Category Archives: Ptsd/cptsd Articles

What Is Psychic Numbing?

 

what is psychic numbing?

Severe emotional distress and trauma can lead to a psychological defense known as psychic numbing.

Psychic numbing occurs when our conscious experience becomes so overwhelmingly, mentally painful that our feelings, in effect, ‘switch themselves off;’ the result is a kind of psychological ‘escape from reality’ – a reality which has become too terrible to tolerate.

Those who experience psychic numbing may use metaphors in an attempt to describe their condition such as : ‘It’s as if I’ve turned to stone,’ or, ‘it’s like my heart’s become made of stone.’ Sadly, in this state, the person may feel s/he no longer cares about him/herself or others – even close family members / previously close friends.

This may sound a distressing state to be in in itself, but part of the condition of psychic numbing means, too, that the person may also not care that s/he doesn’t care.

How Long Does Psychic Numbing Last?

The condition may be a relatively transient response following a severely traumatic incident or it may become a long-term in response to protracted exposure to traumatic conditions especially, for example, if one has developed complex posttraumatic stress disorder as a result of a traumatic childhood. In such cases, the sense of psychic numbing may persist (in the absence of effective therapy) for years or even decades.

what is psychic numbing?

Are Both Good And Bad Feelings Affected?

Generally, yes. Whilst the condition may arise as a defense against bad feelings, the ability to feel anything good tends also to greatly diminish, including the loss of the ability to gain pleasure from food and sex (for more about the inability to experience feelings of pleasure, see my article about anhedonia).

The Sense Of ‘Anesthesia.’

When one is in the grip of psychic numbing, it can feel not only as if one has been given an ’emotional anesthetic’, but, sometimes, too, as if one has also been physically anesthetized as the body itself can become relatively numb to the sense of pain.

Research Into Posttraumatic Stress Disorder (PTSD) And Psychic Numbing :

Some researchers have suggested that the symptom of psychic numbing is intrinsically bound up in the biological responses which form the foundation of PTSD.

Psychic numbing is also closely related to depersonalization and a sense of loss of identity.

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

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Structural Dissociation Theory

structural dissociation theory

Structural dissociation theory was developed by Van der Hart, Nijenhuis and Steele (2006).

Essentially, this theory relates to the idea that many of the behaviors that you may feel uncomfortable about, ashamed of, guilty about, or hate are likely to be the behaviors you unconsciously learned as a child to survive in an environment which was hostile, unpredictable, threatening and unsafe. In the present, these behaviors are likely to be triggered by any occurrences or events which, even remotely, resemble the events which once threatened your safety (psychological or physical) as a child.

In other words, the vulnerable, frightened child continues to live within you, trapped in the past, and responding to events now as if they (or, rather, what these events symbolize) were happening then (during your traumatic childhood).

These behaviors, then, can be seen as adaptations : behaviors that allowed you, as a child, to survive; I repeat : they are the legacy of the child within you that, under extreme circumstances, managed to survive and, as such, should cause neither guilt nor shame. THE BEHAVIORS WERE ESSENTIAL AS A MEANS OF PSYCHOLOGICAL SELF-PROTECTION.

 

Structural Dissociation Theory In Terms Of Neurobiology :

In terms of neurobiology (the physical/biological workings of the brain) the theory states that when events occur that we find threatening (on either a conscious or unconscious level) because they trigger implicit memories of our traumatic childhood :

the right half (hemisphere) of the brain and the left half (hemisphere) of the brain become disconnected to a degree that they no longer communicate with one another in an effective manner.

What Are The Functions Of The Left And Right Hemispheres Of The Brain ?

