Interesting article about PTSD. - Some graphic content.

Interesting article about PTSD. - Some graphic content.
L

Lloydy

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Follow this link to an interesting ( but somewhat heavy ) interview with Donald Meichenbaum talking about his therapy techniques when treating PTSD.

It's interesting to see how this guy treats PTSD, especially when so many of us suffer from this complaint.

There are some parts of the interview that are quite graphic in the description of events that have brought about PTSD.

https://www.behavior.net/column/meichenbaum/

Dave
 
Love this part of the article:

>>>This approach helps clients reframe their reactions as adaptive strengths, rather than as signs of mental illness. We work together to help them not only change their behavior, but also to tell their "stories" differently.

For years I was called hysterical, angry, depressed.. maybe I was just really really good at adapting and coping!!!!

Maybe I'm not crazy after all!!!!

P
 
Ok so I'm REALLY liking this article. For the case of this site - replace "she" with "he"... but the essence is the same...

Consider the client who has been victimized sexually. Envision the clinical impact of this individual characterizing herself as being "damaged goods" or as "soiled property." Such labels, such metaphors, may be culturally reinforced. Whatever the origins and influences, the consequences of such narrative constructions are likely to lead to dysphoric feelings and distressing behavior. In therapy, I would help the client share her story either in individual or group therapy, "validate" her feelings, but at the same time help the client appreciate the price she pays if she goes around telling herself that she is "soiled goods"; that she is "useless." In this way, she can come to also appreciate that she speaks to herself in the same manner that the perpetrator spoke to her. She may inadvertently reproduce the "voice" of the perpetrator, as in the case of the victims of domestic violence. She needs to develop her own voice. One goal of treatment is to no longer let the perpetrator continue to victimize her when he is no longer present. Instead, what is the best revenge?

Hoyt: Living well.

Meichenbaum: To live life well. In therapy, we need to explore with clients operationally what it means to live life well. Moreover, given the cognitive behavioral approach, therapists also consider with clients what are the barriers, the obstacles, the potential reasons why clients may not do anything that they said they are going to do. This, when clients say, "I need to live well," there is a need to help clients translate such general admonitions into behaviorally prescriptive statements such as, "Between now and next time, how will that show up? What will you do differently?" There is also a need to build relapse prevention procedures into the treatment regimen, anticipating "high-risk" situations, as well as ways of handling possible setbacks, so lapses don't escalate into full-blown relapses.
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Dave - where did you get this article?? Its great.

We should all endeavour to choose one thing each day to "live well". My fiance has a glass jar full of slips of paper, when he is looking for "self-care" guidance, he pulls out a piece of paper with a "prescription" on it.

His prescriptions are things like "paint a picture" or "smell a flower" or "go for a walk in nature" or "stretch".

I always smile when I see one of the little pieces of paper in a prominent place in the house. Makes me happy to see when he's caring for himself.

:)

P
 
I don't have time yet to read the whole article, but definitely will. I like what I've seen so far.

About PTSD...

I remember, shortly after I entered counseling, very early in my facing the memories that have brought me here, when my therapist told me it sounded like I had PTSD.

The emotion was amazing when I heard the name for what I was going through: anxiety, etc.

Even now, when I am pretty much living well, having a name for the state I was in is very validating.

Thanks again.
 
Yah this is the approach that the mens group that my partner attends uses. It acknowledges and validates the experience of the survivor instead of "medicalizing" it - i.e. telling someone they are mentally ill, etc.

The approach they use instead, is just like this article, they are compassionate and say "wow you went through something HORRIBLE and you did the best you could to adapt and to survive, by using all the wits and resources around you, you became depressed, you acted out, you did this and that, and thats OK and the best you could do in that horrible circumstance. It allowed you to SURVIVE. But you are now aware that those adaptive coping responses are NOT working for you now, and we are here to help you shift those coping responses that are now hindering your life and your ability to get along in the world to things that are more healthy."

Its a really great approach, really removes the self blame, the stigma, and really puts it in the right context - that what you guys and those guys and so many of us went through WAS horrible and we/them/you really did the best you absolutely could in order to plain old SURVIVE, but now new behaviours and processes have to be learned in order to adapt to an enviornment that is NOT so abusive and painful and traumatic.

This approach is great because it also acknowledges the fact that trauma literally rewires the brain, and some of these maladaptive coping techniques are really hard to get rid of, and may require conscious effort for a long time, and maybe even some "safety plans" that will have ot be in place forever. Psych. research is indeed revealing that shock and PTSD can etch new neural pathways to allow the survivor to respond fast the "next time" this horrible incident appears to be occurring.. whether or not it actually ever occurrs again.

The human brain is a wondrous thing, but in this case, it creates a situation, a state that does not serve its owner well in non-trauma situations.

P
 
a couple of weeks ago the tutor in my counselling class gave me a copy of this article and said " I saw this, and thought of you."

The class know my background and probles ( I'm the favourite 'practice' client ! :rolleyes: ) and the tutor also said that with my work with Survivors, and the style ( if yoy could call it that :D ) that I use, then this guy should be a role model.

