Category Archives: Ptsd/cptsd Articles

Posttraumatic Growth – Techniques to Help Keep Remaining Symptoms of Trauma Under Control

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I have stated before that just because we have entered the phase of posttraumatic growth, this does not mean symptoms of trauma have been completely eradicated. Therefore, in order to be able to maximize the potential of our posttraumatic growth, it is very useful to know about techniques to manage re-emerging symptoms resulting from our experience of trauma, so that they interfere with our recovery as little as possible.

THE TECHNIQUES :

So, if, during our recovery/posttraumatic growth, we feel our symptoms are re-asserting themselves, we can employ the use of the following techniques:

– avoid interpersonal conflict (eg do not allow ourselves to be drawn into energy sapping and demoralizing arguments)

– talk to others about how we are feeling

– take as much time as possible for relaxation (eg gentle exercise,meditation, warm bath)

– indulge in as many enjoyable and pleasurable activities as possible, WITHOUT FEELING GUILTY ABOUT IT (see the activities as a form of necessary therapy)

– treat ourselves with compassion and do not blame ourselves for the effect the trauma has had on us

– keep to a routine; this is very important as it gives us a sense of predictability, control, safety and security

– make use of any social support systems as much as possible (eg friends, family, support groups). Research shows that those with a strong social support network in place cope better with the effects of traumatic experiences

– remember that many individuals who experience significant trauma find that ,once they have come through it, they have gained much inner strength and have greatly developed as people with a much deeper appreciation of life than they had before the traumatic experience/s occurred

– try not to avoid situations which remind you of the original trauma, where at all possible,as this is an effective way of overcoming the fear associated with such situations; avoidance keeps the problem going

– keep reminding yourself that human beings are extremely resilient; many people throughout the ages have been through appalling experiences yet have become stronger people as a result

– it important to remember that seeking professional help is not a sign of weakness or failure

Note : the above suggestions are based on advice given by the Academy of Cognitive Therapy.

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

 


Disturbing Memories – Why They can Remain Unprocessed

disturbing_unprocessed_memories

The human brain is able to process most memories without difficulty. If, however, we have experienced particularly disturbing events during our childhood, it is possible that certain memories connected to such events have not yet been properly processed by the brain. Distressing memories which remain unprocessed can give rise to a number of most unpleasant symptoms; these may include, for example, anger, fear, terror or panic (the types of symptoms experienced by individuals will be strongly connected to the type of experiences connected to the unprocessed, distressing memories).

unprocessed_disturbing_memory

A leading theory is that, under normal circumstances, memories are processed during sleep – such processing involves neural connections being made (so that the memory becomes integrated with other memories), irrelevant detail being discarded, and appropriate learning taking place.

However, sometimes, if a memory is extremely distressing, it overwhelms the brain, preventing it from smoothly integrating the memory alongside other memories. Such distressing memories, in this way, can REMAIN UNPROCESSED, for years or decades, and, as a result, have a profoundly negative effect on how we think, feel and act if we do not seek out and undergo appropriate therapy.

In this circumstance, the distressing, unprocessed memory gets stored with associated unpleasant physical sensations and negative emotions. These unpleasant physical sensations and negative emotions can, in turn, be easily triggered by seemingly unconnected life events. However, the crucial word here is ‘SEEMINGLY’ ; this is because, UNCONSCIOULY, the life event reminds the individual of the events connected to the unprocessed memory.

In this way, for those of us who have unprocessed, distressing memories from our childhoods, our reactions to certain events in our adult lives may seem, on the surface, to be disproportionate, or, even, grossly disproportionate. This is because the events have, on an unconscious level, triggered how we felt in the past (during our childhoods) when the original traumatic experiences connected to the unprocessed memories occurred. This can lead, at times of acute stress, to a phenomenon known as age-regression (click here to read my article on age-regression).