For the sake of simplicity,we can confine ourselves to the functions most pertinent to the theory :

  • The brain’s left hemisphere is involved with day-to-day functioning and is relatively logical, permitting us to struggle on despite internal, mental conflict.
  • The brain’s right hemisphere ‘contains’ the responses that you were forced, by extreme and hostile circumstance, to learn as a child in order to ensure psychological survival, including hypervigilance for imminent danger and perpetual readiness for fight/flight/freezing/fawning – whatever was necessary to avert danger (real or perceived).

structural dissociation theory

Splitting / Fragmentation :

The personality of the individual who has experienced severe childhood trauma can become split / fragmented so that when events occur that cause stress / fear / make the individual feel threatened / remind the individual, however tenuously (on a conscious or unconscious level), of their childhood trauma the responses stored in the brain’s right hemisphere are triggered (fight/flight/freeze/fawn responses) whereas the brain’s left hemisphere guides ‘normal’ everyday behavior, allowing the person, to some degree at least, to function. To simplify :

  • Stress, threat, fear etc / implicit reminders of childhood trauma = right hemisphere dominant
  • Everyday functioning = left hemisphere dominant

Compartmentalization and Self-Alienation :

Whilst such compartmentalization may allow our day-to-day functioning to continue under one guise or another, there is, however, a price to be paid : the individual can suffer from intense feelings of self-alienation, self-loathing, shame (that s/he is ‘concealing’ a ‘bad,’ ‘secret’ self) and a sense of being a ‘fake’ and ‘fraudulent’ person.

My next article (Part Two) will look at how we might best overcome this problem.

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

 

 

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Effects Of Trauma Should Be Addressed Rather Than Its Events

addressing effects of trauma

According to J Fisher, PhD, Assistant Educational Director of The Sensorimotor Psychotherapy Institute and author of the book Healing The Fragmented Selves Of Trauma Survivors, it is of greater importance to address the effects of a person’s traumatic past rather than its specific events. Why should this be?

Sigmund Freud, often referred to as the ‘father of psychoanalysis’, originally treated his patients by helping them to remember, and piece together, their childhood traumatic experiences, the memory of which had been largely repressed.

The idea was that by talking about what had happened to them during childhood, and bringing their traumatic memories into conscious awareness, they would be able to develop a coherent narrative relating to their adverse experiences which would, in turn, alleviate their psychological distress and the symptoms pertaining to their early life trauma.

This kind of therapy is usually referred to as talk therapy or psychodynamic psychotherapy.

Possible long-term effects of childhood trauma

Above : Possible long-term effects of childhood trauma

However, various researchers (e.g. Herman, 1992) have highlighted the fact that many therapists who have adopted this approach to treating their traumatized patients / clients have found that these same patients / clients are made worse rather than better by this ‘talking cure’ strategy.

Specifically, it had been found that patients / clients, when treated in such a way, can become flooded and overwhelmed by the myriad implicit memories this form of therapy is prone, inadvertently, to trigger. To read my article about trauma and implicit (also referred to as non-declarative) memories, click here.

In her book, Fisher takes the view that, rather than bringing into conscious awareness the ‘full narrative’ of our childhood trauma and replaying it in its raw form until we can ‘face-up’ to it, it is more important to learn how to deal with the effects /symptoms of the trauma, such as learning to feel safe,  secure and relaxed in the here and now and to ameliorate present feelings of fear and panic.

Fisher recommends the following cutting-edge therapies for addressing the effects of trauma : mindfulness a based therapies, internal family systems therapy, sensorimotor psychotherapy and clinical hypnotherapy.

 

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

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Childhood Trauma And Non-Declarative Memory

childhood trauma and non-declarative memory

Our long-term memory can be divided into :

1. Declarative Memory (sometimes called explicit memory or narrative memory) – it is the part of our memory that we use for the conscious recall of facts or events.

Declarative memory depends upon language in order to organize, store and retrieve the information that it holds.

2. Non- Declarative Memory (sometimes called implicit memory, procedural memory or sensorimotor memory) – it is this part of our memory that allows us to automatically retrieve information connected to something we have learned without conscious deliberation.

Non-declarative memory

For example, we can get on a bike and ride it without having to concentrate on exactly how we’re doing it or go over in our minds the steps involved in how we learned to do it; indeed, we need not even remember when or how when learned to do it (I certainly don’t) – nevertheless, the necessary ‘know-how’ has been unconsciously, permanently retained.

Non-declarative memory, unlike declarative memory, does not depend upon language for the organization, storage and retrieval of information. Because of this, non-declarative memories are frequently very hard indeed to describe in words (try explaining all the tiny body and muscle adjustments necessary to maintain balance whilst riding a bicycle – yet the memory of exactly how to do this has been faithfully, unconsciously stored, courtesy of your non-declarative memory!).

