Episode #61 

Help For PTSD Sufferers

Do you or someone you care about suffer from PTSD?

How can you know for sure if you have PTSD?

And how can you cope?

In this episode, Dr Julie sensitively examines PTSD - the possible causes, the symptoms and the statistics, as well as giving you some solid CBT tools to be able to get the help you need.

Click to listen now!

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Full Episode Transcript

Hi, and welcome to My CBT Podcast!

My name is Dr. Julie Osborn, I'm a Doctor of Psychology and a licensed clinical social worker specializing in Cognitive Behavioral Therapy.

I'm here to help you bring the power of CBT into your own life. In this podcast, I’ll answer some questions and share with you some practical ways to apply CBT principles and tools so you can achieve a greater level of happiness and satisfaction in your life in relationships.

So in this episode, I'm going to talk about post-traumatic stress disorder.

It's much more common, sadly enough, than we like to think, and it affects people on all different levels, in all different situations. So I thought it'd be really helpful topic to talk about. You know, most of us build our lives around the belief there will be relatively safe and granted normal daily life involves, you know, many stressors, especially in these hectic times. But we expect these pressures to happen and we become accustomed to handling them.

The more flexible we are and the more we know ourselves and are in touch with our abilities, the easier it is to deal with normal, everyday stress. Sometimes, however, any of us can be subjected to catastrophic stress. Our feeling of safety in these circumstances can vanish. We could experience terror and a complete inability to know how to handle these situations that are outside of the ordinary realm of experience. These catastrophic events can include rape, physical or sexual abuse, physical attacks, mugging, carjacking, natural disasters, you know, like earthquakes, hurricanes, tornadoes, floods, fires, car accidents, plane crashes, hostage situations, school shootings, military combat or even the sudden death of a loved one.

So there's lots of different situations. And it is not only the victims of these events, but also witnesses, families of victims and helping professionals who could develop severe stress symptoms that can last for months or even years after the event. PTSD is a term used to characterize people who have endured highly stressful and frightening experiences and who are undergoing the stress caused by memories of the event. It is if the person just cannot let go of the experience, the event comes back to haunt them.

The anxiety experienced during or immediately after a catastrophic event is called traumatic stress. When the symptoms last several months after the event is called post-traumatic stress, PTSD can last for years after the original trauma. It may not become evident initially. For example, an individual may witness a murder as a child, but not experienced the associated stress until midlife life. Some people are more likely to develop PTSD than others. Experts are not sure why some people develop PTSD after relatively minor trauma, when others exposed to great trauma denies those who are very young or very old are more vulnerable.

And PTSD is also associated with intelligence. Those with a higher level of intelligence are less likely to suffer from PTSD. That's just what the research says. I don't have all the answers, but through my research, that's what I was able to find out. And individuals who already suffer from anxiety disorders, some personality disorders or depression seem more likely to get PTSD after extreme trauma as well. It seems that the more vulnerable one feels in dealing with the world, the more likely one is to develop PTSD.

Trauma of great severity is more likely to produce PTSD than lesser trauma. So, for example, it was found with Vietnam War veterans that prolonged combat with sniping and air bombardment produced PTSD more often than brief exposure to combat with few weapons. It's also been found that traumas between people such as sexual assault and muggings are more likely to produce PTSD, the natural disasters like earthquakes or floods. So there's just a little bit of background. You know, nothing's in stone.

Just some research I wanted to share with you just to understand. So let me talk to you about what the symptoms are of PTSD, just kind of understanding. You know, some people have PTSD and they don't even know it. So you might relate to some of this as well.

So people can be considered to have PTSD when they've been exposed to an extreme trauma. The symptoms lasts at least a month in duration and the symptoms cause excessive distress. So that's social functioning in job performance are impaired. One sign of PTSD is that the traumatic event is relived repeatedly in the person's mind, and this appears in the form of what we call flashbacks, which are recurrent images, thoughts or dreams about the event and even nightmares, reminders of the event can cause distress.

So many people go out of their way to avoid places and events that remind them of the catastrophic occurrence. And many people experience anxiety, restlessness, concentration, difficulties, decreased memory. Your. Ability, sleeplessness, hyper vigilance or an exaggerated startle response? Some people even experience what is called survivor's guilt because they survived and others did not or because of the certain things they may have had to do in order to survive. So there's three main clusters of PTSD symptoms in all three of these groupings must be present to be diagnosed with PTSD.

