Tag Archives: Complex Ptsd

PTSD And ‘A Sense Of A Foreshortened Future.’

sense of foreshortened future

The DSM 4 (Diagnostic And Statistical Manual Of Mental Illness, 4th Edition) lists one of the symptoms of posttraumatic stress disorder (PTSD) as a ‘sense of a foreshortened future.‘ It is this specific symptom that I wish to concentrate upon in this article.

The psychologists Ratcliffe et al. (2014) suggested, based on their research, that this involved several elements of altered feelings, perceptions and beliefs, some of which I consider (although not exclusively) below.

NEGATIVE VIEW OF THE FUTURE :

An individual suffering from a ‘sense of a foreshortened future’ may have an extremely negative and pessimistic set of beliefs about the future ; these may include :

  • I will die young / soon / prematurely / imminently
  • I will never have a rewarding and successful career
  • I will never find a partner / have a family.

In other words, the individual who is experiencing a ‘sense of a foreshortened future‘ regards the future as bleak, empty a without meaning. 

  • It follows.of course, that the person’s feelings and emotions in relation to the future will also be negative – rather than being hopeful about it, s/he may fear and dread it.

 

ALTERATIONS IN PERCEPTION OF TIME :

Also, such a person may experience severe alterations in his/her perception of how time operates, including :

  • changes in perception of the passage of time and feeling unable to ‘move forward into the future’
  • changes in how PAST, PRESENT and FUTURE are experienced
  • changes in how the relationship between the PAST, PRESENT and FUTURE are experienced
  • the experience of flashbacks (in which the past is experienced as ‘happening now.’
  • a change in perception of the overall structure of experience

FEELING THAT LIFE IS OVER :

Freeman (2000) coined the term ‘narrative foreclosure’ which refers to a strong sense that one’s ‘life story has effectively ended.’ and that there is no further purpose to it, no further meaning that can be derived from it and no possibility that it will contain deep relationships with others or achievement of any kind. The individual affected in this way may also cease to feel s/he cares about anything or can be committed to any cause or project in the future.

In short, a sense of nihilism may prevail.

LOSS OF TRUST :

Also relevant to an individual developing a sense of a foreshortened future is that it is likely to be intertwined with a general loss of trust which may manifest itself through beliefs such as :

  • others cannot be trusted and pose a threat to me
  • the world is a dangerous place that I should interact with as little as possible

THE ‘SHATTERING’ OF ONE’S EXPERIENCE OF WORLD AND OF OTHER PEOPLE :

Greening (1990) puts forward the view that the individual’s ‘relationship with existence itself becomes shattered’. For example, the experience of trauma may leave the individual with a fundamentally altered views about the safety of the world (Herman, 1992) and his/her place within it ; the world seems meaningless, other people undependable and dangerous, and the self of no value.

LOSS OF PREDICTABILITY :

The individual, too, may come to see life as essentially random and unpredictable, feel that s/he can exercise no control over it, and that, therefore, there is no prospect of life unfolding in a dependable, coherent, cohesively structured way – s/he may feel s/he is no longer travelling through life on a reasonably straight set of tracks, but, rather, on tracks that twist and turn at random and from which one may be completely derailed at any time without warning. Indeed, Stolorow (2007) refers to how the individual may lose his/her sense of ‘safety’ and and of any meaningful ‘continuity’ in life.

Such a person may feel that ‘anything can happen at any time’ and that these things will, inevitably, be very bad. Because of this, s/he may feel perpetually trepidatious and vulnerable – alone in a an alien, sinister, hostile and frightening world ; a world in which there is no structure to hold one in place, no coherence and nowhere one can feel safe or a sense of belonging ; it can seem as if the foundations of one’s life are now built on sand rather than on solid ground and, as such, one’s life is liable to collapse at any time and without warning.

foreshortened sense of future

AN UNSHAKABLE SENSE OF IMMINENT DEATH :

Any future goals the individual had may now seem meaningless and pointless – even absurd ; linked to this can be a feeling that one is no longer moving forward in life and that there is no worthwhile direction in which life can go – any direction feels equally futile and devoid of meaning.

And, because the individual now sees only emptiness lying ahead of him/her in life this can translate into a perception that future time itself has somehow dissolved and has been replaced by a kind of ‘temporal vacuum’. This, in turn, leads to a feeling that nothing of meaningful substance lies between the present and death. Future time is anticipated as a void and in this sense ceases to be real – therefore, DEATH FEELS ABIDINGLY AND PERPETUALLY IMMINENT ; no buffer of a meaningful, substantive, solid, structured, ‘block of time’ is perceived to lie between NOW and DEATH’S OCCURRENCE ; instead, just a nebulous, indistinct haze of ‘virtual nothingness.’ (This is a difficult concept to relate to, or, even, comprehend  if one has not experienced such an unhappy state of being – or, perhaps more accurately put, non-being – oneself).

