Tag Archives: 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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Prolonged Exposure Therapy And Posttraumatic Stress Disorder (PTSD)

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

– situations related to the traumatic experience

– people related to the traumatic experience

– places related to the traumatic experience

– activities related to the traumatic experience

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

a) In Vivo Exposure

b) Imaginal Exposure

In Vivo Exposure :

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

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

Imaginal Exposure:

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

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

How Effective Is Prolonged Exposure Therapy?

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

What Is The Duration Of The Treatment?

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

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

RESOURCES :

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

eBook :

 

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

 

 

 

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PTSD, Self-Hypnosis And Positive Recontextualizing Of Intrusive Memories

According to the psychologist, Spiegel, self-hypnosis can be a useful tool to help individuals suffering from posttraumatic stress disorder (PTSD) overcome problems associated with the troubling symptom of disturbing, intrusive memories of the original trauma.

Spiegel states that self-hypnosis may be particularly useful because certain qualities of the hypnotic experience have much in common with qualities of the experience of the symptoms of posttraumatic stress disorder (PTSD), examples of which include :

– a feeling of reliving the traumatic event

– feelings of dissociation (detachment from reality)

– hypersensitivity to stimuli

– a disconnection between cognitive and emotional experience

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Spiegel argues that this similarity between hypnotic phenomena and the symptoms of posttraumatic stress disorder (PTSD) make sufferers of this most serious and disturbing disorder more hypnotizable than the average member of any given randomly selected population.

It follows from this that those suffering from posttraumatic stress disorder (PTSD) may be particularly likely to be helped by the utilization of hypnotic techniques and procedures, particularly ‘coupling access to dissociative traumatic memories with positive restructuring of those memories’ (Spiegel et al., 1990). By this statement, Spiegel is suggesting that hypnosis could help bring traumatic memories more fully into conscious awareness and alter the way in which they are stored in memory by associating / pairing / linking them with feelings of safety (such as the feeling of being safe and protected in the therapist’s consulting room) rather than, as had previously been the case, high levels of distress.

pack-beat-fear-anxiety

In this way, Spiegel suggests, when these previously disturbing memories are recalled in the future, because they are now associated / paired / linked with feelings of safety, they cease to induce distress.

In effect, then, the traumatic memories have become positively recontextualized  and deprived of their previous power to induce feelings of fear, anxiety and terror.

Therapies other than hypnosis and self-hypnosis that are related to the above theoretical ideas include :
1) Eye Movement Desensitization And Restructuring

2) The Rewind Technique

3) Exposure Therapy

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

 

 

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The Serious Harm Trauma Can Do To Our Nervous System

 

Not very long ago, I was in the supermarket, and, as the till assistant was scanning my shopping items, he gave me a quizical look and asked, ‘Are you alright, you seem to be breathing very heavily?’ This was unexpected and made me feel even more self-conscious than I normally do. In such situations, my mind usually goes blank and I only later realize what I should have said (l’esprit de l’escalier, as I believe they say in France).

However, on this occasion, I did, unusually for me, manage to mutter an immediate response, attempting to casually pass off my canine-like panting as a mild attack of asthma (untrue). The till assistant eyed me wearily, looking disconcertingly unconvinced, as I hastily paid for my items and made my shame-faced escape, immediately lighting a cigarette once back on the street ( thus making my ‘asthma’ excuse look all the more ludicrous).

As a result of this, I’ve been too embarrassed to return and have been forced to take my business elsewhere.( The new supermarket I go to never seems to stock what I want. On the odd occasion they do stock what I want, it seems that once they realize this they immediately discontinue stocking it.)

The truth of the matter is that, at the time, I was pretty much constantly hyperventilating. In this article, I want to look at why and how this can happen.

 

 Above – a suggested breathing exercise to help manage the physiological effects of stress.

We have seen in other articles I have published on this site that there is a significant link between the experience of severe childhood trauma and the subsequent development of post traumatic stress disorder (PTSD) in later life.

If we have developed PTSD, one of the main reasons it can be so intensely distressing is the effect severe and protracted exposure to traumatic stress can have on the body, or, more specifically, the nervous system.

After severe and prolonged trauma, the body can, in effect, become stuck in ’emergency mode.’ In this state, we either ‘freeze’ or else enter the well known ‘fight or flight’ state. The psychological researcher, Levine, with regard to this, suggested that, in response to trauma, we sometimes get stuck in the ‘freeze’ state so that the physiological arousal caused by the fear our experience of trauma has induced becomes trapped in our nervous system and cannot be dissipated.

This, in turn, makes the nervous system yet more vulnerable and sensitive to the effects of stress, so that further stressors in life (on top of the stress of the original trauma) compound the problem exponentially.

To illustrate how this pent up physiological arousal cannot be discharged (making us feel constantly keyed up, on edge and agitated) Levine uses the metaphor of a car being revved up but with the brakes on. Just as this puts great strain on a car’s engine, so, too, is our nervous system placed under enormous strain by a similar process.