How traumatic an event is to an individual, and the subsequent chances the memory connected to the traumatic event will not be properly processed, is influenced by a number of factors; these include the period of time over which the individual is exposed to the traumatic events, genetic predisposition and how the individual PERCEIVES the event.

EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) :

One therapy that has (relatively recently) emerged to treat people suffering from the ill effects of traumatic, unprocessed memories is EDMR therapy, which many have found most effective. To read my article about EMDR, click here.

By helping the individual process the traumatic memories, EMDR can help alleviate psychiatric conditions connected with the previously unprocessed memory. These include :

– depression

– panic

– anxiety

– dysfunctional attachments (relationship problems)

– anger

– PTSD

– complex PTSD

– borderline personality disorder (BPD)

– sleep disruption/nightmares/night terrors

– addictions

– eating disorders

.   

 

Above eBooks now available for immediate download on Amazon. $4.99. CLICK HERE.

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


Fight, Flight, Freeze or Fawn? Trauma Respones

childhood_trauma_delayed_effects

Fight, Flight, Freeze, Fawn  – Responses To Threat

Most of us are already familiar with the concept of the ‘fight or flight’ response to perceived danger – namely that when presented with a threat our bodies physiologically respond by preparing us (eg through the release of adrenalin) to fight against it or run from it. This response served our ancestors well in the event, for example, that they came face-to-face with a dangerous predator.

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However, there are two other responses to threat which are less well known – the ‘freeze’ response and the ‘fawn’ response. I will explain what these are in due course.

Collectively, these responses to threat are known as the 4F responses and each of them represent different responses that modern day humans can have if they have been subjected to sustained and repeated trauma during their childhood.

If we have suffered problematic relationships with our main caregiver/s during our early life, it is likely that we will grow up to be very guarded, ambivalent and suspicious about forming close relationships with others during later life (click here to read my article on this). After all (our conscious or unconscious reasoning goes), if we can’t trust and rely upon our parent/s, whom can we trust and rely upon?

On top of this problem, any relationships we do form, with their inevitable ups and down, are bound, occasionally, to remind us of similar relationship problems we had in our early lives with our caregivers, and, in this way, trigger upsetting and painful flashbacks (click here to read my article on this).

NON-TRAUMATIZED CHILDHOOD VERSUS TRAUMATIZED CHILDHOOD

Those lucky enough not to have experienced a significantly disrupted childhood only utilize the 4F responses appropriately (ie only when they are faced with real danger). However, those who were exposed to serious, ongoing trauma during childhood frequently become FIXATED with one, or, perhaps, two, of the 4F responses (ie the response/s become DEEPLY INGRAINED and REFLEXIVE). Unlike those who did not experience a traumatic childhood, these individuals will also tend to over-rely on these responses and use them inappropriately (ie when there is no serious threat); the reponse/s upon which they have become fixated, learned as a defense mechanism during childhood, tend to remain on a hair-trigger and are thus easily activated.

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Above graph shows that after experiencing trauma our ‘fight/flight’ response becomes much more easily activated than previously.

Let’s look at each of the 4F responses to childhood trauma in turn:

1) THE FIGHT TYPE – The individual who has become fixated, due to his/her childhood experiences, on the ‘fight’ response avoids close relationships with others by frequently becoming enraged and often, too, by being overly demanding. It is theorized that s/he is unconsciously driven to behave in this way because s/he has a deep-rooted need to alienate others so that an intimate relationship cannot develop (as such a relationship would make him/her intolerably vulnerable in that it would carry with it the risk of rejection, similar to the rejection experienced in childhood, which would be psychologically catastrophic).

2) THE FLIGHT TYPE – It is theorized that this type of individual, for the same reasons as above, avoids close relationships with others by immersing him/herself in activities (eg by becoming a workaholic) which do not leave him/her the time to build deep, serious relationships with others.

3) THE FREEZE TYPE – This type avoids serious relationships with others by not participating with others socially; often they will become reclusive and increasingly take refuge in fantasies and day-dreams.