To all intents and purposes, therefore, to an individual suffering from a ‘sense of a foreshortened future, it feels as if one’s life is already over. Indeed, Herman (1992) noted that it was not unusual for those who had been affected by the experience of severe trauma reported feeling as if they were dead or as if part of them had died.

RECOVERY :

The psychologist and expert on trauma and its effects, Herman (referred to above), suggests that there are three main stages involved in recovering from PTSD – to read my article on these three stages, click HERE.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Hypervigilance And Complex Posttraumatic Stress Disorder (Complex PTSD).

hypervigilance and complex posttraumatic stress disorder

If we have grown up in a chronically stressful and traumatic environment in which we often experienced anxiety, trepidation, stress and fear we are at high risk of developing a fundamental, core belief (on a conscious and/or unconscious level) that the world is a dangerous place and that we need to be constantly on ‘red-alert’ and ‘on-guard’ in order to protect ourselves from sustaining further psychological injury.

In other words, we GENERALIZE our perception that our childhood environment was a dangerous place (because of the emotional and/or physical harm done to us there) into a perception that everywhere else/the world in general poses an on-going threat to us.

As a result, we may develop a symptom known as HYPERVIGILANCE.

HYPERVIGILANCE is a main symptom of complex PTSD (complex PTSD is a serious psychological disorder strongly associated with childhood trauma which you can read more about by reading my post entitled : Childhood Trauma : Complex Posttraumatic Stress Disorder (With Questionnaire).

hypervigilance

HOW DOES HYPERVIGILANCE MANIFEST ITSELF?

Individuals suffering from hypervigilance may :

  • constantly analyze the behavior (including body language, facial expressions, intonation etc) of those around them in an attempt to determine if they pose a threat (and, frequently, they may perceive a threat to exist when, in reality, it does not)
  • be in a constant state of anxiety, irritation and agitation
  • have an exaggerated startle response to loud, unexpected noises
  • experience excessive concern regarding how they are viewed by others
  • be excessively suspicious of others / expect others to betray them ; this can give rise to paranoid-like states
  • perceive danger everywhere even though this is not objectively justified
  • easily be provoked into aggression (as a means of defending themselves against perceived threats from others ; in other words, such aggressive outbursts are a (primarily unconsciously motivated) DEFENSE MECHANISM.
  • PHYSICAL SYMPTOMS (including elevated heart rate, hyperventilation, trembling and sweating)
  • have false perceptions that others dislike them, are plotting against them or mean them harm
  • see minor set-backs as major disasters (this is a cognitive distortion sometimes referred to as CATASTROPHIZING.
  • frequently experience fear and panic when, objectively speaking, it is not justified
  • experience obsessive worry and rumination that is intrusive and hard to control
  • suffer from sleep problems (including very frequent waking and nightmares)
  • feel constantly exhausted (due to both sleep problems and the sheer debilitating effects of being in a constant state of anxiety)
  • social anxiety / impaired relationships / social isolation

Therapies For The Treatment Of Hypervigilance :

Therapies that may ameliorate symptoms of hypervigilance include :

Some medications, such as beta blockers, may sometimes also be appropriate, but, it is, of course, always necessary to consult a suitably qualified professional before embarking upon such treatment.

 

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David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Yoga For Complex PTSD

yoga for complex PTSD

Overcoming Trauma Through Yoga: Reclaiming Your Body

 

Studies into the effectiveness of yoga already suggest that it can help to ameliorate both physical and psychological problems including diabetes, arthritis, fibromyalgia, depression and anxiety.

There also now exists evidence (e.g. van der Kolk, 2014, see below)) that it can help to reduce symptoms of Complex posttraumatic stress disorder (Complex PTSD).

