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


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


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

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

– talk to others about how we are feeling

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

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

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

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

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

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

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

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

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

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

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


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Posttraumatic Growth – Reconstructing The Life Story We Tell Ourselves


We make sense of our lives by telling ourselves a story about it – however, this does not mean the story we tell ourselves reflects reality, not least because how we act and behave are often motivated by unconscious processes of which, by definition, we are unaware.


Those who have suffered abusive childhoods very often grow up to believe that they are a ‘bad’ person (click here to read my article in which I explain why this is). Usually, this is the case because they are telling themselves an inaccurate life story (for example, part of the story they tell themselves might be : ‘I deserved to be badly treated as a child because I am a bad person’).

However, in order to recover from the effects of a traumatic childhood, and to start to enter a phase of posttraumatic growth, we need to adjust the story we tell ourselves; this can be achieved by understanding that our bad treatment in childhood was not our fault and that our adult behaviours, which might have been highly self-destructive, have their roots in our childhood experiences.

So, to slightly extend the example above,let’s suppose that the story we have been telling ourselves to make sense of our lives boils down to :

‘I was badly treated as a child because I am a bad person. My adult behaviour confirms that I am a bad person.’ (Old story)


once we understand and make sense of our traumatic experiences, what has happened in our lives takes on a whole new meaning, allowing us to reconstruct our life story to, for example :

‘The bad treatment I received as a child was not my fault. Problem behaviours that I have developed as an adult, resulting from my traumatic experiences, are understandable and forgivable. How I have been feeling and behaving as an adult is a NORMAL REACTION TO ABNORMAL EXPERIENCES. (New adjusted/reconstructed story we need to tell ourselves about our lives to allow posttraumatic growth to take place)

This new understanding of what has really happened in our lives is often a source of great relief and we need to ensure this enlightenment becomes a FUNDAMENTAL part of the new life story that we tell ourselves.

Changing our view of our life story in this way will NOT mean we suddenly become completely free of emotional distress; however, it can mark a point at which we can start to recover, and, with sufficient posttraumatic growth, become a much stronger and, indeed, thriving person.


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David Hosier BSc Hons; MSc; PGDE(FAHE)


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The Main Elements Of Posttraumatic Growth


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).


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

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Childhood Trauma – Steps to Recovery

childhood trauma and stages of recovery

childhood trauma and stages of recovery

It is important to remember that, no matter how severe our particular experiences of childhood trauma were, people can, and do, recover from such experiences if they undergo an appropriate form of therapy ; cognitive behavioural therapy, or CBT (click here to read my article on how CBT can help) for example, is now well established by research findings to be a very effective treatment.

In analysing the recovery process from childhood trauma, it is possible to break it down into seven stages ; I present these stages below :


1) The first very important thing to do is to stop seeing ourselves as abnormal because of the effect our childhood trauma has had on us, but, instead, to see our symptoms/resultant behaviours as A NORMAL REACTION TO ABNORMAL EVENTS/EXPERIENCES.

It is very important to realize that it is highly probable that other people would have been affected in a very similar way to how we ourselves have been affected had they suffered the same adverse experiences that we did.

Coming to such a realization is, I think, important if we wish to keep up our self-esteem.

The kinds of symptoms and behaviours that childhood trauma can lead to are examined in detail in my book ‘The Devastating Effects Of Childhood Trauma’ – see below.

2) A very therapeutic effect can often be achieved by opening up about our traumatic experiences and how we feel they have affected us by talking to others we trust about such matters.

3) If at all possible, it is important that, during the recovery process, we are in an environment in which we feel safe and secure, and which is as stress – free as possible.

4) It is also extremely important that we try to resume normal everyday activities and interpersonal relationships as soon as possible, even if this requires some effort at first. Indeed, the research suggests recovery is very difficult if we do not re-establish human relationships. Also, we need to try to build some structure into our daily lives, as this provides a foundation of stability.

5) We need to accept that we may need much more rest than the average person – this is because the brain needs time to recover. In relation to this, getting the correct nutrients (click here to read my article on this) and sufficient sleep (I needed far more than 8 hours during my recovery) is also very important.

