Category Archives: Ptsd/cptsd Articles

PTSD – 3 Steps to Mastering its Effects.

childhood trauma fact sheet18 - PTSD - 3 Steps to Mastering its Effects.

childhood trauma and ptsd

After severe trauma and the development of post-traumatic stress disorder (PTSD), one of the main symptoms the sufferer has to contend with often things which, in themselves, are not at all threatening can strike terror into the heart of the individual as, in his/her own mind, they are connected to, and re-trigger responses to, the original trauma. Psychologists often refer to this process as fear conditioning.

In normal circumstances, when a person learns to be afraid of something through the process of fear conditions, as time goes on the fear will become less intense and fade away. In psychological terminology, the fear gradually becomes extinguished. However, research by the psychologist Charney reveals that in those affected by PTSD, the necessary learning process required to extinguish the fear does not occur. This results in disturbing memories relating to the trauma persisting, in the absence of treatment for many, many years.

However, if the person affected by PTSD undergoes the right experiences in a treatment program, these disturbing memories CAN be made to loosen their grip upon the individual and become manageable, as, indeed, can the thought processes and reactions that these memories trigger.

In terms of brain activity, the fear generated by the brain structure known as the AMYGDALA can be suppressed by greater activity being generated in another brain structure known as the PREFRONTAL CORTEX. How therapy makes this happen I describe below :

Even the symptoms caused by the most severe trauma imaginable can be overcome (incredibly, studies have revealed even Holocaust survivors have recovered from the PTSD caused by their horrific experiences). The key to recovery appears to be by undergoing a process of relearning.

Dr Judith Herman, an expert in the field of trauma recovery, from Harvard University in the USA, suggests that there are three key phases of recovery. These are ;

1) attaining a sense of safety

2) remembering the details of the trauma and mourning the losses that have occurred because of it

3) re-establishing a normal life

Let’s look at each of these steps in turn :

STEP 1 – ATTAINING A SENSE OF SAFETY : this involves aiding the patient in the understanding that his/her feelings of intense anxiety, fear, nightmares, panic, terror etc are due to the condition s/he is suffering, namely PTSD, and are occurring due to brain dysfunction (which can be treated) rather than because there is any real, present threat or danger. By getting the PTSD sufferer to view his/her symptoms from this angle, these symptoms become less frightening.

Also during this initial step, the therapist can help the PTSD sufferer see that although s/he feels helpless (feeling helpless is one of the main symptoms of PTSD), this is not the case (for example, s/he has already started to take control by seeking therapy for the PTSD).

Furthermore, during this first stage of attaining a greater sense of safety and calm, there is the option of medication for symptoms such as intense anxiety and nightmares. Antidepressants which act on the neurotransmitter serotonin in the brain are one option. A second option is the beta-blocker PROPRANOPOL (I was prescribed this drug and still take it; I have definitely found it to be helpful) which reduces activity in the sympathetic nervous system and reduces agitation; new research on the latter drug is giving very encouraging results.

There is also the option of teaching the PTSD sufferer relaxation techniques such as meditation and self-hypnosis.

STEP 2 – REMEMBERING THE DETAILS OF THE TRAUMA AND MOURNING THE LOSSES WHICH HAVE OCCURRED BECAUSE OF IT : once a relatively calm state and greater sense of safety and security has been attained by the individual suffering from PTSD, the second stage of the therapy can be implemented; this involves RETELLING and RESTRUCTURING the story of the trauma in a SAFE and SUPPORTIVE ENVIRONMENT. In this way, the brain’s emotional circuits develop a more realistic comprehension and response to the traumatic memory, and, also, those things that trigger the traumatic memory.

Indeed, the retelling of the trauma in a safe environment when the PTSD sufferer is relatively calm starts to change the memory itself in terms of both its emotional meaning, and, also, therefore, in terms of its effects upon the emotional brain (ie it starts to give rise to LESS distress and anxiety).

In essence, the emotional response to the trauma is RELEARNED.

The therapist encourages the PTSD sufferer to describe the traumatic memory, however horrible, in as much detail as possible and also to describe in detail the feelings that the trauma evoked. The aim is to is to encapsulate, as far as possible, the whole traumatic episode/s in words.

Why is this important? It is thought that this process of capturing what happened in words places the memory more under control of a brain structure called the NEOCORTEX; this makes the reactions the memories lead to more manageable.

Because this all takes place in a safe environment, the PTSD sufferer is able to start to associate the traumatic memory with feelings of safety and relative calm as opposed to terror.

Once this has been achieved the therapist encourages the individual to mourn what the trauma and resultant PTSD caused him/her to lose. This mourning of what has been lost marks the ability to start to let go of the trauma itself.

– STEP 3 RE-ETABLISHING A NORMAL LIFE : this final stage can now take place, in which the individual can begin to rebuild his/her life. Physiological symptoms drop to a manageable level as do feelings connected with the memory of the trauma.

