I just wanted to touch base with new members and see how you're doing and if there's anything you need/want that would help you settle into OOTS, or if you have any questions?
This section allows you to view all posts made by this member. Note that you can only see posts made in areas you currently have access to.
#601
Please Introduce Yourself Here / For New Members - How are You Doing?
October 20, 2014, 07:30:19 PM #602
AD - Emotional Dysregulation / Emotional Self-regulation
October 19, 2014, 09:40:09 PM
One of the six main symptoms of Complex PTSD is a change in our ability to regulate our emotions (and even to identify them in some cases).
Definition: Self-regulation is the ability to modify our emotions and impulses.
Description: Self-regulation skills let us become aware of our emotions and our responses to people and situations, and they let us change those as needed. They enable us to control our impulses long enough so we can consider the possible consequences of our actions or come up with alternative actions that would be more appropriate. We become able to do something (that we don't really want to do) and also to stop doing something (that we'd really like to do). Self-regulation can also apply to cognitive functions, such as remembering to pay attention.
We're able to exert this control no matter who is or isn't watching. Self-regulated children are self-disciplined even if the teacher is looking the other way. For this reason, self-regulation is not at all the same thing as obedience or docility. It is something we do for ourselves. We're in charge, not people around us who try to exert control.
What it feels like:
Being able to self-regulate enhances our well-being and makes us better able to deal with problems. We become able to control our fits or rage or despair, to take action that's honest and in line with our values, and to work well with all kinds of people in all kinds of situations. Our goals, our responses, and our modes of expression begin to match up.
What not to do:
- Don't beat yourself up if you're less able to self-regulate. If you have CPTSD, a lessened ability to self-regulate is a part of your injury. It's not automatically a fault of character or a weakness.
- Don't lose patience with yourself. Learning how to self-regulate takes time.
- Don't drive yourself too hard. When you're learning to become more aware of your emotions, listen to your instincts when they tell you that you'd best ease off for a while
What to do:
- Gradually and gently become more aware of your emotions and inner states, for example by journaling or practicing mindfulness.
- Learn to remain present to your emotions without judging them harshly. (LINK TO TOXIC SHAMING? OR TO SELF-COMPASSION? OR BOTH?)
- Learn how to choose which situations and/or people you engage with, and how to modify situations and people that trigger a strong negative emotional reaction. Ways of modifying situations are taking a time-out, using conversation-stoppers on difficult topics, or practicing Medium Chill (LINK).
- When evaluating an emotional event, learn to take a step back and see things as if you were an independent third-person observer. This might also prove helpful to some people during difficult events.
- Try out some of the methods that commonly help reduce stress and improve self-regulation. Exercize reduces both emotional distress and the physiological effects of negative emotions, and it improves emotional control. Other things you might give a try are mindful deep breathing, purposely relaxing your body, visualizations, or creative ways of self-expression such as painting or journaling.
Sources:
http://www.toolsofthemind.org/philosophy/self-regulation/
http://www.change-management-coach.com/self-regulation.html
http://en.wikipedia.org/wiki/Emotional_self-regulation
Definition: Self-regulation is the ability to modify our emotions and impulses.
Description: Self-regulation skills let us become aware of our emotions and our responses to people and situations, and they let us change those as needed. They enable us to control our impulses long enough so we can consider the possible consequences of our actions or come up with alternative actions that would be more appropriate. We become able to do something (that we don't really want to do) and also to stop doing something (that we'd really like to do). Self-regulation can also apply to cognitive functions, such as remembering to pay attention.
We're able to exert this control no matter who is or isn't watching. Self-regulated children are self-disciplined even if the teacher is looking the other way. For this reason, self-regulation is not at all the same thing as obedience or docility. It is something we do for ourselves. We're in charge, not people around us who try to exert control.
What it feels like:
Being able to self-regulate enhances our well-being and makes us better able to deal with problems. We become able to control our fits or rage or despair, to take action that's honest and in line with our values, and to work well with all kinds of people in all kinds of situations. Our goals, our responses, and our modes of expression begin to match up.
What not to do:
- Don't beat yourself up if you're less able to self-regulate. If you have CPTSD, a lessened ability to self-regulate is a part of your injury. It's not automatically a fault of character or a weakness.
- Don't lose patience with yourself. Learning how to self-regulate takes time.
- Don't drive yourself too hard. When you're learning to become more aware of your emotions, listen to your instincts when they tell you that you'd best ease off for a while
What to do:
- Gradually and gently become more aware of your emotions and inner states, for example by journaling or practicing mindfulness.
- Learn to remain present to your emotions without judging them harshly. (LINK TO TOXIC SHAMING? OR TO SELF-COMPASSION? OR BOTH?)
- Learn how to choose which situations and/or people you engage with, and how to modify situations and people that trigger a strong negative emotional reaction. Ways of modifying situations are taking a time-out, using conversation-stoppers on difficult topics, or practicing Medium Chill (LINK).
- When evaluating an emotional event, learn to take a step back and see things as if you were an independent third-person observer. This might also prove helpful to some people during difficult events.
- Try out some of the methods that commonly help reduce stress and improve self-regulation. Exercize reduces both emotional distress and the physiological effects of negative emotions, and it improves emotional control. Other things you might give a try are mindful deep breathing, purposely relaxing your body, visualizations, or creative ways of self-expression such as painting or journaling.
Sources:
http://www.toolsofthemind.org/philosophy/self-regulation/
http://www.change-management-coach.com/self-regulation.html
http://en.wikipedia.org/wiki/Emotional_self-regulation
#603
General Discussion / Self-care
October 19, 2014, 09:35:52 PM
Here's the section on "Self-care" that Cat wrote (tks Cat 
) which I thought might prompt some discussion on the topic. Also, if you have any changes to the section, please feel free to add that as well.
SELF-CARE
Definition:
Self-care is anything you do to reduce stress and take care of your physical, emotional, cognitive and spiritual health and well-being.
Description:
If you have CPTSD a certain portion of your time and energy is spent dealing with symptoms. This is energy that you then don't have for other things.
Imagine a glass that's already half full with sand. That's the amount of stress CPTSD adds to your life. Next to it, imagine an empty glass. That's life for someone without CPTSD. He can fill his glass right up with stressors. He'll be fine. But if you do the same, your glass will overflow. It's simply too much.
For this reason, self-care matters. It matters especially when something is additionally draining us of energy, such as:
— recovery (confronting our traumatic past or changing our habits of thought takes energy),
— personal crises, illness, stressful times at work or at home,
— after we've had a flashback
However, many of us were never adequately taken care of as kids. What is worse, some may even have been rejected or abused for showing signs of distress. For that reason, it's understandable that we may not have a clear idea of what good self-care looks like. What makes matters worse is that self-care is often seen as basically the same thing as safe-indulgence and selfishness, and that some people think it's only for the weak.
Some reasons to practice healthy self-care are:
— we have more energy left for daily life,
— we're less likely to burn out or get preventable diseases,
— coping with flashbacks is easier if you're not drained of energy,
— we're only able to really care for others if we've learned to care for ourselves.
An additional bonus: the better we get at this, the better we'll be able to ground ourselves, soothe ourselves, and re-energize ourselves after a flashback.
Some areas we might practice self-care include:
• Physical self-care - caring for your own physical health and well-being (e.g., getting enough rest, eating healthy, exercising regularly, getting regular checkups)
• Emotional self-care - taking care of your emotional health and well-being (e.g., being assertive when needed, expressing your feelings, being your authentic self
• Cognitive self-care – defueling your Inner Critic with rational thinking, grounding yourself with reality checks, practicing mindfulness
• Social self-care - taking care of your social needs and networks (e.g., establishing and maintaining reciprocal relationships, having fun with others)
• Spiritual self-care - drawing on sources of spiritual help that might comfort and guide you, practising meditation and yoga
• Financial self-care.
What to Do
Be kind to yourself. Treat yourself with as much compassion as you'd treat a good friend who's going through a rough patch. If life is particularly stressful and/or you're still reeling from a flashback, don't expect yourself to function at your optimal level. Give yourself a break. Let yourself cut a corner now and then. Do what you can to make your life easier.
Don't do everything at once. Pace yourself. Making one huge change all in one go is now generally thought to be a lot less effective than taking baby steps. Studies have shown that the unemployed spend a lot of energy simply on going without things, energy that they then don't have for other things. This might be worthwhile keeping in mind in case you're tempted to give up smoking, go on a drastic diet, or effect any other massive change that means you have to go without something you're used to, something everyone around you gets to enjoy. If you're stressed out already by your flashbacks and your recovery work, consider postponing it to a later date, or start by gently nudging yourself towards a first tiny baby step.