4) THE FAWN TYPE – This type will often go out of their way to help others, perhaps by performing some kind of community service, but without building up emotionally close, or intimate, relationships, due to a fear,like the other three types detailed above, of making him/herself vulnerable to painful rejection which would reawaken intense feelings of distress experienced as a result of the original, highly traumatic childhood rejection.

Above eBook available on Amazon for instant download (other titles also available) $3.99. CLICK HERE.

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

However


Why can Effects of Childhood Trauma be Delayed?

childhood_trauma_delayed_effects

Delayed onset post traumatic stress disorder (PTSD) ,which can occur as a result of a severely disrupted childhood, is defined by the DSM (Diagnostic Statistical Manual) as PTSD which develops at least six months after the traumatic event/s; however, PTSD can take much longer than this to manifest itself.

One reason why PTSD may not become apparent immediately is that the individual who has been affected by  trauma is able, for a period of time, to employ coping mechanisms (either consciously or unconsciously) which keep the condition at bay. During this period, some of the effects of the traumatic experience/s lie dormant.However, due to the experiencing of  further triggers (stress-inducing reminders of the original trauma), the person’s neurobiological processes (already harmed by the original trauma) may be further adversely affected until a ‘tipping point’ is reached and the s/he meets the criteria for being diagnosed with the disorder.

In other words, there is an interaction between the original damage caused by the trauma and exposure to further stressors later on in life. It follows from this that the more severe the original trauma, and the more severe the stressors life throws at the individual subsequently, the greater is the his/her accumulated risk of developing PTSD. Indeed, this is borne out by the research.

ORIGINAL TRAUMA LEADS TO GREATER VULNERABILITY TO EFFECTS OF FURTHER STRESS :

The original trauma, then, makes the individual more susceptible to being affected adversely by further life stressors. In neurological terms, this is thought to be because the original trauma can damage an area of the brain known as the amygdala; damage to this region makes a person’s fear/anxiety response to stressors much more intense than is normally the case (click here to read my article on how the effects of childhood trauma can physically harm the brain).

The more the individual affected by the original trauma subsequently experiences stressful triggers (see above) which cause him/her to relive it, the more damaged, and hypersensitive to the effects of further stress, the amydala (see above) becomes. Eventually, the amygdala’s response to perceived threat and danger (there does not have to be any real threat or danger ; indeed, one of the hallmarks of PTSD is that it causes the sufferer to see threat everywhere, where it does not, in fact, exist)  become so exaggerated that the individual finds him/herself living in what amounts to a state of almost constant terror (indeed, I myself was in just such a state for more time than I care to recall).

VICIOUS CYCLE:

As the individual starts to perceive, irrationally, threat everywhere, the range of triggers (see above) s/he experiences grows ever wider; this, in turn, yet further sensitizes the amygdala and reinforces the individual’s stress response. Thus, a vicious cycle develops.

CRITICAL PERIOD OF BRAIN VULNERABILITY :

I will finish with a quote from the psychologist Shalev, which I think speaks for itself and requires no further elucidation from me :

‘Following trauma there is a critical period of brain plasticity during which serious neuronal changes may occur in those who go on to develop PTSD.’

NB. To learn more about BRAIN PLASTICITY, and how we can take advantage of the phenomenon to aid our own recoveries,  click here to read my article).

bpd_ebookeffects_of_childhood_trauma_ebook

Above eBooks now available on Amazon for instant download. $4.99 each. CLICK HERE.

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


Abnormal Behaviours Arising when We’re Uncared For.

childhood_trauma_effects

Being cared for as an infant and child is clearly of fundamental importance to our survival. Because of this, humans have evolved, through Darwinian natural selection, forms of behaviour which help to elicit care from others, particularly, of course, from the primary care-giver (an obvious example is that of the baby who will scream and cry for the attentions of his/her mother).

childhood_trauma

If, later in life, we develop a psychiatric condition as a result of our poor care in childhood, this will tend to disrupt our lives; however, it may too carry with it what are known as ‘secondary gains’ which have the effect of encouraging others to care for us. Because of this, it has been hypothesized that some psychiatric conditions, particularly those which follow the collapse of important relationships, may develop, at least in part, due to an unconscious attempt by the sufferer to elicit some form of compensatory care from those around him/her.

