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Monthly Archives: July 2016

PTSD Triggers. The known and unknown

triggers of ptsd

 

It had been a perfect day despite PTSD

You were having fun. All of a sudden the fear, the flashbacks, the avoidance and the panic of PTSD returns.   Why now?

This is the question often asked by patients in clinic. There is a simple answer. Panic frequently re-appears in PTSD.  When it does it often reduces sufferers  to jelly. This often happens suddenly and without warning.   It is all to do with PTSD triggers, (things that resemble or remind the brain of the index incident).

Big triggers and small triggers all can cause a massive panic response

Most people are aware of the big things connected with a trauma.  Some people consciously make a corollary of things that were connected with the traumatic incident.  These lists become their conscious trauma triggers.  They believe that they can then anticipate the ‘hot spots’ and take action.  Action to manage the uncomfortable scenarios. This does not often work.

The problem is, it’s the unconscious and unknown  triggers that knock us off balance and on to our knees.   For example, Gill is a successful career woman.  She was raped six months ago.  The trauma happened on her way home from a nightclub. Gill  is very aware of certain triggers.   She is scared of being alone in town at night. Particularly so, in a certain part of town.  She also jumps at the sight of a certain make of car and freezes if she hears any door slam. 

Gill recalled that recently she was hosting a presentation at her Gallery in Geneva.  All was well.  There were many high profile clients attending. Naturally she wanted to make a great impression.  Instead, she suddenly found her mind racing, her heart pounding and a pressing desire to sprint right out of the room.

At that moment, she felt that her very survival depended on escaping.  She lurched to the ladies room where involuntary shaking gave way to floods of tears.  The presentation now seemed a threat. She was unable to regain her composure.  Instead she called a friend to collect her and left by the back entrance.

Hidden triggers

It was the following week during treatment that she suddenly recalled that she had registered a strong smell of a particular masculine fragrance.  She remembered that her attacker had smelt the same.  She hadn’t been aware of that hidden piece of the jigsaw previously.

Suddenly it made sense.   It had been an unconscious trigger. A trigger that had remained below consciousness until the evening of the presentation.  Now that she is aware of a new trigger, she is able to use techniques learnt in therapy to tolerate her acute sense of fear.  She is able to use learnt strategies to reduce the triggers effect on her.

Set backs are temporary

The point is that for as many triggers we are aware of, there are also as many that remain just out of range.  These are like rocks under the water. It is so important to recognise this fact.  It is a tough fact to accept that even where fantastic progress is made during treatment, there are likely to be set backs.   These set backs are just that, temporary ones. This is the nature of PTSD.

*Client’s name and occupatiation has been changed due to client confidentiality

Written by Christine Tizzard Psychology providers of independent psychology providers based in West Sussex

 

 

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Terror attacks – Helping kids cope

Terror Attacks – Helping kids cope

Reducing the fear of terror with everyday parenting

It is every parent’s nightmare, despite your best attempts, somehow your 6 year old daughter has learnt of the recent terror attack.

She is scared and tearful. She asks you if she or you are going to be hurt by bad people. She tells you there are some ‘mean’ people who want to hurt others.

You don’t want her  innocence to be lost so soon. At the same time, you do want to be truthful. This is a scenario that every parent fears. It is also sadly one we are having to deal with more frequently. What is the best way of handling it? How does a parent explain terror?

The most important thing is and it’s something that most adults forget – A child who has a secure relationship with their parents already has a fortress of containment. This is the best possible starting point for tackling the unpalatable.

Parents view terror and trauma from an adult perspective, through adult eyes. We recognise the ugliness of horror and atrocity. Small children have not yet developed this depth of understanding, thank goodness. Their innocence is also a protection. Unless Children are directly affected by trauma, they don’t recognise it in quite the same way as adults, unless we teach them through our own fear. It’s really important that your children do not see your fear, your rage or your feelings of powerlessness in response to a terror attack. If a child knows their parents are scared, they will be too.

  1. For children a secure and containing relationship with a parent, or another attachment figure is the most important safety feature that protects them from acute fear.