I've read it a couple of times now and it makes a lot of sense.

Dave
 
Yah! I'm right there with all the rest of you! I really respect a lot written in the piece.

HOWEVER: there is one very critical thing that all of us need to remember - our body chemistry has been permanently changed by the ravages to our adrenal glands. Yup - it would be just terrific if we could all just *decide* to change our outlook & our behavior, but there are extenuating factors inside our bodies that make this kind of solution bound to fail.

I am not advocating that we medicate ourselves into a blissful stupor - we already KNOW how to do that with our "acting out" & our various addictions.

But we have to honor the fact that our symptoms are cyclical and CAN COME BACK again & again & again. We can learn how to *manage* them better, but they will NOT ever completely go away, because they are rooted in our altered biology. It just isn't realistic or healthy to think otherwise. If we start believing we can *think* our way out of this, we are setting ourselves up to FAIL MISERABLY - and, let's face it - we are miserable enough already without this kind of added pressure to "succeed" at "healing."


Ultimately, we have good days & we have HORRID days or weeks or months. Then, the symptoms will lessen for a while & we think we have beat them - only to have them re-appear & freak us out again.... There'a an excellent article about this at www.mhsanctuary.com/ptsd/chattrans.htm.

I also love the 2 books written by Ariadne Matsakis called "I Can't Get Over It" and "Trust After Trauma."

Sorry to sound like an Old Curmudgeon, but have just gone through this crummy cycle AGAIN, dammit, after having been symptom-free for YEARS!

UGH UGH UGH!!!

Hope y'all are doing better with it than I am....
 
Kolisha: I have noticed that my symptoms and those of my partner are exacerbated by excess stress in other parts of life, as well as poor self care.

I think a big part of managing the "altered state" can lie in taking care of as much OTHER stuff as possible.. eating well (avoiding too much sugar, fat and caffeine), taking vitamins, taking days off here and there, ensuring a balanced life, not taking on too much work, exercise, spirituality, creative pursuits.

If you can manage the other stuff then when the triggers happen then you have more resources to go on.

Also it does make sense to have "safety plans" in place - if you can identify those places/triggers where you know that they will set you off, have a kind of escape plan all ready just in case. Then when you are in total PTSD or freak out mode then all you have to do is follow the plan.

Does this make sense?

I know that I get over the top and into my own acting out behaviours if I am too stressed.. and if i have a serious argument/run in with my partner or my parents that involves verbal abuse.

He is the same - there is a maximum load level for him after which he comes out swinging (which triggers me.. yadda yadda yadda here we go). He does not appear to be as triggered by big fights with me as I am with him... of course his triggers are different....

I find that we are both better able to recover and get back in the game, and stay in the game (sorry for the sports metaphors) if we are eating well, reasonably healthy, getting enough sleep (sometimes I have to take sleeping pills) exercising, taking time out for fun, etc.

P
 
Dave
Keep in mind that the story of how people cope with stressful events is inherently the story of resilience and courage. Even in the worst scenarios people evidence remarkable strengths. As a therapist, I need clients to attend to that part of their stories. Thus, the "bad things" that happened to people are only one chapter in their life stories.
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As a child and a teen I was "treated" for a bunch of problems that weren't my problems at all, more like reactions to the problems of others around me. But I didn't have a psychologist tell me that, in fact I had just the opposite-- professionals who were more than happy to assume (and tell me) that I was just getting a head start on the addiction and mental illness that were my genetic destiny.

I remember my first appointment with the one who finally treated me like a healthy person--I guess I was 14 or 15-- when I told him "my mom thinks I have problems" he didn't say, "What are your problems", he said "What problems does she think you have? Is she right?" It felt SO GOOD to get the benefit of the doubt for once. We didn't really talk about my problems, we talked about ME and what I did with my days. When I left his office, I felt like I HAD a life story.

He didn't need to tell me that my "problems" were coping mechanisms either, but by the time I was done with him I certainly knew it-- even though I don't think that either one of us ever put that into words.

SAR
 
Originally posted by SAR:
As a child and a teen I was "treated" for a bunch of problems that weren't my problems at all, more like reactions to the problems of others around me. But I didn't have a psychologist tell me that, in fact I had just the opposite-- professionals who were more than happy to assume (and tell me) that I was just getting a head start on the addiction and mental illness that were my genetic destiny.
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OOH welcome to my world!! If I had a dollar for everyone who said "YOU NEED PSYCHIATRIC HELP" I would be rich. As I move into my own life away from my abusive, controlling, alcoholic growing up home, I find that I"m a pretty normal, sane, decent, relaxed human being. I have a pretty strong startle reflex, and very short anger-fuse, but who the hell could blame me growing up in that chaos????
 
SAR
We didn't really talk about my problems, we talked about ME and what I did with my days. When I left his office, I felt like I HAD a life story.
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The person isn't the problem, the 'problem' is the problem.

That therapist realised just that.

Dave
 
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