Moving Past PTSD triggers


Do we ever really heal from trauma?
What does “healing” really mean?

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
adding to the Habits, Memory, EF, and PTSD Series

Responding to a comment

Right after I published the second part of one of my PTSD Awareness articles, author and blogger Chuck Jackson posted a comment that asked a question I couldn’t  answer at length in the comment format.

Do you ever recover fully from PTSD?

Chuck went on to add some context to his question:

Looking at your list of symptoms (mental and physical), if I was honest with myself, I would still mark yes to over fifty percent.

The majority of the time, I live a happy and enjoyable life. It is only during periods of anxiety or prolonged depression, do these symptoms raise their dirty head.

They are not debilitating, just very annoying.

So, for the most part, I suppose we could say that Chuck is essentially “healed.”

He has moved well beyond some pretty nasty stuff in his childhood (his healing journey shared in his stunning book about child abuse, “What Did I Do?).”

But I believe he is asking another, broader question with a much broader application:

Why am I not beyond all of my symptoms all of the time?

Real questions have real answers, so lets take a look at a couple of questions I’m sure we have all entertained at some point in our lives:

I’ll begin with a segment of my comment in answer to his question.

Forgetting is part of the process of memory too

“Forgetting” is still quite the mystery to scientists, even as they learn more about “remembering” – and that is really at the heart of Chuck’s question.

Most of us would prefer to have a way of “erasing” disturbing tracks laid down as the result of earlier experiences so that we can focus on and recall more positive/supportive reactions, thoughts and behaviors instead of disturbing reactions to PTSD triggers.