Complex PTSD Gives Rise To Both Psychological And Physical Symptoms :

We have already seen how the cumulative effects of exposure to ongoing and repetitive trauma can result in the development of Complex PTSD and that the condition adversely affects the body’s physiology leading to impaired functioning of the autonomic nervous system and associated physical problems that can manifest in various ways including :

Furthermore, such symptoms are, in individuals with Complex PTSD, if not ongoing (though they can be : my own hyperventilation and physical agitation went on for years and the former continues to be set off by what most others would consider to be trivial anxieties, whilst my resting heart rate is still, worryingly, running at over one hundred beats per minute), very easily triggered by even relatively minor stressors ; this is because the individual’s capacity to tolerate stress is dramatically compromised, especially in relation to stressors that are linked (on either a conscious or unconscious level) to memories of the original traumatic experiences.

yoga for complex PTSD

Severe Physical Symptoms Of Complex PTSD May Prevent Or Impair Talk-Based Psychotherapy :

If such physical symptoms of Complex PTSD are severe and remain unaddressed there is potential for them to prevent or impair talk-based psychotherapy. For example, in my own case my physical symptoms were so bad that I frequently either could not attend therapy sessions (as I was unable to leave my flat), or, if I did manage to attend, was unable to focus or concentrate properly.

How Can Yoga Help Those Suffering From Complex PTSD?

Yoga that incorporates physical exercises, breathing exercises and mindfulness can be a more effective treatment of the physiological symptoms of Complex PTSD that talk-based psychotherapy because of the fact that it DIRECTLY ADDRESSES SUCH SYMPTOMS THROUGH BREATHING TECHNIQUES AND BODY WORK. Indeed, recent research supports the effectiveness of yoga in this regard – for example, van der Kolk’s study (2014), which I briefly outline below :

The Study :

  • The participants in the study were adult females with Complex PTSD who had not responded to the intervention of traditional psychotherapy
  • These same females were then randomly allocated to one of two groups as shown below :

GROUP ONE : The females who were randomly allocated to GROUP ONE underwent a TEN WEEK COURSE IN TRAUMA SENSITIVE YOGA (a special form of yoga that was developed at the Boston Trauma Center in the U.S.)

GROUP TWO : The females who were randomly allocated to GROUP TWO did NOT undergo this course.

The Results Of The Study :

The main findings of the study were as follows :

At the end of the ten week period :

  • Those in the treatment group (GROUP ONE) were significantly less likely still to meet the diagnostic criteria for Complex PTSD than those in the non-treatment group (GROUP TWO).
  • Furthermore, those in the treatment group (GROUP ONE) showed a significant reduction in depression and self-harm

Longer term studies have found similar results (e.g. Rhodes, 2014).

CONCLUSION :

Yoga may be an effective complementary treatment option to be used in conjunction with talk-based psychotherapies particularly when physical symptoms of Complex PTSD are so severe that they interfere with talk-based psychotherapies, as in my own case (see above).

A major benefit of yoga for the treatment of the physical symptoms of Complex PTSD is that it addresses such problems directly.

 

If you would like to read my related article : ‘TRAUMA RELEASE EXERCISES’, please click here.

 

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What Are The Differences Between BPD And Complex PTSD? : A Study

difference between complex ptsd and bpd

Because there is a considerable overlap in symptoms between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic disorder (complex PTSD) , those with the latter condition can be misdiagnosed as suffering from the former condition (you can read my article about this by clicking here).

In order to help clarify the differences between the two conditions and help show how they are distinct from one another, this article is about a research study which sought to delineate these two very serious psychiatric conditions.

What Are The Differences In Symptoms Between Those Suffering From Borderline Personality Disorder (BPD) And Those Suffering From Complex Posttraumatic Stress Disorder (Complex PTSD)?

A study into the different symptoms displayed by sufferers of borderline personality disorder (BPD) and complex posttraumatic stress disorder (complex PTSD) involving the study of two hundred at eighty adult women who had experienced abuse during their childhoods and published in the European Journal of Psychotraumatology in 2014 compared the symptoms of those suffering from BPD with those suffering from complex PTSD.

The following results from the study were obtained :

SYMPTOMS SHARED APPROXIMATELY EQUALLY BETWEEN THOSE SUFFERING FROM BPD AND THOSE SUFFERING FROM COMPLEX PTSD :

Some symptoms were found to be shared approximately equally between those suffering from  borderline personality disorder (BPD) and those suffering from complex posttraumatic stress disorder (complex PTSD). The symptoms that fell into this category were as follows :

  • AFFECTIVE DYSREGULATION (ANGER) i.e. frequent feelings of intense rage that the individual cannot control (regulate)
  • VERY LOW FEELINGS OF SELF-WORTH
  • AFFECTIVE DYSREGULATION (SENSITIVE) i.e. feelings of hypersensitivity that cannot be controlled (regulated)
  • INTENSE FEELINGS OF GUILT
  • INTERPERSONAL DETACHMENT / ALONENESS i.e. feeling cut-off and alienated from others, isolated and apart
  • FEELINGS OF EMPTINESS

