The post-traumatic stress disorder sourcebook

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Content: The Post-Traumatic Stress Disorder Sourcebook A Guide to Healing, Recovery and Growth by Glenn R. Schiraldi, Ph.D. McGraw-Hill © 2000 446 pages
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Take-Aways · Post-traumatic stress disorder (PTSD) has always afflicted people in the wake of traumatic events, although its clinical name is fairly recent. · PTSD became well known in the 1960s and 1970s when many Vietnam veterans fell victim to it. Some ex-soldiers still suffer from the disorder. · PTSD can be caused by any stressful or catastrophic event, not just combat trauma. · Victims tend to suffer most in the aftermath of "intentional human traumas," such as rape, beatings and torture. · Anxiety and dissociation are the most common symptoms of PTSD. · PTSD victims often suffer flashbacks during which they believe they are reliving the trauma that led to their illness. · Treatment is available for PTSD and recovery is possible with the right therapy. · PTSD treatment includes psychotherapy, medication and survivor support groups. · Through therapy, PTSD victims learn to control their thoughts and their symptoms. · Those who recover from PTSD often feel it made them into better people.
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Relevance What You Will Learn In this Abstract, you will learn: 1) What post-traumatic stress disorder (PTSD) is; 2) What can cause it and why; 3) What its usual symptoms are; and 4) What treatment is available. Recommendation Some people's lives are picture-perfect, filled with sunny days, starry nights and happy weekends. The good times just keep on coming. For post-traumatic stress disorder (PTSD) victims, things also go on forever. Over and over, they mentally relive their most traumatic experiences in a continuing nightmare. PTSD is insidious. First you are the victim of severe, unspeakable trauma. Then, like a ghost, the trauma comes back to haunt you. Many associate PTSD only with combat veterans. However, almost any severe, stressful event can cause PTSD, be it rape or assault, abuse, a natural disaster, a terrorist attack or an accident. PTSD is a deadly, serious problem that plagues its victims. Fortunately, it does not have to be a life sentence. Treatment is available and recovery is possible, as Glenn R. Schiraldi explains in this thorough sourcebook. In fact, he states firmly that PTSD is curable with the proper therapies. If you or someone you care about suffers from PTSD, getAbstract thinks this book could be useful, helpful and encouraging.
"PTSD can be viewed as a fear of the unpleasant memories of the traumatic event that repeatedly intrude into one's awareness." "The story of PTSD is the tale of the indomitable and indefatigable human Spirit to survive and adapt." LoginContext[cu=1600027,asp=4402,subs=1,free=0,lo=en,co=AZ] 2016-01-08 08:57:21 CET
An Ancient Disorder Post-traumatic stress disorder (PTSD) became a highly publicized medical problem when American solders returned home from the Vietnam War during the 1960s and '70s. Some of them were seared in horrific ways by their combat experiences, burnt-out, vacant-eyed and fearful. Others were constantly agitated. Some quickly retreated from all human company and went to live in the wild. Others could not deal with the trauma they had witnessed, and became drug addicts or alcoholics. Some went on confused, dangerous rampages. Others committed suicide. PTSD plagued soldiers and other trauma victims long before today's diagnostic classification. Medics called it "shell shock" during World War I and "battle fatigue" during World War II, but PTSD's lineage is even more ancient. In The Odyssey, Homer wrote of the "travails of Odysseus," including flashbacks. In 490 B.C., Herodotus wrote about a soldier who lost his eyesight after he witnessed the death of his friend. In the 16th century, in Henry IV, Shakespeare wrote of the great concern Lady Percy had for her husband, the soldier Hotspur. He suffered depression, insomnia and night sweats. Of course, these are classic PTSD symptoms seen in soldiers scarred by war.
Causes and Symptoms PTSD, which authorities classified as an anxiety disorder in 1980, can affect anyone who has faced unbearable trauma. This includes a wide variety of catastrophic events or experiences. Some are accidents or industrial calamities (Three Mile Island, auto wrecks). Some are natural disasters (Hurricane Katrina, the tsunami). Some are manmade (rape, kidnapping). These "intentional human traumas" result in the most severe forms of PTSD. They seem to last longest and are hardest to cure. The victims feel outcast or stigmatized, and become cynical and hopeless.