6) We also need to realize that while our experience of trauma entailed a great deal of suffering, many people not only recover from childhood trauma but develop as a human being in extremely positive ways as a result of it ; this phenomenon is known as post traumatic growth (click here to read my article on this).


imagesOG4KSWWLpost traumatic growth

7) Therapy should be seriously considered as there are now many studies which provide extremely solid evidence that therapies such as cognitive behavioural therapy (CBT) can be highly effective. There are many other therapies and self-help strategies, too; I examine these in my book ‘Therapies For The Effects Of Childhood Trauma’ (see below).

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

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How Posttraumatic Growth Relates to Coping Strategies


It is possible, once the worst of the distress caused by trauma is over, to enter a period of posttraumatic growth (click here to read my article on this) in which the experience of our trauma can be used to POSITIVELY TRANSFORM US.

3 responses to trauma- ptsd, resilience, growth

How successful we are in achieving posttraumatic growth is significantly tied up with the coping strategies we employ in the aftermath of our traumatic experiences.

There are two main types of coping strategy ; these are :

1) APPROACH ORIENTED COPING (this strategy involves either changing the situation or managing the emotions we feel in relation to the trauma)

2) AVOIDANCE ORIENTED COPING (this strategy involves ignoring the problems and difficulties we are facing in as far as it is possible and distracting ourselves from them.

Much research has been conducted in relation to the relative effectiveness of these strategies and, as most of us would expect, it has been overwhelmingly shown that, over the long-term, approach oriented coping strategies are superior and lead to much greater posttraumatic growth.

Unfortunately, however, one of the key symptoms of post traumatic stress disorder (PTSD) is that those who suffer from it have a very marked tendency to avoid anything connected to the trauma that they have experienced.

Avoidance coping strategies are not all bad and are likely to have some short-term benefits in many cases, such as helping to protect us until we are ready to confront the trauma which has affected us. In the long-term, however, denial and avoidance are unlikely to lead to posttraumatic growth.

Short-term avoidance can, then, be healthy as it can reflect the fact that the traumatic event was overwhelming and could not be immediately processed. indeed, in referring to the trauma that has been experienced people often use terms like, ‘it’s too big to take in’ or, ‘i can’t accept this has happened ; it can’t be real.’ etc.

However, if avoidance goes on for too long it can prevent the person from working through their problems and the emotions which relate to them. Recovery can be blocked, preventing posttraumatic growth.

It is therefore very helpful, when ready, to move on from using avoidance oriented coping strategies to using approach oriented coping strategies. Using the latter involves accepting what has happened, processing it and working through the emotions the trauma has given rise to. In short, it involves trying to manage the situation in which we now find ourselves.

choosing the direction of our lives after trauma




Task focused coping involves simply working out and implementing as many practical solutions to the problem as possible. This will vary widely from one set of traumatic experiences to another.

Emotion focused coping involves managing our psychological distress.

How we perceive our situation will dictate which of the above two coping strategies we use. If we perceive that positive change is possible and within our control we are likely to use task focused coping strategies. If, on the other hand, we regard a change in our situation to be impossible, we are likely to take advantage of emotion focused coping strategies.

Often, because of the effect the trauma has had on how we think, we may falsely believe there is nothing we can do to improve our life, whereas, looked at objectively, there is. For those who feel this may apply to them, cognitive-behavioural therapy (CBT) can be extremely helpful (click here to read my post on CBT).

One very important emotion focused coping strategy is to seek social support; such support may come from family, friends or professionals. By talking through our situation with others in our social support system we can gain new perspectives, new insights and new understanding which can lead to us positively transforming the meaning that our experience of the trauma has for us. This, in turn, leads to posttraumatic growth.

The quality of the social support we receive is more important than the quantity and it is ESPECIALLY HELPFUL WHEN IT HELPS TO MOTIVATE US TO START TAKING RESPONSIBILITY FOR OUR OWN LIVES.

Also, the better we are able to express our emotions relating to our trauma within our social support system, the more our posttraumatic growth tends to flourish. Intense emotions such as FEAR, ANGER, SHAME, GUILT and RAGE can be VERY DESTRUCTIVE if we do not allow ourselves to talk them through and finally let go of them. Indeed, hanging on to such feelings is extremely likely to BLOCK RECOVERY. Our social support system (especially good professionals) can facilitate our letting go of such feelings.

