Strengths Based Treatment for PTSD | Advanced Counselor Training

I'd like to welcome everybody to today's presentation of a strength-based biopsychosocial approach to understanding post-traumatic stress disorder I'm your host Dr Donal Snipes in this hour we're going to highlight the functional nature of most behaviors and reactions Define PTSD and cptsd examine the function and meaning of their symptoms develop an understanding of why why some people develop PTSD and others don't and explore useful interventions for persons with PTSD now the majority of this video is going to focus on understanding the symptoms I have many other videos that talk about different treatment approaches um so the end part of it just provides a synopsis of a few tools that can be used remember that humans and animals experience reactions that prompt Behavior anger fear and forget about it um these are our stress responses and when people feel angry when something happens and people feel angry they either fight or they Fawn and some people may think well isn't Fawn fear well you can argue that point my definition is if the person is staying they're not running away they're not escaping then it's anger so they're either going to fight or they're going to do whatever they need to do to try to make the other person happy or make the threat go away that's the Fawn fear is when the person fleas or freezes and then forget about it is when the person just kind of lays down and says I give up reactions are responses designed to protect life and either achieve a reward or avoid punishment and exploring behaviors and reactions from that somewhat um unemotional standpoint can help us get curious and under explore things in terms of what is this Behavior communicating in what way is this Behavior helping the organism survive or helping them achieve a reward or avoid punish ment or all of the above so PTSD and complex PTSD PTSD is exposure to an event or multiple events and that produced a sense of extreme horror or trauma and again we're not going to go into specific diagnostic criteria today we're just going to talk in general about the symptoms um people who experience PTSD Maybe uh in the military or they may be Crime Victims um they may be law enforcement law enforcement can fall into either category the defining feature or differentiating feature if you will in many cases for complex PTSD is that there were multiple events it was a repeated exposure to a hor horrific or threatening event in which Escape was difficult or impossible causing a sense of helplessness cptsd is ongoing it's not you a couple of occurrences um it's something that happens with regularity and for some reason the person feels like they can't escape from it in law enforcement and I put law enforcement under cptsd because in order to escape from those traumas that they are exposed to on the regular maybe not every day but on the regular that would mean they'd have to quit their job which would mean they would lose their income which would mean they couldn't support themselves um maybe they don't have training for anybody anything else so it may seem like they're stuck it may seem like they can't um address the situation the military once you sign up you can't just decide six months later he hey I'm not liking this very much um you're there once you're deployed you're there so there is no Escape if you will and the same thing is true when you're in an environment where there is abuse of or neglect of self or other and what do I mean by that obviously abuse of if somebody's abusing me or neglecting me that could be traumatic for especially for children who can't get out of the situation who are sitting there going I can't Sur survive on my own I've got nowhere to go even if it's I don't want to minimize that because actually more deaths occur from child neglect than doe from abuse but um if it's neglect emotional physical neglect the child is you know wondering where their next meal is coming from that's traumatic people adults who are in domestically violent relationships or older adults who are infirmed and relying on caregivers who are being abused or neglected that can be traumatic so that's abuse or neglect of the person it can also be traumatic if you're in an environment which you don't feel like you can escape from in which you're seeing someone else abused maybe the children aren't getting abused but the caregiver is or vice versa or maybe the children and the caregiver aren't getting abused but the family dog is that's traumatic and that's communicating what could happen to you is hap what's happening to this person or this animal could happen to you so it's a loud communication of threat complex PTSD is so complex because it haen happens for so long it's so ongoing and becomes associated with so many different things and it really Alters the person's way of viewing the entire world and viewing themselves so PTSD is exposure to a horrifying event in which there was a sense of helplessness with complex there's also a sense of an inability to escape for each symptom that follows we're going going to identify the function what triggers that symptom or exacerbates it and how the person deals with it or mitigates that symptom and other things they might be able to do reexperiencing the traumatic event uh this can be this can happen for people with cptsd or PTSD why well this event happened and it was very dangerous it was very threatening so your brain says hey don't forget about this you need to protect yourself from this sort of situation so the brain kind of hones in on that and says be aware for next time be on alert alert like if you're out hiking and you step on