Avoid becoming Hungry, Angry, Lonely or Tired (HALT). Whenever possible try to get enough sleep, eat a reasonably balanced diet, and exercise some. In particular, avoid being hungry, angry, lonely, or tired, since those states are known to decrease one's willpower and inner resilience. Exercising the major muscle groups (by taking brisk walks, boxing, dancing, swimming, etc) helps work off excess adrenaline and is often recommended to people who have PTSD, so it's possible that you might also benefit.
Practice grounding yourself. Flashbacks disconnect us from our bodies and take us into a space of "heady" worrying. Grounding exercises might help. Some of us find mindfulness meditation a good tool as well. You could also try consciously calling yourself back to the here and now, telling yourself what year this is, where you are, and that you're safe.
Pay attention to how things affect you and make changes:
Sounds, temperature, light, certain people, the effects of different foods and drinks on you (i.e., coffee and tea, sugar and white flour, milk and milk products, etc). The same goes for people, places, and situations. Find out what drains you of energy and what energizes you. Find things that make you feel good. Hobby, sport, nature, a favourite song, creativity and self-expression, a place you like, a gemstone, taking walks, really good coffee, learning a new skill, calling a good friend, mindfulness meditation, crocheting, qui gong, watching or reading something that makes you laugh.
The idea is to incorporate things into your life that give you energy. For example, if you're stressed, do you have a need for warmth (hot drink, warm clothing, bath or shower)? Does a certain place feel particularly safe and comforting to you? What about a particular song, an activity, a movie? Is there a kind of clothing that makes you feel uncomfortable (because it's itchy or restrictive or simply feels weird) that you can change out of and into something more comfortable and comforting (e.g., a soft bathrobe, a favourite pair of sweats)? Could you picture yourself seeking those things out intentionally after a flashback to help care for yourself?
How often are you in situations that are stressful (having to multitask, being bored, being overworked, having to rush other people, dealing with temper tantrums in kids and grown-ups...)? Could you reduce demands on your time and energy?
Is there anything in your home that, if you simply just catch sight of it, instantly makes you feel bad? For example, an unfinished project that still sits on your shelf and makes you feel guilty whenever you see it, an object that evokes unpleasant memories, a dress that isn't at all what you'd ever wear but your mother gave it to you. What's the worst that could really happen if you just got rid of things that provoke stress or negative feelings?
If you're stressed, do you prefer your place to be perfectly silent, or do you need a steady hum of background noises?
Do you spend your free time doing things that entertain you, or are you just killing time?
Are you the kind of person who gets antsy and drained if they're too alone, or if they're too often among people? If you're an introvert: do you have enough alone time, or enough time spent talking to one or two friends (as opposed to going to parties or interacting with groups)? If you're an extravert, do you think you could do with more social interactions, or with spending time in places where there are people (e.g., libraries, coffeeshops)?
Is there any particular time of day that always feels depressing to you, or any particular day of the week, or any particular holiday? (E.g., always feeling antsy and insecure at early afternoon as that's when parents were the most tired and hence the most prone to sudden rages). Is there anything you could do at that time to make you feel safe, to give you energy, and to remind you that your life is now different?
What NOT to Do
Don't feel guilty or self-centered for taking care of yourself. Think of it like keeping a car full of gas and in good order: it's simply common sense.
Don't push yourself too hard, particularly if life is stressful. The media are full of messages that tell us we ought to make a big change right now. Ignore them.
Don't dismiss your personal preferences as irrelevant. Don't focus on what ought to feel good. Find out what works for you personally and for you alone. If your family are party animals, but you'd much rather sit indoors reading, then that's what energizes you. If everyone around you goes jogging, but you'd rather just take brisk walks, then do that.
Don't listen to people who claim that pushing themselves to the brink of collapse is a badge of honour, a proof of how strong they are, a sign that they've got willpower. Unless you're a fakir, suffering to prove your worth doesn't make sense.
Resources
• "Self-Care is Not Selfish" by L. Stahl. Available: http://www.elephantjournal.com/2014/04/self-care-is-not-selfish-lauren-stahl/
• "How to Stop Feeling Guilty about Practicing Self-Care" by M. Tartakovsky, M.S. Available: Psych Central
• Practicing Self-Care during Stressful Times" by M. Tartakovsky, M.S. Available: Psych Central
• "How Clinicians Practice Self-Care & 9 Tips for Readers" by M. Tartakovsky, M.S. Available: Psych Central
• "Self-care in a toxic world: Self-care may not be what you think it is" by C. Meineck. Available: Psychology Today
• "Self-care is not Selfish" by M. Polce-Lynch, Ph.D. Available: http://www.virginiawomenscenter.com/services-psychology-self-care-is-not-selfish.htm
) which I thought might prompt some discussion on the topic. Also, if you have any changes to the section, please feel free to add that as well. SELF-CARE
Definition:
Self-care is anything you do to reduce stress and take care of your physical, emotional, cognitive and spiritual health and well-being.
Description:
If you have CPTSD a certain portion of your time and energy is spent dealing with symptoms. This is energy that you then don't have for other things.
Imagine a glass that's already half full with sand. That's the amount of stress CPTSD adds to your life. Next to it, imagine an empty glass. That's life for someone without CPTSD. He can fill his glass right up with stressors. He'll be fine. But if you do the same, your glass will overflow. It's simply too much.
For this reason, self-care matters. It matters especially when something is additionally draining us of energy, such as:
— recovery (confronting our traumatic past or changing our habits of thought takes energy),
— personal crises, illness, stressful times at work or at home,
— after we've had a flashback
However, many of us were never adequately taken care of as kids. What is worse, some may even have been rejected or abused for showing signs of distress. For that reason, it's understandable that we may not have a clear idea of what good self-care looks like. What makes matters worse is that self-care is often seen as basically the same thing as safe-indulgence and selfishness, and that some people think it's only for the weak.
Some reasons to practice healthy self-care are:
— we have more energy left for daily life,
— we're less likely to burn out or get preventable diseases,
— coping with flashbacks is easier if you're not drained of energy,
— we're only able to really care for others if we've learned to care for ourselves.
An additional bonus: the better we get at this, the better we'll be able to ground ourselves, soothe ourselves, and re-energize ourselves after a flashback.
Some areas we might practice self-care include:
• Physical self-care - caring for your own physical health and well-being (e.g., getting enough rest, eating healthy, exercising regularly, getting regular checkups)
• Emotional self-care - taking care of your emotional health and well-being (e.g., being assertive when needed, expressing your feelings, being your authentic self
• Cognitive self-care – defueling your Inner Critic with rational thinking, grounding yourself with reality checks, practicing mindfulness
• Social self-care - taking care of your social needs and networks (e.g., establishing and maintaining reciprocal relationships, having fun with others)
• Spiritual self-care - drawing on sources of spiritual help that might comfort and guide you, practising meditation and yoga
• Financial self-care.
What to Do
Be kind to yourself. Treat yourself with as much compassion as you'd treat a good friend who's going through a rough patch. If life is particularly stressful and/or you're still reeling from a flashback, don't expect yourself to function at your optimal level. Give yourself a break. Let yourself cut a corner now and then. Do what you can to make your life easier.
Don't do everything at once. Pace yourself. Making one huge change all in one go is now generally thought to be a lot less effective than taking baby steps. Studies have shown that the unemployed spend a lot of energy simply on going without things, energy that they then don't have for other things. This might be worthwhile keeping in mind in case you're tempted to give up smoking, go on a drastic diet, or effect any other massive change that means you have to go without something you're used to, something everyone around you gets to enjoy. If you're stressed out already by your flashbacks and your recovery work, consider postponing it to a later date, or start by gently nudging yourself towards a first tiny baby step.
Avoid becoming Hungry, Angry, Lonely or Tired (HALT). Whenever possible try to get enough sleep, eat a reasonably balanced diet, and exercise some. In particular, avoid being hungry, angry, lonely, or tired, since those states are known to decrease one's willpower and inner resilience. Exercising the major muscle groups (by taking brisk walks, boxing, dancing, swimming, etc) helps work off excess adrenaline and is often recommended to people who have PTSD, so it's possible that you might also benefit.
Practice grounding yourself. Flashbacks disconnect us from our bodies and take us into a space of "heady" worrying. Grounding exercises might help. Some of us find mindfulness meditation a good tool as well. You could also try consciously calling yourself back to the here and now, telling yourself what year this is, where you are, and that you're safe.
Pay attention to how things affect you and make changes:
Sounds, temperature, light, certain people, the effects of different foods and drinks on you (i.e., coffee and tea, sugar and white flour, milk and milk products, etc). The same goes for people, places, and situations. Find out what drains you of energy and what energizes you. Find things that make you feel good. Hobby, sport, nature, a favourite song, creativity and self-expression, a place you like, a gemstone, taking walks, really good coffee, learning a new skill, calling a good friend, mindfulness meditation, crocheting, qui gong, watching or reading something that makes you laugh.
