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Author Topic: From GoodTherapy.org: Therapy for Post Traumatic Stress  (Read 349 times)

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Offline CZBZ

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From GoodTherapy.org: Therapy for Post Traumatic Stress
« on: September 02, 2009, 02:29:51 PM »
Dear all,

This website has numerous links and articles about 'healing from traumatic experiences'. The first article reposted below, includes their site navigation link at the bottom of the article. Please go to their site directly if you are interested in learning more about Trauma and Healing.

Hugs,
CZ






Trauma is an event that severely threatens our physical survival or safety or our emotional and psychological integrity and safety. A trauma is an event that frightens or shocks us, endangers our long-term well-being, causes us to fear for our life, safety, or sanity, or causes deep emotional pain, confusion, or fear. Even if our life is not in danger, if we believe it is, or if we experience very intense negative emotions for some reason, we may have the experience of trauma.
 
Trauma probably affects most people at some point in our lives – we may have a car accident, suddenly lose a loved-one to death, experience a criminal act (armed robbery, sexual assault, etc) be subject to serious emotional or physical abuse, live or serve in a place where war or terrorism occur, or in some other way be subject to intense fear, either for a moment or for a long period. Some people experience repeated trauma (such as victims of repeated abuse as a child, people who live in war zones, etc). Some psychologists consider birth to be an almost universally traumatizing experience for the newborn baby, who must suddenly leave the warm, dark safety of the womb for the bright, cold, relative chaos of life on Earth.
 
We can recover from trauma, and many people bounce back from traumas quickly and with great resiliency. Many, however, do not.

 
The Medical Model and Post Traumatic Stress / Trauma:
 
The best chance of recovering quickly from trauma is to address it in the immediate aftermath. Crisis debriefing, or Critical Incident Stress Debriefing, is a form of very short-term therapy or counseling that helps people make sense of their experience and feelings, plan to cope and stay safe, and connect with resources that can help them. If you experience trauma, talking about it with a professional as soon as possible can help diminish the chances of lasting ill-affects.
 
However, sometimes trauma does lead to long-term difficulties. The painful or frightening event may be replayed in memories, daydreams, and nightmares. We may avoid situations or people that remind us of the trauma. We may be emotionally numb, depressed, or anxious. Sometimes, people turn to drugs to numb feelings of terror that last for weeks, months, and in some cases, years after a trauma. If you experience such feelings, thoughts, or behaviors after a trauma, know that such experiences are very human and nothing to be ashamed of.  Trauma is more and more common in the United States military due to the current military engagements, and many soldiers seek help to deal with thoughts and feelings that result in being injured, watching fellow soldiers be injured or killed, killing opposing soldiers, or simply from experiencing the intense danger of war.
 
Trauma can be treated, even long after the traumatic event. One very promising treatment is Eye Movement Desensitization and Reprocessing. Other forms of therapy can be helpful as well.
 
Post Traumatic Stress Disorder is diagnoses in certain cases:
 
309.81    DSM-IV Criteria for Posttraumatic Stress Disorder
 
A. The person has been exposed to a traumatic event in which both of the following have been present:
 
     (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
     (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.
 
B. The traumatic event is persistently reexperienced in one (or more) of the following ways:
 
     (1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
 
     (2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

     (3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
 
     (4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
 
     (5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
 
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
 
     (1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

     (2) efforts to avoid activities, places, or people that arouse recollections of the trauma

     (3) inability to recall an important aspect of the trauma

     (4) markedly diminished interest or participation in significant activities

     (5) feeling of detachment or estrangement from others

     (6) restricted range of affect (e.g., unable to have loving feelings)

     (7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
 
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
 
     difficulty falling or staying asleep

     irritability or outbursts of anger

     difficulty concentrating
 
     hypervigilance
 
     exaggerated startle response

 
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.
 
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
 
Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
 
Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor


 
Case examples:
 
Ricky, 24, has recently returned from Iraq where he saw combat. He says he was doing fine until last week, when a robbery occurred in a local store while he was there. Suddenly, memories of combat flooded his senses, and he was paralyzed by them. Now he has nightmares about Iraq, but images of home get “mixed up in there.” Not only does Ricky feel overwhelmed and anxious about these flashbacks, he feels guilty for surviving while two of his friends did not, and guilty for not stopping the robbery at home. Talking about his feelings helps somewhat; focusing on ways to stay safe helps as well. Ricky’s guilt is addressed by exploring the choices Ricky has made and their motivations. Ricky’s beliefs about what it means to be a man, and his high expectations of himself are also explored. The therapist helps Ricky make peace with his own mortality, and teaches Ricky relaxation skills. Ricky asks for a psychiatric referral, and takes anti-anxiety medications to sleep a few times a week. He is also referred to a support group. A year after his first visit, he is no longer taking medications, and is feeling more hopeful, though he still struggles at times with intense grief about the war.
 