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"Healing, recovery and growth are possible." "PTSD is described by great emotional upheaval and the shattering of the soul." "PTSD is a normal response to an abnormal event." "Avoidance is a hallmark of anxiety. We try to flee the things that trigger it." "One cannot numb painful memories without also numbing joyful memories." LoginContext[cu=1600027,asp=4402,subs=1,free=0,lo=en,co=AZ] 2016-01-08 08:57:21 CET
When people suffer a severe trauma, their coping mechanisms can shut down quickly. This happens to PTSD victims. The traumatic event takes over their lives. They repeatedly relive the event in their minds. They have recurring nightmares. Certain triggers or cues can set off an immediate panic attack or a flashback that makes the victim think the trauma is happening again. Other PTSD symptoms include sadness, insomnia, nightmares, anger, sexual problems, fatigue, withdrawal from society and numbed emotions. Victims are easily startled and exhibit a greatly exaggerated "startle response." For example, a combat veteran who suffers from PTSD may immediately drop to the ground when a car backfires. Extreme nervous arousal is another common symptom. The victim's nervous system easily goes into instant alert, causing an inability to fall asleep, plus twitching, jumpiness, restlessness and impatience. PTSD victims go out of their way to avoid stimuli that may trigger flashbacks. They shut down their conscious thinking about the traumatic event. They refuse to discuss it. They avoid people, places and activities that might trigger unpleasant memories, thoughts or responses. They can't concentrate. They often lose interest in activities they once enjoyed. They detach themselves from others, deadening their emotional connections and feelings. They become pessimistic about the future and unable to imagine that good things will ever happen to them again. Sometimes, PTSD victims become supervigilant, assuming danger lurks around every corner. Many victims refuse to leave their homes unless they are armed. Some constantly scan their immediate environment, as well as the people around them, watching for danger or sudden attack. With this stressful behavior, PTSD victims often suffer High Blood Pressure, increased heart rates, sweating, hyperventilation, dizziness or lightheadedness, and elevated stress hormones.
Making the Pain Go Away PTSD victims will do anything to avoid reliving the events that traumatized them. Thus, since pain has become an emotion to them, they often attempt to numb their feelings to shut off the angst of the trauma. They may attempt to block all thoughts of the event, and refuse to look at pictures that might summon up feelings and thoughts about it. Some stay home to avoid any possible negative encounters. Others self-medicate with drugs or alcohol. Many cannot laugh or cry. In whatever form they can, PTSD victims try to achieve "emotional anesthesia." People without PTSD can experience such anxiety symptoms, but when the symptoms are directly associated with a bad event, and they persist for a month or more, then PTSD may be the cause. Acute cases normally last no more than 90 days, though chronic PTSD can last longer. People can suffer delayed PTSD, with symptoms occurring at least half a year after the trauma.
Anxiety and Dissociation Obviously, PTSD can involve many symptoms, most notably anxiety and dissociation. Since PTSD is an anxiety disorder, it always involves symptomatic anxieties in some form, like nervous thoughts, and inappropriate, excessive physical or emotional arousal, or both. The victim's instinctive "fight or flight" stress response mechanism overreacts. When it kicks in, the heart beats faster, muscles tense and breathing speeds up. The mind goes into overdrive, alert for trouble. Over time, the nervous system becomes an unhealthy closed loop. Worry triggers arousal, which promotes further worry. Anxiety itself leads to avoidance of anything that triggers more anxiety. Over time, people come to fear their anxiety triggers, but avoiding these triggers (or fears), means never learning
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"Part of the role of trauma therapy is to teach the survivor how to relate in a relationship." "Dissociation is a defense against an extremely distressful, painful experience." "Anger and other symptoms can be a cue and an opportunity to forgive all parties involved in your hurt." "Give sorrow words: The grief that does not speak whispers the o'erfraught heart, and bids it break." [ ­ William Shakespeare, Macbeth] LoginContext[cu=1600027,asp=4402,subs=1,free=0,lo=en,co=AZ] 2016-01-08 08:57:21 CET
to master them. Plus, people get conditioned to associating the distractions they use to avoid triggers with the triggers themselves. Eventually avoidance mechanisms also become triggers, developing a vicious cycle: Anxiety breeds more anxiety. Consciousness normally is "associated," that is, you understand your surroundings, what takes place around you and how things connect. You are engaged with life. Memories come and go under your control. You can concentrate. Your mind ticks away like a clock. That is association; dissociation is much different. Picture a small deer "clamped in a lion's jaws." Though alive, the deer quickly stops fighting. It becomes nearly comatose as its dissociative mechanism takes over. By "shutting down," it is able, in effect, to escape mentally from the experience of being killed. All mammals, including humans, possess this protective mechanism. People can escape a trauma by "going away" emotionally and mentally. Using a similar mechanism, PTSD victims wall themselves off mentally to avoid flashbacks, bad memories and other negative emotions. Unfortunately, dissociation actually isolates bad memories. Once dissociated, they do not become part of long-term memory. Instead, they remain just out of sight, ready to intrude quickly on the consciousness. Normally, memories become fully integrated within a person's mind. But dissociated memories of a traumatic event remain in the "forefront of awareness," where an infinite number of triggers can evoke them immediately. Walled-off, unstable memories are "highly emotional and relatively nonverbal." The victim's thoughts about them are "automatic, unspoken, unchallenged and disorganized." This can cause major problems. For example, someone who is being attacked may think, "I am fully at this person's mercy." Any related, subsequent stressful experience ­ a flashback, bad memory or another trigger ­ can immediately summon up this horrid thought. Though the victim usually will not speak of it, he or she experiences the emotions associated with thinking of the attack, resulting in panic. Dissociation often includes inability to follow a conversation, a dazed expression, quick blinking, lapses in memory, disorientation, a vacant stare and a lack of emotional affect. Dissociation seems useful in blocking awful memories, but it requires a lot of mental energy, often resulting in fatigue and irritability. Plus, dissociation keeps the victim from "coming to terms with the walled-off material," so healing cannot take place.