The idea is to incorporate things into your life that give you energy. For example, if you're stressed, do you have a need for warmth (hot drink, warm clothing, bath or shower)? Does a certain place feel particularly safe and comforting to you? What about a particular song, an activity, a movie? Is there a kind of clothing that makes you feel uncomfortable (because it's itchy or restrictive or simply feels weird) that you can change out of and into something more comfortable and comforting (e.g., a soft bathrobe, a favourite pair of sweats)? Could you picture yourself seeking those things out intentionally after a flashback to help care for yourself?
How often are you in situations that are stressful (having to multitask, being bored, being overworked, having to rush other people, dealing with temper tantrums in kids and grown-ups...)? Could you reduce demands on your time and energy?
Is there anything in your home that, if you simply just catch sight of it, instantly makes you feel bad? For example, an unfinished project that still sits on your shelf and makes you feel guilty whenever you see it, an object that evokes unpleasant memories, a dress that isn't at all what you'd ever wear but your mother gave it to you. What's the worst that could really happen if you just got rid of things that provoke stress or negative feelings?
If you're stressed, do you prefer your place to be perfectly silent, or do you need a steady hum of background noises?
Do you spend your free time doing things that entertain you, or are you just killing time?
Are you the kind of person who gets antsy and drained if they're too alone, or if they're too often among people? If you're an introvert: do you have enough alone time, or enough time spent talking to one or two friends (as opposed to going to parties or interacting with groups)? If you're an extravert, do you think you could do with more social interactions, or with spending time in places where there are people (e.g., libraries, coffeeshops)?
Is there any particular time of day that always feels depressing to you, or any particular day of the week, or any particular holiday? (E.g., always feeling antsy and insecure at early afternoon as that's when parents were the most tired and hence the most prone to sudden rages). Is there anything you could do at that time to make you feel safe, to give you energy, and to remind you that your life is now different?
What NOT to Do
Don't feel guilty or self-centered for taking care of yourself. Think of it like keeping a car full of gas and in good order: it's simply common sense.
Don't push yourself too hard, particularly if life is stressful. The media are full of messages that tell us we ought to make a big change right now. Ignore them.
Don't dismiss your personal preferences as irrelevant. Don't focus on what ought to feel good. Find out what works for you personally and for you alone. If your family are party animals, but you'd much rather sit indoors reading, then that's what energizes you. If everyone around you goes jogging, but you'd rather just take brisk walks, then do that.
Don't listen to people who claim that pushing themselves to the brink of collapse is a badge of honour, a proof of how strong they are, a sign that they've got willpower. Unless you're a fakir, suffering to prove your worth doesn't make sense.
Resources
• "Self-Care is Not Selfish" by L. Stahl. Available: http://www.elephantjournal.com/2014/04/self-care-is-not-selfish-lauren-stahl/
• "How to Stop Feeling Guilty about Practicing Self-Care" by M. Tartakovsky, M.S. Available: Psych Central
• Practicing Self-Care during Stressful Times" by M. Tartakovsky, M.S. Available: Psych Central
• "How Clinicians Practice Self-Care & 9 Tips for Readers" by M. Tartakovsky, M.S. Available: Psych Central
• "Self-care in a toxic world: Self-care may not be what you think it is" by C. Meineck. Available: Psychology Today
• "Self-care is not Selfish" by M. Polce-Lynch, Ph.D. Available: http://www.virginiawomenscenter.com/services-psychology-self-care-is-not-selfish.htm
#604
RE - Re-experiencing Trauma / Amygdala Hijackings
October 19, 2014, 09:27:08 PM
Here's a section for our Glossary that hopefully will prompt some discussion. And if you have any suggested changes to the draft please add that in as well.
AMYGDALA HIGHJACKING
Definition: The Amygdala is a small region of the brain which plays a key role in emotional regulation, emotional memory and responses to emotional stimuli. An "amygdala hijacking" is a term first used by Daniel Goleman to describe immediate and intense emotional reactions which are out of proportion to the triggering event, and which take over the cognitive areas of the brain; feelings are ramped up while thinking is slowed.
Description: The amygdala is the instinctive and reactive part of our brain that produces lightning-fast emotional responses to events which may be positive (i.e., events that cause us to feel a surge of delight, joy or excitement), or negative (i.e., events that cause instant fear, anger or rage).
This ability to react quickly and instinctively to negative events plays a critical function in our survival, but in the case of CPTSD the amgydala becomes over-reactive and hyper sensitive due to ongoing trauma. Thus, when someone with CPTSD perceive danger or threat, their amgydala triggers more quickly and intensely than other people, especially when faced with the possibility of a trauma inducing situation similar to what occurred in the past (e.g., childhood abuse and neglect). Once the amgydala triggers, it often produces an emotional flashback in which the feelings from past trauma are layered on top of the feelings elicited by the present day situation, and causes a defensive reaction (i.e., fight, flight, freeze or fawn).
What an Amygdala Hijacking feels like: "Amygdala hijackings" override our ability to think and reason for certain periods of time depending on the intensity of our reaction, and often strand us in what Pete Walker describes in his book "CPTSD: From Surviving to Thriving" (2013) as overwhelming feeling states or emotional flashbacks:
"You feel little, fragile and helpless. Everything feels too hard. Life is too scary. Being seen feels excruciatingly vulnerable. Your battery seems to be dead. In the worst flashbacks an apocalypse feels like it will imminently be upon you. When you are trapped in a flashback, you are reliving the worst emotional times of your childhood" (p. 145).
Additionally you may feel quite shaky, highly anxious and frightened and have difficulty thinking clearly. You may feel the need to hide or isolate yourself, and to numb or distract yourself.
What NOT to Do
What TO Do
Resources:
• "13 Steps for Managing Emotional Flashbacks" by Pete Walker. Available: http://www.pete-walker.com/flashbackManagement.htm
• "What Was I Thinking? Handling the Hijack" by Dr. R. Nadler (2009). In particular see the section "The Emotional Audit" pages 5–6. Available: http://www.psychologytoday.com/files/attachments/51483/handling-the-hijack.pdf
AMYGDALA HIGHJACKING
Definition: The Amygdala is a small region of the brain which plays a key role in emotional regulation, emotional memory and responses to emotional stimuli. An "amygdala hijacking" is a term first used by Daniel Goleman to describe immediate and intense emotional reactions which are out of proportion to the triggering event, and which take over the cognitive areas of the brain; feelings are ramped up while thinking is slowed.
Description: The amygdala is the instinctive and reactive part of our brain that produces lightning-fast emotional responses to events which may be positive (i.e., events that cause us to feel a surge of delight, joy or excitement), or negative (i.e., events that cause instant fear, anger or rage).
This ability to react quickly and instinctively to negative events plays a critical function in our survival, but in the case of CPTSD the amgydala becomes over-reactive and hyper sensitive due to ongoing trauma. Thus, when someone with CPTSD perceive danger or threat, their amgydala triggers more quickly and intensely than other people, especially when faced with the possibility of a trauma inducing situation similar to what occurred in the past (e.g., childhood abuse and neglect). Once the amgydala triggers, it often produces an emotional flashback in which the feelings from past trauma are layered on top of the feelings elicited by the present day situation, and causes a defensive reaction (i.e., fight, flight, freeze or fawn).
What an Amygdala Hijacking feels like: "Amygdala hijackings" override our ability to think and reason for certain periods of time depending on the intensity of our reaction, and often strand us in what Pete Walker describes in his book "CPTSD: From Surviving to Thriving" (2013) as overwhelming feeling states or emotional flashbacks:
"You feel little, fragile and helpless. Everything feels too hard. Life is too scary. Being seen feels excruciatingly vulnerable. Your battery seems to be dead. In the worst flashbacks an apocalypse feels like it will imminently be upon you. When you are trapped in a flashback, you are reliving the worst emotional times of your childhood" (p. 145).
Additionally you may feel quite shaky, highly anxious and frightened and have difficulty thinking clearly. You may feel the need to hide or isolate yourself, and to numb or distract yourself.
What NOT to Do
- Don't try and stuff the feelings down, this is likely to increase their intensity
- Don't self-medicate with alcohol or drugs, this only provides short term relief and may lead to addiction
- Don't try and go it alone, isolate or hide from others
- Don't think this will go on forever, it will subside
What TO Do
- Use Pete Walker's "13 Steps for Managing Emotional Flashbacks" to alleviate your symptoms. See http://www.pete-walker.com/flashbackManagement.htm
- Reach out to others including your physician and/or therapist and let them know what is going on and ways they can help
- Drink fluids and rest; the amygdala kicks out a lot of chemicals such as adrenalin and these stay in your system for a few days
- Try to identify what triggers you and avoid these if possible
- Work through past trauma with a therapist and on your own so that there is less fuel to trigger the amgydala
- Use cognitive behavioural therapy techniques to engage thinking and balance off feelings
- Practise healthy self-soothing or calming techniques such as mindfulness, meditation or yoga
Resources:
• "13 Steps for Managing Emotional Flashbacks" by Pete Walker. Available: http://www.pete-walker.com/flashbackManagement.htm
• "What Was I Thinking? Handling the Hijack" by Dr. R. Nadler (2009). In particular see the section "The Emotional Audit" pages 5–6. Available: http://www.psychologytoday.com/files/attachments/51483/handling-the-hijack.pdf
#605
Ideas/Tools for Recovery / Angering
October 19, 2014, 09:17:01 PM
Here's a section on Angering for the Glossary. It's meant to prompt some discussion about angering as a tool for recovery, but also if you have some changes you'd like to see to the section please add those in too.