TRAUMATIC EXPERIENCES ARE FREQUENTLY STORED AS NON-DECLARATIVE MEMORIES :

Due to their their utterly overwhelming nature, we often can’t completely and linguistically, mentally process our traumatic experiences which prevents them from being stored in declarative memory ; when this happens, the traumatic experiences are instead stored in our non-declarative memory.

THE FRAGMENTARY NATURE OF INCOMPLETELY PROCESSED TRAUMATIC MEMORIES :

The incompletely processed traumatic memories stored in non-declarative memory tend to be very fragmentary in nature. As we have seen, too, they are not stored in linguistic form but, instead, often in the form of :

bodily sensations (e.g. muscular tension, increased heart rate, hyperventilation)

images (e.g. these might come to us in nightmares or intrusively and unheralded during our waking hours as a result, often, of unconscious triggers – see below)

emotions (e.g. extreme anger or fear)

Also, our unconscious, non-declarative memories may express themselves through chronic, seemingly inexplicable symptoms and behaviours.

WHY WE FIND IT HARD TO ARTICULATE OUR TRAUMATIC EXPERIENCES :

Because the memory of our trauma has not been properly processed at the linguistic level we are likely to find ourselves unable to articulate our traumatic experiences in any coherent manner. (Click here to read my article on how we find it difficult to talk about our trauma).

TRIGGERS :

Bodily sensations, images, emotions, symptoms and behaviours linked to our non-declarative memories of our original, childhood trauma may be triggered whenever anything even remotely reminds us of this trauma.

In this way, we may find ourselves re-enacting aspects of our original trauma in our everyday lives months, years or, even (in the absence of effective therapy), decades after the actual experience of our childhood trauma is over.

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

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Childhood Trauma and PTSD – Facts and Fiction

 

childhood trauma and ptsd

I have written extensively elsewhere on this site about how severe childhood trauma can lead to, amongst many other psychological conditions, PTSD (post traumatic stress disorder). For example, click here to read one of my articles on the topic.

Table of signs and symptoms of PTSD :

images38F93A5G

However, amongst the general public, certain myths have developed in connection with what PTSD is, how the condition manifests itself and who it affects.

It is these I want to look at in this article :

PTSD – FACTS AND FICTION :

MYTH 1 – PTSD can only be caused by traumatic war experiences.

In fact, nearly three quarters of people in USA will experience a severe trauma at some point in their lives. Of these, about one fifth will go on to develop symptoms which are severe enough and long-lasting enough to be clinically classified as PTSD.

Taking the two above statistics above, it clearly follows that about 15% of people in the USA will suffer from PTSD at some point during their lives.

Whilst traumatic war experiences are indeed one cause of PTSD (what used to be called ‘shell shock’) many other life experiences also lead to the condition; these include natural disasters, being the victim of a serious physical attack and SEVERE CHILDHOOD TRAUMA.

Statistics also show that women are about twice as likely to suffer from PTSD as men are at any given time (this is thought to be connected to the fact that women are more likely to suffer from sexual abuse).

A further breakdown of statistics is shown on the table below:

images

MYTH 2 – Those who develop a psychological condition after a trauma are weak – they should be able to move on with their lives and put it behind them.

Developing PTSD has nothing to do with weakness. Everybody is potentially at risk of developing PTSD given particular experiences, it is just that different experiences affect people in different ways.

Indeed, research now shows that severe and prolonged trauma, particularly in CHILDHOOD, can adversely affect the physical development of the brain (click here to read my article on this) which can in turn make the individual vulnerable to developing not only PTSD but, also BPD (borderline personality disorder), severe anxiety and depression. THIS CAN IN NO WAY BE CONSTRUED AS THE INDIVIDUAL’S FAULT.

In such a situation, however, intensive therapy can help to reverse any harm that was done to the developing brain due to a brain quality known as neuroplasticity (click here to read one of my articles on this).

MYTH 3 – People develop PTSD immediately after the traumatic event that triggered it.

