Traumatic Events

•War

•Rape

•Physical/sexual abuse

•Natural disasters

•Car or plane crash

•Kidnapping

•Violent assaults

•Medical procedures (especially in children and especially from the Dr. on the right )

•Between 15-24% of people who experience trauma develop PTSD

•Most people experience some symptoms of PTSD after a traumatic event, but these symptoms usually decrease

•In people with PTSD the symptoms become worse and they become victimised by their own memories and not the actual event itself

Re-experiencing the event

•Intrusive and upsetting memories of the event

•Flashbacks

•Nightmares

•Distress

•Intense physical reactions, for e.g. increased heart rate

Avoidance and emotional numbing

•Avoiding activities and places

•Amnesia

•Loss of interest in activities

•Feeling detached

•Sense of limited future, hopelessness

Increased arousal

•Difficulty sleeping

•Angry outbursts

•Difficulty concentrating

•Hypervigilance

•Easily startled

Other symptoms

•Anger and irritability

•Guilt, shame , self blame

•Depression

•Suicidal thoughts and feelings

•Feeling alienated and alone

•Feelings of mistrust and betrayal

•Headaches, stomach and chest pains

The Acute Stage

•Victim experiences anxiety and fear

•Fear decreases and evolves into feelings of apprehensiveness

•Anger is usually present

•Victim’s find comfort in sharing experiences, this can provide new ways to respond to the current crises

•If the victim is not successfully treated within 6 months they can develop into the chronic stage

The Chronic Stage

•Moving on from the acute stage the person enters the numbing phase of this stage

•The person can feel isolated, numb and depressed

•This stage can last for several years

•The amygdala has a major role in motivation and emotional behaviour, especially fear and autonomic responses such as raised blood pressure

•A dysfunction in the amygdala could lead to symptoms

•The brain’s natural response to traumatic events is to release stress hormones such as epinephrine or norepinephrine

•Repeated or severe traumas can cause the body’s stress response mechanism to become hyperactive

•External stimuli that remind the person of the trauma can make them unresponsive

•They can exhibit dissociative symptoms such as numbing, emotional unresponsiveness and amnesia

•This is because the brain responds by releasing opiates

•A reduction in serotonin levels can lead to irritability and violent or angry outbursts

•Psychoanalysts would define trauma as an external event or series of events that specifically overwhelm the ego defence mechanisms

•This causes the person to regress to earlier modes of function

•For e.g. after a traumatic event a child who was fully toilet-trained would be unable to maintain bladder control or sleep without his/her mother

•This shows the child is regressing to an earlier state where he/she would have felt more comfortable, safe and protected

Cognitive-behavioural Theory

•Caused by the way the brain processes information about serious threats

•Trauma is insufficiently encoded and laid down as autobiographical memory

•This can lead to dysfunctional cognitive and behaviourist response

•These change reduce stress in the short term but can cause negative long term effects

•It is suggested that when the individual recalls the traumatic event he will remember it with bias.

•This can alter memories of the event and emphasize more negative aspects, making the trauma seem even worse

Social-cognitive Theory

Theory of Shattered Assumptions

•We all have assumptions about how the world should be

•Trauma does not fit into our assumptions

•The ‘shattering’ of our assumptions by the trauma can cause PTSD symptoms

•The consequent re-experiencing of the trauma is the brain attempting to re-examine the events to make new assumptions about the world

Cognitive-behavioural Therapy

•Slowly exposing the person to the trauma

•Attempts to identify the traumatic feelings and replace them with more balanced feelings

•‘Flooding’ is where all the memories are re-experienced at once

•‘Desensitising’ is where traumas have to be dealt with more slowly or one at a time

EMDR Eye Movement Desensitisation & Reprocessing

•Uses eye movements and other right/left stimulations such as hand taps

•‘Unfreezes’ the brains information processing system

•Information processing system can become frozen in times of extreme stress

•These frozen emotional fragments in the mind retain their original intensity

Family/Group Therapy

•Helps family understand what the individual is going through

•Talking to other trauma survivors help people deal with their trauma

•Builds confidence and trust again

Psychodynamic Psychotherapy

•Focuses on emotional conflict created by trauma, particularly when related to childhood experiences

•Individual talks through trauma with psychotherapist

•The therapist can also help with current life situations that worsen symptoms

Medication

•Can help with symptoms but cannot treat the causes PTSD