might be unconsciously driven to become very large (i.e. obese) as it gives us the feeling that we are less vulnerable and more able to defend ourselves. This theory is, however, difficult to prove (although it does not logically follow, of course, that it is necessarily incorrect; indeed, it seems to make intuitive sense).

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

Hartman’s 12 Stages Of Post-Traumatic Stress Disorder (PTSD)


12_steps_of_ptsd

 

 

I have written extensively on this site about how severe and chronic childhood trauma can lead to the development of post-traumatic stress disorder (PTSD) in adulthood (see the PTSD section on the main menu). This is also sometimes referred to as complex post-traumatic stress syndrome (CPTSD). In order to understand the theoretical difference between PTSD and CPTSD, click here.

In connection with PTSD, the writer and researcher, Hartman, has proposed a model of how the terrible mental illness can progress over time, involving the afflicted individual going through 12 painful steps.

This theoretical model is shown in diagrammatic form below:

 

The 12 Steps Of Post-Traumatic Stress Disorder (PTSD):

12_steps_of_PTSD_diagram

 

PTSD Treatment:

The NHS provides excellent information about treatment options for PTSD and this can be found by clicking here.

Information For Therapists:

A downloadable course that trains practitioners to treat PTSD  (using the Rewind Technique) can be found by clicking here.

EBook:

brain damage caused by childhood trauma

 

Above eBook now available for instant download from Amazon – click here for further details.

 

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

Feelings Of Alienation And Disconnectedness Linked To Childhood Trauma

alienation and trauma

If we have suffered severe and protracted childhood trauma, especially if it has resulted in post traumatic stress disorder (PTSD), we may find, as adults, that we feel alienated and emotionally disconnected from other people – we may find we have lost our fellow-feeling, our empathy, concern and compassion for others, as well as our ability to relate to them in any meaningful way.

This can make us feel that we have become cold and callous, leading to feelings of self-hatred, self-disgust and profound loneliness and isolation.

As a result, we may become reclusive and pathologically avoidant of social interaction.

Why might this happen?

A main theory is that it is due to unconscious memories of trauma. In effect, we may have become psychologically trapped at the time of our trauma, feeling and reacting as if the traumatic situation we were once in is going on in the present.

Therefore, we continue to feel extremely unsafe and perpetually under threat, distortedly perceive situations and people, and behave accordingly (e.g. constant hypervigilance, fear and suspicion of others and pre-emptive hostility).

The problem is an inabity to distinguish between our past world (in which we felt in constant danger) and our present (relatively safe) world. So we are, essentially, trapped in a kind of psychological time-warp.

Because of this, when events occur that remind us of our original trauma (even if such reminders are very subtle and operating on an unconscious level, we are in danger of suffering from flashbacks).

We are likely, too, due to our fear and suspicion of others, frequently to get into conflicts with people when we are forced to temporarily, socially integrate (psychologists sometimes refer to this phenomenon as having a disorganized attachment style).

Our sense of isolation and alienation may be further accentuated by our knowledge that others are incapable of understanding the depth of our former, and current, suffering; mere language cannot convey its intensity. As a result, these others may treat us with intolerance, disdain and in an inappropriately morally judgmental manner. This can lead to deep feelings of frustration, resentment, anger and rage.

Useful Link :

Advice on dealing with PTSD from the Royal College of Psychiatrists – click here.

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