From an article I posted 3 years ago now,
Brain-Based Habit Formation:
~~~~~~

Any golf pro will tell you that eradicating their clients’ bad habits is the toughest challenge they face.

It’s much easier and quicker to coach someone to play par golf if they’ve never picked up a club than if they’ve been a bogey golfer for years.

Only the best golf pros understand why that is so and what to do to overcome it more quickly, however!

Brain-Based Habit Formation also explains that old pathways never actually get “deleted” — so unless the bogey golfer practices the new habits EVERY SINGLE TIME he picks up a club, he is likely to slip back into his old habits.

And every single time he “rehearses the old,” he deepens the “brain-grooves” of the habit he wants to eradicate.  In the same manner:

If you focus on your triggers and allow them to control you,
you are likely to find yourself back-sliding quickly.

What is needed is to link a new action to an old cue – to pull yourself gently but intentionally away from the old fears and other manifestations (symptoms) the moment you realize that you are “rehearsing the pain.”

So, in that sense only, I will tell you that,
at present, “PTSD” never really goes away.

NOW, let’s unpack that a bit – because that does NOT mean that you are going to have to suffer for the rest of your life. After all, as I said to Chuck, who cares whether “PTSD” goes away or not if it never troubles you!

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PTSD Awareness Post 2017 – Part II


June was PTSD Awareness Month
Adding to our awareness – Part II

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Updated Refliections Post
Self-Health Series
Part I HERE

“Emotions are very good at activating thoughts,
but thoughts are not very good at controlling emotions.

~  Joseph LeDoux

Since my Sleep Awareness post somehow jumped the queue and was posted at the same time as Part-1 of this article, I decided to wait a bit to give readers a shot at catching up.  Again, my apologies for seeming to inundate with info – it was not intentional.

This Part may seem long, but much of the first half is review — so those of you who read Part-1 will be able to skim through it quickly.

Identifying PTSD

PTSD can present in a variety of ways, with more than a few symptoms in common with depression, in addition to any or all of those characterizing other anxiety disorders.

As I explained in Part I, PTSD is now believed to be caused by a neuro-chemical alteration in the brain in response to exposure to trauma. It holds us prisoner, responding in the moment to threats from the past.

Unprocessed trauma continues to haunt us, eroding our sense of safety and security. As a result, it can keep us stuck in an amygdala-defensive emotional pattern that may induce a variety of symptoms over which we feel we have no control.

In fact, we cannot control them in the moment.  Current therapies are focused on helping us to change our subsequent response to them.

Exposure to trauma physically changes the structure of the brain, upsetting the neurochemical balance needed to respond appropriately, faster than we can over-ride cognitively.

It seems that repeated experience of traumatic events, especially when left to fester unprocessed, can prevent rebalancing, which prevents healing (meaning, allowing the past to remain in the past, confident that you have the strength to handle whatever life throws your way in the future).

In other words, our brains are designed to respond neuro-chemically when our safety is threatened, regardless of what we think about it logically or how we feel about it emotionally.

  • Some of us are able to process those perfectly normal and appropriate fearful responses and move forward.
  • Others of us, for a great many reasons science is still trying to understand, are not.
  • At this point in time, we move forward primarily with statistics.

Statistics explored in Part I

In the previous section of this article we also looked at the prevalence of PTSD compared to the total number of people who ever experienced trauma in their lives.  We took a look at the various risk factors for developing PTSD following exposure to trauma.

You saw that the risk was effectively double for women, and that significantly more women are exposed to trauma in their lives than their male friends and relatives – and that recovery times tended to be longer.

Approximately 50% – five out of every ten women – will experience a traumatic event at some point during their lifetime, according to the The National Center for PTSD, a division of the U.S. Department of Veterans Affairs.

One in ten of those women will develop PTSD as a result.

Inadequate understanding & treatment

Science is still looking for many of the pieces of the PTSD puzzle.

Even though a variety of therapies can help relieve PTSD symptoms, at the current time there is no “cure” – or prevention – nor is there an adequate explanation for how exposure to the same trauma can affect different individuals to different degrees of severity.

We also do not have definitive treatment protocols equally effective for everyone who experiences PTSD.

Brain-based research

Right now it looks like the difference between who recovers from trauma and who is more likely to develop PTSD may turn out to have a genetic component.

It may be also be linked to the size of specific areas of the brain, which could be a product of genetics or epigentics (how your internal and external environments change the expression of your genes).

Related Posts:
Making Friends with CHANGE
A Super Brief and Basic Explanation of Epigenetics for Total Beginners (off-site)

While controversial, the most recent research ties the development of PTSD to the size of an area of the brain called the hippocampus, which is primarily known for its role in the formation of non-disordered memories.

Greater size indicates a greater ability to recover from trauma.

A smaller hippocampus may increase the risk of developing PTSD as well as the severity of its symptoms, and/or lengthen the duration and recovery time.

Some studies suggest that repeated exposure to stress may actually damage the hippocampus, through the repeated release of the stress-hormone cortisol.

Related Posts:
Hippocampal volume and resilience in PTSD
Brain region size associated with response to PTSD treatment

So perhaps PTSD is hormonal?

Cortisol is a mobilizing hormone.  We need it. We might not even get up off the couch without it. However, it is most widely known for its assistance motivating the body for rapid and effective response to a stressful or life-threatening event – our “fight or flight” reaction.

Problems result because our brains and bodies are not designed
to live in a state of persistent and protracted stress.

Scientists have long suspected the role of cortisol in PTSD.  They have been studying it, with inconclusive results, since findings in the 1980s connected abnormal cortisol levels to an increased PTSD risk

A study reported in early 2011 by researchers at Emory University and the University of Vermont found that high blood levels of the hormone PACAP (pituitary adenylate cyclase-activating polypeptide), produced in response to stress, are linked to PTSD in women — but not in men.

PACAP is known to act throughout both body and brain, modulating metabolism, blood pressure, immune function, CNS activity [central nervous system], and pain sensitivity.

Its identification as an indicator of PTSD may lead to new diagnostics and to effective treatments — for anxiety disorders overall, as well as PTSD in particular.

But maybe not cortisol alone

Findings published early this year in the journal Psychoneuroendocrinology point to cortisol’s critical role in the emergence of PTSD only when levels of testosterone are suppressed [April 2017, Volume 78, Pages 76–84 ]