Treatment and Recovery People do recover from PTSD. You can set aside the traumatic event and move beyond it, no longer troubled by scorched memories, anxieties and nervousness. But, to get better, you must be willing to engage in therapy to learn to control your hurtful thoughts and symptoms. Psychiatric care can help you integrate troubling memories so you can put them to rest. You can learn to confront your anxieties and erect protective mental "boundaries." You can discover how to accept yourself, despite your limitations, and to regain balance in your life.
Most important, you can learn to use "mindfulness" to recognize your feelings so you can deal with them. Name your feelings to yourself. Do not judge them. Understand that you possess them. With this thought in mind, also understand that as their owner, you can control them. Do not turn away from troubling feelings. Are you fearful? Everyone is. But fear is not all you are. Remember, "Because you know that you are more than just your fear, you need not be afraid."
Coming to terms with PTSD has both complex and prosaic elements. For example, to relax, you must learn to breathe comfortably and easily with your lips closed. You also
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"Trauma is but a detour over which the human spirit triumphs." "The good news... is that PTSD can be treated successfully. With the right treatment, victims can begin to heal and return to the journey of joyful living." "Eventually, one faces the reality of the event, experiences all thoughts and feelings, talks it through with others, corrects erroneous thoughts, comes to terms with the experience, grieves, and restores equilibrium." LoginContext[cu=1600027,asp=4402,subs=1,free=0,lo=en,co=AZ] 2016-01-08 08:57:21 CET
need to learn to let go of your upsetting feelings and to deal with them as a mother deals with a crying infant. She carefully examines her baby to ensure that everything is okay and then lets it be. Do that with your bad feelings. What can you do inside yourself to transform them? In therapy, you can find the answers you need to reduce and eliminate negative emotions. Through treatment, you can eventually rid yourself of PTSD. Accepting this fact is a vital first step. Don't run from treatment. Seek it out. Learn about the numerous approaches that therapists use. Avoid "retraumatizing behaviors" (violence, drugs and so on). You cannot attempt "memory work," the essence of trauma therapy, without a mental health professional. Learn to trust your therapist. Work with him or her so you can confront troubling memories and associations. The therapist will teach you to deal with "automatic thoughts and distortions," and to get beyond guilt, a common problem for PTSD victims. When it comes to therapy, you must be ready to move beyond any "secondary gains" your PTSD may confer, for example, justifying a failure to achieve. Trauma therapy will not work if you are addicted to drugs or alcohol, or if you keep living in an environment that directly brings on the trauma (i.e., an abusive home). Try to stabilize your life. Treatment Types PTSD treatment modes include regular sessions with a mental health professional, specifically a psychotherapist, such as a psychiatrist, psychologist or clinical social worker. Medication can help you deal with your symptoms. Survivor support groups offer a useful vehicle for confiding in others about your previously concealed wounds. Experts recommend against trying to treat yourself. If PTSD has shut down your coping abilities, you need an expert therapist to help you restore them. Plus, only a trained professional can help you benefit fully from such useful trauma therapy techniques as dream management, expressive art therapy, traumatic incident reduction (TIR), thoughtfield therapy, eye-movement desensitization, hypnosis and healing rituals. At the same time, you can do a lot for yourself. For example, you can learn to control your symptoms, including "containing" your flashbacks. You can learn to relax by putting formal relaxation techniques, such as meditation or progressive muscle relaxation, to work. You can also use "autogenic training" (like self-hypnosis) to gain serenity and peace. You can do other things for your recovery. For instance, avoid losing your temper. Eating right and getting enough exercise are both crucial for your mental and physical health. And you can use sleep techniques to learn to sleep properly (eight hours is essential). Some Silver Linings People who are able to move beyond horrible trauma exhibit great character. They grow as human beings. They discover special strengths and INNER WISDOM. They become more centered and, if they are religious, more spiritual. They often become role models. PTSD is a dreadful scourge, but victims who overcome it often say they have become better persons for doing so. They have been through fire and come out whole. With the proper care, many victims have been able to make this noble journey.
About the Author
Glenn R. Schiraldi, Ph.D., is an expert on anxiety, stress, depression and anger. He has written numerous books on these topics. He is a former faculty member at the University of Maryland and he worked on stress management at the Pentagon.
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