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Julian D. Ford, Ph.D.Judith Ford, M.A.
Copyright © 2001 by the University of ConnecticutAll rights reserved.
No part of this work may be copied or distributedwithout prior written permission.
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What is PTSD?• POST: After
• TRAUMATIC: A Threat to Your Survival
• STRESS: Brain’s Alarm System
• DISORDER: Unable to meet your goals
• PTSD: Survival Skills Keep the Brain’s Stress Alarm Constantly Turned On
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TraumaDepression
Irritability
Decreased interest
Numbing
Decreased concentration Insomnia
Physiological hyperarousal Psychomotor
agitation
Foreshortened future
Hopelessness
Depersonalization Derealization
Identity disturbance
Substance abuse Eating disorders
Somatization
Generalized anxiety Panic
attacksFlashbacks
Nightmares
Startle Hypervigilence
Intrusive memorie
s
Amnesia
PTSD
Major Depression Anxiety Disorder
Self-destructive behavior
Borderline Personality
Bremner & Marmer, 1998
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Trauma Affect Regulation: Guide for Education & Therapy
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FREEDOM STEPS
Seven skills ~
Designed to engage theFiling & Thinking Centers to:
Counteract the bodily reactivity, mental confusion, emotional distress, and social isolation caused by PTSD.
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Anterior MEDIAL Posterior Front Middle Rear
Top(Dorsal)
Bottom(Ventral)
Pre-Frontal Cortex Amygdala Hippocampus
Anterior Cingulate
Alarm
Filing Center
Orient- ing Center
Thinking Center
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SOS: Three Steps to Focusing
• Step I: Slow Down – Take a Time Out; Calm Your Body;
One Thought at a Time
• Step II: Orient Yourself – Notice your surroundings – where you
are and who is with you; – Focus on something of interest that you
can see or hear
• Step III: Self Check – How Much Stress? How Much Control?
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What Is an Alarm Trigger?
• Reminder of a past traumatic memory
• Based on specific aspects of trauma
• Turns on the alarm & sends a signal that something terrible is happening now
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Peanuts Classics ®
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Peanuts Classics ®
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Peanuts Classics ®
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Peanuts Classics ®
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recognizing triggers
• We respond to triggers/cues regularly; however, triggers that cause alarm reactions send a message to the brain that the threat is immediate and real.
• Recognizing triggers in advance makes it possible to use Filing and Thinking Centers and prevent or manage alarm reactions.
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• Helping clients to recognize personal triggers increases the likelihood of allowing for a response rather than a reaction.
• Recognizing triggers increases sense of personal control.
recognizing triggers
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REACTIVE Emotions
“Charged” Emotions– Flash of anger– Wave of grief– Paralyzed with
guilt– Frozen with fear
Shutdown Emotions– Shock– Numb– Withdrawn– Discouraged
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MAIN Emotions, Thoughts, Goals• Allows evaluation and choice
• Measured
• Flexible
• Manageable
• Hopeful
• Confident
• Empathic
• Cooperative
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Reactive/Main Thoughts
REACTIVE
• Loud
• In your face
• Demand action
• Promise instant gratification
MAIN
• Quiet
• In the background
• Require stepping back
• Hold out genuine gratification
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REACTIVE/MAIN goalsREACTIVE
• Getting away from danger
• Making it through the immediate situation
• Evening the score
MAIN
• Doing worthwhile things right now
• Achieving a good and meaningful life
• Building relationships
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ExampleStressor: I was betrayed • Alarm Reaction
– Emotion: Rage– Thought: I can’t trust anyone– Goal: I’m going to keep my distance from
everyone so I don’t get betrayed again.
• Self Regulation – Emotion: Confidence – Thought: I need to find someone trustworthy &
trust myself– Goal: I’m going to build relationships in which
I’m respected and loved
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Example
• Stressor: I said hurtful things to a friend
• Alarm Reaction– Emotion: Ashamed– Thought: I’m a bad person– Goal: I’m going to give up this friendship
• Self Regulation– Emotion: Determined– Thought: I need to learn from my mistakes and
make good choices– Goal: I’m going to ask for help and keep trying
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MAIN Emotions, Thoughts, Goals
Can you…
Evaluate the situation,
and
Choose what is really important to you?
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Identifying your good intentions activates your
Thinking Center and turns down the Alarm.
As the Alarm is turned down, you are able to
recognize a wider range
of Options.
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Example
• Alarm reactions/options:• Yelling at someone• Giving up • Trying to make it all work out instantly
• Positive options:• Listening and working out a solution• Finding a new way to try again• Taking one step at a time
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Making a contribution is turning down the alarm to recognize the true ways the client is making a difference in her/his life and the life of others at the present moment.
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“You cannot teach a man anything; you can only help him find it within himself.”
- Galileo (1564 –1642, Italian astronomer and mathematician)