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

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Recovery of Repressed or Buried Memories of Abuse

There has been a long-standing debate about the reliability of recovered memories of trauma and abuse.

The psychologist Loftus made made a distinction between Type I and Type II traumas. Type I traumas refer to a single event, whereas Type II traumas refer to those which were repeated and ongoing. It has been argued that Type I traumas become indelibly seared into conscious memory, whereas Type II traumas are susceptible to being repressed.

Loftus also puts forward the view that, in general, memory tends to be unreliable. She stresses that memory does not work like a tape recording, but is instead a less than perfect reconstruction of events. Loftus theorizes that memories may be distorted through factors such as fears, wishes, fantasies, social context and extraneous recollections. However, research suggests that highly significant and central events ARE remembered accurately – it is the less significant details of the event which are prone to distortion.

For example, somebody who witnesses a shooting is hardly likely to erroneously recall it as a stabbing; however, details such as the appearance of the perpetrator are far more likely to be unreliable.

Another psychologist involved in research relating to repressed memory recovery, Yapko, suggests that some recovered memories of trauma and abuse may be false as they were placed into the person’s mind, either wittingly or unwittingly, by a therapist. This may be due to incompetence, personal influence, a wish to prove a ‘pet theory’, a loss of neutrality, convincing the patient they must recover their buried memories in order to get better, or by focusing too much on the past at the expense of the present and the future. Despite the views of Yapko, however, there is little solid evidence that therapists can inadvertently create clinically significant false memories in their patients. It is worth repeating that memories of highly significant, dramatic and emotionally charged events overwhelmingly tend to be accurate.


A study by Loftus focused upon females with substance misuse disorders who were undergoing treatment as psychiatric outpatients. They were interviewed about their memories of sexual abuse and it was found 19% of them claimed that they had forgotten their abuse for a long period of time before they eventually recovered the memories.

Another study, by the psychologist Schatzow, of 53 females, found that 28% of them had significant memory loss of trauma.

The psychologist Williams, too, conducted research into repressed memories. His study made use of hospital records of females, 38% of whom had no memory of their documented abuse.

HOWEVER, these studies focused largely on details of memory and Type II trauma, rather than on single dramatic, central events (Type I trauma).


The psychologist Terr has put forward the view that repressed memories are most likely to be recovered once the danger has passed and the person who experienced the trauma has started to feel relatively safe. This may be, for example, in the consulting room of a trusted therapist or in the context of a safe marriage or other significant relationship. Often, too, the recalled memory will be connected to a trigger or cue which relates to the buried traumatic memory closely enough to reactivate it.


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

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Study Shows 73% Recover from Borderline Personality Disorder (BPD)

recovery from BPD

Until recently, it was frequently suggested that borderline personality disorder (BPD) was very difficult, if not impossible, to treat. During my research for this article, I have been disturbed to discover, also, that in the recent past some clinicians did not regard BPD as an illness at all – instead, they put forward the view that those diagnosed with BPD were not mentally disordered, but, rather, simply ‘bad’ and ‘manipulative’ people!

This reminds me of a time I made a very serious and determined suicide attempt and the psychiatrist I saw afterwards (who knew very little about me) tried to make the case that I had not really intended to kill myself but was seeking attention and sympathy. When I protested and tried to explain the attempt had been made very much in earnest (one might even say, ‘deadly earnest), he responded (and I quote him verbatim) : ‘It sounds like you’re talking bullshit to me!’

Highly professional, I must say!

In connection with the cynical and deeply insulting attitude that my psychiatrist displayed, I would also point out that, in my own personal view, some individuals (in my case, certain family members and former friends) like to take the view the BPD sufferer is not really ill as this, in their minds, absolves them of any responsibility to provide help and support.

Despite such pessimism, a study funded by Columbia University found that 73.5% of the participants who took mpart in their study recovered from BPD within 6 years. Even more encouragingly, it was found in the same study that more than half actually recovered within just 2 years.

Another encouraging finding of the study was that only 6% of those who had recovered relapsed (and, even if they did, this was mainly due to the effects of an extremely stressful event/s).