Testosterone is one of most important of the male sex hormones,
but is is also found in women, albeit in much lower concentrations.

According to UT Austin professor of psychology Robert Josephs, the first author of the study:

“Recent evidence points to testosterone’s suppression of cortisol activity, and vice versa.

It is becoming clear to many researchers that you can’t understand the effects of one without simultaneously monitoring the activity of the other.

Prior attempts to link PTSD to cortisol may have failed because the powerful effect that testosterone has on the hormonal regulation of stress was not taken into account.”

PTSD Risk Can Be Predicted by Hormone Levels Prior to Deployment, Study Says

What we think we know for sure

What science does believe it now knows is that PTSD is a result of both the event that threatens injury to self or others, and the emotional, hormonal response to those events that involve persistent fear or helplessness.

At this time, the goal of PTSD treatment is to reduce, if not eliminate, chronic fear-based emotional and physical symptoms to improve the quality of day-to-day life.

Research is ongoing to see if it is possible to chemically block the development of PTSD by blocking the formation of fear memories.

Blocking human fear memory with the matrix metalloproteinase inhibitor doxycycline

Current treatments are limited to psychotherapy, CBT (cognitive behavioral therapy) or other types of counseling/coaching, and/or medication, along with less well-known and less widely accepted attempts at intervention like EFT (Emotional Freedom Technique: “tapping”) and EMDR (Eye Movement Desensitization and Reprocessing).

The value of information

Before we explore the variety of treatments currently available (in a future article), let’s take a look at some of the symptoms associated with PTSD.  It will help you understand your own or those of a loved-one with PTSD.

Understanding, empathy and self-acceptance walk hand in hand – which are healing all by themselves.

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The importance of Trigger Warnings


I expect Universities to be places of enlightened thinking
The University of Chicago flunked the test

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
A Mental Health Awareness Post

A Trigger Warning is no different from a RATING

A Trigger Warning is NOT content censorship – it is a WARNINGPeriod.  It allows for the use of coping strategies by those students who need them.

It is absolutely insane to put forth some black and white argument expressing fear that supporting its use in ANY circumstance will facilitate its application to all situations where some student might take offense.

  • Few thinking individuals are up in arms about impinging on the rights of people who want to watch certain types of films simply because they are rated X to guide those who do not.
  • Rational people do not insist that the ban on guns in schools be lifted, holding up 2nd Amendment Rights  (the right to bear arms, for my non-American readers).

And yet, The University of Chicago sent out a letter to incoming Freshman outlining their [non] logic as they disclose that they will not support the use of Trigger Warnings and Safe Spaces on their campus.

Rather than using this issue as a chance to increase Mental Health Awareness, which is to be expected from any institution claiming education as its purpose, The University of Chicago has chosen to issue what amounts to a gag order.

We have a L-O-N-G way to go where educating people about Mental Health is concerned – but for a University to be so blatantly unaware is both frightening and appalling. I’d yank my kid out of that “educational” environment in a heartbeat!

Why all the fuss?

Regular readers are aware of the reasons for my reluctance to use the WordPress reblog function – so I hope you will jump over to the posts below to read the rest of the excellent points surrounding the words quoted below.

In her introduction, Maisha Z. Johnson explains the issue in terms anybody might easily be able to understand, EVEN the decision-makers at The University of Chicago, especially John Ellison, U of C dean of students (who is declining to respond to emails, etc. by the way).

THAT would mean, of course, that they’d bothered to upgrade their egregious lack of education about mental health issues before responding in what I feel strongly is a cruel and ignorant fashion.

Two college students return to campus after both were present for an act of violence.

One of them was physically injured in the incident. In order to return to class, he asks to have space around his desk to allow him to stretch, because sitting still for too long would aggravate his injury.

How would you feel about his request? Would you understand why such an accommodation would help him heal? Expect his professors to oblige?

Now, the other student’s pain isn’t visible – it’s emotional.

He wasn’t physically hurt, but he lost a loved one, and he’s traumatized. Certain reminders have resulted in panic attacks, and he’d rather not experience that again – especially not when he’s trying to move on with his life and get an education.

So he also makes a request, asking his professors if they can give him a warning before covering material that relates to the type of violence that took away his loved one.

How would you feel about this student’s request?

What he’s asking for is a content warning, also commonly called a trigger warning. And it’s a huge source of debate.

. . . when it comes to an able-bodied person experiencing a temporary injury and needing support to heal, there’s usually not much debate about whether or not they should be allowed in class with crutches, a cast, or extra space around their desk.

The sharp contrast between this acceptance and common attitudes towards trigger warnings reveals something disturbing about our society’s approach to trauma and mental illness.

Read more of this post . . .


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Complex PTSD Awareness


C-PTSD Awareness
Signs and Symptoms of Chronic Trauma

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
from the Self-Health Series

One of the factors of PTSD is that some people seem to have severe cases while others do not — that some soldiers were more vulnerable to extreme trauma and stress than others.

As an explanation for some of these complications it has been suggested and researched that there is a form of PTSD that is called DESNOS [Disorders of Extreme Stress Not Otherwise Specified]. Another term is C-PTSD or Complex-PTSD. ~  Allan Schwartz, LCSW, Ph.D

 

Relatively Recent Distinction & Debate

Many traumatic events that result in PTSD are of time-delimited duration — for example, short term military combat exposure, rape or other violent crimes, earthquakes and other natural disasters, fire, etc.  However, some individuals experience chronic trauma that continues or repeats for months or years at a time.

There is currently a debate in the Mental Health community that centers around the proposed need for an additional diagnosis. Proponents assert that the current PTSD diagnosis does not fully capture the core characteristics of a more complex form – symptoms of the severe psychological harm that occurs with prolonged, repeated trauma.

Let’s DO It

One of the longest-standing proponents is Dr. Judith Herman, a professor of clinical psychiatry at Harvard University Medical School. She is well respected for her unique understanding of trauma and its victims, and has repeatedly suggested that a new diagnosis of Complex PTSD [C-PTSD] is needed to distinguish and detail the symptoms of the result of exposure to long-term trauma.

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