However, some symptoms were found to be significantly more prevalent amongst those suffering from borderline personality disorder (BPD) than amongst those suffering from complex posttraumatic stress disorder (complex PTSD) as shown below :

SYMPTOMS THAT WERE FOUND TO BE SIGNIFICANTLY MORE PREVALENT AMONGST THOSE SUFFERING FROM BORDERLINE PERSONALITY DISORDER (BPD) THAN AMONGST THOSE SUFFERING FROM COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) :

 

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Retraumatization Caused By Psychiatric Care Institutions

retraumatiztion

Retraumatization :

If the trauma we experienced as children was severe enough, we may, as adults, at one time or another, require residential psychiatric care (such as inpatient treatment on a psychiatric ward in a hospital, as was necessary in my own case on several occasions).

Obviously, the quality of the care we receive in psychiatric facilities can vary very considerably ; unfortunately, this means that, if we are unlucky, we may find ourselves in an environment that not only fails to be therapeutic, but is actively retraumatizing.

In What Ways Can A Psychiatric Facility Retraumatize Us?

According to Fallot and Harris (2001), the ways in which we can be retraumatized in psychiatric institutions can be divided into two main categories ; these are :

1) BY THE SYSTEM (policies, culture, procedures, rules etc). For example :

2) BY THE RELATIONSHIPS WE HAVE WITH THOSE ENTRUSTED WITH OUR CARE (e.g nurses, psychiatrists etc)

Let’s look at each of these in turn :

1)  RETRAUMATIZATION BY THE SYSTEM. Examples of how this may occur include :

– lack of choice regarding treatment ; for example, being prescribed medication when a form of psychotherapy may be more appropriate and more effective.

– not being given the opportunity to give feedback to the professionals caring for us about how we feel in relation to the treatment we are receiving

– being treated impersonally and not as an individual but, instead, according to how one has been ‘labelled’ by one’s diagnosis (two individuals with the same diagnosis may manifest very different symptom and have very different needs. In the case of those who have been diagnosed with borderline personality disorder, such individuals may experience the additional trauma as being regarded as ‘a trouble maker’ due to misinterpretation of the true causes of their behavior.

– constantly having to retell personal details relating to one’s psychological condition.

2)  RETRAUMATIZATION BY THOSE ENTRUSTED WITH OUR CARE.  Examples of how this may occur include :

– betrayal of trust

– feeling one is not being listened to and/or is being rushed when explaining one’s condition

– feeling one’s views are being dismissed /not taken seriously / invalidated

– being spoken to disrespectfully, insultingly or inappropriately

– being subjected to punitive ‘treatment’ methods (e.g. locked in isolation room without toilet or proper bedding)

– lack of communication / collaboration between patient and staff

My Own Experiences :

SECTIONING :  When my illness was at its worst, I was sectioned (despite my ardent protests) because it was felt I was a high suicide risk (which, in truty, I was) ; however, being sectioned accentuated feelings of powerlessness, humiliation and loss of autonomy

AGGRESSIVE/THREATENING PATIENTS : Unfortunately, some patients one is exposed to in psychiatric wards can be aggressive and intimidating, leading to feelings of being unsafe and constantly under threat

UNPROFESSIONAL STAFF : Sadly, occasionally one comes across staff who are not above behaving unprofessionally ; this can exacerbate feelings of mistrust

ELECTRO-CONVULSIVE SHOCK TREATMENT (ECT) : Because I was so ill – utterly unable to function and, indeed, almost catatonic at times, as well as a very high suicide risk, I was ‘strongly encouraged’ to undergo ECT treatment ‘voluntarily’ on several occasions ; in fact, though, there was no genuine choice as I was told that, if I did not undergo it ‘voluntarily,’ I would be sectioned and the act of sectioning me would, in turn, give the hospital the legal right to administer the treatment even without my consent. Due to the controversial nature of ECT treatment, this was an intimidating, degrading and, quite arguably, dehumanizing position in which to be placed. (To read my article about my experience of ECT, click here.)

COMPULSION TO ABSCOND :  Indeed, I often found the conditions to which I was confined so intolerable that, on three occasions, I absconded (each time with the intention of committing suicide – to read about one such incident, see my article On Being Suicidal (Or, Why I Carried A Rope In A Bag Around London For Three Months ).