Examples of such conditions include :

1) Neurotic depression

2) Parasuicide

3) Abnormal Illness Behaviour

4) Conversion Hysteria

5) Anorexia Nervosa

Let’s take a closer look at each of these in turn :

1) NEUROTIC DEPRESSION – this type of depression frequently follows the loss of an important supportive relationship and may include care-eliciting behaviours (eg crying). It is often the case that this will produce sympathy, concern and support from others (such as family and professionals) which can serve to reinforce the condition.

parasuicide

2) PARASUICIDE – this is attempted suicide which is non-fatal. Again, it often follows the ending of an important relationship. It is not necessarily a deliberate way of influencing others to provide emotional support, but in some cases there may have been an unconscious desire for the act not to be successful, resulting in a ‘half-hearted’ attempt. It is often called ‘a cry for help’, and this phrase was originally used by the psychologist Stengal in 1964.

It is important to point out, however, that many suicide attempts fail even when the person unambiguously wanted to end their own life – it must not be assumed, therefore, that a failed suicide attempt was intentionally unsuccessful.

3) ABNORMAL ILLNESS BEHAVIOUR – This was first described by the psychologist Pilowsky in 1969. It may manifest itself in the form of hypochondriasis or psychogenic pain, for example (psychogenic pain is pain which has no obvious physical cause but is generated by mental distress).

As with the previous conditions, ‘abnormal illness behaviour’ often follows interpersonal problems. It is particularly likely to occur when those close to the sufferer tend to treat him/her significantly better when s/he is unwell.

4) CONVERSION HYSTERIA – this condition was first proposed within the framework of psychodynamic theory. Essentially, it refers to the physical expression of of internal mental conflict and distress, frquently following on from the loss of emotional support.

It is thought to be especially likely to occur when the individual is restricted in his/her ability to express his/her inner mental turmoil through other channels (eg not skilled at articulating emotions and feelings).

Like the other three conditions already described, it often attracts the care and support of others.

5) ANOREXIA NERVOSA – Because the individual suffering from this condition refuses food/proper nutrition and may well become emaciated, it creates anxiety in  those close to the individual and is particularly likely to elicit care-giving from both them and from professionals. This can reinforce the symptoms.

 

RESOURCES :

www.minddisorders.com – Effects of Child Neglect – click here

 

EBOOKS :

 

effects_of_childhood_trauma_ebookbpd_ebook

Above eBooks now available on Amazon for instant download. $4.99 each. CLICK HERE.

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


PTSD – What Happens in the Brain?

childhood_trauma_effects

Post-traumatic stress disorder (PTSD) is one of the potentially devastating effects that may follow on from childhood trauma, and, in this context, the condition is frequently referred to as ‘complex PTSD.’ But what is actually happening inside of the brain in individuals who are suffering from this most serious condition?

To answer this question, it is necessary to look at two particular brain structures; these are :

1) THE AMYGDALA -this structure can be viewed as the brain’s ‘FEAR CENTRE’

2) THE HIPPOCAMPUS – this structure is able to activate/deactivate the amygdala

ptsd_biology_brain

Next, it is necessary to understand that :

under stress, the body produces two hormones called ADRENALINE and CORTISOL :

The functions of these two hormones are as follows:

– ADRENALINE – this produces physical responses to stress such as increased heart rate and sweating

– CORTISOL – this flows to the hippocampus and at first helps to lay down the memory of the trauma, but, in excessive quantities over sustained periods of time, it can damage the hippocampus, causing its cells to degenerate and, eventually, die. This process is called APOPTOSIS.

