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Entries from July 2008

PTSD Explained

PTSD researcher Dr. Paula Schnurr received the Ladies Home Journal "Health Breakthrough Award" for her work with PTSD and women veterans this year. She provided needed data that revealed benefits of prolonged exposure therapy. Now you may have thought all therapies were equal, but they are not. In fact, an assessment conducted by the American Psychological Association found a deficiency of research on PTSD, which is of growing concern in today’s complex global war and terrorism climate.

If you're wondering about PTSD because you've heard about it in the news or you know someone who suffers from it, or if you are battling it yourself, here's a little information about the history of PTSD along with some information about recent treatments.

First known as “Shell Shock” among WWI veterans, PTSD (Post-traumatic Stress Disorder) is a debilitating condition brought on from witnessing or experiencing a traumatic event (see below for criteria). It affects about 5.2 million Americans aged 18-54. Traditionally, PTSD treatments have included a mixture of psychotherapy (talk therapy), pharmacotherapy (medication), Eye Movement Desensitization (EMDR) and Cognitive Behavioral Therapy (CBT). In addition, newer research about Exposure Therapy has demonstrated some promising results. Exposure Therapy involves slowly and carefully re-exposing the person to images of the trauma until the images and memories no longer evoke an anxiety response. Please note that researchers are continuing to investigate even better treatments.

Because no one treatment fits all, researchers are also recognizing those who suffer from Complex Grief. Complex Grief can be experienced by those who have PTSD (similar to Survivor’s Grief—the guilt and grief one experiences when surviving a war or tragedy). It can also affect family members of lost soldiers in war. Part of the grieving and healing process involves finding meaning in the loss. The complexity comes about when meaning can’t be found. In addition, researchers are discovering that the former “move on” approach isn’t working. Rather, it’s about honoring and remembering.

DSM-IV Criteria for PTSD

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: (1) difficulty falling or staying asleep (2) irritability or outbursts of anger (3) difficulty concentrating (4) hypervigilance (5) 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.



Changing Careers an American Tradition

I often remind clients that the average person changes careers 5-7 times in their lifetime. Some think it’s a new phenomenon, but take a look at what de Toqueville observed about Americans in 1831…

Excerpt from Alexis de Toqueville’s “Democracy in America”…

The inhabitants of the United States experience all of the wants and all the desires that result from an advanced civilization; and as they are not surrounded, as in Europe, by a community skillfully organized to satisfy them, they are often obliged to procure for themselves the various articles that education and habit have rendered necessities. In America it sometimes happens that the same person tills his field, builds his own dwelling, fashions his tools, makes his shoes, and weaves the coarse stuff of which his clothes are composed. This is prejudicial to the excellence of the work, but it powerfully contributes to awaken the intelligence of the workman. Nothing tends to materialize man and to deprive his work of the faintest trace of mind more than the extreme division of labor. In a country like America, where men devoted to special occupations are rare, a long apprenticeship cannot be required from anyone who embraces a profession. The Americans therefore change their means of gaining livelihood very readily, and they suit their occupations to the exigencies of the moment. Men are to be met with who have successfully been lawyers, farmers, merchants, ministers of the Gospel, and physicians. If the American is less perfect in each craft than the European, at least there is scarcely any trade with which he is utterly unacquainted. His capacity is more general, and the circle of his intelligence is greater.

(Vol 1, 425)


What to Expect in Divorce: 8 Stages of Healing

No one word can describe what it feels like to go through a divorce. People have different experiences. Some people are relieved while others are completely devastated. In fact, it's not uncommon to experience a little of both feelings in varying forms at different times. There is a light at the end of the tunnel of divorce. To help you know what to expect while going through a divorce, here are 8 common stages of divorce. Some people reach all 8 stages while others hover at lower stages until future relationships take them to the last stage.

1. Experiencing a roller coaster of emotions that range from numbness to intense feelings of anger, fear, pain, sadness and even joy, love, hope and excitement. The feelings continue to cycle until healing occurs.

2. Pulling away from others and almost obsessing exclusively on partner to seeking validation through an assortment of love interests or engaging in a serious passionate affair, with person having opposite characteristics of partner.

3. Grieving loss of identity and combined memory--divorce identity crisis.

4. Losing oneself in activities (work, play, gambling, eating, travel, sex).

5. Having moments of clarity and spiritual lifting followed by pain and then lifting and then pain...with each lifting time lasting a little longer and each painful return being slightly improved.

6. Slowly, an appreciation for partner and shared life creeps up. Some, but not all, can even attain the "lesson" learned from the experience.

7. After healing, a new identity reveals itself and old passions and interests are reignited.

8. An independence and confidence coupled with deeper humility and appreciation for others occurs.


Ancient Wisdom Reveals Why We Do What We Do

We get so tempted to ruminate and reinvent the wheel when history has already revealed an answer. Chances are whatever project on you're working or whatever problem you're trying to solve has been contemplated before and maybe even fixed. That's why Goethe said "He who cannot draw on three thousand years is living from hand to mouth." So, check with your elders and look at history.

As for psychology's history, at just over 100 years old, the field is just an infant. However its parent -philosophy - is much older and has much wisdom to shed. For instance, here is what Aristotle 384 BC- 322 BC (student of Socrates and tutor to Alexander the Great) purported long ago...

All human actions have one or more of these seven causes:

CHANCE

NATURE

COMPULSION

HABIT

REASON

PASSION

DESIRE

Can you find one of these root causes in your own behavior?