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Archive for the ‘Illness’ Category


The Second Pandemic: PTSD

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It has been a little over one year since COVID 19 made its world debut. In that time we have all seen reports of horrendous deaths from the disease, the toll it has taken on our healthcare professionals and the tremendous changes it has brought to every society in the world:

  • constant mask wearing
  • hypervigilance around health and contagion
  • decreased movement around our communities and world
  • elimination of cultural group activities from rock concerts to political events to pubs
  • the constant background fear of death or long term disability

In addition to these profoundly stressful changes in our lives, we have seen brutal killings on live TV by people who are supposed to protect us, as well as by mass murderers; social and political uprisings, the polarization of politics and the death of cooperation between political parties. These changes have left people all over the world uncertain about their future, about their safety, and about their financial survival. 

Many people understand that they are chronically traumatized. And many deny that these events affect them, even while acting out their fears and angers on their loved ones and those around them (itself a trauma symptom).

In the current Diagnostics and Statistical Manual on PTSD we have a list of criteria that apply to our collective experience of COVID and mass unrest. I have paraphrased some of these criteria; the ones that are verbatim from the DSM are in quotes.

1. “Exposure to actual or threatened death” by one of these four means: “directly experience the traumatic event(s)”, “witnessing in person, the traumatic event(s) as it occurred to to others, “learning that the traumatic event(s) occurred to a close family member or friend, and/or experiencing repeated or “extreme exposure to aversive details about the event(s)” as part of one’s work. 

Check. We would have to be very isolated indeed to not have experienced at least one of these criteria. As for the fourth criteria, that is officially listed as being “part of one’s work”, I disagree as a trauma therapist. Exposure is exposure. Just because the DSM says your exposure doesn’t count because you were not ‘on the job’ doesn’t mean that you were not traumatized. There is research showing that repeated viewings of traumas on TV or other media create a trauma response in viewers. I believe this criteria may be changed in future versions of the DSM.

2. Presence of one or more of these disturbing intrusive symptoms: uncontrollable recurrent memories and perseverations around the event(s); nightmares related to either the content of the event or the emotions around the event (loss, sickness, contagion, fear of the future etc.); flashbacks, or other dissociative reactions around the event(s), which for children can include repetitive play of the trauma or event; “intense or prolonged psychological distress at exposure to internal [your own memories] or external [in the environment] that symbolize or resemble an aspect of the traumatic event.

Translation: You cannot stop thinking about COVID, COVID related losses (school, travel, etc.) or other traumatic events related to COVID or social unrest. You cannot stop the feels that keep coming, and you feel depleted because of this. It is hard to focus on daily routines and feel ‘normal’ again. You may take extraordinary precautions that are not strictly necessary or none at all as a rebellion to these feelings.  You may have insomnia as the mind unconsciously avoids dream content related to COVID or social unrest and pops us out of sleep as we approach REM phase, where memories are processed.

3. Avoiding anything that reminds you of the traumatic event(s) in one or two of these ways: “Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about  or closely associated with the traumatic event(s) and/or “ [making] efforts to avoid external reminders (people, places, conversations,  activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s)”. 

In other words, you don’t want to think about it and you don’t want to talk about it anymore. Even reading this blog may be a trigger. (Did you make it this far?) You may avoid shows about: illness, contagion, disasters etc. that you previously enjoyed. Or you may avoid discussing COVID with friends and family, or avoid talking about your feelings about it. Denial is another way our minds practice PTSD-related  avoidance. We may minimize COVID or say we are not at risk, or refuse to take precautionary measures. All of these are trauma responses, in other words,  our mind unconsciously and automatically protects us through avoidance.

Some of these behaviors make other people very angry and are themselves a stimulation of the trauma. You may be very reactive to people who minimize the risk of COVID to themselves and others. Both of these reactions are traumatic in nature. We do not, necessarily, choose our defense (which is a whole other blog topic). Some people intellectualize and want to learn everything about the event; others want to know nothing or deny reality. Both groups are avoiding their feelings, although intellectualization is preferable to denial. Avoiding feelings, in general, is a traumatic response, as well as a cultural one (some cultures value feelings more than others). 

