Monthly Archives: July 2015

Opposites That Can Both Be True

 

 

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Opposites That Are Both True

By: Angela Englander                   July 28, 2015

This exercise is designed to help people challenge unhealthy thinking patterns and reduce black and white thinking. By challenging your mind to believe two seemingly contradicting messages at the same time your brain is learning to see things through a healthier perspective. This exercise also helps people decrease anxiety, challenge obsessive thoughts, and reduce emotional suffering. For this activity you just read the sentences below and think about how they can both be true at the same time. After reading the list, try to think of some other things that can both be true at the same time. By training your brain out of black and white thinking you will experience your life in a happier and easier way.

  • The day can be sunny AND it can rain
  • You can disagree with the rules AND also follow the rules
  • You can enjoy going out AND enjoy spending time at home
  • You can work AND you can rest
  • You can disagree with someone AND also be friends
  • You can try to change AND accept yourself as you are
  • You can be tough AND be gentle
  • You can be independent AND also want help
  • You can be with others AND be lonely
  • Someone can have a valid reason for wanting something from you AND you can say no
  • You can be a misfit in one group AND fit well in another group
  • You can have a fight with someone AND still be friends
  • You can be mad at someone AND love and respect that person
  • You can be mad at yourself AND love and respect yourself
  • You can enjoy your life as it is AND you can work to change and achieve goals

 

Three Phase Treatment of Childhood Trauma

two people graphic

Three Phase Treatment of Childhood Trauma

By: Angela Englander                                       July 28, 2015

Stage 1: Establishing a sense of safety and emotional wellbeing

In order to heal from trauma a person must gain a sense of safety, without this feeling of safety a person may continue to be in the fight or flight response and their brain and body will continue to be focused on survival. When survival is the priority, gaining skills and feeling happy are not important to the brain, as long as the person survives the crisis. In traumatized people, the feeling of being in a crisis does not end.

There are a variety of ways to establish emotional wellbeing, often they involve gaining the skills and experiences that were missed in the individual’s childhood. Emotion regulation skills and emotion expression skills are commonly linked to childhood trauma, they are also linked to many mental illnesses.

Emotion regulation skills and emotion expression skills are naturally gained through a technique called mirroring. The child will model their emotions based off their primary caregiver and the way the caregiver expresses their own emotions. When these skills aren’t gained in childhood they can be learned through a number of therapeutic techniques including: dialectical behavioural therapy, cognitive behavioural therapy, and skills based trauma treatment techniques. If you go to http://waystowellbeing.ca/links-resources/ you will be able to view a chart that discusses emotions and ways that emotions occur naturally.

Stage 2: Working Through the Traumatic memories and body memories

            Often people who have experiences traumatic events continue to hold onto part of those events in their body, their emotions, their mind, or the patterns they live out. In order to let go of the trauma and put it in the past they must work through their memories of the trauma and challenge the physical sensations they may be feeling as well as the life patterns in which they may live out their trauma. By validating the traumatic experience and not avoiding the thoughts and feelings they associate with the trauma they can accept it and it won’t need to keep being a theme in their present life.

It is important to have completed the first phase of trauma treatment so that the traumatic memories, intense emotions, and physical experiences will not be as overwhelming for the patient. It is important for the individual working through their trauma to be safe and not at imminent risk because of the feelings that come from discussing their trauma.

A variety of exercises can be used to work through trauma, they include: discussing memories, role play, using toys or other objects, doing art, and creating a story to tell the trauma that has been experienced. Using many of these techniques a patient can rewrite their story allowing them to relieve themselves of guilt and understand their role in healing. They can also explore different perspectives about the trauma and move from being a victim to being a survivor. These exercises also allow the patient to explore their false beliefs about the trauma and about themselves and establish a healthier way of thinking. Having healthier beliefs will increase the patient’s self-esteem, sense of self, and feelings of safety.

Stage 3: Establishing connections in the community and a network of support

            Through making connections in the community the patient will be able to get more involved and start having positive relations and connections with other people. By having positive experiences with people a sense of connection and safety can begin to develop and trusting relationships can be formed. This also helps with the feelings of being separate and alone that have been associated with some traumatic experiences.

The other major benefit of having a support network in the patient’s community is that the patient will have a smooth transition once therapy ends. The patient will be able to connect with people and find support when they need it. Having friends and community connections may also help prevent future mental health challenges and trauma reactions because the patient will not feel like they are alone and having to take on their weight of their traumatic experiences on their own.

 

I hope you have enjoyed this article! As always feel free to e-mail me angela@waystowellbeing.ca and let me know what you think. Also feel free to share any comments you may have in the section below. I wish you well on your healing journey!

Reference: Herman, J. (1992). Complex PTSD: A Syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3) 377-391

Herman, J. (2009). Trauma and Recovery: The aftermath of violence- from domestic abuse to political terror.

Pros and Cons of living the life you want

Pros and Cons of Living the Life you want

 By: Angela Englander

This chart can be used to calculate the pros and cons of making a choice that contributes to you living the life you want to live.