a poisonous snake and you get bit that's traumatic and when you're hiking in the future or when you see snakes in the future that your brain's going to go oh remember that thing that was really bad stuff um that's a survival mechanism reexperiencing can come through intrusive upsetting memories of the event uh you remember what happened flashbacks acting or feeling like the event is happening again and our brain will do that to us if we're reminded of it it can feel like that's happening again because all those sensory cues that were associated with that event your brain May kind of turn on again if you will nightmares feelings of intense distress when reminded and intense physical Panic reactions to reminders this is natural when your body or your brain senses something that reminds them of a trauma reminds them of something that was dangerous then your brain triggers the stress response and the stress response is going to dump a bunch of cortisol and norepinephrine and other stuff so you can fight flee Fawn uh freeze or forget about it generally the person experiences intense panic and physical symptoms that stress response amps up it causes the heart rate to increase it causes the Palms to sweat it causes um breathing to increase to help the person prepare to fight or flee so physical symptoms that we see difficulty falling or staying asleep so let's think about this if you've been in an environment or in a situation that was dangerous and now you're trying to fall asleep when we're asleep we are vulnerable depending on the person example if you um were in an environment where it was regularly unsafe because of abuse or neglect especially abuse um the person you may have difficulty falling or staying asleep because you never know when that threat is going to appear if for example you were the Survivor of a tornado or a hurricane that was devastating to your area you may be able to fall or stay asleep a lot of the time but if it's raining outside or if it's forecast to rain outside it may be more difficult if the tragedy the tornado happened while you were sleeping it may be more difficult to fall or stay asleep even if rain's not forecast cuz maybe you didn't know it was going to rain and then you woke up and your roof was gone that's traumatic that is extremely traumatic the person may experience irritability or outbursts of anger uh recognizing when our stress response is triggered we have that fight or flee you are in survival mode so you are tend to be people tend to be more reactive instead of contemplative about how they respond they're already feeling stressed and one more thing is just like make it stop make it stop go away okay we understand this so if we can help people recognize you're having difficulty falling asleep because you don't feel safe all right we're going to talk in a little little while about strategies to help you feel safe what can you do you have more irritability and outbursts of anger because your stress response is already primed you're already you know stressed out un under under currence of stress so it doesn't take much to make you feel completely out of control hypervigilance being on constant red alert and I put this under physical symptoms because when somebody's hypervigilant they're not relaxing they're scanning they're looking they're listening all of their senses are heightened if you will will to prepare for and to be alert for any threat that may be happening that's freaking exhausting now we understand why it happens if you have been um caught unawares before if you have experienced a trauma before then you're going to be more hypervigilant even after for example a car accident and maybe it wasn't a bad car accident but it was a car accident you may be more hypervigilant when you're driving you're scanning you're paying attention for drivers that aren't paying attention themselves you're paying attention for to um see if there are any animals that are going to run out in front of you you're a little more hypervigilant after you start feeling safer driving you have more experiences where nothing bad happens you probably will become less hypervigilant you'll become you'll still be vigilant but not hyper Vigilant and helping people again understand that's your brain's way of saying oh I ain't going to get caught with my pants down again okay feeling jumpy and E easily startled that's different than hypervigilance hypervigilance is awareness scanning paying attention feeling jumping and easily startled is having an extreme stress response when something happens when the dogs bark when somebody knocks at the door when somebody drop something this is your stress response your HPA axis going something happened I don't know what it is I feel out of control okay not everybody is as sensitive to being jump jumpy and easily startled but some people are and it's important that people be able to communicate recognize that's their their stress response it's a little hyper sensitive right now okay be able to communicate to people what makes it worse so people can be more sensitive to their needs for example not slamming doors um but also recognizing when that happens and they they they jump they startle all right I'm going to get grounded I'm going to look around I'm going to recognize who where and when I am and I am going to uh just let that go instead of getting angry about it instead of dwelling on it it is what it is I still do that um somebody will drop something that that's really loud or the dogs will bark all of a sudden crazy for no apparent reason and I will startle and I you know may say something about it but then I recognize I'm at home I'm safe it's all good and I can calm myself back down I can use use my distress tolerance and my down regulation down regulation tools fatigue if you can't sleep you're irritable all the time you're constantly scanning and you're constantly tense and prepared to spring into action yeah you're going to be fraking exhausted makes sense totally makes sense in order to address that fatigue the person is going to have to get to a place where they can feel safe where they can feel empowered and the core of trauma complex or otherwise is feeling unsafe and disempowered somatic complaints some people are less emotional and they tend to use um to use an analogy swallow their emotions they may feel more pain because their muscles are tensed so much and you know how your muscles can get achy things can get out of alignment and you can feel more pain if you're not getting enough sleep if your HPA axis that stress response is overactive it can lead to disregulation of that system which can lead to increased uh inflammation stress no matter where it comes from causes changes in our gut microbiome so people may start experiencing gastrointestinal problems any of these can be traced back to potentially a trauma now you may be scratching your head going well how do I know if they've got the flu or if they've got trauma when did the symptoms start and how long have they been going on if the trauma occurred six months ago and they just started developing stomach pain may be related but may be related to other stressors or or something physical um if the somatic complaint started shortly after the trauma you can be pretty certain that it's related um and in order to address those sematic complaints it's important for the person to understand why do I have these this pain why do I have these aches why do I have this you know GI upset well let's look at how stress impacts the body let's look at how you feeling unsafe and Powerless impacts the body and why when we are stressed our body says it's time to fight or flee not rest and digest you got to choose which is why you're not supposed to go exercise shortly after eating because your body can't exercise and rest and digest at the same time so your somatic complaints like GI distress is going to be partly because that stress response is is hyperactive as that tones down some of that other stuff may come back into alignment now that doesn't mean we're going to diagnose that we can help people understand where it might be coming from but obviously refer for a physical as always and then addictive behaviors and I know they're behaviors but where do you stick this addictive behaviors regardless of whether it's gambling or sex or alcohol or drugs or even adrenaline they are often used to help the person numb the pain or feel some semblance of control over something interpersonal symptoms of trauma persistent difficulties in sustaining relationships and in feeling close to others remember when people have a mental health diagnosis it's rare that somebody has every single symptom and people don't have to have all the same symptoms if your trauma was interpersonal in nature then yeah you may have difficulties and sustaining relationships because other people are perceived as a threat if you develop PTSD or cptsd and the people around you don't get it and they're invalidating then it may have you may have difficulty feeling understood and accepted and supported which leads to difficulties in sustaining those relationships there may be a lack of interest in relationships and social engagement especially if the trauma was uh interpersonal being around people means that there's a an increased chance of threat so you're already exhausted why do you really want to subject yourself to that uh what is the behavior saying why have you lost interest in relationships um there the people don't seem to understand you um you just don't have the energy to engage in them what's going on what is that behavior saying feelings of mistrust and betrayal if you were um tra traumatized if you were threatened in some way by somebody else then you can see where that might happen if it was somebody that you knew and thought you trusted you can see where that might be even more intensified but feelings of mistrust and betrayal can also happen if this event occurs it's traumatic say a hurricane and other people either don't help or they take advantage of you and we've seen that after hurricanes and tornadoes and other things where is this fear of other people inability to trust other people where's this coming from what thoughts are contributing to your inability or the person's inability to trust others alternately there may be occasional intense relationships but the person has difficulty sustaining them some people who've been traumatized are Desperately Seeking another person that can help them feel safe but because of the intensity of their trauma and generally the inability to communicate what's going on and what they need it comes off as overpowering if the original trauma was interpersonal then you may see the vacillation between all good and all bad I can trust you I need you you help me feel safe the minute I start to sense something is off or Troublesome I hate you and you know that that is one of those key features that we associate with borderline personality but I would encourage you to consider trauma emotional symptoms loss of interest in activities and life in general if you're not getting good sleep if you're stressed out all the time if you're hypervigilant if you you know all that stuff is going on you don't have a lot of energy not to mention the fact that your neurotransmitters are going to be becoming imbalanced um you need to be able to get rest you need to be able to set your circadian rhythms you need to be able to eat a healthy diet and have your body actually absorb the nutrients to make the neurotransmitters that can help you feel interested in activities and life in general dopamine norepinephrine serotonin oxytocin all of those things are important and when you are stressed it Alters the balance not only of your neurotransmitters that I just uh talked about but your hormones um estrogen testosterone thyroid hormones so people might start feeling very flat and blah feeling detached from others or emotionally numb well you may not feel much of anything sometimes trauma was um causes people to detach from their own feelings because it was so overwhelming and so overpowering they just put up a wall they don't feel anything anymore um other times it may be feeling detached from others because they you feel like they don't get you they don't understand what you've been through they don't validate your perspective and a lot of times even well-meaning therapists and doctors and loved ones may inadvertently invalidate people by trying to tell them either it's not that bad or trying to take their trauma and take their pain away it's theirs let them have it if they feel um betray by people okay you when you're ready to work on that when you're ready to to look at it I'm here to talk but if you feel betrayed far be it from me to tell you that you're wrong people experience reality through the lens of their prior experiences and we need to recognize that a sense of a limited future especially if the trauma was painful or physically threatening persistent problems with affect regulation and disregulation this goes back to that disregulation of the stress response the HPA axis when the HPA axis is on for too long The receptors become resistant to the uh cortisol they become glucocorticoid resistant which means the person is is not going to feel energized excited they're going to feel flat a lot of the time but when they finally do experience a threat of some some sort it's going to be intense because the brain has to secrete a tsunami of stress hormones just to get the receptors to wake up and pay attention so the person goes from Flat to Furious or flat to frantic that's exhausting people who've experienced trauma also deal with anger shame sadness humiliation guilt and sometimes Survivor guilt how a person interprets and feels about a trauma is very individualized so we need to ask them do you feel angry about this do you feel shame or guilt what is it that you're feeling and let's talk about what's causing those feelings what thoughts are you having that are triggering those emotional reactions cognitive symptoms difficulty concentrating you're not getting enough sleep you're stressed out you're hypervigilant you're scanning all over the place looking for threats yeah you're not going to be concentrating on your PowerPoint it's just not going to happen people who are in fight or flee are not engaging their prefrontal cortex they're going to have a lot more ADHD type symptoms because that's not where their energy is recognizing that compassionately um providing accommodations for that while the person is healing is important okay you can't concentrate on a movie for an hour and a half no problem what can you concentrate on you can't uh focus on reading a book for two hours okay how much can you do if that's something you want to do helping people learn how to chunk stuff so they can get it done without taxing their concentration and making sure that they have prompts that are helping them remember things writing things down not trying to remember a grocery list not trying to remember what they're supposed to do this week having pretty much everything um scheduled into a planner or prompts dissociative symptoms are very common um and that's you know we all know the brain kind of checks out when the person starts to feel overly um stressed out and sometimes people will report that the dissociative symptoms are like they're a fly on the wall watching what's going on other people report the dissociative symptoms are like they just they lose time um and that's the brain bra protective mechanism it says oh boy this is just too overwhelming peace out I'm gone um and and that's somewhere between freeze and forget about it I think in terms of a stress response recognizing the protective function of the dissociative symptoms helping people figure out you know what triggers dissociation for you and what can help you stay grounded in the moment moment sometimes narrating what's going on sometimes talking on the phone to somebody while they're doing something that's stressful if they um I've shared with you before a client I worked with uh used had had horrible horrible history of abuse and cooking being in the kitchen was very stressful because of some abuse she had um experienced as a child playing with pots and pant she made too much noise and it was bad um so when she would be in the kitchen she would dissociate and that's not good when you're cooking for her talking through things or talking to someone while she was doing it was helpful for keeping her in the moment after trauma people can have persistent beliefs about themselves as being diminished defeated or worthless accompanied by a deep and pervasive feeling of Shame guilt failure Rel related to the stressor I should have known better I shouldn't have um a lot of times we try to we rethink it number one hindsight's always clearer than in the moment in the moment you're terrified you're in fight or flee you may not know what the best response is but even if you're looking prior to the trauma and saying well I I should have known better not to do these things well it happened and nobody's perfect encouraging people to start examining those things and how holding on to those beliefs that they and and punishing themselves feeling guilty or shameful for making a mistake how that's contributing to their quality of life now and what they can do to learn from it and prevent it in the future inability to remember important aspects of the trauma or even unimportant aspects of the trauma can be frustrating for people and the brain when you're stressed interestingly when the brain has a bunch of glutamate which is your main excitatory uh neurotransmitter it actually prevents the formation of memories so the brain says you know what I really don't want to remember this and some people may never remember certain aspects of the trauma increase negativity and pessimism if you feel unsafe you're probably not going to look around and see a world full of puppy dogs kitty cats and Roses or whatever makes you happy um you're going to look around and you're going to see potential threats you're going to see potential helplessness and addressing some of those cognitive symptoms will help the person start to feel safer and more empowered environmental symptoms deliberate avoidance of reminders of the trauma if you experienced a trauma when you were driving then deliberately avoiding driving I'm not getting in a car again or I'm not getting in an airplane again or or whatever it is okay if you know sometimes you can't avoid reminders of the trauma uh um but if you were a survivor of a tornado um deliberately avoiding watching um television shows about tornadoes probably is in your best interest but recognizing that and sometimes it's healthy you can avoid watching a show about a tornado and it's not going to have significant impact on your life if you were in a bank when it was held up and now you avoid going into Banks and oh by the way a bank is kind of like a store there's lots of people I don't know lots of uncontrolled variables then you start not wanting to go into any public places okay that's a problem and helping the person develop tools to deal with that specific and generalized triggers and I kind of alluded to that specific triggers are those that are associated with the trauma it was was nighttime it was a parking garage you were um held up your purse was stolen um whatever so there are very specific triggers however there can these triggers can become generalized maybe you are in um a parking lot at night and you start to feel anxious well it's similar it's night there's a car in involved now parking lots as well as parking structures are threatening to you so you can see how these things can generalize if they have some characteristics that are similar to the original trauma then that trauma those trauma reactions those trauma feelings or perception of threat becomes associated with those similar situations and very quickly a person can have difficulty going anywhere without being reminded triggered um reminded of their trauma so triage pineus and nater did some work um I cited them in my dissertation so this was in the late 90s um probably that they were doing the research that indicated there are certain things that make people more likely to develop post-traumatic stress disorder after a trauma most people process it okay thank you very much and go through a process that we call traumatic growth it doesn't become traumatic stress disorder but for some people they get stuck feeling helpless and disempowered and unsafe so what may cause that well if you're if you are the victim all right you're going to be more likely to develop PTSD than if you observed somebody else who was a victim uh or if you're similar to the victim and I see this a lot in law enforcement where responders will go to a uh a scene maybe it's a a child drowning and they've got children and they can even though it's not their child in the pool they can see sort of their mind says it this could be your your kid and it's more traumatic it sticks with them harder than people who maybe didn't have kids so similarity to the victim also makes people more prone to getting stuck proximity to your safe zones these are places where prior to the trauma you felt safe your home your your immediate neighborhood your work the immed Med area around there hopefully generally we feel safe in those areas um when I was in college we had sadly enough a serial killer that plagued the uh city of Gainsville for a while and up until that point we didn't think twice about walking by ourselves at night going jogging with our headphones on whatever and once that happened that was our safe Zone we felt if we were on campus even though it was a big campus if we were on campus we were safe well that was incorrect thinking anyway but it hit home when all of a sudden it became very objectively unsafe so it's important to recognize if it happens in somewhere where you did feel safe and now all of a sudden that's ripped away from you that could make it more difficult to feel safe there again not impossible difficult social support after the trauma 244872 support within the first 24 hours is most helpful and most effective because that trauma is fresh it hasn't started to be processed and accommodated and um whatever by your brain it it's right there and support during this period can help people process stuff before they start locking it down 48 hours is still good generally the initial emotional reactions have subsided some but there's a lot of confusion and disorientation uh you can still process a lot of stuff in the first 48 hours if a person feels during this period that they are safe and empowered it's may not be the time to actually talk through what happened the important thing is help helping the person start to feel safe and empowered again if they're left out there flapping in the breeze for 72 hours before anybody is there to help them feel safe and empowered they're at a much greater risk of developing uh post-traumatic stress issues history of mental health problems if the person already had a history of anxiety or depression or addiction or something else trauma is a huge trigger for relapse it doesn't mean it will happen but it means it could happen um and the number of stressors the person's experienced in the past six months why six months I don't know I don't know if they pulled that out of the hat or um if they found that it was six months was more important than 12 months but remember every time you experience a stressor it drains you and and if you've had 12 stressors in the past six months you're probably walking around going I can't take one more thing and then a trauma hits that's o system overload if you've only had two or three stressors in the past six months and Trauma hits yeah it is overwhelming but it may not be complete system overload when you're talking to people a assessing or screening if you were not the victim how are you similar to the victim this helps us try to get a handle on whether they're at greater risk for developing post-traumatic stress how are people around you similar to the perpetrators again looking for their inability to trust others and feel safe and empowered what was or would have have been helpful for other people to do after the trauma if people ignored them that's not helpful if people were just constantly telling them hey it's okay you'll be fine that's invalidating too you know hear my reactions hear my experience validate where I'm coming from and help me figure out how to get my footing again because I just had the rug pulled and who can you Rel rely on to do those helpful things now now the helpful things are important that we and we'll talk about it in a minute but you got to communicate that what is it when you're in crisis what is it when you're feeling unsafe and Powerless that you need and want people to do do you want them to just sit there sometimes just having another person there is enough do you want to talk about your feelings or do you want to do anything but talk about your feelings what is it that would be helpful to you because what's helpful for you may not be what's helpful for them it doesn't matter helping them understand what's helpful for you they can do that physical interventions sleep sleep helps balance our neurochemicals lack of sleep triggers the stress response sleep helps reduce cortisol and HPA access activity and has been associated with the ability to better control ruminations and intrusive thoughts which are prominent for a lot of people with PTSD in order to help people improve their sleep help encourage them to develop a routine to let their body know when it's time to sleep for exam when kids they come home from school they play they eat dinner they take a bath you read them a story they go to bed that routine actually helps set their Arcadian Rhythm it's not just the light outside help them figure out ways to release stress and tension for some people it's journaling for others it's jogging woodworking whatever it is that helps people kind of release some stress uh can be helpful medication is out there for some people and it can be something like over-the counter like melatonin or something harder um like ambian for example that is a personal decision for the individual to make interpersonal interventions helping people find non-judgmental people you know think about in your life who in your circle is non-judgmental and if there is nobody where can you find non-judgmental people and it can be trauma specific people who who have been in the military and experienced trauma through being in war or trauma through the military sometimes feel like they're better understood and less judged by people who've been through similar experiences their perception of feeling understood and accepted is what's important even if you haven't been through it and you are the most non judgmental person in the world if they don't feel that way if they don't expect it or perceive it then saying well you can talk to me why don't you just talk to me that's that's invalidating so we need to help them a place where find a place where they feel accepted and understood ideally finding support that's available 24/7 that's one of the beauties of the internet is people can find a chat room if nothing else pretty much anytime of the day but helping them find healthy message boards and chat rooms that they can access helping them put um either icons on their mobile device or bookmarks on their um on their browser so they can easily find it helping them find people that they perceive as empathetic understanding willing to take their perspective and able to handle it a lot of people who've experienced trauma are reticent to share their experience and their feelings because they're afraid they're going to either scare or overwhelm the person they're telling and that's true even for therapists I've worked with a lot of people who have been very cautious starting to tell me about their trauma even though they wanted to tell me because they were like I don't know if if she can handle it I'm like bring it on you know um if you're a therapist reassuring people that you can handle what's going on you're not going to be overwhelmed by whatever they have to tell you can be really important same thing if you're a parent and your child has been um traumatized surrounding yourself with people who are open to learning what you need to help you and I already touched on that a lot if somebody is trying to be supportive but they're going to do it their way they're going to fix it for you or they're going to tell you that you need to talk about your feelings they're telling you what they think you need that's not helpful being surrounded by people who are willing to say what is it that you need and let me help you that's what's um going to be most helpful and that will help the person feel more impact empowered and safer because they've got people listening to them we need to encourage them to use these interpersonal relationships to help them meet their health and safety safety needs you know getting groceries eating healthfully whatever and handling the details people who are in shock or traumatized can't remember squat so helping them figure out what they need to do for prompts and writing things things down notes on the refrigerator um if they've got like an Alexa or whatever that they can tell when to add stuff to a list I don't have one of those I don't know how it works but um some some more techy people may have that um keeping notes on their mobile device setting prompts and appointments with reminders all of those things are important not expecting themselves to remember something because then when they don't remember it they're going to feel bad and you know emotional interventions another pneumonic you know I love my pneumonics idea helping people develop emotional intelligence by identifying their emotions uh effectively and accurately in self and others what is this person feeling what am I feeling learning how to downregulate to get into their wise mind okay I'm feeling angry or it seems like this person's feeling angry which is making me feel anxious let me downregulate so I can effectively process explore the function of the feeling if I feel angry or anxious then that's my body saying hey there might be a threat um and what triggered that feeling why am I thinking there might be a threat right now and then actively solve the problem help people learn about pieces of motivation physical motivation how is doing whatever this is going to help me feel physically better less pain more energy how is it going to improve my relationships how is it going to help me feel happier or less stressed how is it going to help me think more clearly and logically move toward my goals how is what can I put in my environment that can remind me to do these things and how is it in line with my values encourage people to create successes and be patient don't expect to go from PTSD to completely recovered in 3 weeks that's not that's not realistic don't expect to go from can't remember anything to don't need to write down anything in three weeks make sure people set small achievable smart goals so they can have those successes successes help promote dopamine promote a sense of confidence and empowerment and safety sometimes people are not going to succeed even if they try they may fail at something so helping them be compassionately patient is also important you may have intended to go looking for a job today and it was just it was too overwhelming okay you know that you didn't achieve your goal today but let's look at why that happened being patient and compassionate with yourself and developing a strategy to address those things encourage people to do things that used to help them feel happy don't expect those things to make them feel over the moon happy anymore but occasionally exposing themselves to things that used to make them smile whether it's puppies or sunrises or babies giggling I love watching babies giggling on the internet I don't know why um and help people process the dysphoria encourage them to talk to somebody to start unpacking that unpleasant emotional baggage in terms of trauma recovery trauma is a grief process you lost a sense of safety and a sense of personal power you lost potentially a sense of control you lost potentially hope and idealism you thought the world was a wonderful place and you realized oh maybe not um there are a lot of sort of esoteric losses in addition to potentially tangible losses that happen for trauma and it's important that people understand the breadth of their losses and process those in their own time just like any grief process people need to do it in their own time remember the stages of grief or denial anger it's a threat this whatever this was it was taken away it made you feel powerless okay so you're going to get angry bargaining trying to figure out how to make it not have happened depression accepting that it did happen or recognizing that it did happen and sitting for a minute with your sense of powerlessness okay I can't change it can't make it go away and then acceptance how are you going to integrate it into your next chapter so the questions that you can ask ask people what losses did you experience as a result of the trauma do it one by one don't have a whole laundry list here one loss at a time sometimes it can be helpful for people to write their losses on index cards and you just process one index card a day or a week what about this loss makes you a feel angry or afraid or threatened how can you deal with this anger or fear in a help healthful way remember remind them that anger and fear protect them and ex have them explore what they still need to be protected from in this situation remind them that depression signals a sense of hopelessness or helplessness and recognition that what's done is done and they can't change it therefore you once they've sat with those feelings for a bit they've developed a sense of safety and power that's helped them move out of the threat zone they've sat with that depression for a minute accepted that the loss occurred then how do they move to full acceptance how do they integrate it into the next chapter of their life you know what's the character Arc cognitive desensitization can be very helpful some things that people logically know are threatening still evoke a startle response so helping them acknowledge the event be kind to themselves all right somebody dropped something I jumped I got scared well it was what it was recognize the value of the startle response in protecting yourself identify times when the startle response might be greater if somebody drops something in the library that's probably going to be more startling than if somebody drops something in a restaurant for most people and identify ways to mitigate the startle response for example if people making loud noises or something is startling maybe sitting with your back to the wall so you can see what's going on so you feel less um vulnerable some beliefs about safety happiness or people or situations in general can be distorted by trauma encourage people to explore what happened what the belief is if the belief is based on facts or feelings feelings are not facts how reliable the source of those facts are whether the person is using any extreme words whether they're considering the whole picture or just this little part or their part or you know um in what ways does holding on to the belief protect them in what ways does holding on to the belief impair their ability to achieve their rich and meaningful life and how can they best use their energy to move forward this is part of cognitive processing therapy which can be very helpful with PTSD in terms of cognitive errors overgeneralization encourage people to find exceptions and change their language instead of always or never and or All or Nothing sometimes a few the control fallacy encourage them to examine the facts in context if they think I could have controlled it is that true what are the facts in context if this happened when you were a child could you have controlled it if it happened now maybe you could but as a six-year-old you couldn't or maybe the situation no matter how old you were was uncontrollable or the belief that they can change it if I would have only blah um then wouldn't have happened how do you know that all or nothing thinking encourage people to examine the facts find exceptions and again change their language catastrophizing expecting the worst possible scenario or seeing the worst possible aspects encourage people to look at all the facts and then the probability if you're catastrophizing that every time we have a a thunderstorm there's going to be a tornado that's catastrophic thinking um or every time that there's a bad storm there's going to be a tornado and the house is going to be destroyed what are the facts for and against that belief and what is the probability that that's actually going to happen based on those facts personalization means taking taking it personally it's my fault or this had to do with me unhooking the behavior or the experience from the person can be helpful and encouraging them to look for alternate explanations why did this happen other than it's your fault or um what are some alternate explanations and then mind reading I should have anticipated this person was going to do this no none of us can read mines is that can you give me examples of When anybody is SU successful 100% of the time at mind reading environmentally encourage people to address triggers in their environment like sounds smells and sights that may cause them to remember the trauma get rid of things that are excessively triggering and add sounds smells and sights that help them feel safe and empowered fun has a lot of great tools for reducing stress because we tend to be more stressed if we can't see around us if we can't see someone who might sneak up on us so it talks about adding mirrors and it talks about doing different things that may help reduce stress from a practical standpoint anchoring is also important so when you awaken you can stay in or get in the present moment being able to easily turn lights on with a you know a tap thing or having a safety item with you like a light um a flashlight or for a lot of people a dog a dog can help them actually feel grounded and feel safe and sometimes able able to relax so they can get to sleep in terms of creating safety help people reflect on what they've done that helps them feel safe what they can do to take back their safe zones their home and their work how they can protect themselves from trauma in general in the future encourage them to reflect on how the experience changed how they view things what's important to them and how they're going to live their life now encourage them to brainstorm different ways to create safety at home at night in the car at their office and again any of those safe zones is important trauma can occur from a single event or multiple ongoing stressors traumatic events can change people's beliefs about the world in a very extreme way for some people understanding the functions of symptoms can help them desensitize so when they start to feel something they're able to say okay this is just a feeling and I'm actually not in danger right now can help them modify their beliefs and make positive mindful choices thank thank you everybody for being here today and I'll see you next week

Channel: Doc Snipes

Views: 4,023

Keywords: self help, counselling, counselor

Id: DI4KAJgAVms

Length: 60min 48sec (3648 seconds)

Published: Thu Mar 14 2024