4.  Negative alterations in cognitions and mood associated with the traumatic event(s), as evidenced by two (or  more) of the following: 

  • Loss of memory around the event(s) [one of the more extreme reactions]
  • “Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world”
  • “Persistent, distorted cognitions about the cause or consequences of the traumatic  event(s) that lead the individual to blame himself/herself or others.”
  • “Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).”  
  • “ Markedly diminished interest or participation in significant activities.”  
  • “Feelings of detachment or estrangement from others.”  
  • “ Persistent inability to experience positive emotions (e.g., inability to experience  happiness, satisfaction, or loving feelings).” 

What strikes me about this section is how real it is socially, except for the loss of memory bit. 

(Also how much the word “persistent” is used.)

 “Persistent exaggerated negative beliefs or expectations about oneself, others or the world” Check.

“…lead the individual to blame himself/herself or others”

Check.

“Persistant negative emotional state”

Check. It’s like a nightmare we cannot get out of, which then becomes a trigger for all of our other unresolved traumas from this (and other, if you believe in that) lifetimes.

“Markedly diminished interest or participation in significant activities”. 

Check. But in a weird way. COVID prevents us from participation and maintaining interest. Double check.

“Persistent inability to experience positive emotions”. 

Check and Checkmate. We all feel depressed. We are all grieving. It is hard enough to maintain hope in the persistence of COVID, never mind the persistence of our collective trauma around COVID. Ugh.

5. Unpleasant behavioral changes as a result of the event that include two or more of the following: Insomnia or other sleep disturbance, inappropriate emotional outbursts that are out of character, hypervigilance, exaggerated startle response, and/or difficulty focusing and/or concentrating. 

Well, yes. Most of these for most folks. One only has to venture online to see the reactivity happening. Nearly everyone I know either as a friend or patient has struggled with sleep this year. You can check in with yourself as to whether you are still washing your hands 10 times/day or wearing your mask when you really do not need to (hypervigilance), or if you jump when someone comes up behind you unexpectedly. 

Many people came into this period of time with PTSD, either diagnosed or not. They have been suffering tremendously because their systems were already sensitive to traumatic stress. The rest of humanity may now suffer some level of PTSD. I say “level” because although PTSD is by definition a very unpleasant condition, it can have levels of severity beyond baseline. If you are having dissociative symptoms such as depersonalization (“feeling as though one were in a dream; feeling a sense of unreality of self or body  or of time moving slowly”)  or derealization (the world around you feels “unreal, dreamlike, distant,  or distorted”) you may have a more severe situation that needs attention. Technically it is called PTSD with dissociative symptoms. 

Oh yes. And these symptoms need to have gone on for more than one month. 

Check.

Please, dear reader, remember: I would not write this blog if I did not feel you or your loved ones could be helped. There are many resources available to help you heal from PTSD. My book, The Trauma Tool Kit: Healing PTSD From the Inside Out is available in libraries all over the world, and has a rating of 4.6/5 stars on Amazon where it is available on Kindle and Audible (in my own voice).

Be well and stay safe, Susan PB

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5 E-Kindle Book 5th Edition (p. 308). Indephent. Kindle Edition. 




Reiki and PTSD

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I have been told by many people over many years including intuitive clients that I should be using my hands in my healing work. Up until this past year I politely and firmly declined. Therapists consider touch to be taboo and risky. Most agencies make it clear that touch is not to happen between client and therapist – ever.

What happened to change my mind was Reiki. I started to do some research and found that many therapists (as well as nurses and doctors) across the United States use Reiki in their practice, including in the hallowed hospitals of the Harvard Medical system. Over 800 hospitals use Reiki, and it is an evidence-based practice for stress and chronic pain, two symptoms clearly related to PTSD.