Note: The format is going to be shortened for the Glossary sections as they take forever to write as you can imagine. From now on it will just be Definition, Description and Resources and maybe at some later point they will be expanded to this longer format.
ANGERING
Definition: Angering is the expression of one's feelings of resentment of and rage over the trauma inflicted by an abuser in a way that does not hurt either the survivor or anyone else.
Description: Angering is a one of four "processes of grieving" (angering, crying, verbal ventilation and feeling) described by Pete Walker in his book "CPTSD: From Surviving to Thriving" (2013, pp. 222 to 225). It involves expression of one's deeply held feelings of hurt, anger and even rage over the abuse or neglect at the hands of the perpetrator. It is important to point out that angering is not directed at the person who inflicted the trauma, but against the internalized version which in CPTSD commonly takes the form of a virulent and vicious Inner Critic (ICr).
What It Feels Like:
Angering pushes the shame and blame back onto the ICr (internalized perpetrator of the abuse or neglect) where it belongs. In this way it defuels the ICr and helps the flame of self-protective capacities which were arrested in childhood or suspended in adulthood to ignite. It fuels instead self-care, compassion and confidence in ourselves that we can as adults be angry without taking a toll on our inner landscape by not turning shame and blame against ourselves, but outwardly when an occasion calls for healthy anger.
What Not to Do
• Do not direct your anger against the real life perpetrator of your abuse/neglect. This can be risky physically and emotionally, and in recovery it is the internalized version of the abuser that we need to stand up to and defuel – the ICr. Do not let compassion stop you. If you over-identify with the perpetrators of your abuse/neglect, and/or if you pity them, you might shrink from feeling any anger towards them. Remind yourself that you aren't being angry at who they truly are throughout their lives. You're angry at who they were during your abuse. You're angry at one aspect of them. You're angry at the parts of their abuse that still lives on within you - the negative messages they sent you, and the memory of how they treated you.
• Do not let your ICr convince you that you are self-centred or bad for being angry.
• Do not let others convince you that you need to forget about the past and just move on.
What to Do
• If possible, first practice angering in a therapeutic setting where you will have professional support and guidance for the process.
• If your CPTSD developed as a result of childhood abuse or neglect, remind yourself that although you were not allowed to be angry or express negative emotions when you were a child, you are an adult now and it is safe and healthy to do so.
• Direct your angering at the internalized version of your perpetrator - the Inner and Outer Critic.
• If angering triggers an emotional flashback, soothe yourself with whatever techniques are helpful (e.g., "13 Steps to Managing Emotional Flashbacks"), and remind yourself that the flashback is a message from your Inner Child (IC) that there is work to be done.
Source and Resources:
• "Shrinking the Inner Critic" by Pete Walker
• "13 Steps for Managing Emotional Flashbacks" by Pete Walker
• "The Importance of Recovering the Feeling Nature" by Pete Walker
Note: The format is going to be shortened for the Glossary sections as they take forever to write as you can imagine. From now on it will just be Definition, Description and Resources and maybe at some later point they will be expanded to this longer format.
ANGERING
Definition: Angering is the expression of one's feelings of resentment of and rage over the trauma inflicted by an abuser in a way that does not hurt either the survivor or anyone else.
Description: Angering is a one of four "processes of grieving" (angering, crying, verbal ventilation and feeling) described by Pete Walker in his book "CPTSD: From Surviving to Thriving" (2013, pp. 222 to 225). It involves expression of one's deeply held feelings of hurt, anger and even rage over the abuse or neglect at the hands of the perpetrator. It is important to point out that angering is not directed at the person who inflicted the trauma, but against the internalized version which in CPTSD commonly takes the form of a virulent and vicious Inner Critic (ICr).
What It Feels Like:
Angering pushes the shame and blame back onto the ICr (internalized perpetrator of the abuse or neglect) where it belongs. In this way it defuels the ICr and helps the flame of self-protective capacities which were arrested in childhood or suspended in adulthood to ignite. It fuels instead self-care, compassion and confidence in ourselves that we can as adults be angry without taking a toll on our inner landscape by not turning shame and blame against ourselves, but outwardly when an occasion calls for healthy anger.
What Not to Do
• Do not direct your anger against the real life perpetrator of your abuse/neglect. This can be risky physically and emotionally, and in recovery it is the internalized version of the abuser that we need to stand up to and defuel – the ICr. Do not let compassion stop you. If you over-identify with the perpetrators of your abuse/neglect, and/or if you pity them, you might shrink from feeling any anger towards them. Remind yourself that you aren't being angry at who they truly are throughout their lives. You're angry at who they were during your abuse. You're angry at one aspect of them. You're angry at the parts of their abuse that still lives on within you - the negative messages they sent you, and the memory of how they treated you.
• Do not let your ICr convince you that you are self-centred or bad for being angry.
• Do not let others convince you that you need to forget about the past and just move on.
What to Do
• If possible, first practice angering in a therapeutic setting where you will have professional support and guidance for the process.
• If your CPTSD developed as a result of childhood abuse or neglect, remind yourself that although you were not allowed to be angry or express negative emotions when you were a child, you are an adult now and it is safe and healthy to do so.
• Direct your angering at the internalized version of your perpetrator - the Inner and Outer Critic.
• If angering triggers an emotional flashback, soothe yourself with whatever techniques are helpful (e.g., "13 Steps to Managing Emotional Flashbacks"), and remind yourself that the flashback is a message from your Inner Child (IC) that there is work to be done.
Source and Resources:
• "Shrinking the Inner Critic" by Pete Walker
• "13 Steps for Managing Emotional Flashbacks" by Pete Walker
• "The Importance of Recovering the Feeling Nature" by Pete Walker
#606
SOT - Sense of Threat / Hypervigilance
October 19, 2014, 09:08:58 PM
Here is a section for the glossary that Cat drafted (many tks Cat 
). I thought it would be a good discussion topic and if you have any feedback for amending the draft, please let us know that as well.
Hypervigilance
Description:
Hypervigilance is a tendency to constantly scan your environment for threats. You're hyper aware of your surroundings in a way that makes you feel tense, anxious, and constantly on guard.
For sufferers of CPTSD, hypervigilance often means being hyper-aware of things connected with their traumatic experiences. Some random examples:
⦁ If you were traumatized by people who could be nice one day and highly abusive the next, you might be wary of nice people, always searching for signs that they'll turn on you.
⦁ If you've been emotionally neglected, you'll search for signs that you're boring someone and that they're itching to get away from you.
⦁ If you were abused and punished for the smallest mistake, you'll search your own behaviour and actions for signs that you're less than perfect.
Seen this way, hypervigilance is a normal reaction to an abnormal (and highly traumatic) situation. It let us notice possible threats at once. Back then, in the situation that caused our CPTSD, this was a vital survival skill.
The problem with hypervigilance is that it doesn't go away on its own. Even when we're safe, we're still looking at the world around us as if we're under threat. This level of awareness is exhausting and stressful. Many of us aren't even conscious of our own hypervigilance. We developed it as children, and it's become our normal level of awareness. We'll get through our day at work or through a party without any problems - only to collapse once we're at home and by ourselves, so utterly drained that all we can do is veg out on the sofa and watch TV.
People who live with CPTSD survivors often feel that they must walk on eggshells, since the slightest less-than-absolutely-affectionate facial expression can cause massive anxiety.
What NOT to do
Don't feel guilty for feeling drained and exhausted after you've been in a situation that cranked your threat-scanning radar up to eleven.
Don't tell yourself that you "shouldn't be like that". CPTSD is an injury; you're suffering from its effects.
Don't lose hope. Things can get better.
Don't jump to conclusions, and don't assume that everything that feels threatening is threatening. Someone's "disapproving looks" might simply be caused by a splitting headache.
What TO do
Allow yourself some downtime after stressful situations. Many of us prefer activities that don't require us to be at all alert and aware, like vegging out on the couch and watching TV.
Limit your stressors and pick your battles. If every social situation is stressful to you, try shopping on the internet.
Educate yourself about emotional flashbacks (LINK).
