Category Archives: Ptsd/cptsd Articles

How Does PTSD Develop?

causes of ptsd

childhood trauma and ptsd

WHAT IS THE DEVELOPMENTAL PROCESS OF POST TRAUMATIC STRESS DISORDER (PTSD)?

The psychologists Foa et al developed the following model to illustrate the psychological process through which PTSD develops.

When a person experiences something which is very traumatic the memory becomes enmeshed into the brain’s circuitry – in essence, a FEAR STRUCTURE becomes incorporated into the brain.

THE FEAR STRUCTURE can be divided into 3 individual units. These are as follows :

a) STIMULI of the trauma. This refers to things which my trigger memories of the trauma. Stimuli my gain access to the brain via any of the 5 senses (ie sight, hearing, smell, taste and touch). To use a simple example, someone traumatized by being injured in an explosion in a war may have the trauma response triggered by loud bangs such as fireworks going off (the loud bang being the stimuli).

b) RESPONSES to the traumatic event. This includes both physiological responses (eg racing pulse, hyperventilation) and psychological responses (such as a feeling of terror).

c) MEANINGS ATTRIBUTED TO THE STIMULI AND RESPONSES (eg this means I must be in great danger).

When somebody suffering from PTSD experiences an event which triggers the original memory of trauma, laid down in the brains circuitry, they feel intense distress. Typically, in response to this distress, they will take evasive action (ie try to evade, or get away from, the event which is triggering the traumatic response). It is the meaning aspect of the fear structure ( c, above) which creates the most anguish. The problem lies in the fact that they find it exceptionally difficult to reconcile their old (pre-trauma) beliefs about events and their new (post trauma) beliefs about events (doing this successfully, which therapy can help them, eventually, to do, is known as the PROCESS OF ACCOMMODATION).

An example of pre- and post- traumatic beliefs, which, if the process of accommodation has not taken place, would be in opposition with one another are :

PRE-TRAUMA – the world is a pretty safe place in which I can generally feel relaxed in

POST-TRAUMA – the world is very dangerous and unpredictable and I must always be on my guard against threats which seem to be coming at me from every direction (at worst, leading to clinical paranoia)

COMPULSION TO MAKE SENSE OF THE TRAUMATIC BELIEF

The individual who suffers from PTSD will often try , obsessively, to make sense of the traumatic event which occurred to him/her. This arises because s/he finds it impossible to square what has occurred with pre-trauma beliefs.

THE DEEP PSYCHOLOGICAL PAIN OF TRYING TO MAKE SENSE OF THE TRAUMATIC EVENT

Whilst the individual suffering from PTSD feels driven to make sense of the trauma, constantly thinking about it creates feelings which are both terrifying and overwhelming. THIS CREATES A TERRIBLE PSYCHOLOGICAL TENSION IN THE MIND – there is the PULL TOWARDS ATTEMPTING TO MAKE SENSE OF WHAT HAPPENED ON THE ONE HAND, BUT ALSO THE PULL OF TRYING TO STOP THINKING ABOUT IT ON THE OTHER.

Foa and her colleagues have put forward the theory that it is the tension, created by having one’s thoughts pulled powerfully in two directly opposing directions, which leads to the extreme HYPERAROUSAL (intense anxiety).

The two opposing views of the world the individual tries desperately to fit together (‘safe world’ versus’ unsafe world’) is rather like trying to FIT TWO PIECES OF JIGSAW TOGETHER, ONE OF WHICH HAS BEEN DAMAGED, SO IT NO LONGER FITS.

Therapy can lead to a resolution of this dilemma, leading to a compromise belief, linked to the two opposing beliefs, such as :

THE WORLD IS GENERALLY SAFE FOR ME BUT NOBODY HAS A COMPLETE GUARANTEE, OCCASIONALLY BAD THINGS HAPPEN.

TREATMENTS :

COGNITIVE BEHAVIOURAL THERAPY IS AN EFFECTIVE TREATMENT FOR THE EFFECTS OF TRAUMA – there is a lot of research evidence to support this.