As it turns out, one does not need to even touch a client in order to provide Reiki healing energy in a session. So last April I received my Reiki I and II attunements and started offering Reiki to my clients.

The results were astonishing:

– I’ve had several clients report a full night’s sleep after several months or years of sleep disruption, a common side effect of PTSD

– Clients are able to release emotions and cry on the treatment table in a way they usually do not in session. The beauty of Reiki is that they may not know why they are crying; they don’t have to have a reason or specific memory, but they always feel better afterwards and move forward in resolving previous traumas.

– Many report a feeling of a loving, warm and compassionate energy that they have not felt before or in a very long time.

– People report improved digestion and bowel function. On the table I hear people’s gut making bowel sounds, a sign of parasympathetic function being restored to the autonomic nervous system.

– Although I talk about grounding in sessions as do many trauma therapists I have found that Reiki helps clients inhabit their body more fully, and they can really notice the lack of grounding or energy in their lower body. This improves greatly over 2-3 sessions and instigates a firmer resolve to practice grounding exercises such as walking barefoot outside.

– Clients become deeply relaxed and often report the deepest states of peace in their body than they have felt in many months or weeks. Too often therapy is a very stressful experience; Reiki provides a corrective emotional experience for treatment!

– Sometimes people experience physical symptoms resolving. One patient who’d had a persistent red rash for many days reported the rash clearing up within hours of the session. Another experienced her feet becoming stronger and less prone to injury.

Often there is validation between what I as the Reiki practitioner am feeling and what the client is feeling in their body. I had one client that when I held my hands in the position around her face and temple I felt intense heat between the jaw and temple, almost as if my hands were held up next to a flame. My client felt this heat as well, and became very emotional. Later she connected that very spot to where she received electroshock therapy years before which, for her, was both validating and healing.

Although I had the intention that I would probably not touch my therapy clients, I found that people were more offended if I would not touch them. So now before sessions I get their permission and usually only touch around the head, neck and lower legs.

This past December I went back to become a Reiki Master, and have signed up for my next level of training in August. I hope very soon to be offering Reiki attunements, trainings and certifications for therapists. Stay tuned!

If you have received Reiki, I would love to hear about your experiences in the comments section!




Find Your ACE Score

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Last year I posted about the largest study you’ve never heard of : the Adverse Childhood Events Study.  ACE has shown by using over 17000 participants data over several years that the more adverse childhood event categories you’ve been exposed to, the higher your chance of illness, obesity, mental problems, and socioeconomic ills.  You do not have to have full blown PTSD to be exposed to these risks.   People with the highest scores died, on average, 20 years sooner than people with the lowest scores.  The good news is that getting treatment and adopting healthy lifestyle behaviors can mitigate your risk.

What is your risk?  Take the questionnaire below:

 

Finding Your ACE Score While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you?

or

Act in a way that made you afraid that you might be physically hurt?
Yes No If yes enter 1

2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you?

or
Ever hit you so hard that you had marks or were injured?

Yes No If yes enter 1

3. Did an adult or person at least 5 years older than you ever…
Touch or fondle you or have you touch their body in a sexual way?

or

Attempt or actually have oral, anal, or vaginal intercourse with you?
Yes No If yes enter 1

4. Did you often or very often feel that …
No one in your family loved you or thought you were important or special?

or

________

________

________

Your family didn’t look out for each other, feel close to each other, or support each other? Yes No If yes enter 1 ________

5. Did you often or very often feel that …
You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?

or

Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

Yes No If yes enter 1 ________

6. Were your parents ever separated or divorced?
Yes No If yes enter 1 ________

7. Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her?

or
Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?

or
Ever repeatedly hit at least a few minutes or threatened with a gun or knife?

Yes No If yes enter 1 ________

8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? Yes No If yes enter 1 ________

9. Was a household member depressed or mentally ill, or did a household member attempt suicide?

Yes No If yes enter 1 _______

10. Did a household member go to prison? Yes No If yes enter 1 _______

Now add up your Yes scores:  ___________

For more information go to www.acestudy.org.