This is not always the case. It is true that if the severely traumatic experience is a one-off event, such as being violently mugged, symptoms of PTSD do tend to occur soon afterwards.

However, in the case of childhood abuse, which may have extended over a period of years, full blown PTSD may not develop for many years after the abuse has ended (click here to read my article explaining why this is).

It is for this reason that, in many cases, people do not realize that they have PTSD and therefore erroneously blame themselves for how they feel and behave (eg they may be prone to outbursts of extreme anger and rage).

And even if they realize they seem to have a condition similar to PTSD, they do not link it to their traumatic childhood experiences.

Unfortunately, this means many PTSD sufferers who could benefit from therapies such as CBT (cognitive behavioural therapy) and DBT (dialectical behaviour therapy) are not getting the help which could, potentially, dramatically improve their lives.

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

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Symptoms Of Dissociation : Mild And Severe

 

dissociation

If we have suffered significant childhood trauma, we may, as adults, frequently find ourselves in various states of dissociation, ranging from mild to severe. Indeed, dissociation is a key feature of complex posttraumatic stress disorder (Cptsd).

What Is Meant By The Term ‘Dissociation’?

Dissociation is a symptom of the effects of childhood trauma which we developed as a defense mechanism in order to better equip us to cope with the emotionally painful and destructive environment in which we grew up. It is a way of mentally escaping and psychologically cutting off from reality; it is sometimes colloquially referred to as ‘zoning out’ or ‘tuning out’.

Dissociation And Flooding :

We are particularly likely to dissociate when we feel overwhelmed, or ‘flooded’, by stress and psychological threat. Symptoms of dissociation can range from mild to severe. I outline examples of such symptoms below:

symptoms of dissociation

Mild symptoms include:

– feeling in a daze (sometimes referred to as ‘mind fog’),

– feeling utterly exhausted, numb and soporific for no obvious reason,

– finding oneself tongue-tied when trying to talk about difficult experiences (as if experiencing a kind of mental block).

 

More severe symptoms include:

– amnesia for certain events, or large periods of time, in one’s life (for example, I have no memory whatsoever of large chunks of my childhood) – such ‘dissociative amnesia’ far exceeds normal forgetfulness.

time loss : an individual may suddenly find him/herself in a particular place, with no memory of how s/he got there, unable to remember anything that has occurred in the recent past (eg the last few hours or days)

feeling very out of control (eg uncontrollably angry)

– periods of apparent deafness (at my first school, when things were at their worst at home between my parents, at times I did not respond to my name being called out in class – the school thought I was suffering from deafness; in fact, though, the cause was deep psychological trauma. This is certain as it became apparent this ‘deafness’ only occurred when the class was discussing parents/family matters or associated topics).

symptoms of association

 

Dissociation And Switching:

Some people dissociate when under extreme stress (ie when ‘flooded’, see above) in a way that almost resembles ‘changing personality’; this is referred to as ‘switching’.

In fact, it is NOT a literal switch of personality, but a switch of ego states/states of consciousness sometimes referred to by psychologists as ‘parts’ or ‘alters.’

Studies suggest that nearly all people who suffer such switching have experienced severe early life trauma. It is NOT a genetic disorder.

When a person switches due to stress, they switch from the ego state/state of consciousness/part/alter that s/he relies on for his/her day-to-day functioning to the ego state/state of consciousness/part/alter that is normally dissociated/’kept in a separate compartment’ in mind (it is this separation that allows the individual to function daily, by preventing the feelings in the dissociated part from interfering in it).

This dissociated part contains profoundly painful trauma related feelings such as fear, shame and anger.

 

Can dissociation be treated?

The short answer is, YES.

Individuals can be helped by becoming aware of the link between their childhood trauma and the dissociated part of their mind that they switch to when under severe stress.

As well as this, individuals suffering from dissociation can be enormously helped by learning the skills of mindfulness. Mindfulness, essentially, helps a person to live in the present/the ‘here and now’, rather than staying trapped in the past.

RESOURCES :

Excellent site about MINDFULNESS – mindfulness.org

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

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Complex Trauma : Some Important, Lesser Known Facts

Complex trauma facts

Complex Trauma : Lesser Known, Important Facts.