Also, hypnotherapy can provide relief from many of the symptoms of trauma (eg anxiety, fear etc).

TO FIND OUT MORE ABOUT HYPNOSIS, HERE IS A LINK TO A RECOMMENDED HYPNOTHERAPY BLOG TO WHICH THIS SITE IS AFFILIATED : http://www.hypnosisdownloads.com/blog/feed/?a=5719!blog

I hope you have found this post of use.

Best wishes, David Hosier BSc Hons ; MSC ; PGDE(FAHE).

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery

Childhood Trauma: Complex Post-Traumatic Stress Disorder (with Questionnaire).

 

complex post traumatic stress disorder questionnaire

Survivors of extreme trauma often suffer persistent anxiety, phobias, panic, depression, identity and relationship problems. Many times, the set of symptoms the individual presents with are not connected to the original trauma by those providing treatment (as certainly was the case for me in the early years of my treatment, necessitating me to undertake my own extensive research, of which this blog is partly a result) and, of course, treatment will not be forthcoming if the survivor suffers in silence.

Any treatment not linked to the original trauma will tend to be ineffective as THE UNDERLYING TRAUMA IS NOT BEING ADDRESSED. Also, there is a danger that a wrong diagnosis may be given; possibly the diagnosis will be one that may be interpreted, by the individual given it, as perjorative (such as a personality disorder).

ptsd

Individuals who have survived protracted and severe childhood trauma often present with a very complex set of symptoms and have developed, as a result of their unpleasant experiences, deep rooted problems affecting their personality and how they relate to others. The psychologist, Kolb, has noted that the post-traumatic stress disorder symptoms survivors of severe maltreatment in childhood might develop ‘may appear to mimic every personality disorder’ and that ‘severe personality disorganization’ can emerge.

Another psychologist, Lenore Terr, has differentiated between two specific types of trauma: TYPE 1 and TYPE2. TYPE 1 refers to symptoms resulting from a single trauma; TYPE 2 refers to symptoms resulting from protracted and recurring trauma, the hallmarks of which are:

– emotional numbing
– dissociation
– cycling between passivity and explosions of rage

This second type of trauma response has been referred to as COMPLEX POST-TRAUMATIC STRESS DISORDER, and more research needs to be conducted on it; however, an initial questionnaire to help in its diagnosis has been developed and I reproduce it below:

1) A history of, for example, severe childhood trauma

2) Alterations in affect regulation, including
– persistent dysphoria
– chronic suicidal preoccupation
– self-injury
– explosive or extremely inhibited anger (may alternate)
– compulsive or extremely inhibited sexuality (may alternate)

3) Alterations in consciousness, including
– amnesia or hypernesia for traumatic events
– transient dissociative episodes
– depersonalization/derealization
– reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation

4) Alterations in self-perception, including
– a sense of helplessness or paralysis of initiative
– shame, guilt and self-blame
– sense of defilement or stigma
– sense of complete difference from others (may include sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)

5) Alterations in perceptions of perpetrator, including

– preoccupation with relationship with perpetrator (includes preoccupation with revenge)
– unrealistic attribution of total power to perpetrator (although the perpetrator may have more power than the clinician treating the individual is aware of)
– idealization or paradoxical gratitude
– sense of special or supernatural relationship
– acceptance of belief system or rationalizations of perpetrator

6) Alterations in relations with others, including

– isolation and withdrawal
– disruption in intimate relationships
– repeated search for rescuer (may alternate with isolation and withdrawal)
– persistent distrust
– repeated failures of self-protection

7) Alterations in systems of meaning
– loss of sustaining faith
– sense of hopelessness and despair

Anyone who feels their condition may be reflected by the above is urged to seek professional intervention at the earliest opportunity.

Above eBooks now available on Amazon for immediate download. $4.99. Click here.

 

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

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery

Exciting Early Research Findings on the Medication Propranolol’s (a Beta-Blocker) Effectiveness for Treating Symptoms of Trauma.

Recent studies on the beneficial effects of the beta-blocker medication PROPRANOLOL on REDUCING THE ADVERSE SYMPTOMS OF TRAUMA are very encouraging and exciting.

