PTSD

As defined by the American Psychiatric Association:

An experience beyond “the range of usual human experience,” that “would be markedly distressing to almost anyone, and is usually experienced with intense fear, terror and helplessness” (DSM-IIIR, p. 247).

Examples: serious threat to one’s life (or that of one’s children, spouse, etc.), loss of a child, rape, military combat, natural or accidental disasters, and torture.

The Effect Trauma has on the Memory:

A person may use their natural ability to dissociate to avoid conscious awareness of a traumatic experience while the trauma is occurring. One could remember an overwhelming traumatic event with conscious thoughts, feelings, or “memories,” at a later date. For the past 100 years their have been clinical works on veterans who have survived combat.

In Post Traumatic Stress Disorder (PTSD), a psychiatric diagnosis common among people who have survived horrific events, the defining diagnostic features are memory distortions. People with PTSD inevitably experience extremes of recall regarding traumatic circumstances: intrusive memories of the event (hypernesia) or avoidance of thoughts and feelings about the event (amnesia).

Many people say they are “haunted” by the memories of traumatic experiences which disrupt their daily lives. One may re-live the trauma over and over in their heads as if the trauma is happening in the present time or have reoccurring “pictures”. A person with PTSD may also have nightmares, or “flashbacks.”

A traumatized person may make deliberate efforts to avoid thoughts, feelings or activities and which may remind them of the event. In severe cases, avoidance of these reminders may cause a person to have “dissociative amnesia,” or memory blanks of important aspects of the trauma.

Source from which the previous information was attained:
Rachel Downing, M.S.W., L.C.S.W.
The Sidran Foundation in conjunction with The Sheppard and Enoch Pratt Health System.

Stress Related Reactions to a Traumatic Event

Below is a list of symptoms which may occur in a person who has suffered a traumatic event.  These reactions are normal in abnormal situations, however, if you experience these symptoms for more than a month, and/or feel you are unable to regain control of your life, please consider seeking professional mental health assistance.

  • Recurring thoughts or nightmares about the event.
  • Having trouble sleeping or changes in appetite.
  • Experiencing anxiety and fear, especially when exposed to events or situations reminiscent of the trauma.
  • Being on edge, being easily startled or becoming overly alert.
  • Feeling depressed, sad and having  low energy.
  • Experiencing memory problems including difficulty in remembering aspects of the trauma.
  • Feeling “scattered” and unable to focus on work or daily activities.  Having difficulty making decisions.
  • Feeling irritable, easily agitate, or angry and resentful.
  • Feeling emotionally “numb,” withdrawn, disconnected or different from others.
  • Spontaneously crying, feeling a sense of despair and hopelessness.
  • Feeling extremely protective of, or fearful for, the safety of loved ones.
  • Not being able to face certain aspects of the trauma, and avoiding activities, places, or even people that remind you of the event.

The above list is thanks to The American Psychological Association

Help for Post Traumatic Stress Disorder

You should feel comfortable with the relationship with a therapist.  Feel free to make decisions about the direction of the treatment.  A good therapist is willing to listen to and work with you and will be flexible in your treatment to better suit your needs.  As I stress in my web site, “If you don’t feel comfortable with the doctor, then find someone else!”   The following are topics for you to discuss with your therapist before extensive uncovering of traumatic memories.

  1. Discuss with your therapist his/her orientation towards memory and memory retrieval.  Memory is not a video tape.  Memory is very complex and many natural distortions may occur.  The dichotomy that it is all true or all make up is too simple an explanation for such a complex issue.
  2. Develop a trusting relationship with your therapist.
  3. Know and understand your diagnosis.
  4. Discuss the goals and purpose for the retrieval of memories.
  5. If diagnosis is to be used, discuss the pros and cons.  Ask about your therapist’s training in hypnosis.  Obtain informed consent.  Be aware that in many states memories recovered under hypnosis my not be used in court.
  6. As much as possible stabilize your everyday life before uncovering memories.
  7. Develop skills to handle strong feelings that often accompany the retrieval of trauma memories.
  8. Develop a plan with your therapist to control basic safety towards self and others.
  9. Talk with key social supports about your therapy and the memory work you plan to do .  Let them know ways to be supportive.
  10. Discuss the pros and cons of doing outside reading and involvement in self-help groups.
  11. Discuss the long term effects of trauma.  If you continue to play a victim role in your life, work to get out of these roles and relationships.  Do not uncover memories if you are currently being abused.
  12. Plan together for specific sessions to do the memory work.

Items 1-12 written by Rachel Downing, M.S.W., L.C.S.W.
The Sidran Foundation in conjunction with The Sheppard and Enoch Pratt Health System 

Hypnosis 

Hypnosis is quite common in trauma therapy. Careful use of hypnotherapy can be helpful but it also can be problematic if used imprudently. Hypnosis is not to be used to “dig for” forgotten traumatic memories. The uncovering of forgotten memories needs to occur in the larger context of treatment for psychiatric distress or disability.

If your therapist suggests the use of hypnosis should be an informed consumer and ask about the purposes of this type of therapy. Before beginning this type of treatment, a responsible therapist will get informed consent (better if in writing) from you. This way you will be better informed of the purposes, benefits and risks of, and alternatives to this treatment. You will have agreed, without coercion, to its use.

Please seek a therapist who specializes in treating dissociative disorder or PTSD.