– 1.4% of the participants commited suicide in the first 2 years of the study

– 1.7% of the participants commited suicide in the next 2 years of the study

– 0.7% of the participants commited suicide in the final 2 years of the study

(This gives a total of 3.8%, or about 1 in 25, who commited suicide during the study).

– 65.9% achieved good psychological functioning by the end of the study (32.4% after 2 years, 48.3% after 4 years, 65.9% by end of study).


– Impulsiveness (this symptom improved best of all)

– Mood/affect (although this improved leat well)

– Interpersonal functioning


– Suicidal behaviours

Psychotic symptoms

The study also showed that the two factors which most helped the individuals to recover were :

1) Ending a destructive relationship

2) Determination to get well.

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

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Posttraumatic Growth – How Trauma can Positively Transform Us

posttraumatic growth

childhood trauma posttraumatic growth

‘Whatever does not kill me makes me stronger.’

– Nietzsche

Much of the research into the effects of severe trauma has concentrated upon its NEGATIVE effects; indeed, a large proportion of the articles on this site have analysed such effects. However, as new research is showing that the experience of trauma can also have a positive transforming effect upon a person’s life, I thought I would redress the balance by including some articles, of which this is the first, on this new and exciting area of research which has been named POSTTRAUMATIC GROWTH.

Research is showing that, rather than destroying a person’s life, severe trauma can lead, in the end, to people gaining new strength and wisdom, redefining them in a positive way.

There are many documented cases of such transformations taking place. One such example, often quoted in the literature about recovery from trauma, is that of a man named Leon Greenman, a Holocaust survivor who spent years in a concentration camp. Years after he was liberated, during the 1960s (in response to a fascist political organization called the National Front) he devoted his life to giving talks on his experiences and why what he endured must never happen again – in this way, he found great meaning and was able to use his appalling experiences to positive effect.

Trauma, then, can mark a great turning point in our lives. It can help us to become more true to ourselves, to look at the world from a fresh perspective and to take on new challenges.

We are not able to undo that which has happened, but we can choose what new directions it will take us in. Many people grow and develop following severe trauma, and it is only recently that studies have started to be conducted on this positive aspect of the change in us that trauma can lead to; up until now, research has concentrated very much upon the negative aspects, such as post-traumatic stress disorder (PTSD).

In fact, it is now being shown that trauma can act as a springboard to a higher level of functioning and growth – it seems, indeed, that the initial effects of trauma can be reversed and turned to our advantage. In this way, the negative and positive effects of trauma often go hand-in-hand. Posttraumatic growth is thought to be able to take place by the person making sense of what happened and then going on to find new meanings and understandings.

The new study of posttraumatic growth, then, focuses on how the suffering we endure as a result of trauma can positively transform our lives, rather than on just the suffering itself.

More posts will follow this introduction to posttraumatic growth, which will focus on how we can achieve it.

I hope you have found this post encouraging.

childhood trauma borderline personality disorderchildhood traumachildhood trauma therapies and treatments

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Recovery from Childhood Trauma – Improving Our Mindset.

changing mindset

developing a positive mindset

If our mental well-being is poor as a result of childhood trauma, one thing we can do, which comes from the scientific discipline known as POSITIVE PSYCHOLOGY, is to practise improving our mindset.

The psychologist Dweck, from Stanford University in the USA, proposed that there are essentially two types of mindset. These are :



Let’s look at each of these in turn :

– People with a FIXED MINDSET tend towards the belief that their personal qualities and abilities (eg intelligence) are ‘carved in stone’ and unchangeable

– People with a GROWTH MINDSET, on the other hand, believe these same personal qualities and abilities can be changed and improved over time.

Dweck’s research found that the type of mindset we have has a strong effect on our behaviour and our general approach to life. For example, according to Dweck, someone who is depressed and anxious and also has a FIXED MINDSET will assume that they will permanently remain so, whereas the GROWTH MINDSET may, for example, believe they will emerge from their ordeal a stronger and better person was more empathy with the suffering of others.

