Category Archives: Ptsd/cptsd Articles

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).

 

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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).

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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).

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Copyright 2016 Child Abuse, Trauma and Recovery

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).

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Copyright 2016 Child Abuse, Trauma and Recovery

Why We May Severely Over-react To Minor Stressors.

Over react stress

We have seen from previous articles that I have posted on this site that, if we suffered chronic stress during our childhood, our ability to deal with stress as adults can be drastically diminished, making it difficult to cope with the daily stressors that others may easily be able to take in their stride.

We may, for example, become disproportionately enraged if we temporarily misplace our keys, inadvertently snap a shoe-lace, or are thwarted in our vehicular progress down the street by a succession of obstinately and infuriatingly red traffic lights.

The reason for such overreactions can lie in the fact that our chronically stressful childhoods have disrupted the process in the brain associated with the production of stress hormones.

In particular, levels of the stress hormones adrenaline and cortisol may have become chronically too high.

It follows that, when we experience a minor stressor, too much adrenaline and cortisol are released. Let’s look at the effect that these two stress hormones have upon the body:

1) The Effect Of Adrenaline On The Body:

– causes heart rate to increase

– causes blood pressure to go up

– causes breathing rate to become more rapid (sometimes leading hyperventilation, a distressing reaction associated with panic).

2) The Effect Of Cortisol On The Body:

– transports energy to muscles by diverting it from areas of the body where it is not immediately needed (such as the stomach).

So, the effects of adrenaline and cortisol combined are to prepare the body for ‘fight or flight’, as if we were being threatened by a ravenously hungry tiger (when, in fact, we are just stuck in traffic or have mislaid our keys etc). In such a case, energy builds up in the body which is not dissipated, causing great tension.

 

Why do people overreact?

Above: Over-reacting to minor stressors can be caused by chemical/hormonal inbalances resulting from a chronically stressful childhood.

In order to attempt to free ourselves from this unpleasant feeling of tension, we may try to partly dissipate it by shouting obscenities or pounding our fists against some wholly innocent inanimate object (this is sometimes referred to by psychologists as a displacement activity).

In other words:

We are responding to minor stressors as if they posed severe, even life-threatening, danger. Our brain is preparing us for fight or flight because it has grossly overestimated the risk the minor stressor poses to us. It is ‘fooled’ into making this error due to the disruption of the body’s system that produces adrenalin and cortisol caused by our chronically stressful childhood.

And, following the same logic, when we’re unfortunate enough to experience major stressful events in our adult lives, we may find ourselves going into nuclear meltdown, utterly overwhelmed and unable to cope.

eBook:

brain damage caused by childhood trauma.  depression and anxiety

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

 

MP3/CD

Reduce everyday stress.      Reduce Everyday Stress. Click here for further information.

 

 

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

 

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Copyright 2016 Child Abuse, Trauma and Recovery

Adverse Effects Of Trauma On Memory

Trauma and memory

New memories are stored in the region of the brain known as the hippocampus. However, not all memories that enter the hippocampus are stored by the brain permanently.

Only some are transferred to the cerebral cortex for long-term storage; the rest fade away. The more important the memory, and, in particular, the more intense the emotions connected to the memory are, the more likely it is to be permanently stored. This process in called memory consolidation.

When an event occurs that is very threatening or damaging to us, the stress of this causes stress hormones ADRENALIN and CORTISOL to be released into the brain.

The effect of these stress hormones is to strengthen the memory of this threatening or damaging event.

The stress hormones released into the brain (in particular, the amygdala) also ensure the memory of the negative event becomes strongly associated with the emotions (such as fear and terror) that it originally evoked.

intrusive_memories

So, for example, if we are viciously attacked and maimed by a savage and demented Rottweiler, cortisol and adrenaline will be released into our brain to ensure that the memory is indelibly stored. These same stress hormones will also ensure that the emotions we felt at the time of the attack, such as fear and terror, also become strongly associated with the memory of our unfortunate encounter with the less than friendly canine miscreant.

This way of storing such memories evolved for the survival value it confers on our genes.

Also, when extremely traumatic events occur, the hippocampus can become so excessively flooded by stress hormones such as cortisol and adrenaline that it incurs damage.

This damage can then alter the way that the traumatic event is stored. Because of this the memory may become:

fragmented

‘foggy’ / ‘blurry’

distorted

inaccessible to conscious awareness

Furthermore, the memory of the extremely traumatic event may become highly invasive – especially when the person in possesion of the memory is reminded of the traumatic event (even tangentially) – and constantly break through into consciousness wholly unbidden, re-triggering the release of excessive amounts of stress hormones into the brain ; this can lead to:

flashbacks

nightmares

obsessive rumination about the traumatic event

 

Resources:

For advice about dealing with intrusive memories, click here.

