Trauma And Post Traumatic Stress 5 23 10

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Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normalreaction to an abnormalsituation.•Any human being has the potential to develop PTSD•Cause external –Psychiatric Injury not Mental Illness•Not resulting from the individual’s personality –Victim is not inherently weak or inferior

Transcript of Trauma And Post Traumatic Stress 5 23 10

  • 1. Trauma andPost Traumatic StressJanet Louise Parker, B.S., M.S., D.V.M.People are like stained glass windows. They sparkle and shine when the sun is out; but when the darkness sets in, their true beauty is revealed only if there is a light within.Elizabeth Kbler-Ross

2. Positive Stress (or eustress) Competent management Mature leadership Everyone is valued and supported. enhances well-being Enhances performance and fuel achievement. 3. Negative Stress (or distress) Threat Coercion Fear Dysfunctional and inefficient management Diminishes quality of life Injury to health 4. Post Traumatic StressPost Traumatic Stress Disorder(PTSD) is a natural emotionalreaction to a deeply shockingand disturbing experience. It is anormal reaction to an abnormalsituation. 5. Who Gets PTSD Crime Victims Persons experiencing death of family member, friend, co-worker Returning Veterans Cancer Survivors & their family Domestic Violence Victims Sexual Assault Victims Targets of Workplace Bullying 6. Origin is External not Internal Any human being has the potential to develop PTSD Cause external Psychiatric Injury not Mental Illness Not resulting from the individuals personality Victim is not inherently weak or inferior DSM-IV-TR (APA, 2000) 7. Impact of Trauma Difficulty trusting others and forming close relationships (may appear withdrawn, uncooperative, defensive or aggressive). Fear or concern about safety. Difficulty managing and expressing feelings. Lack of belief in self-worth and capabilities. 8. Hyper-arousal Hypervigilance Sleep disturbance Irritability Dissociation Depression Problems of Proneness concentrationto anger Vulnerability to Exaggerated startle medical illness response 9. Traumatic Memory Intrusive Reenactment recollectionsplay Nightmares Perceptualillusions Emotional (somatic) Dissociation, memories,memory retrieval actingout/ reliving trauma. 10. Denial Avoidance Substance abuse, Emotional Social/geographicalnumbing,isolation Amnesia, Desexualization, Loss of active estrangement and socialdetachment interpersonal Obsessive-engagement, compulsive Attention diversionas defense 11. Self-concept, Ego states Demoralization, Prone to ego fragmentationdissociation,hopelessness and Identity diffusion helplessness Vulnerability Shame, guilt Loss of spirit and Misanthropic vitality, dysphoria, beliefs Faulty cognitions 12. Interpersonal relations: Alienation Issues of loss, abandonment Mistrust Impulsiveness Detachment Self-destructive Boundaryrelationships problems with others 13. Patterns of anticipation Individuals suffering from PTSD live daily life as if the traumatic experience is recent, even though it may have happened years earlier. Triggers will cause the event to be re-experienced. Isolation and paralysis of the mind(Holter, 2005, abstract). 14. NCPTSD, July 4, 2007 32 % War experiences 48 % Abuse (spousal, childhood, sexual, bullying) 19 % Crime 18 % Accidents 8 % Acts of terrorism 5 % Natural disasters 15. Response to Chronic Stress Breakdown of immunesystem Increased heart rate and blood pressure Increased cortisol level Shrinking of the hippocampus (affecting learning and memory) Enlargement of the amygdala (affecting emotional behaviors) 16. Dissociation PTSD is soul murder Disconnection between the traumatic events and the meaning associated with those events Interferes with ability to verbalize the events and their meaning 17. 3 Levels of Victimization 1. Loss of feelings of safety, loss ofperception of an orderly world, andloss of a positive sense of self.2. People do not believe, and deny the severity of the trauma thus blaming and stigmatizing the victim. (Ridicule and Punishment)3. Perceiving oneself as a victim with no personal power 18. Daubert Standard Standard for admitting expert testimony Scientific basis for professional opinions Federal Rule of Evidence 702 when evaluating claims ofpsychological injuries as authorized by the Civil Rights Actof 1991 19. Trauma-Informed Services Trauma-informedTraditional Approaches Problems/Symptoms are Problems/Symptoms are inter-related responses todiscrete and separate. or coping mechanisms to deal with trauma. People providing servicesare the experts. Trauma Providing choice,Survivors broken, & autonomy and control isvulnerable. central to healing. Primary goals are defined Primary goals are definedby service providers and by trauma survivors andfocus on symptom focus on recovery, self-reduction. efficacy, and healing. Reactive services and Proactive preventingsymptoms are crisis driven further crisis & avoidingand focused on minimizing retraumatization.liability. 