Obviously, vulnerable patients who find themselves compelled to abscond, as I did, potentially expose themselves to a high level of risk in a multitude of ways.

The Trauma-Informed Environment :

Tailor and Harris (2001) state, based on the main ways in which retraumatization may occur, therapeutic environments that cater for the traumatized (e.g. those suffering from PTSD or complex-PTSD) should be trauma-informed. Trauma-informed environments should :

1) Be calm and comfortable

2) Provide the patient with choice

3) Empower the patient

4) Recognize the strengths and abilities of the patient

5) Involve the patient, as far as possible, in all decision-making processes.

 

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

 

 

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Trauma Triggers : Definition And Examples

 trauma triggers
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Possible Adverse Physical Effects of CPTSD

childhood_trauma_questionnaire

Unfortunately, as well as psychological effects, if we have developed complex post traumatic stress disorder (CPTSD) as a result of our childhood experiences (click here to read my article on the difference between PTSD and CPTSD), the condition can also give rise to adverse physical effects (i.e. bodily/somatic effects).

The main reason for this is that, as sufferers of CPTSD, we tend to be chronically locked into a state of distressing hyper-arousal (which psychologists often refer to as the fight/flight state – click here to read my article on this).

Essentially, this means that our SYMPATHETIC NERVOUS SYSTEM becomes CHRONICALLY OVER-ACTIVATED, which, in turn, can lead to harmful bodily processes resulting in, for example :

– over-production of ADRENALINE (a hormone that is produced by the body when we perceive ourselves to be in danger, preparing us for ‘fight or flight’)

– disrupted sleep (which can have a deleterious effect on our physical health).

– stomach disorders (due to a tightened digestive tract)

– excessive muscle tension

– shallow/rapid breathing (causing us to take in too much CO2 (carbon dioxide)  and not enough O (oxygen) – this can cause panic attacks

– a general inability to relax leading to unhealthy ‘self-medication’ such as excessive drinking, smoking, over-eating, use of narcotics

images

WHAT CAN BE DONE?

There are various strategies we can use to help manage this problem, including :

– stretching exercises

– yoga

– massage

– mindfulness meditation

– self-hypnosis for relaxation

(See ‘RECOMMENDED PRODUCTS’ in the MAIN MENU for mindfulness and self-hypnosis products, or click here).

The above therapies are likely to be more effective if combined with other therapies that address the root of the problem (i.e. adverse childhood experiences). In relation to this, the following may be considered :

– COGNITIVE BEHAVIOURAL THERAPY (CBT) – click here to read my article on this

– DIALECTICAL BEHAVIOURAL THERAPY (DBT) – click here to read my article on this

– EYE MOVEMENT DESENSITISATION AND REPROCESSING THERAPY (EMDR) – click here to read my article on this

RESOURCES :

HELP FOR PTSD – ROYAL COLLEGE OF PSYCHIATRY

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

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Complex PTSD

 

complex PTSD

Complex PTSD:

There has been some controversy regarding the difference between post traumatic stress disorder (PTSD) and complex PTSD amongst researchers.

During the early 1990s, the psychologist Judith Herman noted that individuals who had suffered severe, long-lasting, interpersonal trauma, ESPECIALLY IN EARLY LIFE, were frequently suffering from symptoms such as the following:

– disturbance in their view of themselves

– a marked propensity to seek out experiences and relationships which mirrored their original trauma

– severe difficulties controlling emotions and regulating moods

– identity problems/the loss of a coherent sense of self (click here to read my article on identity problems)

– a marked inability to develop trusting relationships

and, sometimes:

– adoption by the victim of the perpetrator’s belief system

Furthermore, some may go on to become abusers themselves, whilst others may be constantly compelled to seek out relationships with others who abuse them in a similar way to the original abuser (i.e. the parent or ‘care-taker’)

It is most unfortunate that, prior to the identification of the disorder that gives rise to the above symptoms, now referred to as complex PTSD, those suffering from the above symptoms were NOT recognized as having suffered from trauma and were therefore not asked about their childhood traumatic experiences during treatment. This meant, of course, that the chances of successful treatment were greatly reduced.

Research has now demonstrated that the effects of severe, long-lasting interpersonal trauma go above and beyond the symptoms caused by PTSD.