Indeed, if the traumatic experience is severe enough these biological changes in the brain (ie the excessive production of neurotoxins such as cortisol) can cause the hippocampus, in effect, to shut down.

This means it can no longer regulate or switch off the FEAR PRODUCING AMYGDALA,  causing the latter brain structure  to go into overdrive.

Thus, a situation arises in which the AMYGDALA BECOMES OVERACTIVE DUE TO THE UNDERACTIVITY OF THE HIPPOCAMPUS. Without proper intervention, this state of affairs may persist for many years.

The processes described above can lead to what has been called a TRAUMATIC CASCADE, causing the individual to feel a constant state of hyper-arousal, hyper-vigilance, anxiety and fear, perceiving danger, or the threat of danger, everywhere.

IMPLICATIONS FOR TREATMENT :

In such a poor and intensely painful emotional state, it is not possible for the individual to start properly processing, in a therapeutic manner, his/her experiences of trauma. This prevents the recovery process from getting underway.

In order to rectify this, a vital step, before therapeutic processing of traumatic experiences can begin, is to bring these constant feelings of fear and anxiety down to a level at which they are at least manageable. This may involve the prescribing of appropriate medication, behavioural techniques, or a combination of the two.

Indeed, studies involving both humans and animals have shown that such interventions can lead to the recovery of the hippocampus so that, once again, it may begin to regulate the amygdala as intended and alleviate excessive and superfluous feelings of fear and anxiety.

bpd_ebook  child_trauma_and_NEUROPLASTICITY, functional_and_structural_ neuroplasticity

Above eBooks available for instant download at Amazon. $4.99. CLICK HERE

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


Effect of Early Trauma on Brain’s Right Hemisphere Development.

effect of childhood trauma on brain development

effect of childhood trauma on brain development

As recently as 25 years ago, it was still frequently believed that the structure of the brain had already been genetically determined at birth. Now, however, we of course know that this is absolutely NOT the case. Indeed, the experience, in early life, of trauma, abuse or neglect can have a profoundly adverse effect upon both the brain’s chemistry and its architecture (ie the way in which its physical structure develops).

The diagram below shows the human brain’s left and right hemispheres together with some of each hemisphere’s particular functions.

CLICK ON IMAGE TO ENLARGE

effect of childhood trauma on brain development

CLICK ON IMAGE TO ENLARGE

Studies on animals can help us to understand the effects of trauma on the developing human brain. For instance, if animals are subjected to inescapable stress they develop behaviours such as :

   – abnormal alarm states

   – acute sensitivity to stress

   – problems relating to both learning and memory

   – aggression

   – withdrawal

The symptoms listed above are, in fact, very similar to those displayed in humans who are suffering from post-traumatic stress disorder (PTSD).

In both the cases of humans and of animals, investigations suggest that prolonged exposure to stress adversely affects a vital brain system ( the NORADRENERGIC BRAIN SYSTEM).

Indeed, in humans it has been found that even in adults (let alone children) just one exposure to severe trauma (eg a terrifying battle) can significantly alter an adult’s brain and lead to PTSD.

STUDIES ON EFFECTS OF CHILDHOOD TRAUMA ON BRAIN :

Drissen et al (2000) found that those who had suffered severe childhood trauma had smaller volumes of two vital brain structures which play a role in stress management; the two structures physically affected by trauma were :

1) THE AMYGDALA

2) THE HIPPOCAMPUS

On average, those who had experienced severe childhood trauma were found to have :

  – amydallas which were 16% smaller than those who had not experienced significant trauma

   – hippocampuses which were 8% smaller than those who had not experienced significant childhood trauma.

Further research by Shore (2001) has shown that the brain’s right hemisphere (see diagram of the brain’s right and left hemispheres above), which has deep connections into the limbic and autonomic nervous systems, is impaired in terms of its ability to regulate these systems properly;  leading to profound difficulties managing stress  in those who had suffered serious childhood trauma.