I hope you have found this post helpful.

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

 

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

How Does PTSD Develop?

400dpilogo - How Does PTSD Develop?

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).

 

cropped childhood trauma fact sheet15 200x5921 200x59 - Childhood Trauma: Complex Post Traumatic Stress Disorder (with 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).

imagesca5tpxei - Childhood Trauma: Complex Post Traumatic Stress Disorder (with Questionnaire).

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 POSTTRAUMATIC STRESS DISORDER (CPTSD) 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:

CPTSD QUESTIONNAIRE

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.

RESOURCES :


q? encoding=UTF8&MarketPlace=GB&ASIN=1623158249&ServiceVersion=20070822&ID=AsinImage&WS=1&Format= SL250 &tag=childhoodtr0c 21 - Childhood Trauma: Complex Post Traumatic Stress Disorder (with Questionnaire).ir?t=childhoodtr0c 21&l=am2&o=2&a=1623158249 - Childhood Trauma: Complex Post Traumatic Stress Disorder (with Questionnaire).

Click image above for further details or to download free sample.


DIGITAL BOOK THUMBNAIL 1 1 - Childhood Trauma: Complex Post Traumatic Stress Disorder (with Questionnaire).

Above eBook, Childhood Trauma And Its Link To CPTSD, now available on Amazon for immediate download. 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

Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.

 

childhood trauma fact sheet51 1 200x60 - Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.

Trauma And Brain Development

How are early life trauma and brain development related?

Recently, there have been various cutting-edge studies into the neurological effects of child abuse and child neglect- in other words, how childhood trauma has been shown to damage the developing physical brain.

It has been shown that BEHAVIOURAL PROBLEMS, following childhood trauma, can be scientifically traced back in origin to damage, caused by child abuse, neglect etc., to both the brain’s PHYSICAL STRUCTURE and its CHEMISTRY. As well as behavioural problems resulting from this damage, it has also been shown to impair the sufferer’s ability to LEARN.

Indeed, it has been estimated that about 75% of children in the care system could have suffered such adverse effects on the physical brain following their particular traumas.

THE POSITIVE NEWS

This is all very depressing; however, there is also good news: the damage that the brain has suffered is NOT ALWAYS PERMANENT. If therapeutic interventions are made, especially when the brain is still developing during childhood, the brain is able, to some extent (due to its plasticity), to rewire itself in such a way that development can return much closer to the norm than it would have done without such intervention. The intervention needs to include the child being given a loving, secure, stable and supportive environment.

In general, the more protracted and intense the childhood trauma, the more serious the damaging effects on the physical brain will have been.

c - Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.

Above –  Trauma and brain development: An illustration of how childhood trauma can seriously, adversely affect physical development of the brain

 

WHICH BRAIN REGIONS ARE AFFECTED?

Severe and prolonged childhood trauma has been demonstrated to potentially damage:

a) THE CORTEX (the function of the cortex is to facilitate RATIONAL THINKING).

b) THE HIPPOCAMPUS (the function of the hippocampus is, in part, to facilitate the REGULATION of our EMOTIONS).

Given that these regions of the brain are sometimes damaged by childhood trauma, and given the function of these regions, we need hardly be surprised that if we have suffered childhood trauma we might find ourselves behaving IRRATIONALLY at times and finding it very difficult to CONTROL OUR EMOTIONS.

Indeed, in one study it was found those who had suffered childhood trauma were much more likely to have:

a) an underdeveloped cortex

b) a smaller hippocampus

Further studies have found that another brain area, the AMYGDALA (which also has a very prevalent role in regulating our emotions) becomes OVERSENSITIVE and OVERACTIVE in those who have suffered childhood trauma. As a result, it will often signal extreme danger – putting us constantly on ‘red-alert’, as it were – even when, in objective terms, there is no, or very little, danger threatening us. Our fear response, then, operates on a hair-trigger.

HOW BRAIN CHEMISTRY IS AFFECTED BY CHILDHOOD TRAUMA:

Studies have also found that prolonged and severe STRESS in early life can also affect the production of chemicals (also known as neurotransmitters) in the brain. For example:

a) CORTISOL (which regulates stress)

b) SEROTONIN (which is closely tied to MOOD and BEHAVIOUR)

Dysfunction of these chemicals leads, respectively, to:

a) us becoming far more susceptible and far more likely to be adversely affected by stress

b) us becoming far more prone to severe, CLINICAL DEPRESSION and much more prone than normal to IMPULSIVE VIOLENCE/AGGRESSION.

content 4964975 DIGITAL BOOK THUMBNAIL1 - Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.

Above eBook available on Amazon for immediate download.  CLICK HERE.

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.

Traumatic Memories

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.

download50 - Childhood Trauma Leading To 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