5 Facts About PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop when one has experienced a traumatic event. Here are 5 facts about PTSD:

  1. PTSD can develop not only after having experiencing trauma, but also from having witnessed it.
  2. Symptoms of PTSD include reliving the event through flashbacks and nightmares, avoiding possible triggers, excessive arousal which includes a hypervigilance to danger, and an increase in negative thoughts and feelings.
  3. We can have post-traumatic symptoms and it not develop into a disorder. This will often be affected by one’s support system, the severity of the trauma, and how the symptoms were treated soon after experiencing or witnessing the trauma. Cumulative trauma can also lead to PTSD.
  4. Although some may experience irritability, increased anger (including outbursts), others will experience flat affect – their ability to feel is dampened by their traumatic experience and its after effects.
  5. Although we don’t often hear about post-traumatic growth when reading about PTSD, it is an important element to consider in our journey to heal.

Knowing about PTSD and how it can affect both ourselves and our loved ones can be an important step to understanding how trauma affects us in the short term (acute stress response) and the long term (symptoms and possible disorder.)

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What is an Acute Stress Response?

I recently sat with a client who had been a witness to a serious car accident. She had been involved in helping those injured and at the time of the accident was in full swing action mode. Three weeks later, she was still struggling with some of the after effects of that incident.

When we have an especially upsetting experience or trauma, we will often experience an acute stress reaction. Very often, that will include a re-experiencing of the event with intrusive images or flashbacks. It can also include a state of hyper-arousal in which we may feel irritable, have trouble sleeping, difficulty concentrating, and feeling on edge. And lastly, an acute stress reaction can lead us to purposefully avoid thoughts and feelings, people or places that are linked to the event. For example, she was avoiding going along that stretch of road to get to work.

Typically, almost everyone who is exposed to a traumatic event will experience an acute stress reaction. Although the reaction may vary in its intensity, it will usually resolve within a few weeks. As we began working through some of the client’s symptoms, she was able to identify that she was sleeping better, not thinking about it as much, and was not quite so consumed with the images that were left behind.

When we are aware that we can experience such a reaction, we can also reassure ourselves that it is a typical response to a stressful event and that a normal recovery will take place. Sometimes, however, the symptoms remain and this is when we are at risk for developing post traumatic symptoms. Tomorrow’s post will look at 5 facts about PTSD.

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Dumbo’s Advice

One of my favourite quotes that I use in therapy comes from the movie Dumbo, featuring the lovable, Disney character born with larger-than-life ears. Having been mercilessly teased for his big ears, he has learned to dislike his appearance and his growing lack of self-worth reinforces what becomes a self-fulfilling prophecy; Dumbo begins to feel and act as a bumbling, useless elephant who can’t get anything right. Eventually separated from his mother, he befriends a mouse who helps him to accept himself as he is; advising Dumbo that “the very things that held you down are going to carry you up.”

The themes in this 1941 movie are still relevant to our own understanding of the often long-lasting negative effects of the experiences we may have had as a child. Ingrained as part of our inner self, we begin to feel certain of these core beliefs, and in turn we carry the torch and inadvertently contribute to their reinforcement, bringing them into our adult lives. It is only through our own self-exploration and challenge of these core beliefs; in asking ourselves “whose voice am I actually listening to?” and “does it have to be this way?” that we can begin to wear away at those schemas.

It took Dumbo a bit of fumbling for sure and he had to have both faith and support to push past his lack of self-worth, but he eventually learned that the very things that were holding him down, indeed carried him up. He was able to push past his fears, challenge his belief that he was just a useless elephant and he saved the day when his larger-than-life ears allowed him to fly.

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The Help of Family

In a CAMH article entitled “Families are Vital to Patient Recovery,” written by a mother of a 21 year old suffering with mental illness, these passages were particularly striking to me: “I think the majority of families do understand and appreciate the similarities between mental illnesses like bipolar disorder or schizophrenia and physical illnesses. They absolutely are diseases just like diabetes, cancer and heart disease – but they can be far more difficult illnesses for families to cope with because they have had to deal with their loved one’s behavioural changes, personality changes and possibly bizarre, frightening and risky behaviours.”

She goes on to add, “Mental health practitioners know, and research proves, that a supportive family increases the chances for recovery. But families are suffering immensely and the demands on them are unlike most other diseases. Families need to be supported, educated and listened to. Letting them know they are a valued part of the team can be empowering for families at a time when they feel completely helpless.”

For any family members who are feeling the often isolating effects of supporting a loved one with mental illness, contact CAMH’s Office of Family Engagement for information about valuable resources at (416) 535-8501 ext 33202, email: familyengagement@camh.ca, or website: http://www.camh.ca/families 

To contact Canadian Mental Health Association in Ottawa (CMHA): (613) 737-7791 – cmhaoc@magma.ca

To read the full article: http://www.camh.ca/en/camh-news-and-stories/families-are-vital-to-patient-recovery

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The Link Between Love and Approval

The association that exists between love and approval is one I see over and over again in therapy. Formed usually in childhood, we begin to make links as to how to get affection and attention from our caregivers. Sometimes this comes when we are good or quiet, other times when we ‘take care of.’ Very often, love and approval is linked because of an emphasis on achievement or success; talent or beauty.

Our attachment system is one that guides us to seek unconditional love; when we associate love with approval, we have been taught that love is conditional. Patterns can get repeated with our intimate partners and with our children, as we often carry that association into our adulthood.