In this way, a vicious circle develops: the more stressed we become, the less able the nervous system is able to cope, so the more stressed we become…and so on …and so on…

This highly distressed state actually alters the cells in our nervous system (in a process called KINDLING) and it is this that causes our nervous system to become hypersensitive and hyper-reactive, particularly in response to any stressors which, consciously or unconsciously, remind us of our original trauma.

 

To find out about PTSD treatment options, click here.

 

Recommended Resource:

 

Overcome Hypervigilance Clinical Hypnotherapy MP3. Immediate download. Click here for further information.

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

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Copyright 2015 Child Abuse, Trauma and Recovery

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

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The Main Elements Of Posttraumatic Growth

childhood-trauma-fact-sheet

Many people, after suffering a terrible trauma, find that, once they have got through it and started to recover from its damaging psychological effects, they eventually reach a stage whereby they are able to use their adverse experiences to develop them as a person in highly positive ways that benefits both themselves and society at large. This has been termed by psychologists posttraumatic growth (click here to read an earlier article I have written about this).

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After experiencing trauma comes a slow process of recovery (assuming effective therapy is sought); the length of time recovery takes will depend both upon the type, intensity and duration of the trauma, as well as the age the individual was when s/he experienced the trauma, and also the affected individual’s personal characteristics, temperament and genetic make-up.

Once the person who experienced the trauma is able to manage his/her painful and distressing emotions more effectively, finds memories of the trauma less difficult to cope with, and is able to function reasonably well on a day to day basis, a transition can start to take place in which the person begins the process of moving on from recovery into posttraumatic growth. Ideally, this period of growth and development should be guided and facilitated by an appropriately qualified and experienced therapist.

The process of posttraumatic growth involves taking stock of what happened and analysing its significance. The American Psychological Association identify ten key elements that the process involves :

1) re-establishing meaningful relationships with other people

2) accepting that change is an inevitable part of life

3) setting goals and starting to move towards them

4) taking decisive action

5) working on developing a positive self-view

6) learning from the past

7) good self-care

8) developing an optimistic outlook

9) seeking out opportunities for self-discovery

10) seeing crises as challenges rather than as insurmountable obstacles

-76_AA278_PIkin4,BottomRight,-69,22_AA300_SH20_OU02_childhood traumachildhood trauma therapies and treatments

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

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Post Traumatic Stress Disorder (PTSD) Questionnaire

PTSD test

test for post traumatic stress disorder

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.

childhood traumachildhood trauma therapies and treatmentschildhood trauma borderline personality disorder

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PTSD – 3 Steps to Mastering its Effects.

dealing with ptsd

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).

 

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Trauma: How Cognitive Processing Therapy can Help.

It is always important to treat post-traumatic stress and this is particularly the case in relation to childhood trauma. This is because it is during childhood that we form our core beliefs about ourselves, others and the world in general. Childhood trauma can severely distort these beliefs in a highly destructive manner. Without treatment, these damaging views and beliefs can endure for a life-time, blighting the entire life of the affected individual, even ruining it.

Cognitive Processing Therapy (CPT) is a particular type of Cognitive Behaviour Therapy (CBT) and there is now much evidence from research studies that it can prove highly effective in the treatment of the effects of trauma:

Frequently, individuals who have suffered childhood trauma find themselves in a perpetual and distressing struggle with painful memories. Thoughts about these often become circular and overwhelming, never reaching a resolution. The person experiencing them can feel more and more conflicted as time goes on if effective treatment is not sought.Indeed, many who seek therapy do so because they find they have become ‘stuck’ or ‘caught up’ in their painful thoughts, memories and feelings and they feel unable to properly integrate or make sense these.

CPT helps people to understand what they went through, how it affected them, and how it has affected, in a negative and distorted way, their view of themselves, others and the world in general (psychologists refer to such thinking as a ‘negative cognitive triad’, one of the key symptoms of clinical depression).

CPT aims to help individuals rectify this negative cognitive triad and gain AUTHORITY over their trauma-related memories and feelings, or, to put it another way, CPT helps people to be IN CONTROL OF THEIR MEMORIES AND RELATED FEELINGS, rather than the other way around.

Many individuals who have experienced childhood trauma, also, very frequently, find themselves ‘living in the past’: continually brooding on what happened, why it happened and how it has adversely affected their lives; such ruminations may become obsessive. CPT helps break this pattern of thinking: one of the key elements of CPT is to help people CREATE A BOUNDARY BETWEEN THE PAST AND THE PRESENT so that the individual can free him/herself to finally live in the ‘now’ rather than the ‘then’.

For more information about CBT and help for recovery from trauma a good site is: http://www.psychologytools.org/ptsd.html

Because I found CBT very useful in my own recovery, and, additionally, because it has a very solid evidence base showing that it is an effective therapy, I have listed links to two online CBT courses below :

I found CBT an important part of my recovery and therefore highly recommend A Clinically Proven Online CBT Course For Panic and Anxiety Disorder Created By Professional Therapists. Adheres to the Ethical Guidelines set down by the British Association for Behavioural and Cognitive Psychotherapists (BABCP). FREE 30 DAY TRIAL.Click Here!

CBT program to address anxiety featuring the A.W.A.K.E.method. Full refund within 15 days of purchase if unsuitable. Click Here!.

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

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