 

                        Doing what you want                                   Not doing what you want

PROS  

 

 

 
CONS  

 

 

 

Here is an example of how to use this sheet. For this example the thing I want to do is joining a weekly dance class. I’ve decided this is something I could do that would make my life happier.

                        Doing what you want                Not doing what you want

PROS -I’d meet new people

-I’d get in shape

-It would be a fun Thursday night activity

-I would improve my coordination

-I would be more active

-I would get healthier in the long-term

-I’d be alone more often

-I’d be less social

-I’d be bored more often

CONS -I might miss a shift at work

-It costs $300 for 12 weeks

-I might get embarrassed

-The other students might not like me

-I would keep wanting to take a dance class

-I would be thinking about it

-I would feel like I’m missing out

-I would keep thinking about what it would be like to take a dance class

 

After reading my chart I would consider the points I’d written in the pros of doing what I want and the cons of not doing what I want sections and use these to decide how strongly I want to do the activity. Then I would look at the cons of doing what I want and the pros of not doing what I want and decide how resistant I am and how much doing what I want would negatively influence my life. Using the above example the main thing holding me back would be the cost of the dance class but I see more points in the categories of wanting to do the dance class so after thinking about the choice I would do it. After finishing up the dance class series I may sit down and make another pros and cons chart about the decision to check and see if it was worth the time and money you invested to attend the dance class and if it was a good decision looking back. This reflection process will train your brain to think critically about various decisions in your life and you will begin to make choices with confidence and start living a life you want to live.

What’s keeping you from living the life you deserve?

What’s keeping you from the life you deserve?

By: Angela Englander

Use this worksheet to figure out what false beliefs are keeping you from achieving the life you want. For each belief figure out if it’s something you feel about yourself, then use the space below to write a challenge to that false belief.

I don’t deserve to get what I want/need…

Challenge: ______________________________________

If I was qualified and skilled I would already have my dream job…

Challenge: ______________________________________

Making requests is a really pushy/bad/selfish thing to do…

Challenge: ______________________________________

I am inadequate if I can’t solve all my problems by myself…

Challenge: ______________________________________

Helping other people is a sign of weakness…

Challenge: ______________________________________

Admitting when I make a mistake will mean I’m a bad person…

Challenge: ______________________________________

If I show weakness people will take advantage of me…

Challenge: ______________________________________

 

Below you can write a list of your own false beliefs and challenge them. This will allow you to retrain your brain and increase your self-esteem. It will also help you remove barriers that are keeping you from reaching your full potential!

Criteria For Complex PTSD

Criteria For Complex Post-Traumatic Stress Disorder

From: Chapter 6: Diagnosing and Identifying the Need for Trauma Treatment, in First stage trauma treatment: A guide for mental health professionals working with women (© CAMH 2003)

The diagnostic construct of complex PTSD or DESNOS is not currently recognized in the DSM-IV as a freestanding diagnosis, but is instead presented as associated features of PTSD. Complex PTSD is expected to be included in the next edition of the diagnostic guidebook, the DSM-V. However, it is unclear if it will be given the name complex PTSD or DESNOS. Currently, both terms are referred to interchangeably in the clinical literature in this area.

Simple post-traumatic stress consists of changes to three areas of functioning, while complex post-traumatic stress consists of changes to six domains of functioning. The diagnostic criteria for determining the presence of complex post-traumatic stress entails that a number of specific changes (outlined below) are present in each of the six domains of functioning.

Diagnostic criteria for complex post-traumatic stress responses
(I) Alteration in Regulation of Affect and Impulses
(A and one of B to F required)

  • affect regulation
  • modulation of anger
  • self-destructive behaviour
  • suicidal preoccupation
  • difficulty modulating sexual involvement
  • excessive risk-taking

(II) Alterations in Attention or Consciousness
(A or B required)

  • amnesia
  • transient dissociative episodes and depersonalization

(III) Alterations in Self-Perception
(Two of A to F required)

  • ineffectiveness
  • permanent damage
  • guilt and responsibility
  • shame
  • nobody can understand
  • minimizing

(IV) Alterations in Relations with Others
(One of A to C required)

  • inability to trust
  • revictimization
  • victimizing others

(V) Somatization
(Two of A to E required)

  • problems with the digestive system
  • chronic pain
  • cardiopulmonary symptoms
  • conversion symptoms
  • sexual symptoms

(VI) Alterations in Systems of Meaning
(A or B required)

  • despair and hopelessness
  • loss of previously sustaining beliefs

Luxenberg, Spinazzola, van der Kolk. Reprinted with permission from The Hatherleigh Company, Ltd., New York.www.hatherleigh.com, 1-800-367-2550. © 2001

This article has been copied from http://knowledgex.camh.net/amhspecialists/specialized_treatment/trauma_treatment/first_stage_trauma/FirstStageTT_ch6/Pages/criteria_complex_ptsd.aspx to provide people with information on complex PTSD diagnostic criteria. For more information please check out the link above and read their article on how that diagnosis is made.