If it's at all possible without triggering additional anxiety, try to see which situations are very stressful and hard to manage, which are so-so, and which are relatively easy. Knowing which situations are hard to cope with makes it easier to prepare for them in advance, and to plan for enough downtime afterwards. Knowing which situations are easy to manage lets you road-test coping skills in a relatively safe environment. Once something is proven to work for you, you can then try applying it to middling situations.
Such coping skills might be:
-- finding things that give you a reliable sense of safety: wearing shades, wearing make-up, wearing headphones; always carrying a mobile phone and enough money for a taxi; always carrying a bag with food, water, and a first aid kit; asking a friend to call you during a party so you can answer the phone and (if necessary) pretend to be called away; carrying something that feels good and comforting to you (such as chocolate, a souvenir, prayer beads, a cuddly toy).
-- consciously finding an alternative, realistic explanation for things that feel threatening: "this person isn't giving me a disapproving look, they're simply startled by the squeaky wheels of my shopping trolley"
-- attention-focussing: instead of examining every single person in a shop for threats, focus on a few important things: the shelf you need to get to, the cashier, etc.
-- attention-retraining: try to focus your attention on positive cues in your environment (i.e. for signs that someone is kind, friendly, attentive, non-aggressive, etc).
-- limiting your overall level of awareness, for example by wearing headphones and playing music, by reciting poetry (not out loud, only in your head), or by visualizing a relaxing place (like a sunset on a beach or a snowy landscape). Another thing to try might be mindful deep breathing. If you have an overactive imagination, see if you can use that to keep yourself busy in a pleasant way, like imagining two pirates having a duel in the middle of the shop.
). I thought it would be a good discussion topic and if you have any feedback for amending the draft, please let us know that as well. Hypervigilance
Description:
Hypervigilance is a tendency to constantly scan your environment for threats. You're hyper aware of your surroundings in a way that makes you feel tense, anxious, and constantly on guard.
For sufferers of CPTSD, hypervigilance often means being hyper-aware of things connected with their traumatic experiences. Some random examples:
⦁ If you were traumatized by people who could be nice one day and highly abusive the next, you might be wary of nice people, always searching for signs that they'll turn on you.
⦁ If you've been emotionally neglected, you'll search for signs that you're boring someone and that they're itching to get away from you.
⦁ If you were abused and punished for the smallest mistake, you'll search your own behaviour and actions for signs that you're less than perfect.
Seen this way, hypervigilance is a normal reaction to an abnormal (and highly traumatic) situation. It let us notice possible threats at once. Back then, in the situation that caused our CPTSD, this was a vital survival skill.
The problem with hypervigilance is that it doesn't go away on its own. Even when we're safe, we're still looking at the world around us as if we're under threat. This level of awareness is exhausting and stressful. Many of us aren't even conscious of our own hypervigilance. We developed it as children, and it's become our normal level of awareness. We'll get through our day at work or through a party without any problems - only to collapse once we're at home and by ourselves, so utterly drained that all we can do is veg out on the sofa and watch TV.
People who live with CPTSD survivors often feel that they must walk on eggshells, since the slightest less-than-absolutely-affectionate facial expression can cause massive anxiety.
What NOT to do
Don't feel guilty for feeling drained and exhausted after you've been in a situation that cranked your threat-scanning radar up to eleven.
Don't tell yourself that you "shouldn't be like that". CPTSD is an injury; you're suffering from its effects.
Don't lose hope. Things can get better.
Don't jump to conclusions, and don't assume that everything that feels threatening is threatening. Someone's "disapproving looks" might simply be caused by a splitting headache.
What TO do
Allow yourself some downtime after stressful situations. Many of us prefer activities that don't require us to be at all alert and aware, like vegging out on the couch and watching TV.
Limit your stressors and pick your battles. If every social situation is stressful to you, try shopping on the internet.
Educate yourself about emotional flashbacks (LINK).
If it's at all possible without triggering additional anxiety, try to see which situations are very stressful and hard to manage, which are so-so, and which are relatively easy. Knowing which situations are hard to cope with makes it easier to prepare for them in advance, and to plan for enough downtime afterwards. Knowing which situations are easy to manage lets you road-test coping skills in a relatively safe environment. Once something is proven to work for you, you can then try applying it to middling situations.
Such coping skills might be:
-- finding things that give you a reliable sense of safety: wearing shades, wearing make-up, wearing headphones; always carrying a mobile phone and enough money for a taxi; always carrying a bag with food, water, and a first aid kit; asking a friend to call you during a party so you can answer the phone and (if necessary) pretend to be called away; carrying something that feels good and comforting to you (such as chocolate, a souvenir, prayer beads, a cuddly toy).
-- consciously finding an alternative, realistic explanation for things that feel threatening: "this person isn't giving me a disapproving look, they're simply startled by the squeaky wheels of my shopping trolley"
-- attention-focussing: instead of examining every single person in a shop for threats, focus on a few important things: the shelf you need to get to, the cashier, etc.
-- attention-retraining: try to focus your attention on positive cues in your environment (i.e. for signs that someone is kind, friendly, attentive, non-aggressive, etc).
-- limiting your overall level of awareness, for example by wearing headphones and playing music, by reciting poetry (not out loud, only in your head), or by visualizing a relaxing place (like a sunset on a beach or a snowy landscape). Another thing to try might be mindful deep breathing. If you have an overactive imagination, see if you can use that to keep yourself busy in a pleasant way, like imagining two pirates having a duel in the middle of the shop.
#607
RE - Re-experiencing Trauma / Glossary Section for Emotional Flashbacks
October 19, 2014, 07:22:12 PM
Here's a section on EFs I wrote for the glossary. Thought it might spur some conversation about EFs, but also if you have some suggestions (add, edit, resource, whatever), please let me know.
EMOTIONAL FLASHBACKS
Definition: An emotional flashback is the re-experiencing of mild to intense emotions that were experienced during past trauma and which may be of short to long duration. The person may or may not connect these feelings to the original trauma.
Description: Emotional flashbacks (EFs) involve mild to intense feeling states (e.g., anger, shame, fear) that were felt in past trauma, but which not processed and integrated into the person's psyche. EFs are triggered by present day situations which engage past emotions and layer them on top of current emotions. For example, a person who grew up with a parent who was angry and abusive may react with sudden intense fear to a minor conflict at work and not understand what is happening or why because often people with CPTSD do not connect these feelings to past trauma. Emotional flashbacks are contrasted by the visual flashbacks experienced with PTSD where sufferer sees the traumatic event replayed in their mind's eye.
What It Feels Like: A person experiencing an EF may have sudden emotions ranging from mild and being somewhat unsettled to intense and being overwhelmed by feelings which rise up (and sometimes seemingly out of nowhere) in response to a present day situation or trigger. Emotionally they may include anger, fear, shame, and powerlessness. Physically, breathing may quicken and become shallow, heart rate may increase, muscles may tighten and they may feel anxious and jittery (adrenalized). Cognitively, they may feel foggy and have difficulty thinking clearly. Things may seem a bit unreal or surreal and off kilter as though the ground is shifting under their feet (derealisation). Internally there may be a sense of being fractured or not feeling like oneself or being detached (depersonalization). They may have an intense need to hide so that no-one will see what is going on.
What NOT to Do
• Don't think that you must be crazy or broken; an EF is a response to a psychological injury rather than a defect of character
• Don't listen to your Inner Critic if it tells you that you are weak or 'bad' for having an EF, or that you deserve to feel the way you do
• Don't self-medicate with alcohol or drugs. Although it is tempting to numb oneself this can lead to addiction.
• Don't isolate yourself. You may feel safer in the short term, but longer term you will not learn that although in the past no-one was there for you, in the present others can and will help you
• Don't dissociate if possible. Again, while this may help in the short term in the longer term it is difficult to remember and process past trauma.
What TO Do
• Cat's Meow. "Emotional Flashbacks"
• Villines, Z. (2013). "Complex PTSD: Response to Prolonged Trauma"
• Walker, P. "13 Steps for Managing Emotional Flashbacks"
EMOTIONAL FLASHBACKS
Definition: An emotional flashback is the re-experiencing of mild to intense emotions that were experienced during past trauma and which may be of short to long duration. The person may or may not connect these feelings to the original trauma.
Description: Emotional flashbacks (EFs) involve mild to intense feeling states (e.g., anger, shame, fear) that were felt in past trauma, but which not processed and integrated into the person's psyche. EFs are triggered by present day situations which engage past emotions and layer them on top of current emotions. For example, a person who grew up with a parent who was angry and abusive may react with sudden intense fear to a minor conflict at work and not understand what is happening or why because often people with CPTSD do not connect these feelings to past trauma. Emotional flashbacks are contrasted by the visual flashbacks experienced with PTSD where sufferer sees the traumatic event replayed in their mind's eye.
