Tag Archives: Ptsd

Why Complex PTSD Sufferers May Avoid Eye Contact

A study by Lanius  et al. was conducted to cast light upon why many with individuals suffering from posttraumatic stress disorder (PTSD), including those suffering from complex-PTSD, often find it excruciatingly uncomfortable every time the rules of social etiquette compel them to make eye to eye contact with another human being (I, myself once attempted to circumvent this problem by deliberately buying a pair of glasses with lenses that were by far the wrong strength for me so that, whilst, to whomever it was I was required, as the law of social norms decrees, to make eye contact, I appeared to be doing so in the conventionally stipulated manner,  in fact, all that my eyes were actually meeting with was a comfortingly, non-threatening blur).

Returning to Lanius’ et al.’s experiment :

The experiment consisted of two groups :

1) Survivors of chronic trauma

2) ‘Normal’ controls

What Did The Experiment Involve?

Participants from both of the above groups were subjected to brain scans whilst a making eye to eye contact with a video character in such a way as to mimic real life face to face  contact.

What Were The Results Of The Experiment?

In the case of the ‘normal’ controls (i.e. those who had NOT suffered significant trauma), the simulated eye to eye contact with the video character caused the are of the brain known as the PREFRONTAL CORTEX to become ACTIVATED.

HOWEVER:

In the case of the chronic trauma survivors, the same simulated eye contact with the video character did NOT cause activation of the PREFRONTAL CORTEX. Instead, the scans revealed that, in response to the simulated eye contact, the part of the chronic trauma survivors’ brains that WAS ACTIVATED was a very primitive part (located deep inside the emotional brain) known as the PERIAQUEDUCTAL GRAY.

 

 

INTERPRETATION OF THESE RESULTS :

The prefrontal cortex helps us judge and assess a person when we make eye contact, so we can determine whether their intentions seem good or ill.

However, the periaqueductal gray  region is associated with SELF-PROTECTIVE RESPONSES such as hypervigilance, submission and cowering.

Therefore, we can infer that those with PTSD / complex PTSD may find it hard to make eye contact because their brains have been adversely affected, as a result of their traumatic experiences, in such a way that, when they make eye contact with another person, the ‘appraisal’ stage of the interaction (normally carried out by the prefrontal cortex) is missed out and, instead, their brains, due to activation of the periqueductal region, cause an intensely fearful response.

This constitutes yet another example of how severe and protracted childhood trauma can damage the physical development of the brain.

 

Link : Lanius et al’s study.

 

eBook :

 

Above eBook now available on Amazon for instant download. Click here for further details.

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

Study Shows PTSD Sufferers Can Be Willing To Risk Life For Cure

PTSD sufferers

Anybody who has suffered from post traumatic stress disorder (PTSD) / complex post traumatic stress disorder (cPTSD) knows that the mental torment and anguish it entails can be extreme and unremitting.

Frustratingly (putting it mildly), such pain is impossible to describe in words to those who have been fortunate enough never to have experienced such conditions much in the same way as it would not be possible to describe to a person who has been blind from birth what it’s like to experience the color red (or any other color, for that matter).

It may well be useful, therefore, to outline the findings of the following study which helps to demonstrate how desperate sufferers of PTSD may become to be free from their ineffable suffering.

 

THE STUDY :

 

Zoellner and Feeny (2011) carried out interviews with 184 individuals who had been diagnosed with PTSD.

 

 

RESULTS :

Two main findings that help convey just how desperate people can be to be free from the constant distress PTSD can induce were as follows :

  1. On average, participants in the study said they would be prepared to undergo a treatment that would completely cure their PTSD even if such a treatment carried 13 per cent risk of resulting in their immediate death.
  2. On average, participants said they would be prepared to give up 13.6 years of their lives to be relieved of their PTSD symptoms.

Through the interviews conducted in the study, it was also found that symptoms linked to hyperarousal, hypervigilance, insomnia and irritability were particularly difficult to tolerate.

 

RESOURCES :

eBook :

Above eBook now available for immediate download from Amazon. Click here, or on image above, for further details (other titles available).

 

Overcome Hypervigilance | Self Hypnosis Downloads. Click here for further details.

 

Further information about PTSD and complex PTSD. Click link below :

www.nhs.co.uk/PTSD

 

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

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)

 

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.

 

Above eBook now available on Amazon for instant download. Click here or on above image for further details.

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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 :

 

Above eBook now available from Amazon for instant download. Other titles available. Click here for further information.
 

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

 

 

 

Why Is Physical Illness More Common In PTSD Sufferers?

PTSD and physical illness

If we have suffered from significant childhood trauma leading to the development of post traumatic stress disorder (PTSD) in our adult lives this also puts us at increased risk of developing various unpleasant physical symptoms. This is because the trauma has had chemical effects in our brain (leading to our PTSD) which can have knock-on adverse effects upon our body. I provide examples of the kind of symptoms that may result below :

SYMPTOMS :

  • increased rate of heartbeat
  • stomach / digestive problems
  • rapid and shallow breathing (often referred to as hyperventilation)
  • shaking / trembling / tremors / localized muscle spasms
  • feeling faint / light-headedness
  • sweating

DISEASES AND DISORDERS :

A positive correlation exists between the incidence of post traumatic stress disorder (PTSD) in a population and the incidence of certain physical diseases and disorders (shown below) in that same population. However, further research needs to be conducted in order to ascertain whether having post traumatic stress disorder (PTSD) increases one’s risk of suffering these conditions or whether having such conditions makes one more vulnerable to developing post traumatic stress disorder (PTSD).

Some of the diseases and disorders associated with PTSD are as follows :

  • cardiovascular disease
  • increased probability of suffering from heart attacks
  • IBS (irritable bowel syndrome)
  • headaches
  • certain autoimmune disorders (eg those causing problems with the skin)
  • pregnancy complications
  • miscarriage
  • preterm contractions
  • obesity

 

Above : PTSD physically, biologically and chemically alters the brain – these changes may lead to physical symptoms, diseases and disorders in some sufferers, on top of the immense psychological pain and suffering it causes all who are unfortunate enough to have the condition.

 

Why Do Such Links Between PTSD And These Disorders Exist?

Various theories have been put forward in an attempt to explain why such links between PTSD and physical disorders such as those listed above exist.

  1. Increases in stress hormones such as cortisol over time have an adverse physical effect upon the heart and cardiovascular system.
  2. PTSD can lead to unhealthy ways of trying to cope with mental pain and suffering such as excessive drinking, excessive smoking and the ingestion of dangerous narcotics and overeating (so-called ‘comfort eating’) all of which, in turn, can lead to declining physical health.
  3. PTSD sufferers tend also to be seriously depressed and therefore lethargic – this can mean that PTSD sufferers take very little physical exercise leading to a greater likelihood of developing physical health problems.
  4. PTSD causes a change in the balance of chemicals in the brain and these changes, in turn, may cause yet further changes adversely affecting the immune system and various bodily organs.
  5. Changes in certain chemicals that negatively affect the mind also adversely affect the stomach.

 

eBook :

Above eBook now available for immediate download from Amazon. Click here.

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

 

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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