According to the research, there are 4 main areas of behaviour that our particular mindset affects. These are:





Let’s look at how these areas are affected by our mindset :

– GOALS : Fixed mindset people tend to set PERFORMANCE GOALS which are easily measured; for example ‘I must get at least 70% in my test.’ If they get 70% or more, they consider themselves ‘a success’. If they don’t meet their target, they consider themselves ‘a failure.’ This is sometimes called ‘all or nothing’ thinking or ‘black and white’ thinking.

Growth mindset individuals, on the other hand, are less concerned with the specific performance outcome, but, instead, with what are termed ‘learning goals’ – they would therefore be more focused on what they learned from the experience of working toward and sitting the exam, rather than dwelling on whether they should label themselves a ‘success’ or ‘failure.’

In summary, to use a travelling metaphor, the FIXED MINDSET individual is concerned only with the destination, whereas the the GROWTH MINDSET individual is much more focused on what they learned from the experience of having taken the journey to the destination.

– RESPONSE TO FAILURE : Again, according to Dweck, people with a FIXED MINDSET feel ‘hopeless and helpless’ and also ‘feel depressed and lose confidence and motivation’ when they fail. They tend to believe if they fail at a task once, they are doomed to always fail at it. They therefore give up and right themselves off. For example, the FIXED MINDSET individual who fails an exam may decide never to re-sit it as s/he believes s/he would be bound to fail again. The GROWTH MINDSET individual, on the other hand, may well form the attitude that with some  extra work s/he will be able to pass the exam the second time around.

– EFFORT PUT INTO ACHIEVING GOALS : People with FIXED MINDSETS tend to believe they can either do something or they can’t ; that they are good at it or bad at it and that this state of affairs will remain permanently in place, The GROWTH MINDSET individual, on the other hand, may take the view that you can become pretty good at just about anything if you put your mind to it and are not afraid to put in the practise. Therefore, the latter group are less likely to quit trying, and are less prone to becoming discouraged if they find something difficult at first.

– WILLINGNESS TO TRY OUT NEW SOLUTIONS : When faced with a problem, difficulty or challenge, individuals with a FIXED MINDSET will tend to keep applying the same behaviour in order to attempt to overcome it. When they finally realize that performing the particular behaviour is to no avail, they will tend to give up. Their GROWTH MINDSET counterparts, on the other hand, will be much more willing to try to apply various new and novel solutions, which, in turn, leads to a greater probability of overcoming whatever the particular problem happens to be.


One of the main techniques employed by Dweck to help people develop a GROWTH MINDSET is to teach them about the brain’s neuroplasticity . When we learn something new, the brain physically changes – for example, it grows new neural connections (neurons are just another name for brain cells) and increases its density in the area of the brain related to the particular skill. A well known example comes from London taxi drivers. Studies revealed that the part of taxi drivers’ brains which deal with spatial awareness are denser than the same brain area of non-taxi drivers. The brain, in this respect, is rather like a muscle – by practising a particular skill, the area of the brain related to that skill actually physically develops.

I hope you have found this post of interest. Please leave a comment if you wish – I will respond asap.

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

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Recovery: How the Brain can ‘Rewire’ Itself (Neuroplasticity).


Severe childhood trauma can adversely affect the way in which the brain develops, leading to, for example, extremes in anxiety or great difficulty in controlling emotions. However, there has been exciting research conducted showing that the brain is able, under certain conditions, to ‘rewire’ itself, correcting its own faulty circuitry, and, thus, alleviating the behavioural and emotional problems caused by the original damage.

The adult brain is much more changeable and modifiable than had previously been believed. There is now a large amount of evidence to show that damaged neural (brain) circuitry resulting from severe childhood trauma can be corrected, reshaping our brain anatomy and consequent behaviour, with the right kind of therapeutic interventions. In other words, it is now clear that brain architecture continues to change throughout adulthood and this can be manipulated in highly beneficial directions.

Many people who suffer extreme childhood trauma go on to develop personality disorders as adults; one hallmark of these disorders is rigid, destructive behavioural patterns. Research is now showing, however, that certain therapeutic interventions, due to neuroplasticity (the brain’s ability to change itself), can change those behaviours to become more flexible and adaptive (helpful in creating a more successful life).