So one is intrusive symptoms, so intrusive and repetitive memories which stir up negative feelings. Experience during the trauma can overwhelm a person. And these memories can appear in the form of, as I mentioned earlier, flashbacks, a feeling of reliving the trauma, frequent distressing, the memories of the trauma, nightmares, emotional, physical distress and traumatic memories are triggered. Another symptom is what they call arousal symptoms. So this is when PTSD sufferers experience physiological reactions, which indicate that they don't feel safe and they're physically on the alert to deal with danger.

So examples could be been easily startled or feeling jumpy.

The hyper vigilance, which is like feeling like you're on guard even when the situation safe concentration, difficulties, outbursts of anger and irritability problems and falling asleep or staying asleep. One thing I want to mention about the hyper vigilance against PTSD can come in many different forms, many different situations. And I know recently I did a podcast and adult children of alcoholics and a lot of people that I meet that are ACOR have the hyper vigilance and a lot of them.

It's interesting, the same kind of coping mechanism they've shared with me is, you know, they say that when they go into a room, you know, like a group, they sit with their backs to the wall so they can see everything that's going on in the room.

And they know where the exit is because they might have had a lot of violence in their home with the alcoholic or addict. So I just wanted to share that, that, you know, that's trauma growing up in a home like that and that those are coping mechanisms that people use for the rest of your lives. And they might not even think much about it. But when you start talking about different things you do, that's something that's come up a lot.

So I wanted to share that. And another symptom is avoidance. So people suffering from PTSD go out of their way to escape the overpowering memories and arousal symptoms. And this pattern of behavior can include, you know, avoiding places, people or situations that serve as a reminder of the trauma, avoiding thoughts or feelings associated with the trauma, memory loss about some aspects of the traumatic events, feeling emotionally numb, feeling a strange, detached from other people, feelings of hopelessness and helplessness about the future and a decreased interest in pleasurable activities.

So those are some of the symptoms of PTSD and there's other emotional physical problems that may accompany PTSD. Unfortunately, some people seek relief from these symptoms without dealing with the root cause so that the symptoms persist. These problems might precede PTSD, in which case they become exacerbated or they might develop after the onset of the PTSD. So the emotional problems I'm talking about could include panic disorder, agoraphobia, where you have a fear being out in public, social anxiety, for example, speaking in public depression, OCD, sleep disorders, suicidal thoughts and substance abuse.

The physical problems can include skin problems, pain, GI disorders, fatigue, respiratory problems, low back pain, muscle cramps, headaches and cardiovascular problems.

So it's important to remember that PTSD is a normal reaction to a very abnormal situation and there's no shame in experiencing these symptoms. Nor is having these symptoms a sign of weakness by any means. Help is available, obviously, from trained professionals so that in most cases, with the appropriate effort and courage, the symptoms can disappear completely or at least substantially decrease and become more manageable. So if you feel like you are suffering from PTSD or you know someone you know really for yourself, get help or encourage that person.

Because as I've shared with you and I know we have practices have been too long, yet I've given you a lot of information, but there's so many different symptoms that you just might not connect and realize that there's trauma that you're struggling with. So about getting help for the PTSD. I want to talk about that. You know, we live in a world of relative safety most of the time, but it is a world in which people often lack support for dealing with calamities.

And in these times, we may not have the extended family, long term friendships, a sense of neighborhood feeling of community. There's support from religion that's historically helped people in times of crisis. We usually go on without difficulty as long as things go smoothly. Right. But when a crisis occurs, we sometimes simply do not know what to do or where to turn. And that's true for a lot of people. Traumatic events can leave us stranded. We may lack.

Not only social support when a crisis occurs, but also the language for understanding the place of tragedy in our own lives, and we may not know how to conceptualize it, how to use the words that can describe a disaster and make it real, we may not know how to react emotionally when crisis comes into our lives. These are feelings that we have never experienced before, and they may frighten us. So we may refuse to accept the crisis or to deal with it.

We think we are strong and able to endure anything. So it's really easy to be in denial and refusing or not knowing how to deal with the thoughts and feelings that accompany a major catastrophe, unfortunately sets you up for PTSD and it is not your fault. Good news is that PTSD is highly treatable, especially again if it's caught early. The idea behind the treatment is to process or work through the traumatic event, as well as to manage the immediate troublesome symptoms the person is experiencing.

And again, a trained therapist can help the PTSD symptoms and the sufferer to find the words in a safe and gentle way to talk about the event and to confront the feelings that accompany the experience. This is not an easy step, but it's definitely necessary one to be able to just start talking. While it might seem natural to avoid reliving a painful memory. Right. Who wants to go through that? It's actually important to face the memories, feel the emotions and try to work through them.