Complex PTSD Symptoms :

The main symptoms of complex PTSD are as follows:

1) severe dysregulation of mood

2) severe impulse control impairment

3) somatic (physical) symptoms (e.g. headaches, stomach aches, weakness/fatigue)

4) changes in self-perception (e.g. seeing self as deeply defective, ‘bad’ or even ‘evil’)

5) severe difficulties relating to others, including an inability to feel emotionally secure or empowered in relationships

6) changes in perception of the perpetrator of the abuse (e.g. rationalizing their abuse/idealization of perpetrator)

7) inability to see any meaning in life/existential confusion

8) inability to keep oneself calm under stress/inability to ‘self-sooth’

9) impaired self-awareness/fragmented sense of self

10) pathological dissociation (click here to read my article on DISSOCIATION)

The DSM IV (Diagnostic and Statistical Manual IV) first named  complex PTSD as: DISORDER OF EXTREME STRESS NOT OTHERWISE SPECIFIED (DESNOS). Now, however, complex PTSD is listed as a SUB-CATEGORY of PTSD.

Whilst it is certainly true that there is an OVERLAP between the symptoms of PTSD and complex PTSD, many researchers now argue that PTSD and complex PTSD should be regarded as SEPARATE and DISTINCT disorders.

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Cognitive Hypnotherapy for Stress Related Disorders.

childhood_trauma_effects

Stress can be defined as the perception that the psychological demands being made upon us exceed our ability to cope with them. It has been well documented that the experience of stress (especially chronic stress) is linked to both physical and psychological disorders.

Sometimes, if the stress experienced is very severe, such as in the case of suffering protracted childhood trauma, the condition of post traumatic stress disorder (PTSD) can develop. For example, research carried out by Donovan et al., (1996) found that childhood physical punishment was strongly associated with the later development of PTSD.

Indeed, childhood trauma in general (be it sexual, emotional, physical, or a combination of these) very significantly increases the probability of developing PTSD later in life – one of the reasons for this is that such adverse early experience can greatly lower our later ability to cope with stress. Thus, as well as being badly affected by stress in childhood, we are also, as a consequence, then far more vulnerable to the effects of stress in adulthood.

Siegel (1996) identified three specific categories of symptoms of PTSD; these are :

A) INTRUSIVE SYMPTOMS (eg flashbacks, preoccupation with trauma related thoughts which are extremely hard to dispel from the mind)

B) EMOTIONAL NUMBING (eg the inability to experience feelings of pleasure – this is formally referred to as ANHEDONIA)

C) HYPERAROUSAL (extreme and uncontrollable responses – for example, the startle response – to trauma related stimuli)

REASONS WHY HYPNOTHERAPY MAY BE OF PARTICULAR BENEFIT TO SUFFERERS OF PTSD :

Hypnotherapy may be particularly beneficial for those who suffer from PTSD due to the fact that there is an analogy between the above three types of symptoms and the three major components of hypnosis. The three components of hypnosis which are analogous to A, B and C above are :

A) ABSORPTION

B) DISSOCIATION

C) SUGGESTIBILITY

Let’s look at why the analogy exists in relation to A, B and C :

A) Because those with PTSD have deeply absorbed their traumatic experiences, it is likely, too, that they will be able to effectively absorb information provided to them whilst in hypnosis

B) Emotional numbing is a form of dissociation (you can read my article on dissociation by clicking here). As hypnotic trance is also a form of dissociation, it is likely that PTSD sufferers will be easily able to enter into the hypnotic trance state

C) Hyperarousal involves heightened responsiveness. This suggests that those who suffer from PTSD will be highly responsive to therapeutic hypnotic suggestions.

HOW ELSE CAN HYPNOTHERAPY HELP THOSE WHO SUFFER FROM PTSD?

Hypnotherapy can help the individual with PTSD to DISTANCE THEMSELVES and DECENTRE from the immediacy of their traumatic experiences.

Also, hypnotic suggestions can be given that help the individual restructure and modify the memory of the trauma in a way that makes it less distressing

Furthermore, it can reduce, or eliminate, any feelings of self-blame the individual may have in connection with their trauma.

THE TELESCOPE TECHNIQUE :

The telescope technique is sometimes used to help individuals recover from PTSD : under hypnosis,  the client is instructed to imagine ‘viewing’ his/her trauma through the wrong end of a telescope – using this mental image, the client is told s/he can increase the length of the telescope to make the trauma ‘look’ yet more distant and tiny. The client practises this technique, and variations of it, throughout several hypnotherapy sessions. Eventually, s/he will be able to apply the technique at will without the assistance of the hypnotherapist. Whilst the technique may sound a little facile, many have found such a technique, or techniques similar to it, can be highly effective at reducing feelings of anxiety and distress connected to the trauma.

childhood_ trauma _workbook

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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).

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