But you can never be free when love and approval are linked. What brings us freedom is acceptance. And if we couldn’t get it from our caregivers, the greatest gift we can give ourselves (and therefore our loved ones), is to begin accepting. That we can’t always get it perfect, that we sometimes make mistakes. That it isn’t our job to be responsible for someone else’s happiness, that we can have confidence in our own identity. We can remind ourselves that beauty comes from the inside and that we can live simply and still be rich.

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The True Meaning of Success

I came across this lovely poem by Ralph Waldo Emerson that reminds us what success really looks like:

“To laugh often and much; to win the respect 

of intelligent people and the affection of children;

to earn the appreciation of honest critics and endure

the betrayal of false friends; to appreciate beauty;

to find the beauty in others; to leave the world a bit better whether

by a healthy child, a garden patch, or a redeemed social condition; 

to know that one life has breathed easier because you

lived here. This is to have succeeded.”

– Ralph Waldo Emerson

It is far less about what we have collected and far more about how we have impacted those around us. It is far less about a focus on the future, and far more about how living a meaningful life affects our present. We can give ourselves permission to seek joy; to find the beauty in the every day.

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A Thought From Dr. Phil

If you listen to Dr. Phil at all, you will often hear him say “We create our own experience.”

On the one hand, this refers to the active decisions we make in our daily life. It aligns with the goals we have, how we want to proceed, move forward, and purposefully ‘design’ our lives so that we feel fulfilled at the end of the day. But it also includes our reaction to challenge and hardship. Those are the things we don’t always have control over.

None of us expected 2020 and the pandemic that would quickly halt society. Sometimes we are blindsided by a break up, the death of a loved one, the loss of a job. We can’t get through life without some struggle; without disappointment. We create our own experience through our reaction to events. This is where the choice is still ours. We are much better served to feel what we need to feel and lean into the process of what is happening so as to move towards acceptance.  We stand at the crossroads of process or avoidance. We stand at the crossroads of giving up or pulling up our boot straps. We stand at the crossroads of staying stuck or deciding to heal.

“We create our own experience;” a valuable thought from Dr. Phil.

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Communication Styles; Post 4

Our healthiest communication style is assertiveness; it is a way of communicating that validates our own needs without dismissing anyone else’s and delivers the message “I am important and so are you.” 

When we want to honour our own importance, the first step is to be able to recognize our own needs. Sometimes we have to ask ourselves, “What is it I really want in this situation? How do I want to be treated?”

Once we can identify what we need, the next step is to be able to state it. We will get the best result when we are able to do so as calmly as possible, as this will carry more weight and less emotion. Using “I” statements are also a good idea, as they allow you to focus on your own feelings in the situation. For example, “When you show up late, I feel quite uncomfortable and awkward standing outside the theater. Perhaps we can come up with a solution to avoid this happening in the future.”

Sometimes we follow all the rules in honouring both our importance as well as someone else’s and not get the feedback you hoped for and that is okay. What is not to be overlooked is the attempt we made towards improved communication; therefore, we want to reward the effort not the outcome. At the end of the day, you made yourself important and that is to be noted and recognized 🙂

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Communication Styles: Post 3

Moving right along in our series about communication styles, today’s post is about passive-aggressiveness. True to its name, it is a combination of both the passive and aggressive positions. In this style of communication, you sacrifice your own needs, and although it feels okay to do so, it also comes with some resentment attached to it. And as a result, usually somewhere along the line, you get back at the person who asked you to sacrifice your own needs in some way. The message that is sent to both yourself and others is “I am not important and neither are you.”

A good example of all three styles of communication takes place in a restaurant. Three people are seated in a steak house; all three have ordered their meat medium-well. When the orders come from the kitchen, it is discovered by each of these people that their steaks are a bit too rare. The passive person will say nothing; after all, they don’t want to upset anyone, hence they deny their importance. The aggressive person will insist the steak be returned and will be angry with either the waitress or the chef for their incompetence in getting it wrong, hence they make themselves more important than the person they are being grouchy with. And lastly, the passive-aggressive person will most likely say nothing to the waitress but they will either not leave a sufficient tip or complain to anyone who will listen that the steak house is not a good restaurant choice, hence denying their importance as well as others.

As I often note, everything exists on a continuum, including communication styles.

Tomorrow’s post will be about the healthiest life position of “I am important and so are you.”

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Communication Styles: Post 2

Yesterday we looked a how a passive style of communication can position ourselves into unimportance; today we will focus on what tends to be an aggressive or dominant form of communication. What characterizes this form of communication is the pull to have your own needs met first. Typically, a person has learned that their needs trump others’ either because as a child their needs were not met (and they defaulted to elbowing their way to the front of the line) or they were taught, through direct or subtle messages, their greater importance in life. Either way, it has come to this person honestly and in order to feel safe, their wants and desires fight for primacy.  Sometimes aggressive communication includes anger to get their way (we won’t poke an angry bear, even a silent one) other times it is sheer stubbornness, but either way, others around them will experience that person as selfish, or as a “taker.”

When you use a dominant communication style, the message that you send out is “I am important and you’re not.” Not surprisingly, it is often quite common to see someone with a passive communication style in a relationship with someone who is more dominant; a good example of the “opposite energy attracts” principal at work.

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