  2.  Explain that there are a few bad people in the world who want to cause harm but that there are many more good people. Fictional characters can often be used as good examples for younger children.  They are often powerful archetypes of strength and character that children can easily relate to.

  3. Tell them the good people in the world outnumber the bad. Point out all the people who your child knows who help others in different ways. These people could be friends, family members, teachers, doctors etc.…

  4. Tell them that they have no need to worry as Mum, Dad, Nanny or another attachment figure will always keep them safe. Explain to them that it is the parents’ job to protect them from the few bad people in the world.

  5. Never provide more information than needed about a horrific situation. Use factual language but avoid the over use of descriptive phrases and pronouns.  It’s correct to say ‘Some people were hurt’. Rather than ‘Some people had their arms  and legs smashed and or crushed’.

  6. Always answer their questions truthfully in a basic age appropriate manner.

  7. Try to find a positive balancing thought to your child’s concern. In the case of the events in Nice a balancing thought would be a) The good and brave people who stepped in to help or b) The doctors who are working round the clock to make the injured better.

  8. The focus here is to help the child balance their nebulous fear of bad people posing a threat in the world with concrete evidence of the certainty of many better people in the world. This will help a child to form a mental representation of safely, particularly a young child where the ability to engage in abstract thinking is not yet developed.

Written by Dr Chrissie Tizzard Chartered Consultant Adult, Adolescent and Child Psychologist. Director Christine Tizzard Psychology Limited. Specialist in the assessment and treatment of trauma and related disorders in adults and children. www.ctpsy.co.uk

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Is creativity boosted by depression or personality traits or both?

Is creativity boosted by depression or personality traits or both?

A Swedish study carried out in 2012 suggested depressed individuals might have the edge in the creativity stakes.

Great Poets such as Dickinson and Plath; seminal writers like Virginia Woolf and Hans Christian Anderson have been simultaneously lauded and devalued as being able to write better than most because of their poor mental health. A double edged sword perhaps.

The truth is creative writers are no more likely than the rest of the population to suffer from depression. The lived experience of depression is often a turning inwards on the self. It is a slowing of processes and a preoccupation. In a nutshell, a stuckness with one’s perception. This introspection and rumination can be a rich petrie dish environment in which to capture one’s deepest feelings, reflections and thoughts. If lucky these germs of creativity can develop into inspiring and poignant art, writing or poetry.

The cathartic outpouring or release from ‘the dark night of the soul’ can find its form in something of beauty.   In others this outpouring of emotion can be destructive and ugly.

 

virginia

It is perhaps a journey down a different track to suggest that Dickinson’s ‘Hope is the thing with feathers on’, and Plath’s Daddy might each have been successfully birthed without a veil of depression.  One might argue that both poet’s deep introspection and reflection added the extra quality of genius. Perhaps we come a little closer to reality when we explore another area of thought. Were these great contributors of literary legacy simply INFJ’s, (Introversion, iNtuition, Feeling, Judgement?) INFJ’s who at different times experienced poor mental health.

For those unfamiliar with Jungian theories and the Myers Briggs Personality Types. Different personality types/traits confer a distinct predisposition to certain behaviours. You can try the test at  www. humanmetrics.com.

The point is when we try to reduce things to an absolute conclusion, we limit the lens of possibility. All things look the same. We foreclose.  In narrowing the lens of possibility we risk killing our own creativity and intelligence and that of those around us. A growing of intelligence calls for an ability to consistently update hypotheses.  More now than at any other time.

Novelist Virginia Woolf committed suicide by drowning.

Poet Silvia Plath committed suicide.

Poet Emily Dickinson suffered from depression.

Fairy-tale author Hans Christian Andersen, who wrote The

Ugly Duckling and The Little Mermaid battled depression.

US author and journalist Ernest Hemingway, who wrote for Whom the Bell Tolls, had depression and killed himself with a shotgun

Author and playwright Graham Greene, who wrote the novel Brighton Rock, had bipolar disorder

 

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