PTSD

POST TRAUMATIC STRESS DISORDER

I. WHAT IS PTSD AND ACUTE STRESS DISORDER

A. WHAT IS ACUTE STRESS DISORDER 1. DEFINITION--DSM-IV

a. the person experienced, witness, or was confronted with events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. b. the persons response involved intense fear, helplessness, or horror 2. SYMPTOMS a. subjective sense of numbing, detachment, or absence o

emotional responsiveness b. reduction in awareness of surroundings c. derealization d. depersonalization e. dissociative amnesia (inability to recall an important

aspect of the trauma.

B. WHAT IS POST TRAUMATIC STRESS DISORDER 1. DEFINITION-DSM-IV

a. the person experienced, witness, or was confronted with events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

b. the persons response involved intense fear, helplessness, or horror.

2. SYMPTOMS a. recurrent and intrusive distressing recollections of

the event, including images, thoughts, or perceptions.

b. recurrent distressing dreams of the event c. acting or feeling as if the traumatic event were

recurring including a sense of reliving the experience, illusions, hallucinations, and disassociative flashback episodes

including those that occur upon awakening and when intoxicated.

d. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

e. physiological reactivity on exposure to internal or external triggers that symbolize or resemble an aspect of the traumatic event.

3. PERSISTANT SYMPTOMS a. difficulty falling or staying asleep

b. irritability or outbursts of anger c. difficulty concentrating d. hypervigilence e. exaggerated startle response f. sense of foreshortened future.

C. WHAT SITUATIONS CREATE TRUAMA 1. CHILDHOOD PHYSICAL ABUSE a. spankings or hitting which leaves bruises b. inappropriate discipline such as "standing on one's

knees” being place in a closet, going without nourishment, left at home alone at an inappropriate age, etc.

2. CHILDHOOD SEXUAL ABUSE a. Overt-touching genitals, fondling, any sex which

involves penetration such as intercourse, oral or anal sex, use of objects, etc.

b. Covert-use of pornographic materials in front of the children, making sexual comments about the child's body or behaviors, nudity at an inappropriate age, etc.

3. DOMESTIC VIOLENCE --A witness to abuse is a victim of abuse4. NEGLECT AND EMOTIONAL ABUSE a. Inappropriate nourishment b. Caring for children while under the influence of substances, including cigarettes. c. Leaving children unattended or sleeping while children are awake. d. Blaming children for parents' bad behavior 5. DISASTERS CAUSED BY NATURAL OR UNNATURAL EVENTS

a. Hurricanes, tornados, floods b. Witnessing shootings

c. Suicide or unnatural death of a loved one d. War

II. RECOVERY FROM PTSDA. EFFECTS ON BRAIN DEVELOPMENT AND BRAIN CHEMISTRY 1. Role of limbic system, amiglia, and adrenal glands.

2. Effects on corpus colosseum 3. Right brain lead—an emotional response to

solving a logical problem

B. STAGES OF RECOVERY 1. Identifying the trauma 2. Identifying the perpetrator 3. Confronting blame v shame issues in the trauma--"I hate

myself for what he did to me". "What's wrong with me that this keeps happening?"

4. Taking action to report the trauma if possible— Holding perpetrator accountable.

a. What is an outcry? b. Why children recant--barriers may be fear of

reprisal, fear of abandonment, fear of having to testify, etc.

c. Repressed memories v false memories

5. Stages of grief - denial, anger, bargaining, despair, and acceptance. a. Use of anger to develop boundaries and confront abusive behavior b. Bargaining is a result of co-dependency and fear of abandonment. c. Despair v depression d. Acceptance doesn’t mean submission—it is looking at the situation realistically and deciding what we are going to do about it. e. Understanding co-dependency and learned helplessness as barriers to recovery.

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6. Developing tools for intervening with triggers. a. Identifying neurochemical response from trigger b. Identify intervention to prevent response from progressing

c. facilitating a cool-down d. identifying and utilizing a support system.

Family shelter, CIU, CVRCC, AA/NA/Al-anon/ACOA Private therapy, religious affiliation.

e. Re-parenting and inner-child work

REFERENCES

Knauer, Sandra, 2002, Recovering From Sexual Abuse, Addictions, and Compulsive Behaviors. Hayworth Press, Inc.

10 Signs of Relationship Abuse – Human Relations Media.