David Hosier BSc Hons; MSc; PGDE(FAHE)


Treatment for Trauma Related Nightmares

how to help someone with PTSD nightmares

About 1 in 20 people suffer from nightmares. However, amongst those who are suffering from post traumatic stress disorder (PTSD), research indicates that this increases to approximately 70% – 95%. Those with PTSD may well also suffer from related psychological problems including intrusive memories, flashbacks and panic disorder.

Often, the content of the nightmare in those who suffer from PTSD will relate closely to the original trauma – resulting in a partial reliving of the experience/experiences. However, this is not always the case.

People who suffer from trauma related nightmares are more likely to have accompanying body movements (eg thrashing about – yes, that really does happen, as I can vouch for personally; it’s not just in the movies!) during their frightening dreams than those who have nightmares which are non-trauma related.

how to help someone with PTSD nightmares

TREATMENT FOR PTSD RELATED NIGHTMARES :

The standard treatment for PTSD itself often improves nightmares. However, there is also a specific therapy available known as IMAGERY REHEARSAL THERAPY. This form of therapy involves the individual, under the guidance of the therapist, rehearsing content of the nightmare WHEN AWAKE repeatedly and changing the ending of the nightmare to make it less frightening.

More research needs to be conducted on the effectiveness of drugs at reducing nightmares, but, to-date, the most promising drug for this treatment is called PRAZOSIN.

Also, cognitive behavioural therapy (CBT) and Eye Movement Desensitization and Reprocessing Therapy (EMDR) have been shown in studies to be effective.

Some therapists claim to be able to help individuals who suffer from nightmares to turn these nightmares into what are known as LUCID DREAMS ( a lucid dream is a dream in which a person is aware s/he is dreaming and can exercise control over what happens in the dream. It is a genuine phenomenon; I know this because I have had about half-a-dozen such dreams in my life-time). However, more research needs to be conducted into this subject.

Finally, hypnotherapy and self-hypnosis can be used to reduce and improve nightmares by helping with changing the dream content (see above) and helping the person transform the nightmare into a lucid dream (see above). More on this can be found in the paper : ‘Hypnotherapy for Sleep Disorders‘ (Beng-Yeong Ng).

RESOURCE :

STOP RECURRING NIGHTMARES – SELF HYPNOSIS DOWNLOAD

Disclaimer : Always seek medical advice before taking medication to treat nightmares.

BSc Hons; MSc; PGDE(FAHE).


Post Traumatic Stress Disorder (PTSD) Questionnaire

ptsd test

As we have seen in several of the previously published articles on this website (eg click here), severe childhood trauma can lead to the development of post traumatic stress disorder (PTSD). If you are concerned you might suffer from the condition, it is important to seek advice from a relevantly qualified mental health professional.

However, if you want to find out if you have symptoms which PTSD can cause, you may find it interesting and useful to look at the list of items below and count up how many apply to you. REMEMBER, THE TEST DOES NOT REPLACE A PROFESSIONAL MEDICAL ASSESSMENT AND DIAGNOSIS.

SELF-REPORT POST TRAUMATIC STRESS DISORDER (PTSD) TEST :

(score 1 point for each item you answer YES to)

1) Have you been exposed to a traumatic event or events?

2) Did the trauma cause you to experience feelings of intense fear/ horror and powerlessness/impotence/helplessness

3) Does it sometimes feel as if you are reliving or re-experiencing the trauma (ie flashbacks)

4) Do you experience nightmares which are associated with the trauma that you experienced

5) Did the traumatic experience involve you witnessing serious injury/death or did it involve you being seriously injured/threatened with death?

6) Do you have thoughts or mental images related to the trauma which are intrusive, difficult to control and hard to dispel from the mind?

7) When something reminds you of the trauma, or you find thoughts about it intruding on your mind, does it cause serious distress?