  • The majority of individuals who come into contact with mental health services have a history of complex trauma (Bloom, 2011)
  • The ‘Adverse Childhood Experiences‘ (ACE) study found that on a daily basis GPs see patients who are suffering from the effects of complex trauma but do not realize that this is the fundamental problem; instead, the patient is diagnosed according to the particular symptom (such as anxiety or addiction) presenting at the time of the consultation. Because of this, the root problem often remains unaddressed.
  • Complex-PTSD is more common than ‘ordinary’/single incident PTSD and its effects more wide-ranging.

Complex trauma

  • Whilst complex-PTSD is closely linked to the sufferer’s having experienced some form of child abuse (emotional, sexual or physical) it also occurs when a parent/parents/primary carers are in some way inadequate or deficient due to trauma they themselves experienced as children that remains unresolved. In this way, the ill-effects of childhood trauma can be constantly passed on from generation to generation. So, for example, the abuse a child suffers may stem from the abuse his/her grandfather suffered at the hands of his’/her (the same child’s) great-grandfather.
  • Medical Trauma – even routine operations and surgeries can traumatize the child, especially if they involve immobilization or anesthesia (Levine, 2010)
  • Hypoarousal – this is essentially the opposite of hyperarousal and occurs as a psychological defense mechanism in response to extreme ongoing stress/ trauma – it involves what might colloquially be called an emotional shutdown, or, more technically,’dissociation‘.  Unfortunately, GPs may mistakenly diagnose such a condition as depression (Rothschild, 2011) [TO READ MY ARTICLE : 2 OPPOSITE WAYS THE CHILD RESPONDS TO STRESS : HYPERAROUSAL AND DISSOCIATION, CLICK HERE]’
  • Inability to ‘move on’ – some individuals, suffering from the effects of complex trauma, are told by others that they should ‘just move on’ with their lives. However, this ‘advice’ (though it is usually more of a criticism) is based upon a failure to understand that a person cannot simply ‘move on’ from trauma until the trauma has been resolved. Indeed, invalidating or undermining the effect of the traumatized individual’s traumatic experiences is highly likely to compound his/her suffering.
  • To end on an optimistic note : even though the development of the child’s brain may be adversely affected by the experience of complex trauma (eg the development of the amygdala), the fact that the brain has a property known as neuroplasticity means such individuals can still be optimistic about their prospects of recovery.

RESOURCES :

Complex traumaComplex trauma

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

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Recovery From Complex PTSD

recovery from complex PTSD

According to Peter Levine, an expert on the adverse effects of childhood trauma on our adult lives and the complex post traumatic stress disorder that can result, typically there develops various signs in victims that may indicate the recovery process is underway. The main signs of recovery that Levine identifies are as follows :

1) A REDUCTION IN THE NUMBER, AND INTENSITY, OF EMOTIONAL FLASHBACKS THAT WE EXPERIENCE (an emotional flashback is when an event occurs in our lives that triggers similar painful emotions to those we experienced as a child in relation to our traumatic experiences – such flashbacks may result in regressive behaviour such as extreme, uncontrollable, childlike tantrums. For example, if we had a cold and rejecting father who was always denigrating us, we may over-react when we are criticized by our boss at work).

2) WE BECOME LESS SELF-CRITICAL (those who have suffered childhood trauma very frequently, and erroneously, blame themselves for their terrible childhood experiences and/or internalize the negative view parents/primary carers had of them when they were children – to read my article on how a child can falsely come to see him/herself as ‘bad’ and how this inaccurate self-view may be perpetuated, click here).

3) WE BECOME LESS ‘CATASTROPHIZING’ (many who suffer childhood trauma develop into adults prone to extremes of negative thinking, often referred to as cognitive processing errors.’ One such cognitive processing error is that we may be prone to ‘catastrophizing’ which means we tend to always expect the worst and to interpret situations in their worst possible light. Often, too, we attribute the worst possible intentions and motivations to the behaviour of others. As we begin to recover, this tendency diminishes).

4) WE START TO FIND IT EASIER TO RELAX (one of the worst aspects of my illness was a perpetual, tormenting feeling of the most intense agitation making anything even vaguely approaching relaxation utterly impossible, every medication was tried – and failed; even electro-convulsive shock therapy (ECT) was tried on several different occasions over the years – again, utter failure. When we finally do start to recover, however, the ability to relax gradually returns).

5) WE BECOME LESS DEPENDENT UPON OUR LEARNED DEFENSE MECHANISMS (it is very common for those of us who have experienced childhood trauma to develop into adults who feel very vulnerable to being hurt or exploited by others if we ourselves were hurt and exploited by our parent/s or primary-carer/s during our early lives. In order to protect ourselves, we may have unconsciously learned to develop certain defense mechanisms such as aggression  or avoidance. As we recover, however, we find we become less reliant on these psychological defenses, according to Levine.

6) OUR RELATIONSHIPS WITH OTHERS START TO IMPROVE AND WE BECOME LESS INTIMIDATED BY SOCIAL SITUATIONS (another common outcome of significant childhood trauma is that we can find, in adulthood, that we are quite inept when it comes to forming and maintaining relationships with others. We may, too, find social situations very intimidating, and, even, develop social phobia. A sign of recovery, however, is an easing of such interpersonal difficulties).

 

FOUR MAIN STEPS ALONG THE ROAD TO RECOVERY :

Levine states that the main steps to recovery are as follows :

1) PSYCHOEDUCATION

2) REDUCING SELF-CRITICISM

3) GRIEVING FOR OUR CHILDHOOD LOSSES

4) ADDRESSING ‘ABANDONMENT DEPRESSION’

Let’s look at each of these in turn :

1) The first step of recovery from complex PTSD, according to Levine, is psycheducation (which is sometimes referred to as ‘bibliotherapy‘. This involves learning about our psychological condition and becoming aware of how it is linked to our adverse childhood experiences. Levine also emphasizes the usefulness of learning about mindfulness).

2) The second step of recovery from complex PTSD is to, in Levine’s phrase, shrink our inner critic.’  In other words, we need to gradually learn how to stop taking such a negative view of ourselves and of everything we do – one effective therapy which can help us to achieve this is cognitive behavioural therapy (CBT). (To read my related article, entitled :‘How The Child’s View Of Their Own ‘Badness’ Is Perpetuated’, click here).

3) The third step of recovery from complex PTSD, says Levine, is to grieve for our childhood losses. These losses may include our missing out on feelings of safety, security, simple childhood happiness and a care-free state of mind as well as a loss of any self-esteem we may have once had. To read my article about coming to terms with childhood losses, click here). Levine suggests that this process may take up to two years.

4) The final step of recovery from complex PTSD is to address what Levine calls the core issue, namely our ‘abandonment depression.’ An important part of this step is also to learn how to be self-compassionate. (To read my article about abandonment issues which may we may develop as a result of childhood trauma, click here).


Resource :

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Crying Helps Re-Engagement With Authentic Feelings

Benefits Of Crying:

As a child, even well into my teens, I cried extremely frequently. Usually this was alone at home, but, on occasion, at my prep school (which I attended until I was eleven) I was removed from the class for crying (there was little compassion on offer from the teachers) when I was particularly upset about what was going on at home.

Once, even, to my acute embarrassment and shame (at the time), I started to cry (or quietly whimper) in a second year (now it would be called Year Eight)  English class at my secondary school when I was about thirteen, desperately trying to conceal this inconvenient outburst of emotion from both my teacher and classmates.

Also, at about fifteen years of age, I once even rushed upstairs at home after one of my frequent arguments with my family and shut myself in my bedroom wardrobe where I stubbornly and emphatically insisted upon remaining (not that anyone encouraged me to come out), sobbing copiously, for a not inconsiderable period of time. It is quite clear to me, and, presumably, will be to the reader, too, that my emotional development had been arrested at a much younger age.