What It Feels Like: A person experiencing an EF may have sudden emotions ranging from mild and being somewhat unsettled to intense and being overwhelmed by feelings which rise up (and sometimes seemingly out of nowhere) in response to a present day situation or trigger. Emotionally they may include anger, fear, shame, and powerlessness. Physically, breathing may quicken and become shallow, heart rate may increase, muscles may tighten and they may feel anxious and jittery (adrenalized). Cognitively, they may feel foggy and have difficulty thinking clearly. Things may seem a bit unreal or surreal and off kilter as though the ground is shifting under their feet (derealisation). Internally there may be a sense of being fractured or not feeling like oneself or being detached (depersonalization). They may have an intense need to hide so that no-one will see what is going on.
What NOT to Do
• Don't think that you must be crazy or broken; an EF is a response to a psychological injury rather than a defect of character
• Don't listen to your Inner Critic if it tells you that you are weak or 'bad' for having an EF, or that you deserve to feel the way you do
• Don't self-medicate with alcohol or drugs. Although it is tempting to numb oneself this can lead to addiction.
• Don't isolate yourself. You may feel safer in the short term, but longer term you will not learn that although in the past no-one was there for you, in the present others can and will help you
• Don't dissociate if possible. Again, while this may help in the short term in the longer term it is difficult to remember and process past trauma.
What TO Do
- Recognize that you are having an EF and reassure yourself that what you are feeling is made more intense because feelings from the past of being abused or abandoned are layered over your current emotions.
- Give yourself time to soothe yourself and grieve the remembered pain of your past trauma.
- Tell yourself that what you are feeling is due to a psychological injury and not a defect of character (e.g., you are not weak or broken)
- Use grounding and self-soothing strategies such as Pete Walker's "13 Steps for Managing Emotional Flashbacks" to bring yourself into the present moment and calm yourself
- Seek support - Tell your physician/therapist and trusted family members/friends about your EFs, and allow them to support and care for you.
• Cat's Meow. "Emotional Flashbacks"
• Villines, Z. (2013). "Complex PTSD: Response to Prolonged Trauma"
• Walker, P. "13 Steps for Managing Emotional Flashbacks"
#608
General Discussion / Holidays
October 19, 2014, 06:25:57 PM
It's ironic, how our FOO affect us differently and yet we end up in the same place - CPTSD. I do not like to go all out any more because my NPDM made every holiday such an intense, pressure filled extravaganza of decorating, feasting, family gatherings which may have looked good but underneath - anger, tension, drama. Yuk, yuk, yuk!
We used to go all out for our son but he is off at university and is content with a more subdued XMas when he comes home.
Nowadays my H and I are quite happy to maybe put up a tree, have a lovely XMas dinner out and call it a day - so much less tension and pressure! I am NC with my extended FOO and NPDB and LC with my NPDM so it's easy to do. We've actually talked about going south and skipping XMas altogether.
Will your FOO be hoovering when you don't go all out do you think? That can be difficult at first because of their expectations.
We used to go all out for our son but he is off at university and is content with a more subdued XMas when he comes home.
Nowadays my H and I are quite happy to maybe put up a tree, have a lovely XMas dinner out and call it a day - so much less tension and pressure! I am NC with my extended FOO and NPDB and LC with my NPDM so it's easy to do. We've actually talked about going south and skipping XMas altogether.
Will your FOO be hoovering when you don't go all out do you think? That can be difficult at first because of their expectations.
#609
Inner Child Work / Neat Tool for IC Work
October 18, 2014, 11:06:53 PM
So I had my second session with my new T and we did this really neat (scary) IC exercise. With my dominant hand I would write down a question for my IC. My first one was "What do you want to say to me?" Then I had to switch to my non-dominant hand and have her answer which of course looked and felt like a little kid writing. It went back and forth it went for about 20 minutes.
It was amazing because my IC is normally very much in lock down, but this technique brought her right out - it was amazing really and quite powerful. I cried quite a bit and it was a bit of a sad, lonely kind of crying at first then turned into relief and some joy at having her speak up and be reassured by adult me.
Anyway, quite an experience and recommend it as a great tool for connecting with your IC.
It was amazing because my IC is normally very much in lock down, but this technique brought her right out - it was amazing really and quite powerful. I cried quite a bit and it was a bit of a sad, lonely kind of crying at first then turned into relief and some joy at having her speak up and be reassured by adult me.
Anyway, quite an experience and recommend it as a great tool for connecting with your IC.
#610
Emotional Abuse / Emotional Abuse You Carry the Cure in your OwnHeart (Possible Trigger)
October 14, 2014, 08:02:55 PM
This is an excellent article by Andrew Vach "You Carry the Cure In Your Own Heart" a lawyer and author. May be triggering as it is quite powerful. http://www.vachss.com/av_dispatches/disp_9408_a.html
Here's an excerpt:
Adult survivors of emotional child abuse have only two life–choices: learn to self–reference or remain a victim. When your self–concept has been shredded, when you have been deeply injured and made to feel the injury was all your fault, when you look for approval to those who can not or will not provide it—you play the role assigned to you by your abusers.
It's time to stop playing that role, time to write your own script. Victims of emotional abuse carry the cure in their own hearts and souls. Salvation means learning self–respect, earning the respect of others and making that respect the absolutely irreducible minimum requirement for all intimate relationships. For the emotionally abused child, healing does come down to "forgiveness"—forgiveness of yourself.
How you forgive yourself is as individual as you are. But knowing you deserve to be loved and respected and empowering yourself with a commitment to try is more than half the battle. Much more.
And it is never too soon—or too late—to start.
Here's an excerpt:
Adult survivors of emotional child abuse have only two life–choices: learn to self–reference or remain a victim. When your self–concept has been shredded, when you have been deeply injured and made to feel the injury was all your fault, when you look for approval to those who can not or will not provide it—you play the role assigned to you by your abusers.
It's time to stop playing that role, time to write your own script. Victims of emotional abuse carry the cure in their own hearts and souls. Salvation means learning self–respect, earning the respect of others and making that respect the absolutely irreducible minimum requirement for all intimate relationships. For the emotionally abused child, healing does come down to "forgiveness"—forgiveness of yourself.
How you forgive yourself is as individual as you are. But knowing you deserve to be loved and respected and empowering yourself with a commitment to try is more than half the battle. Much more.
And it is never too soon—or too late—to start.
#611
Letters of Recovery / Guidelines for Recovery Letters
October 13, 2014, 07:58:46 PM
Guidelines for Writing a Recovery Letter
Write a letter which will help you in one way or another to move forward in your recovery. The letter can be to the perpetrator(s) of your abuse or neglect, to your Inner Child who would so much like to come out of the dark place s/he is hiding, your Inner Critic who is crowding your head and heart with negative messages, or anyone who has touched your life in some fashion. You can write more than one letter. Remember to stay within the board guidelines:
• Keep it confidential - remember this is the internet so don't include information that will allow anyone to recognize your identity (i.e., replace real names with initials or pseudonyms)
• Be honest and real. Don't sugar-coat it or exaggerate it what you have to say. Try to tell it like it really is/was and how you felt/feel about it.
• Angering is important but don't dehumanize or resort to degrading put-downs or insults if your letter is to the perpetrator of your abuse or neglect.
For Those Who Read These Letters of Recovery
Treat each letter with the utmost dignity and respect. This is a sacred place where some very important things are "said" for the first time. There are many tears and years of pain bound within the lines of these letters so we ask that is you respond you:
• Listen for and validate the original poster's feelings
• Don't critique the letter or tell the poster what they should have said
• Don't use this forum for debate or discussion. Use the other forums for that
• Report any concerns or abuses of this forum
Write a letter which will help you in one way or another to move forward in your recovery. The letter can be to the perpetrator(s) of your abuse or neglect, to your Inner Child who would so much like to come out of the dark place s/he is hiding, your Inner Critic who is crowding your head and heart with negative messages, or anyone who has touched your life in some fashion. You can write more than one letter. Remember to stay within the board guidelines:
• Keep it confidential - remember this is the internet so don't include information that will allow anyone to recognize your identity (i.e., replace real names with initials or pseudonyms)
• Be honest and real. Don't sugar-coat it or exaggerate it what you have to say. Try to tell it like it really is/was and how you felt/feel about it.
• Angering is important but don't dehumanize or resort to degrading put-downs or insults if your letter is to the perpetrator of your abuse or neglect.
For Those Who Read These Letters of Recovery
Treat each letter with the utmost dignity and respect. This is a sacred place where some very important things are "said" for the first time. There are many tears and years of pain bound within the lines of these letters so we ask that is you respond you:
• Listen for and validate the original poster's feelings
• Don't critique the letter or tell the poster what they should have said
• Don't use this forum for debate or discussion. Use the other forums for that
• Report any concerns or abuses of this forum
#612
Checking Out / Quite Busy mid-Oct to end-Dec
October 13, 2014, 06:33:27 PM
Just wanted to let everyone know that work is about to get quite busy for me and that I will not be posting as much. I will check in daily though to take care of any admin and answer any PMs.
#613
General Discussion / Ego States
October 12, 2014, 02:28:55 AM
I was just reading an article about EMDR and CPTSD and found the following about ego states:
Introduction to Ego State Therapy
Ego state theory was developed initially by Paul Federn (1932, 1943) and extended by John Watkins and Helen Watkins (1995), Richard Erskine (1997), Eric Berne (1963), and Richard Schwartz (1997). It posits the existence of an internal family variously termed parts, ego or self states, or selves, or conceived of as neural or memory networks.
The ego state system can be thought of as a segmentation of the personality into self states or parts at points along the dissociation continuum that comes about due to normal differentiation, introjection, or trauma. Ego states may be described as an organized system of behaviors and experiences that have varying boundaries. The states may be organized to enhance adaptability in coping with events or problems. Some ego states are delineated by time dimensions: a five-year-old, teenager, or infant, for example. Others are delineated by function, trait, or role, for example self-hater, nurturer, critic, executive, bratty kid, daredevil, curious, nature lover, parent, grandparent, and so on.
Ego states may have normative imaginal or creative functions, such as daydreaming. However, ego states formed in childhood may function maladaptively in present life situations. They seek to protect their existence and roles, even if those are counterproductive. This is similar to organizational maintenance theory: no corporation willingly goes out of business. Ego states can conflict with each other, leading to intrapsychic conflict. Finally, they have the capacity to change, combine, grow, and adapt.- [/i]
I must say I really like the last line!!
Introduction to Ego State Therapy
Ego state theory was developed initially by Paul Federn (1932, 1943) and extended by John Watkins and Helen Watkins (1995), Richard Erskine (1997), Eric Berne (1963), and Richard Schwartz (1997). It posits the existence of an internal family variously termed parts, ego or self states, or selves, or conceived of as neural or memory networks.
The ego state system can be thought of as a segmentation of the personality into self states or parts at points along the dissociation continuum that comes about due to normal differentiation, introjection, or trauma. Ego states may be described as an organized system of behaviors and experiences that have varying boundaries. The states may be organized to enhance adaptability in coping with events or problems. Some ego states are delineated by time dimensions: a five-year-old, teenager, or infant, for example. Others are delineated by function, trait, or role, for example self-hater, nurturer, critic, executive, bratty kid, daredevil, curious, nature lover, parent, grandparent, and so on.
Ego states may have normative imaginal or creative functions, such as daydreaming. However, ego states formed in childhood may function maladaptively in present life situations. They seek to protect their existence and roles, even if those are counterproductive. This is similar to organizational maintenance theory: no corporation willingly goes out of business. Ego states can conflict with each other, leading to intrapsychic conflict. Finally, they have the capacity to change, combine, grow, and adapt.- [/i]
I must say I really like the last line!!
#614
Research / EMDR and the Treatment of Complex PTSD: A Review
October 12, 2014, 02:13:01 AM
Korn, D. (2009). EMDR and the Treatment of Complex PTSD: A Review, Journal of EMDR Practice and Research, 3 (4). Available: http://www.ingentaconnect.com/content/springer/emdr/2009/00000003/00000004/art00006?crawler=true&mimetype=application/pdf
Abstract:
The diagnosis of posttraumatic stress disorder (PTSD) covers a wide range of conditions, ranging from patients suffering from a one-time traumatic accident to those who have been exposed to chronic traumatization and repeated assaults beginning at an early age. While EMDR and other trauma treatments have been proven efficacious in the treatment of simpler cases of PTSD, the effectiveness of treatments for more complex cases has been less widely studied. This article examines the body of literature on the treatment of complex PTSD and chronically traumatized populations, with a focus on EMDR treatment and research. Despite a still limited number of randomized controlled studies of any treatment for complex PTSD, trauma treatment experts have come to a general consensus that work with survivors of childhood abuse and other forms of chronic traumatization should be phase-oriented, multimodal, and titrated. A phase-oriented EMDR model for working with these patients is presented, highlighting the role of resource development and installation (RDI) and other strategies that address the needs of patients with compromised affect tolerance and self-regulation. EMDR treatment goals, procedures, and adaptations for each of the various treatment phases (stabilization, trauma processing, reconnection/development of self-identity) are reviewed. Finally, reflections on the strengths and unique advantages of EMDR in treating complex PTSD are offered along with suggestions for future investigations.
Abstract:
The diagnosis of posttraumatic stress disorder (PTSD) covers a wide range of conditions, ranging from patients suffering from a one-time traumatic accident to those who have been exposed to chronic traumatization and repeated assaults beginning at an early age. While EMDR and other trauma treatments have been proven efficacious in the treatment of simpler cases of PTSD, the effectiveness of treatments for more complex cases has been less widely studied. This article examines the body of literature on the treatment of complex PTSD and chronically traumatized populations, with a focus on EMDR treatment and research. Despite a still limited number of randomized controlled studies of any treatment for complex PTSD, trauma treatment experts have come to a general consensus that work with survivors of childhood abuse and other forms of chronic traumatization should be phase-oriented, multimodal, and titrated. A phase-oriented EMDR model for working with these patients is presented, highlighting the role of resource development and installation (RDI) and other strategies that address the needs of patients with compromised affect tolerance and self-regulation. EMDR treatment goals, procedures, and adaptations for each of the various treatment phases (stabilization, trauma processing, reconnection/development of self-identity) are reviewed. Finally, reflections on the strengths and unique advantages of EMDR in treating complex PTSD are offered along with suggestions for future investigations.
#615
Research / A Developmental Approach to Complex PTSD
October 12, 2014, 01:47:41 AM
Cloitre, M., Stolbach, B., Herman, J., van der Kolk, B., Pynoos, R., Wang, J. & Petkova, E. (2009) "A Developmental Approach to Complex PTSD: Childhood and Adult Cumulative Trauma as Predictors of Symptom Complexity," Journal of Traumatic Stress, Vol. 22 (5). Available: http://www.mentalhealthconnection.org/pdfs/ptsd-predictors.pdf.
Abstract:
Exposure to multiple traumas, particularly in childhood, has been proposed to result in a complex of symptoms that includes posttraumatic stress disorder (PTSD) as well as a constrained, but variable group of symptoms that highlight self-regulatory disturbances. The relationship between accumulated exposure to different types of traumatic events and total number of different types of symptoms (symptom complexity) was assessed in an adult clinical sample (N = 582) and a child clinical sample (N = 152). Childhood cumulative trauma but not adulthood trauma predicted increasing symptom complexity in adults. Cumulative trauma predicted increasing symptom complexity in the child sample. Results suggest that Complex PTSD symptoms occur in both adult and child samples in a principled, rule-governed way and that childhood experiences significantly influenced adult symptoms.
Abstract:
Exposure to multiple traumas, particularly in childhood, has been proposed to result in a complex of symptoms that includes posttraumatic stress disorder (PTSD) as well as a constrained, but variable group of symptoms that highlight self-regulatory disturbances. The relationship between accumulated exposure to different types of traumatic events and total number of different types of symptoms (symptom complexity) was assessed in an adult clinical sample (N = 582) and a child clinical sample (N = 152). Childhood cumulative trauma but not adulthood trauma predicted increasing symptom complexity in adults. Cumulative trauma predicted increasing symptom complexity in the child sample. Results suggest that Complex PTSD symptoms occur in both adult and child samples in a principled, rule-governed way and that childhood experiences significantly influenced adult symptoms.
#616
Therapy / Info about Treatment - Updated 05 May 2022
October 12, 2014, 01:42:30 AM
There are numerous types of approaches used to treat Complex PTSD although most are based on treatment of PTSD and/or other issues such as anxiety and depression. As Ford and Courtois (2020) suggest in their review of existing therapeutic models, "the crucial question of when and for whom different evidence-based treatment models or their components are recommended remains unanswered". That said, there are a number of commonly used models they found to be effective in the treatment of Complex PTSD including: Eye Movement Desensitization and Reprocessing (EMDR), Emotion Focused Therapy, Prolonged Exposure Therapy, Cognitive Behavioural Therapy (CBT), and Interpersonal Psychotherapy. They also point to promising emerging models/approaches including: sensorimotor psychotherapy, experiential therapy, and various mindfulness approaches.