One study, by Dr Roger Pitman, involving 22 patients, found that anxiety associated with trauma was greatly reduced in those patients given the drug compared with those who were not given it.

In another study, conducted in France, it was found that anxiety in patients suffering the effects of trauma was halved compared to those patients to whom the drug was not administered.

HOW IS THE BETA-BLOCKER PROPRANOLOL THOUGHT TO WORK?

What is particularly exciting about this drug is that it is thought to actually WEAKEN THE NEURAL MEMORY TRACE OF THE MEMORY ITSELF.

The drug blocks beta receptors in the brain, reducing the effects of adrenaline on neurons (neurons are brain cells).

The drug works on the SYMPATHETIC NERVOUS SYSTEM which has the effect of reducing physiological symptoms associated with anxiety such as a pounding, racing heart and rapid, shallow breathing (also known as hyperventilation).

Individuals suffering from the effects of trauma often report having vivid and intense memories of the traumatic event/s. It is thought that the drug addresses this problem by acting on the memory trace, causing it to fade away and decay normally, thus greatly weakening its grip on the individual and ameliorating symptoms of anxiety.

One study has even demonstrated that just a single dose of propranolol, in certain, specific cases, can be of benefit (although it is usually prescribed over the long-term).

FURTHER RESEARCH:

As stated above, research into the uses of this drug to treat the effects of trauma is at an early stage; more studies are being conducted. It should be pointed out, though, that the drug is not effective in every case.

Anyone considering taking the medication should discuss it with their doctor.

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

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery

Childhood Trauma Leading To Traumatic Memories.

effects-of-childhood-trauma

Remembering traumatic events is in some ways beneficial. For example, it allows us to review the experience and learn from it. Also, by replaying the event/s, its/their emotional charge is diminished.

However, sometimes the process breaks down and the memories remain powerful and frightening. Sometimes they seem to appear at random, and at other times they can be TRIGGERED by a particular event such as a film with a scene that shows a person suffering from a similar trauma to that suffered by the person watching it.

Traumatic memories can manifest themselves in any of the 3 ways listed below:

FLASHBACKS
INTRUSIVE MEMORIES
NIGHTMARES

1) FLASHBACKS

These are often intense, vivid and frightening. They can be difficult to control, especially at night.

Sometimes a flashback may be very detailed, but at other times it may be a more nebulous ‘sense’ of the trauma.

Sometimes the person experiencing the flashback feels that they are going mad or are about to completely lose control, but THIS IS NOT THE CASE.

Traumatic_memories

2) INTRUSIVE MEMORIES

These are more likely to occur when the mind is not occupied. They are more a recollection of the event rather than a reliving of it. When they do intrude, they can be painful. Often, the more we try to banish them from memory the more tenaciously they maintain their grip.

3)NIGHTMARES

These can replay the traumatic events in a similar way to how they originally happened or occur as distorted REPRESENTATIONS of the event.

HOW RELIABLE ARE MEMORIES OF TRAUMATIC EVENTS?

There used to be concern that some memories of trauma may be false memories. However, the latest research suggests that memories of trauma tend to be quite accurate but may be distorted or embellished.

However, false memories CAN occasionally occur. This is most likely to happen when someone we trust, such as a therapist, keeps suggesting some trauma (eg sexual abuse) must have happened.

It is important to remember, though, that parents or carers will sometimes DENY or DOWNPLAY and MINIMIZE our traumatic experiences due to a sense of their own guilt. In other words, they may claim our traumatic memories are false when in fact they are not.

REPRESSION

Very traumatic memories may sometimes be REPRESSED (buried in the unconscious with no conscious access to them). In other words, we may forget that a trauma has happened. As I suggested in PART 1, this is a defense mechanism. Sometimes the buried memories can be brought back into consciousness (eg through psychotherapy) so that the brain may be allowed to process and work through the memories allowing a recovery process to get underway.

Further Information:

An excellent link to read more about traumatic memories can be found by clicking here.

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

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery