The arousal symptoms of PTSD most commonly overlap with the symptoms of Panic and Anxiety. Imagine your body is like a car engine. With PTSD (and anxiety/panic) your engine is always revved up and ready to go. It’s like you have your foot on the gas pedal and on the brake, this way all you have to do it let off the brake and off you go. The flight, fight, freeze survival system our body has does this on purpose so you do not waste precious time accelerating, which makes sense if you are in a life and death situation, the problem is when your body starts to react like this to regular day to day stress. Imagine what happens to a car engine if you constantly rev the engine while holding down the brakes. It gets worn down and starts to break down. This is what happens to our body when it is under the constant strain of anxiety. Fatigue and exhaustion are all common experiences for those who suffer from PTSD, anxiety, and panic. With PTSD, the body is always revved up and ready to go, aka it is in a state of arousal; that means muscles are tense, breathing and heart rate are fast, and blood pressure is high. People with PTSD often feel on edge, on guard, easily startled, and hyper vigilant. This also primes them to be more easily irritated and angry. It is also very hard to concentrate and sleep. So the primary way to cope with symptoms of arousal is slow the body down through 1) Breathing and 2) Soothing.…read more
The One Thing: The Surprisingly Simple Truth Behind Extraordinary Results by Gary Keller is intended for an audience of business employees who are trying to be more productive and thus hopefully more successful. This book was recommended to me when I was starting up my private practice. I felt like I was being pulled in so many directions with so many things that needed to get done. This book helped remind me to prioritize my tasks and focus on the one thing that would help me advance my private practice the most. This helped with my decision making and task list. If you’ve ever stared at your To Do List and had no idea where to start, start by reading this book.
Keller’s message is in the same vein as McKeown’s message in Essentialism; however, I felt it was easier to apply Keller’s message in the moment. As a psychologist, I love it when authors present things within a cognitive framework. Keller starts his book out with “The Lies.” These are dysfunctional thoughts that derail us and keep us stuck. He then follows that up with “The Truth.” These are healthy thoughts, that allow us to move forward. He backs these thoughts up by summarizing the research in this field (examining the evidence is the primary task of thought challenging in CBT). For example, Keller reviews why the belief that we can multitask and depend on willpower to get things done are lies. The truth is our brain can only genuinely focus on one task at a time, and our willpower is finite and it runs out (which is why resisting that bowl of cereal late at night is so hard when you’ve put in so much effort throughout the whole day to be good). The topic of willpower comes up in a lot of these types of books, most notably Mel Robbin’s The 5 Second Rule, where she talks about why we’ll “never feel like it” when it comes to doing things we know we have to. The overarching message here, is that we can’t rely on willpower and need to learn to create habits and routines to keep us on track and to basically parent ourselves.
A visualization Keller uses about the importance of choosing the One Thing right now that is the most likely to help your project, job, goal, move forward is of dominos:…read more
I previously wrote about understanding the symptoms of PTSD here and learning about how it develops and factors that maintain it here. Today’s focus is how to cope with the cluster of PTSD symptoms called re-experiencing or “intrusive” symptoms.
What are Re-experiencing Symptoms?
Re-experiencing or Intrusive symptoms of PTSD are symptoms where you feel as if you are re-living the trauma or being haunted by the trauma. The memory of the trauma plays out so vividly for you that you feel as if it just happened again. The most intense version of this is when you have a flashback and for awhile you forget that you are safe and you believe you are back in the trauma again. These memories are “intrusive” meaning they pop up and intrude on your day at the worst times. These memories also cause intense emotional and physical reactions, leaving you feeling very upset and very worn out.
Why do we Re-experience the Trauma?
The Optimistic Child by Martin Seligman, Ph.D. teaches you how to “immunize” your child against depression by teaching them how to think optimistically. Dr. Seligman is the former president of the American Psychological Association and the founder of the Positive Psychology movement. I absolutely loved his book and I recommend it for anyone, even if you don’t have kids. It is a very dense read. It did make me feel like this was a textbook for a course on child psychology, but what you learn from it is invaluable. The Optimistic Child basically outlines, in a very clear, easy to follow manner, how to use cognitive behavioral therapy in your life. If you want to know what a CBT therapist does in session read this book! Dr. Seligman advocates that every parent has to first learn how to use these skills themselves before they can teach it to their own kids. My poor kids have a psychologist for a mother and I of course read this thinking about how I can help my own kids but the target range for the program here is for 8 to 13 year olds. Children under 8 years don’t yet have the ability for meta-cognition so the approach is a bit different but Dr. Seligman addresses this too at the end of his book.
A few of the key highlights from the book:
Optimism is not just a look at the silver lining, think positive, or wear rose colored glasses approach to life. Optimism, as taught in cognitive behavioral therapy, is how you explain the things that go on around you. It is your explanatory style. Dr. Seligman outlines 3 patterns of thinking that differ the most between optimists and pessimists:…read more
Last week we reviewed what PTSD looks like (you can read about those symptoms here). This week we are going to review why PTSD develops. The focus will be on the role our Fight – Flight – Freeze survival response system plays in the development and maintenance of PTSD.
Fight – Flight – Freeze Survival Response System
Is our instinctual survival system that keeps us safe and protects us from harm:
Fight = stay and fight off the danger/threat
Flight = run away from the danger/threat
Freeze = shut down physical or emotional pain to just survive when you know you can’t escape or fight back.…read more
Grieving Mindfully: A Compassionate and Spiritual Guide to Coping with Loss by Sameet Kamur, Ph.D. is a wonderful book about coping with any type of loss. I like that it addresses the many types of loss that we experience throughout life such as breaking up, moving away, growing apart, and of course, when someone passes away. If you’re already familiar with the traditions of mindfulness then this book will be a great fit for you. If you are not familiar with the traditions of mindfulness Dr. Kamur does an excellent job of introducing you to this wonderful practice. Though I focus on cognitive behavioral therapy in my practice, mindfulness has been and continues to be one of the primary coping skills that I teach for distress tolerance. I often feel like CBT and mindfulness are two sides of the same coin. They are how we learn to not let our thoughts and feelings control us.
Dr. Kamur describes loss as rupture to our identity. …read more
Before you get your knickers in a bunch, hear me out. I’m not talking about people with severe mental illness (SMI), complex trauma, or personality disorders. Of course there are always exceptions and it always depends on each client’s unique situation. However, the most common reasons people seek out therapy for: depression, anxiety, stress, life adjustment/transitions, does not require long term individual therapy.
Long term, supportive therapy is like going to the Spa.
When we talk about trauma and post-traumatic stress disorder (PTSD) we think of specific events: Combat, Rape, Assault, Fire, Car Accident, etc… However, there are 3 other types of events that occur daily, little by little, over a long period of time that are also traumatic and can lead to the development of PTSD in some people:
One night you make your partner’s favorite meal: steak. You go out of your way to get it just right and look forward with hope to see the smile on his face when he sees you remembered his favorite and nailed it. Dinner goes smoothly. He loved it and praised your excellent cooking skills. All is good. Two weeks later you decide to do the same thing. Surprise him with his favorite steak dinner. This time though, as soon as he realizes it he starts berating you for wasting money, steak is expensive! He blames you for all your financial troubles starting with buying steak! Then he berates your cooking: overdone, under seasoned, etc… You are no good, you’re stupid, you’re lucky he’s even with you! Uncertainty. You never know if what you do will please him or upset him. You and everyone else walk on eggshells around him. Life is an uncertain mess and because of that you are always on guard, always on alert, just waiting for something to go wrong. Another example: …read more
Its cliche: “You have to love yourself before others can love you.” Motivational speakers, coaches, therapists all say some iteration of this phrase when teaching about self-esteem and self-worth. I recently had a client express their frustration with this cliche, “It’s simply not true!” he said, and then he proceeded to give examples of people struggling with self-esteem and feelings of worthlessness who are still loved by their friends, parents, spouse, kids, etc… I agreed with him and then challenged him to look at the cliche slightly different:…read more