..there is no need for despair because, along with all the other things we have learned about trauma over the course of the past several decades, a number of treatment methods have been developed, tested, and proven effective. Christine Courtois, PhD
....the past 20 years have brought us extraordinary, evidence-based breakthroughs in the treatment and healing of trauma. In a wide range of fields, psychologists, neuroscientists, pioneering therapists, and traditional healers are making enormous progress in helping us to recover—and to turn our energies toward our greater dreams and life purpose. - The Healing Trauma Summit, June 2018
Dr. Judith Herman (Ford & Courtois, 2020) suggests researchers and clinicians must next focus on what components of the numerous models are most effective in treating complex trauma. "Since it is not realistic to expect that practitioners will become expert in numerous different, specialized techniques, some researchers now suggest that we might be ready to shift our focus from studies of competing models to studies that elucidate the common features of effective therapies" (2020). Given many (most) survivors experience difficulty wading through the numerous approaches and choosing one that works for them, having fewer but more specific, evidence based models for Complex PTSD would be a welcome change.
For further information about current therapeutic models/approaches, here are two bibliographies of research articles and books. While written for researchers and clinicians for the most part, they can be useful in helping you to dig a little deeper into various models. Beyond these resources a simple Google search will bring up loads of articles about various treatments for trauma (a word of caution here - not all models/approached are evidence-based).
A Word About More Accessible Treatment
Therapy for Complex PTSD until recently has only been available in large cities where therapists with knowledge and experience of this type of trauma tend to cluster. More and more, however, treatment is offered virtually. While this means therapy is now more accessible geographically, it remains financially inaccessible for most survivors. In most countries, a limited number of sessions are covered by government or Insurance plans, after which survivors must pay out of pocket and it is prohibitively expensive. Sessions run from $175 to $250 and what this means is that survivors go without treatment or pay dearly $700 to $1,000 monthly. In short, many survivors simply cannot afford to get well. This must change. Mental health is not separate from physical health, they are intertwined and should be treated as such. Hopefully as we find each other in forums like this, as more trauma organizations serving complex trauma survivors are formed, we will join our voices and make enough noise to get this message to the ears that need to hear it.
Guidelines for Treatment
Cloitre, M., Courtois, C., Ford, J. Green, B., Alexander, P., Briere, J., Herman, J. Lanius, R., Pearlman, L., Stolbach, B., Spinazzola, J. & van der Hart, O. (2012). ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults. International Society for Traumatic Stress Studies.
Cloitre, M., Courtois, C., Charuvastra, A., Carapezza, R., Stolbach, B. & Green, B. (2011). Treatment of Complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24 (6)
Kezelman, C. & Stavropoulos, P. (2019). Practice Guidelines for Clinical Treatment of Complex Trauma, Australia: Blue Knot Foundation
Kezelman, C. & Stavropoulos, P. (2012). Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery, Australia: Blue Knot Foundation
..there is no need for despair because, along with all the other things we have learned about trauma over the course of the past several decades, a number of treatment methods have been developed, tested, and proven effective. Christine Courtois, PhD
....the past 20 years have brought us extraordinary, evidence-based breakthroughs in the treatment and healing of trauma. In a wide range of fields, psychologists, neuroscientists, pioneering therapists, and traditional healers are making enormous progress in helping us to recover—and to turn our energies toward our greater dreams and life purpose. - The Healing Trauma Summit, June 2018
Dr. Judith Herman (Ford & Courtois, 2020) suggests researchers and clinicians must next focus on what components of the numerous models are most effective in treating complex trauma. "Since it is not realistic to expect that practitioners will become expert in numerous different, specialized techniques, some researchers now suggest that we might be ready to shift our focus from studies of competing models to studies that elucidate the common features of effective therapies" (2020). Given many (most) survivors experience difficulty wading through the numerous approaches and choosing one that works for them, having fewer but more specific, evidence based models for Complex PTSD would be a welcome change.
For further information about current therapeutic models/approaches, here are two bibliographies of research articles and books. While written for researchers and clinicians for the most part, they can be useful in helping you to dig a little deeper into various models. Beyond these resources a simple Google search will bring up loads of articles about various treatments for trauma (a word of caution here - not all models/approached are evidence-based).
A Word About More Accessible Treatment
Therapy for Complex PTSD until recently has only been available in large cities where therapists with knowledge and experience of this type of trauma tend to cluster. More and more, however, treatment is offered virtually. While this means therapy is now more accessible geographically, it remains financially inaccessible for most survivors. In most countries, a limited number of sessions are covered by government or Insurance plans, after which survivors must pay out of pocket and it is prohibitively expensive. Sessions run from $175 to $250 and what this means is that survivors go without treatment or pay dearly $700 to $1,000 monthly. In short, many survivors simply cannot afford to get well. This must change. Mental health is not separate from physical health, they are intertwined and should be treated as such. Hopefully as we find each other in forums like this, as more trauma organizations serving complex trauma survivors are formed, we will join our voices and make enough noise to get this message to the ears that need to hear it.
Guidelines for Treatment
Cloitre, M., Courtois, C., Ford, J. Green, B., Alexander, P., Briere, J., Herman, J. Lanius, R., Pearlman, L., Stolbach, B., Spinazzola, J. & van der Hart, O. (2012). ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults. International Society for Traumatic Stress Studies.
Cloitre, M., Courtois, C., Charuvastra, A., Carapezza, R., Stolbach, B. & Green, B. (2011). Treatment of Complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24 (6)
Kezelman, C. & Stavropoulos, P. (2019). Practice Guidelines for Clinical Treatment of Complex Trauma, Australia: Blue Knot Foundation
Kezelman, C. & Stavropoulos, P. (2012). Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery, Australia: Blue Knot Foundation
#617
Questions/Suggestions/Comments / How to Use the "Quote" Function
October 08, 2014, 09:55:05 PM
See three ways to insert quotes in posts from our sister site OOTF - http://outofthefog.net/forum/index.php?topic=3153.0
#618
Questions/Suggestions/Comments / Forgotten or Lost Password?
October 05, 2014, 05:48:58 PM
If you forget/misplace your password, please don't just create a new account - there is no way to link the two and it just leaves people wondering what happened to the "former you." Instead:
Go to login screen as usual, type in whatever password you think it was; click enter.
Login in box appears again: click on "forgot your password" link. Prompts are fairly clear and easy to follow from this point.
Authentication reminder appears: You can enter either username or email address.
You then have two options: Either "email me new password" or "let me set new password by answering my secret question." (Reminder: You might want to consider setting the secret question on your profile if you have not already done so!)
Go to login screen as usual, type in whatever password you think it was; click enter.
Login in box appears again: click on "forgot your password" link. Prompts are fairly clear and easy to follow from this point.
Authentication reminder appears: You can enter either username or email address.
You then have two options: Either "email me new password" or "let me set new password by answering my secret question." (Reminder: You might want to consider setting the secret question on your profile if you have not already done so!)
#619
Discussion About Psychoactive Substances / WARNING - Forum Includes Threads about Psychoactive Substances
September 30, 2014, 01:51:29 PM
NOTICE - OOTS does not endorse the use of any illegal psychoactive substances.
WARNING - For any members reading/posting to this board, please note that discussion of psychoactive substances is involved, some of which are legal in certain countries and illegal in others. There are ongoing clinical trials medicinal or therapeutic use of substances such as MDMA, psilocybin, cannabis and several other substances being conducted around the world (e.g., http://www.maps.org/). It is important to understand that for safety and legal reasons, the trials are conducted under strict government and medical supervision. Pure ingredients are used whereas street drugs more often than.
In this particular sub-forum posters may NOT encourage others to use any psychoactive substances. Rather, you may share your own experiences with them and/or discuss the research into substances which may/may not help with CPTSD. Posts which contravene this will be edited or removed.
Thank you for your cooperation.
Kizzie
Site Manager
WARNING - For any members reading/posting to this board, please note that discussion of psychoactive substances is involved, some of which are legal in certain countries and illegal in others. There are ongoing clinical trials medicinal or therapeutic use of substances such as MDMA, psilocybin, cannabis and several other substances being conducted around the world (e.g., http://www.maps.org/). It is important to understand that for safety and legal reasons, the trials are conducted under strict government and medical supervision. Pure ingredients are used whereas street drugs more often than.
In this particular sub-forum posters may NOT encourage others to use any psychoactive substances. Rather, you may share your own experiences with them and/or discuss the research into substances which may/may not help with CPTSD. Posts which contravene this will be edited or removed.
Thank you for your cooperation.
Kizzie
Site Manager
#620
Research / CPTSD vs Borderline Personality Disorder
September 28, 2014, 04:09:42 PM
"Complex PTSD, Affect Dysregulation, and Borderline Personality Disorder" by Ford & Courtois (2014) - newly published academic article which is quite a slog reading but the bottom line in their opinion is that PTSD, CPTSD abd BPD overlap, but are different and need to be better differentiated by clinicians and researchers:
We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.
Added: Helps if I give the link doesn't it?
http://www.bpded.com/content/1/1/9
We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.
Added: Helps if I give the link doesn't it?
http://www.bpded.com/content/1/1/9