Patricia, 39, is a highly anxious person. A full history reveals severe abuse as a child, which Patricia is reluctant to revisit. The therapist allows several sessions to go by before bringing it up again, and when she does, Patricia becomes very upset and angry. Patricia finally agrees that her reaction indicates the abuse is still “dogging” her, and she agrees to a referral for EMDR. The EMDR process helps her being a real recovery from the abuse, and her anxiety diminishes considerably.

Therapy for Post Traumatic Stress /Trauma:

 There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of worry. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Marriage Counseling may be important part of therapy for worry if worry is occurring in a relationship. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for trauma or any other issue, it is helpful to familiarize oneself with these elements.


Click here to view article and Table of Contents:

GoodTherapy.org


*     *     *

Crime Therapy and Trauma

Written by Nancy Poitou, M.A., M.F.T., C.T.S.


Trauma is defined as an event that threatens life or bodily integrity. One may be traumatized directly, through a relationship with someone who has been traumatized or through witnessing such an event. Because a person survived a trauma physically intact does not mean that they are not injured. Just as too much stress on a bone will break it, too much stress on the psyche will cause a breakdown of normal functioning.

The symptoms in the aftermath of a trauma are sometimes so extreme that individuals often feel as though they are going crazy. Indeed the mood swings, anxiety, lack of sleep, inability to concentrate and think clearly, changes in appetite, flashbacks, nightmares and depression may feel crazy but are symptoms of psychological injury. Flashbacks and nightmares can be so extreme that it feels as though the traumatic event is recurring. Relationships and self confidence can suffer as a result.

There are three groupings of symptoms of Post Traumatic Stress Disorder. “Avoidance” is a common reaction to a trauma, attempting to repress it by denying its effects, focusing only on the positive, avoidance of any discussion or reminder of the event. Although avoidance may in the moment feel better, it also delays the victim in getting the help needed to completely recover from the trauma symptoms. The sooner the victim gets help, the better the prognosis. The second grouping of symptoms is the “re-experiencing symptoms;” flashbacks, nightmares, and mood swings fall into this category. The third grouping of symptoms is “hyperarousal symptoms” of anxiety, insomnia, feeling jumpy and fearful. All of these symptoms are normal reactions to an abnormal event.

Trauma symptoms are not understood by non-professionals who have not been traumatized. Comments by others in the wake of trauma can often compound the effects of the trauma. In the immediate aftermath of the traumatic event, affect and mood can swing widely, people can fluctuate between feeling numb and hysterical and everything in between. All of these fluctuations are normal reactions to the traumatic event. Immediate reactions to a traumatic event are as unique as the individuals who have them, and because the variety of reactions is not what others expect, the victim is sometimes not believed, his or her distress is invalidated and the victim may, as a result, question his or her sanity all the more.

Terrorism, abuse, crime are interpersonal traumas caused by one or more human perpetrators. Interpersonal trauma often means that the ability to trust and feel safe often affect one’s ability to have and sustain relationships that are intimate, satisfying and nurturing.

Natural disasters can have a devastating effect on one’s ability to hope and maintain faith in the wake of human and material losses.

Any type of trauma can include a spiritual crisis where one’s beliefs about the universe are shattered, a sense of power and safety are torn away, and one is left with the additional loss of faith and belief that the universe is friendly and good and that there is a purpose and place for him or her within the grand design.

Through a holistic approach, treatment is not limited to symptom elimination, but includes emotional and relationship healing as well as addressing the spiritual and existential dimensions of the trauma.

Post Traumatic Stress Disorder is highly treatable and real healing is possible....



Click here to read full article:

Crime Trauma and Mental Health







“The moment a woman comes home to herself, the moment she knows that she has become a person of influence, an artist of her life, a sculptor of her universe, a person with rights and responsibilities who is respected and recognized, the resurrection of the world begins.” ~Joan Chittister
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