8) Do you avoid things that remind you of the trauma? Examples include activities, people and places

9) Do you find you have less interest in activities that you used to enjoy?

10) Are you unable to remember something significant that occurred during the trauma (this is sometimes referred to as repression)

11) Do you try to avoid speaking about what happened during the trauma?

12) Do you find yourself more irritable than you were before the trauma occurred and that you get angry much more often?

13) Do you suffer from insomnia (such as finding it hard to get off to sleep and/or waking too early)?

14) Has your concentration become impaired since the trauma?

15) Do you find you no longer wish to interact with others as much as you did prior to the trauma and that you now have difficulty trusting other people?

16) Do you fear that, because of the trauma you suffered,  it will significantly, negatively impinge upon your future life in areas such as career, relationships and life span?

17) Has your ‘startle response’ become more sensitive since the trauma?

18) Have the symptoms that you’ve experienced since the trauma lasted for a minimum of one month so far?

19) Since the trauma, do you find it harder to feel emotions (eg feeling ‘numb’ for much of the time) and/or harder to display emotions to others?

20) Do you feel hypervigilant (ie feel as if you are constantly on ‘red alert’) for much of the time and constantly have a sense of impending disaster?

21) Have what used to be your everyday routines been disrupted by how you now feel (eg social life, work)?

A guide to interpreting your score :

0-3      It is not likely that you have PTSD

4-9      It is likely you have PTSD

10 +   It is very likely you have PTSD

DISCLAIMER – This does NOT provide you with a diagnosis, it is just a guide. If you suspect you have PTSD, or a related condition, you are strongly advised to seek the relevant professional advice.

 

 

 

The eBook above are available on Amazon for immediate download. CLICK HERE

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


Top 10 Most Common Thoughts of Those with PTSD.

effect of PTSD on thinking

common thoughts of people with PTSD

One of the worst things about post traumatic stress disorder (PTSD) can be that we feel completely alone and cut off from the rest of society. We can feel that nobody else could possibly comprehend the intensity of our suffering. This is certainly what I felt when my depression and anxiety were at their worst – indeed, I felt like this for several years as all therapeutic interventions in the first few years of my condition failed.

When we are at our lowest, it can be helpful to remember that others are suffering as much as we are. In the case of PTSD, research has shown that sufferers tend to have the same kind of thoughts – I list the top ten below:

– I can’t trust people anymore

– Other people want to harm me and the world is a dangerous and  threatening place

– I am utterly helpless

– The reason I can’t cope is that I’m weak

– Something terrible is just about to happen

– I am completely unable to cope and this will never change

– It’s my fault that the trauma happened, I should have done something which would have prevented it

– From now on I can’t make a single mistake, if I do, it will be extremely dangerous to me

– I can never rely on anyone to protect me

– I will never recover from feeling this way

It should be noted that these thoughts could be operating beneath the level of conscious awareness – therapy can help expose these underlying core beliefs and help the individual to replace them with more positive ones; cognitive-behavioural therapy (CBT) is often very effective in this regard. However, some people are uncertain whether or not to seek such therapy (many are available in addition to CBT). As a general guide, it is probably best to seek professional help if you are suffering from symptoms such as those described below:

One of the main questions to ask is:

– Are my symptoms interfering with my social, occupational or academic functioning?

If this is the case, it is definitely advisable to seek expert advice on what kind of therapy may ameliorate your symptoms. Even just talking to someone about the traumatic experience/s can be of value. Specific symptoms that can be addressed through various types of therapy include :

– poor sleep/insomnia

– the development of a harmful dependence on alcohol and/or drugs

– intrusive and distressing nightmares, memories or flashbacks

– constantly feeling agitated and irritable

– difficulty responding on an emotional level  to family/partner

Professional support is particularly advisable for those who are socially isolated and/or have nobody else to talk to about their traumatic experiences.

I hope you have found this post helpful.

Best Wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).