Another problem those who have suffered extreme childhood trauma  develop later on is extreme and obsessive worry which can be so severe it is pathologically categorized as obsessive-compulsive disorder (OCD). For the purposes of explaining how neuroplasticity works, let’s take that (ie OCD) as our example of a problem which needs to be alleviated.

With OCD, obsessive worries can become so extreme that the person experiencing them becomes actively suicidal. Such a tortured state of mind can persist for months or even (as in my own case) years. Indeed, one suicide attempt nearly killed me and I even underwent electroconvulsive therapy (ECT) — to no avail, most regretably (see the ‘My Story’ category if you want to read a bit more about this profoundly distressing period of my life). When anxiety is this pathological, medications may dampen the symptoms somewhat, but, this, of course, fails to address the root psychological cause of the problem.

With this kind of anxiety, terrible and terrifying events are unremittingly anticipated – whether these are largely imagined or not is not the point : the problem is that the threats FEEL real. When something truly appalling is even remotely possible, in the mind of the individual experiencing obsessional anxiety, it FEELS INEVITABLE.

In order to address such life-threatening (due to risk of suicide) conditions, the psychologist Jeffrey Schwartz has developed a NEUROPLASTICITY-BASED TREATMENT; it has already yielded excitingly successful results.

To understand his form of treatment, let’s first examine the theory of why those suffering from OCD become mentally fixated on their intense anxieties.

Schwartz, first of all, compared the brains of those who suffered from OCD with the brains of those who did not (by taking scans). After he delivered his form of psychotherapy, he took the scans again which revealed the brains of the patients had normalized.

In ‘normal’ people, when something goes wrong, there is a period of anxiety which gradually wears off. However, with OCD sufferers, the period of anxiety is not only much more intense but also maintains an iron mental grip on the sufferer – the individual becomes ‘stuck’ in this intense anxiety phase. So what is going on in neurological terms?

Schwartz generously enlightened us in the following manner :

1) When something anxiety inducing occurs, a region of the brain, known as the ORBITAL FRONTAL CORTEX, is alerted. Activity in this region of the brain is far greater in those who suffer OCD – it becomes HYPERACTIVE.

2) A chemical message is then sent from that brain region to another brain region – the CINGULATE GYRUS, triggering the anxiety response. IN PEOPLE WITH OCD, the activity here is, again, far more than normally intense. Crucially, too, in people with OCD, the intense activity in this brain region STAYS ‘LOCKED ON’ (as if the ‘ON SWITCH’ which has activated it CANNOT BE ‘SWITCHED OFF’). Indeed, Schwartz referred to this phenomenon as ‘BRAIN LOCK’. (In ‘normal’ individuals the activity in the stimulated brain regions gently fades away, as the brain designed it to do).

The treatment Schwartz developed is designed to ‘UNLOCK’, and normalize, the manner in which the brain’s circuitry works.

THE FIRST STEP in the therapy is for the OCD sufferer to RELABEL what s/he is experiencing AS A SYMPTOM OF HIS/HER OCD. S/he should remind him/herself that it is ‘just’ the neurological malfunctioning (the ‘brainlock’) which is the true cause of his/her discomfort, NOT the content of the anxiety itself. This relabeling provides some mental distance from the content of the obsessive concern. The more the person can concentrate on the physiological reasons for the feeling of distress, and the more s/he can distance her/himself from its actual content, the more effective the therapy tends to be.

Once this has been acknowledged, THE SECOND STEP is to REFOCUS THE ATTENTION ON SOMETHING POSITIVE and, ideally, pleasure-inducing.

As the person gets better at implementing these steps, new brain circuits start to develop : the obsessive circuits begin to be bypassed. Of course, changes do not materialize instantaneously – the brain takes time to ‘rewire’ itself.

If the person finds implementing the above two steps difficult to do, s/he should remind him/herself that even distancing him/herself from the content of the anxiety and doing something pleasurable instead for just one minute will help develop the beneficial new brain circuitry.

Two rather pithy sayings, often quoted by psychologists, help us to remember the theory behind the therapy :

– ‘neurons that fire together, wire together’

– ‘neurons that fire apart, wire apart’

To end this post with an encouraging statistic, it is worth recording that 80% of Schwartz’s patients got better when this therapy was combined with medication.




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

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