 

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

 

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Childhood Trauma Leading To The Need To ‘Self-Medicate’.

self medication

Until a few years ago I consumed excessive amounts of alcohol (leading to some appalling consequences that I will describe in future posts). Two main reasons for this most ill-advised and, above all, desperate behaviour are both clichés: one: I drank to reduce my social anxiety and, two: I drank to numb my intense and intolerable psychological pain.

The root cause of my social anxiety and psychological pain derived, I feel sure, from my traumatic childhood. Indeed, such childhood trauma is very often the root cause of why people in general use alcohol, and other psychoactive substances such as illicit drugs, to self-medicate (ie. attempt to ameliorate their emotional and psychological pain).

A main reason that many find it so hard to stop or reduce their reliance on such self-medication is that they are unaware that the origin of their addictive need to self-medicate lies in their traumatic childhood experiences and that the adverse psychological consequences which they seek to numb by excessive drinking or drug taking are symptoms of this trauma.

This lack of insight leads to the root cause of the particular addiction remaining untreated, making it much harder for the individual to recover from his/her reliance on mind-altering substances.

Very sadly, other people, perhaps ill-informed family members, who also are unaware of the true origins of the problem, may, due to their lack of understanding, blame the individual for his/her, as they may erroneously perceive it, ‘weakness of character’ and ‘selfishness’ (it is not selfishness – being addicted to, for example, alcohol is hardly fun or enjoyable; one does not choose to suffer from such an addiction, by definition).

self medication

Equally sadly, the addict may blame him/herself, adding to his/her depression and worsening yet further his/her already extremely low self-esteem, thus, in all likelihood, aggravating still further his/her addictive disorder.

Whilst the afflicted individual may sometimes enter stages of incipient recovery, if his/her childhood trauma remains therapeutically unaddressed, s/he is likely to relapse when events in his/her life trigger traumatic memories and flashbacks.

It is useful to provide some statistics in connection with the idea of childhood trauma leading to self-medication as an adult: for example, intravenous drug users are 1000% (one thousand per cent) more likely to have suffered childhood trauma than non-intravenous drug users. A second example is that (in the USA) female alcoholics are twice as likely to have suffered significant trauma compared to their non-alcoholic counterparts.

The Role Of Adrenaline:

Those suffering from the effects of severe trauma, such as those who have been diagnosed with posttraumatic stress disorder (PTSD), have been found to produce in their bodies excessive quantities of the hormone adrenaline which significantly contributes to their feelings of deep anxiety and general psychological distress.

It is hardly a coincidence, then, that one of the illicit drugs they can become dependent upon is heroin as this drug is highly effective at shutting down the brain’s adrenaline center – the locus coeruleus.

Other drugs that have a similar effect are Valium, alcohol and benzodiazepines (the latter is a drug which played a role in the shamelessly hounded and persecuted musical genius Michael Jackson’s tragic and untimely death – it is well documented that he was traumatized by his childhood, not least because his father, Joe Jackson, would allegedly whip his son if he made mistakes during rehearsals when he rehearsed with his older brothers who made up the Jackson Five).

Conclusion:

Therapies for those who have experienced significant childhood trauma and are consequently addicted to the sort of substances referred to above are far more likely to be successful if they do not ignore the root cause of the problem – namely the afflicted individual’s childhood traumatic experiences.

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

 

 

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Why It’s So Hard To Talk About Our Experience Of Severe Trauma

Language is a cracked kettle on which we beat out tunes for bears to dance to, while all the time we long to move the stars to pity.’

Gustave Flaubert

 

Whenever I have become highly emotionally upset about my traumatic childhood experiences, in the presence of another person, I have found I become highly inarticulate, unable to communicate coherently what I am feeling and why I am feeling it.

It is as if there is some kind of mental blockage, rendering me incapable of conveying verbally my state of mind in any meaningful way. Essentially, I seem to regress, leaving myself with the verbal dexterity of the average three- year- old (albeit, perhaps, on occasion, a three- year- old with a precocious knowledge of swear words).

As it transpires, it would seem there is a scientific and neurological explanation for this loss of articulacy when in such emotional distress relating to one’s traumatic experiences:

Our inability to verbalize our feelings about our traumatic experiences is most powerful immediately after the traumatic experience itself and during periods in which we are experiencing flashbacks (when we experience flashbacks, the brain reacts in much the same way as it did when we experienced the original trauma).

During such periods, research has revealed that the part of the brain responsible for language production, known as Broca’s area, all but shuts down. In some cases, the traumatised individual may enter a kind of speechless daze.

Broca's area

In calmer moments, traumatised individuals may talk about their traumatic experiences, but in a superficial way that does not remotely capture the intense distress, rage and mental agony their experiences may have evoked – language cannot adequately convey what it is like to experience such feelings.

Because we can’t communicate properly what our experience of trauma was like, or how it has made us feel, we can start to feel extremely isolated and cut-off, emotionally, from the ‘normal’, everyday world.

No -one can understand what happened to us or how it affected us as our experiences are, quite literally, beyond words; this produces, in many of us, an especially intense and profound sense of loneliness.

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

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