 




The Power of Persistence (or What you Resist, Persists)

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I don’t know how to say this to you any other way so I’m just going to say it:  There is no easy way to heal from psychological trauma.

There is no pill, no elixir, no magic wand, no therapist, no book, no workshop, no yoga class, no blogger that will give you a quick fix from your suffering.  I’m sorry; I truly am.

If you want to heal from PTSD you are going to have to work very hard for a long time. You are going to have to spend money (probably a lot of money relative to your income) to get help to overcome what you feel should have never happened to you. And then you will have to work some more.

In my book I compare the journey of healing PTSD to the journey that Frodo takes in The Lord of the Rings trilogy to cast the evil, all powerful ring back into it’s source: a dangerous volcano hidden inside of an even more dangerous enemy territory governed by an all seeing magical evil sorcerer.  Frodo has two choices.  He can either stay in his comfort zone in the bucolic shire of his childhood and live in denial until his land is ultimately overrun with evil mutant elves and destroyed while the ring has corrupted him (or someone else) completely.  Or, he can man up and take the journey, one that is most perilous and with no guarantee of success and try to destroy the thing forever.

This is basically our choice as well. Is the journey so easy? If it were, everyone would make it.

Yes, I know it sucks.  But suck it up folks. That is the way it is.  I can only say this to you, not because I am cruel and heartless, but because this is a journey that I’ve taken.  I’ve done the dirt time, so to speak, in spades.

It is totally worth it.  The sooner you get over resistance to healing and begin, the better.  Healing PTSD takes a chunk of your life.  Not healing from PTSD takes your entire life (and possibly future lifetimes if you believe in that sort of thing).

Take a moment and review the pros and cons of healing:

 Pros                                                                 Cons

 Peace of mind                                                  Nightmares and flashbacks for the rest of your life, chronic anxiety

 

 The ability to love and be loved                  Failed relationships; people who are afraid of you; persistent loneliness

 

 Bodily health                                                  Heart disease, migraines, joint pain, digestive issues, diseases

 

 Wisdom                                                           Ignorance, bitterness, confusion

 

 Compassion for self and others                   Self-pity, entitlement, self-loathing, shame

 

 Money well spent in healing                        Money ill spent in addictions, diversions and distractions

 

Well, you get the picture. 

 So which will it be?  Healing PTSD does have an endpoint.  It brings gifts beyond compare but only if you finish the job.  You have no more time to lose. Put this at the top of your New Year’s Resolutions and you will ring in a much brighter 2014.

Blessings on your journey of healing!

 

Endurance is the most difficult of all the disciplines but it is to the one who endures that the final victory comes. ~ Buddha

 

 

 

 

 




Dissociative Identity Disorder

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DID (dissociative identity disorder) is the outcome of early and severe trauma and always involves multiple levels of PTSD. Some of you may know it as multiple personality disorder. Unfortunately there is still a lot of ignorance, fear and titillation around DID. I just returned from speaking at the 2nd annual Healing Together conference in Orlando, Florida, which was organized by and put on for those suffering from DID and those who care for them. I have never attended a more open-hearted, mindful and enlightening conference. About a third of those there had been diagnosed with DID. Robert Oxnam, the famous scholar who came out as a multiple on 60 minutes was the keynote speaker. Contrary to what you might believe, there was much laughter and open sharing of stories. Jaime Pollack, the bubbly and energetic founder gave the opening and closing speeches. She shared her process of coming out publicly with DID, while still holding her job as a preschool teacher. The sharing of her story, as Robert’s did, allowed those around her to share the abused parts of themselves and feel cared about and accepted. In the end, Jaime exhorted those with DID to adopt a “so what” attitude to their multiplicity. It is just one more disability in the world and nothing to be ashamed of. Thanks Infinite Mind for putting on such a wonderful conference! If you suffer from DID or extreme trauma, I hope to see you there next year!




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