20. Understanding Trauma Anxiety causes traumatized individuals to have difficulty in processing information. Understanding trauma response and its triggers. Recognizing behaviors as adaptations. Identifying and reducing triggers to avoid re- traumatization. 21. Poor Support Intensifies DamageWhen an individualsuffering fromPTSD is unable toresolve issuesrelated to thetrauma he/she isunable to establisha new baseline ofbiopsychosocialfunctioning. 22. Secondary Re-Traumatization The loss of human potential is incalculable. Society has a tendency to blame the victim for not being able to simply get over it and this cultural lack of support can be classified as secondary wounding and promotes a victim mentality, thus keeping the problem going.Human beings, like plants grow in the soil of acceptance, not in the atmosphere of rejection. John Powell, S.J. 23. Re-Experiencing Trauma Re-experiencing original trauma (symbolically or actually). Trauma Survivor responds as if there is danger even if it is not actual danger. Triggers may be subtle and difficult to identify.One of the most courageous things you can do is identify yourself, know who you are, what you believe in, and where you want to go. Sheila Murray Bethel 24. Trauma Victims Disposable? Our society views many objects as disposable and when an object is tarnished or dented the tendency is to deem its value gone, throw it away, and rush to the stores to replace it. Humans are not objects, and the growth potential available though the healing process is infinite. 25. From Vulnerability to StrengthCelebration Self Actualization Overcoming Vulnerability Recognition Compensation Self Esteem Needs Sharing with Others (Sense of Belonging) Exploring Protection Needs Identifying Safety NeedsDenial of VulnerabilityElimination of Danger Vulnerable 26. Promoting Safety Because PTSD is soul murder and splintersthe sense of self, and creates acute mistrust inthe individuals environment . Provide a safe physical environment. Provide emotional safety: tolerance for widerange of emotions. A Sense of Safety is Critical to relationshipbuilding. 27. Build Trust Long Term Process PTSD changes the diagnosed individuals life and greatly impacts the lives of those with whom they are close and regularly interact. Trusting relationships are essential to combat the dehumanizing effect of trauma. 28. Supporting Control, Choice & Autonomy Trauma survivors feel powerless. Equalize power imbalances. Recovery requires a sense of power and control. Relationships should be respectful and support mastery. Trauma Survivors should be encouraged to make choices. 29. Communicating OpenlyIf I can listen to what he tells me, if I can understand how it seemsto him, if I can sense the emotional flavor which it has for him, thenI will be releasing potent forces of change within him.Carl Rogers Respect Trauma Survivors right to openexpression. Discourage withholding information or keepingsecrets. 30. Integrating Care Because of the dehumanizing nature of trauma it is important that care approaches deal with the client holistically as opposed to treatments designed solely to reduce symptoms. Trauma Survivors symptoms and behaviors are adaptations to trauma. Services should address all of the survivors needs rather than just symptoms. 31. Fostering Healing Humans are not objects, and the growth potential available though the healing process is infinite. Instilling hope. Strengths-based approach. Future orientation. Cultural Competence 32. Inward Reflection Trauma causes individuals to look spiritually inward. The healed self that was once traumatized can project itself into the future with joy, serenity, and a measure of wisdom. Walsh (1985) 33. UPSIDE to Trauma? According to Wilson et al., 2001 Individuals, once healed, arepotential guides, healers, teachers,and may be subjects of scientificinquiry concerning resiliency,salutogenesis, and self-efficacy 34. InspirationsGreat minds have purposes, others have wishes. Little minds aretamed and subdued by misfortune, but great minds rise above them.Washington Irving Sometimes I think that the main obstacle to empathy is ourpersistent belief that everybody is exactly like us. John Powell, S.J. The deepest craving of human nature is the need to feelappreciated. William James Great Things are not done on impulse but by a series of small things brought together. Vincent van Gogh