Friday, July 29, 2022

Complex PTSD (C-PTSD)

Complex Posttraumatic Stress Disorder (C-PTSD) is not included in the DSM-5. For this reason, we want to make a note of it here, especially as it relates to what could be viewed as treatment-resistant PTSD.    

PTSD and C-PTSD are similar in their root causes, with the "C" distinction reflecting the repetitive nature of the trauma experienced over a long period of time. People who have survived complex trauma, especially the trauma of sexual abuse, often display similar symptoms as those who live with Borderline Personality Disorder. Common symptoms include severe depression, mood swings, anger, extreme feelings of loneliness and anxiety. Those who live with these symptoms can be seen as having difficulty regulating their emotions. This often leads to a diagnosis, especially in women, of bipolar disorder.

C-PTSD is often misdiagnosed as Borderline Personality Disorder. The two share overlapping symptoms with one key difference, their attachment style triggered reactions[1]. 

With Borderline Personality Disorder the attachment style is one of needing someone to react to. They are hypervigilant about signs of rejection. Their fragmented sense of self is unstable and comes from a base of profound emotional emptiness with fears of being abandoned. 

With C-PTSD the attachment style is not based on fear of abandonment. Thiers is a more relational detachment style. In other words, they would prefer to be left alone in many cases. Their hypervigilance is based on safety. It is easier to keep the peace in their lives if they do not have to risk getting close enough to someone who could hurt them. 

While C-PTSD can be a severe and debilitating disorder, C-PTSD treatments do exist and are effective.

 Recovery from C-PTSD is a long process that often involves the standard treatments for PTSD (cognitive processing of the trauma), as well as additional psychotherapy to work assist emotional regulation, skill building to overcome learned behaviors and habits that formed during the duration of the trauma, and Somatic psychotherapy to help retrain the nervous system to function and respond appropriately instead of defaulting to stress responses. This is especially important if the trauma experienced began during childhood.

We value your feedback and ideas! Reach out on our Community Facebook Page!

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Friday, July 22, 2022

Prolonged Exposure Therapy (PE) for PTSD


Prolonged Exposure (PE) Therapy is an evidence based treatment for PTSD. We can find a PE provider through the Strong Star Provider Network at University of Texas Health Science Center or even through Psychology Today or Google.

PE therapy typically takes 12-15 sessions with a therapist; each session is 90 minutes. PE therapy goes right for the jugular of criterion C of PTSD: avoidance. Rather than avoid our trauma, we intentionally invite the most traumatic event into the session using a technique called “imaginal exposure.” After learning breathing techniques to manage anxiety, we imagine and describe the traumatic event in detail with guidance from a therapist. After the imaginal exposure, we process the experience with our therapist. We audio record the session while describing the event so that we can listen to the recording between sessions; this helps us to further process our emotions and practice breathing techniques. Think of the imaginal exposure like this: it’s like watching a horror movie. 

When we first watch a horror movie, it scares the crap out of us because that’s what horror movies do. What if we watch the horror movie back-to-back three times? It’s still going to be scary, but, after the third time, we know what is coming and when and it’s not as bad as the first time. What if we watch that horror movie ten times? Twenty times? A hundred times? Eventually, watching that movie doesn’t affect us as much because we’ve seen it and we know what’s coming. This is called habituation; a decrease in response to a stimulus after repeated presentations. In PE therapy, we’ll be watching our horror movie literally hundreds of times—in session with our therapist and in between sessions by listening to our recordings. 

The second part of PE therapy is called in vivo exposure, a fancy term for “in real life.” With our therapist, we make a list of stimuli and situations connected to our trauma, such as specific places or people, and create a plan to intentionally expose ourselves to these stimuli in a way that is gradual and safe. 

We realize that the thought of retelling our experience out loud can be anxiety-provoking. It’s tough, especially at the start, but PE therapy is undeniably effective. It also can be adapted into treatment for Moral Injury. PE therapy isn’t for everyone, and that’s okay because there are other treatments available, not just one. 

Have you tried PE therapy? What worked for you? We value your feedback and ideas! Reach out on our Community Facebook Page!

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Friday, July 15, 2022

Cognitive Processing Therapy (CPT) for PTSD

 

Cognitive Processing Therapy (CPT) is an evidence based treatment for PTSD. We can find a CPT provider through the Strong Star Provider Network at University of Texas Health Science Center or even through Psychology Today or Google.

CPT typically takes 12 sessions with a therapist; each session is about 60 minutes. CPT can be done individually or in group sessions, and it uses a workbook for written assignments (this is a picture of an "ABC Worksheet" used in CPT). "Cognitive" means that we pay attention to our thoughts and think about what we are thinking about. 

CPT recognizes that trauma warps our fundamental belief systems—beliefs about ourselves, others, and the world—and that those warped beliefs affect our walking, talking, everyday lives.

In CPT, we learn about the relationships between thoughts and emotions and then learn to identify the automatics thoughts that maintain our PTSD symptoms. 

We write an “impact statement” that details our understanding of why the traumatic event occurred and what impact it has had on our belief systems. Next, we’ll use workbook exercises to identify and address unhelpful thinking patterns related to safety, trust, power and control, esteem, and intimacy. Our therapist will ask questions and work with us to recognize unhelpful thinking patterns, reframe our thoughts, reduce our symptoms, and come to a better understanding about ourselves and our relationships.


CPT forces us to get out of "auto-pilot" and start challenging our thought patterns. Often these are thoughts we have held on to for a long time. 

Have you tried CPT? What worked for you? We value your feedback and ideas! Reach out on our Community Facebook Page!

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Monday, July 11, 2022

The 11th: Buddy Check Day

 

The 11th day of each month is Buddy Check Day reminding us to check in with other veterans. By getting in touch with others, we can enjoy camaraderie, check on each other’s well-being, and maybe even connect another veteran with a service they can use.

Buddy Check can be as simple as picking up the phone, talking, texting, or visiting.

Buddy Check Day is a great opportunity for veterans to connect with each other, and for other community members to reach out and connect with veterans.

It promotes camaraderie and connectedness. It also serves as an opportunity to educate folks on issues that are relevant to veterans across Texas and to educate folks on the services that are available to veterans.

We value your feedback and ideas! Reach out on our Community Facebook Page!

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Friday, July 8, 2022

PTSD Treatment Option: EMDR


Eye-Movement Desensitization and Reprocessing (EMDR) 

This amazing information is from the EMDR Institute, found online at www.emdr.com, and EMDR is an evidence-based treatment widely available to treat PTSD. It is an eight-phase treatment that focuses attention on three distinct time periods: the past, present, and future. Sessions often last between 60-90 minutes. 

The eight-phases include: 

History-taking: In this phase, the therapist obtains a detailed history of the client’s past memories and current struggles. During this phase, the therapist will try and identify targets for the EMDR processing (these can be distressing memories or incidents). 

Client preparation: This is where the client learns techniques for active healing trauma processing. The therapist will go over strategies, suggest relaxation techniques, and other coping strategies that can help their client deal with emotional distress and maintain improvements as the sessions progress. 

Assessment: In this phase, the client is asked to picture an image closely related to the target memory and to elicit the negative response and beliefs associated with the memory. The client is also asked to identify a positive belief that they would like to believe instead. 

Desensitization: The therapist ask their client to focus on a specific memory, belief, or emotional trigger while simultaneously engaging in bilateral stimulation (BLS). BLS consists of alternating right and left stimulation, whether it’s tapping of the toes or tapping on the shoulders. It can also include audio or visual stimulation with the use of light. This stimulation may include eye movements, taps, or tones. 

It is believed that BLS used in EMDR activates both hemispheres of the brain, which is believed to have a soothing effect, dim the intensity of the memory while allowing the client space to process it without an overwhelming psychological response. This continues until that memory is no longer triggering for the client. 

Installation: With the help of the therapist, this is where the client starts to replace negative thoughts with positive ones. Continuing to review the triggering memory with BLS, the client is asked to assess the emotional response and rate it against the positive belief (brought up during the assessment phase) they would prefer to associate it with.  

Body scan: Here, the client is assessed for changes in body sensations when thinking of the negative incident and positive thought. Any remaining tension in the body is targeted by the therapist for additional processing. 

Closure: Client’s will be asked to write down any thoughts or emotions that arise during the coming week, and will be reminded of the self-soothing techniques they learned during the session to process any negative thoughts that may surface. 

Reevaluation: This phase is to review and/or assess for other targets that cause distressing emotion within the chosen memory. 

EMDR is one of the treatments available for PTSD, and there are several great options. Don’t stress out about which treatment to choose. Most cognitive-behavior therapies for PTSD work by exposing clients repeatedly to anxiety-provoking stimuli, either in their imagination (imaginal exposure) or in real life (in vivo exposure). When exposure to either type is sufficiently prolonged, clients’ anxiety dissipates.

If we try one treatment for PTSD nd it doesn’t work, we have others more to fall back on. If we try others and they don’t work, we may be dealing with Complex PTSD, treatment-resistant PTSD, or have co-occurring disorders to work through. Do not lose hope, this simply means we have a little more work to do with our treatment professional to come up with a more targeted course of action.

We value your feedback and ideas! Reach out on our Community Facebook Page!

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Friday, July 1, 2022

Independence Day - Call Your Buddy


Team, this weekend is going to be hard. It's Independence Day weekend and our Facebook feeds will be full of pictures and tributes to those we've lost to combat and to suicide. And it is hard. I'm not here to force-feed you some rah-rah message about how life can change; I'm here to stand with you - because this weekend consistently sucks every single year and we need each other right now. 

A lot of us will seriously consider suicide this weekend. And I get it. I wish I didn't, but I think we all do - and it's fucking awful to feel this way. Please do your buddy checks this weekend, and nag the shit out of the people you love. Please ask: "are you thinking of suicide right now?" - this doesn't glorify suicide or give anyone ideas, but it does get straight to the point, and this weekend especially that candor is important. 

I've never met a combat Vet who lost more buddies to war than they did to suicide, and that's not okay. Rather than doing 22 push-ups, I encourage you to pick up the phone and call someone to check in. 

If you learn that your battle buddy is in trouble, here's how to get help: call the Veterans Crisis Line at 1-800-273-8255 and Press 1 or send a text to 838255. You can text the crisis line while you are on the phone. Ask you buddy where they are located, who is with them, and whether or not they have a weapon. Pass this info on to the crisis line; they will send emergency services. 

I know that no one wants to piss off their buddy, but no one wants another dead buddy either - so choose your battles. The single most loving thing anyone ever did for me personally was stage an all-out intervention; it saved my life. 

Please consider sharing this info. Thanks, Team - stay safe out there.

TL;DR: call your battle buddy, ask them directly if they want to kill themselves, get them help.

AND YOU - if you're in this head space, talk to someone now - like right now. Call your buddy, call the crisis line, do whatever it takes to hang on until this feeling passes because the world would not be better off without you.

*****

If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSDThe Soldier's Workbook

or Acknowledge & Heal, A Women's-Focused Guide to PTSD