William Wordsworth, in his poem ‘Ode : Intimations Of Immortality From Reflections On Early Childhood‘, refers to ‘thoughts  that  often lie too deep for tears‘ and, when one is especially afflicted by profound depression and/or traumatized, this line of poetry is often most apposite  – one simply becomes numbed and internally deadened by the sheer intensity of one’s chronic and unrelenting mental suffering. In such a condition, as a psychological defense, all feelings and emotions shut down ; however desperately one wants to cry, one is unable to do so.

Something deep in our soul is blocked or frozen.

Being Finally Able To Cry Can Be A Breakthrough Moment In The Process Of Recovery :

The psychotherapist, Pete Walker, in his excellent book entitled : Complex Trauma – From Surviving To Thriving, explains the benefits of crying in that finally being able to cry after a long period of emotional numbness (emotional numbness is a key feature of complex post traumatic stress disorder) can signify a major turning point in the recovery process, marking our re-engagement with our long suppressed feelings.

Relevant Research :

There also exists a body of research supporting the idea that crying is beneficial. For example, the biochemist, W. Frey, reports that crying helps to rid the body of chemicals that are produced by stress and, therefore, when we cry, by lowering the concentration of these chemicals within our biological system, we reduce our stress levels ; this not only makes us feel better mentally but also has physical benefits (for example, by lowering our blood pressure).

Also, research carried out by Gracanin et al at the University of  Tilburg in the Netherlands supports the idea that crying can improve mood.

Conclusion :

Unfortunately, males in our society are often discouraged from crying on the erroneous grounds that it is ‘weak’ or ‘unmanly’. In fact, though, crying can be of immense therapeutic value, particularly when one has been feeling emotionally ‘dead inside’ for a long period of time due to having experienced severe trauma.

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

 

 

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Prolonged Exposure Therapy And Posttraumatic Stress Disorder (PTSD)

Major symptom of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (cPTSD)click here to read about the difference between these two conditions – are fear, anxiety and even terror induced by :

– situations related to the traumatic experience

– people related to the traumatic experience

– places related to the traumatic experience

– activities related to the traumatic experience

Prolonged Exposure Therapy Involves Two Specific Types Of Exposure To Trauma-Related Phenomena :

a) In Vivo Exposure

b) Imaginal Exposure

In Vivo Exposure :

Prolonged exposure therapy works by encouraging the individual with PTSD / cPTSD, in a supportive manner, very gradually, to confront these situations / people / places / activities whilst, at the same time, feeling safe, secure and calm. Because this part of the therapy involves exposure to ‘real life’ situations / people / places / activities it is called in vivo exposure.

This is so important because avoiding these situations / people / places / activities, whilst reducing the individual’s anxiety in the short-term, in the longer-term simply perpetuates, and, potentially, intensifies, his/her fear of these things.

Imaginal Exposure:

The therapy also involves the PTSD / cPTSD sufferer talking over details and memories of the traumatic experience in a safe environment and whilst in a relaxed frame of mind (the therapist can help to induce a relaxed frame of mind by teaching the patient/client breathing exercises and/or physical relaxation techniques; hypnosis can also be used to help induce a state of relaxation). Because this part of the therapy ‘only’ involves mental exposure to the trauma (i.e. thinking about it in one’s mind), it is called imaginal exposure and can help alleviate intense emotions connected to the original trauma (e.g. fear and anger).

Both in vivo and imaginal exposure to the trauma-related stimuli are forms of desensitizing and habituating the patient / client to them, thus reducing his/her symptoms of PTSD / cPTSD.

How Effective Is Prolonged Exposure Therapy?

Prolonged exposure therapy is a type of cognitive behavioural therapy (CBT) and research into the treatment of PTSD suggests it is the most effective treatment currently available.

What Is The Duration Of The Treatment?

The length of time a patient / client spends in treatment varies in accordance with his/her needs and his/her therapist’s particular approach. However, the usual duration of the treatment is between two and four months, comprising weekly sessions of approximately ninety minutes each.

On top of this, the patient / client will need to undertake some therapeutic exercises/activities in his/her own time, set by the therapist as ‘ homework assignments’. These assignments will include listening to recordings of imaginal exposure therapy sessions.

RESOURCES :

The National Center For PTSD has developed a PROLONGED EXPOSURE APP, or PE APP. Click here for further information and download instructions.

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

 

 

 

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