Transcript Donna Masterson, PTSD

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 abuse
4. 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 PTSD
A. 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.
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.