When this happens, the trauma no longer controls the person and the person is now in control of the memory of the trauma so that he or she can approach it objectively and flexibly. There are other highly effective techniques for dealing with PTSD also so cognitive behavioral therapy can help. But the one that I refer to a lot as well, when I have a client who's dealing with trauma and I've have colleagues I work with. So we're doing the CBT as well as this other therapy that's called MDR, which stands for Eye Movement Desensitization and Reprocessing, which the trauma is intensely processed under the guidance of a trained therapist.

And they focus on our thoughts and work on issues where we feel stuck and trying to get beyond the trauma. So that's where the cognitive therapy can really help. Sometimes people call it cognitive processing therapy, so they all kind of overlap each other in different terms you might use for cognitive therapy. That's OK. And the MDR is really, really beneficial and is very successful for a lot of people. And I know that it's a shorter term therapy for most.

So I know I'm here to talk about CBT, but my goal is to educate you guys and get you going in the right direction. And whatever therapy that's going to be, I want to talk about it. And for PTSD, that is the one diagnosis that I always try to include my clients seeing someone who is also trained and armed, if I think that'll be helpful.

So I want to say that a person who has survived a traumatic event will probably never feel as if the event never happened. But the distressing and disruptive effects of PTSD can be alleviated in therapy. A person can to describe a coherent account of his or her life. And people are able to do this are much less susceptible to the effects of trauma. So therapists can use a number of techniques to help someone work through their traumatic events, some involving talking, some involving more physical interventions.

Sometimes medicine can help to lessen the anxiety, depression and sleep difficulties, as well as the physical symptoms which go along with PTSD and their social agencies. Now they use highly effective techniques such as what they call critical incident debriefing to help people process their way through a trauma immediately after a disaster occurs in a community. So sometimes when you see things on TV, you know, we're whole communities affected. You hear that? You know, there's people being sent out to help people process what's going on and have counselors on site, especially.

I know, like with school shootings, there's always counselors on site. So the kids that want to talk, there's somebody available right then. And they're also victims of violence are often now given support to talk about the event soon after it's occurred. So the old way of thinking was that the strongest people were those who could hold in their emotions and face tragedy stoically. Unfortunately, this is precisely the pattern which leads to PTSD. And now we know that real strength comes from knowing oneself and expressing that sense of self in the world with openness, honesty, integrity and courage.

I always share with my clients that feel weak because they've shown up to therapy and they think they should have been able to handle things themselves or fix things. And I say it's the people that show up are the ones that are strong because they're willing to be uncomfortable and they're willing to really look at themselves and have the courage to make those changes. So if you're feeling like you know or not feeling I'm sorry, guilty as saying that, I'm thinking I.

They should be able to handle this. It happened so long ago, it shouldn't be an issue anymore. You know, other people go through things worse than me. I thought I thought I thought, right, that's going to keep you from getting the help you need. So let me also just give you some statistics just to give you a feel for how common PTSD can be as well, because most people are exposed to extreme stress, although they're able to process their way through the reactions and never develop PTSD.

It also has been estimated that 70 percent of people will be exposed to a traumatic event in their lifetime. Of those people, 20 percent will go on to develop PTSD. Also, at any given time, an estimated five percent of people have PTSD and approximately eight percent of the population will develop PTSD during their lifetime. Also, women are about twice as likely to develop PTSD as men, mostly because women are more susceptible to experience interpersonal violence, including rape and physical beatings and victims of domestic violence and childhood abuse at a tremendous risk for PTSD.

And the leading cause of PTSD is rape. So whatever your circumstance, and especially if it was in your childhood and you think that you're past that in your OK, just kind of taking inventory, I'm going to ask you some questions if you can think about to see if you even have PTSD and if you do, to be able to seek some help. So I'm going to ask you 13 different questions. And if you have at least seven of the following and several months after you've experienced a catastrophic event, it's advisable to have a professional counsel to determine a therapy for PTSD even indicated.

Right. Just to get just going. I tell people all the time, just go get educated, go talk to somebody, see if that's a fit for you, see if there's something you need. So here we go again. It's 13 different questions. So take note and see if you relate to at least seven or more. It be worthwhile to go talk to somebody so no one is over. Strong physical sensations, sweating, rapid heartbeat when I think about the event.

Number two is I try to avoid having upsetting thoughts or having contact with things or places associated with the event. Number three, my feelings are numb and I have difficulty experiencing normal pleasure and happiness. Number four, I'm always watchful to make sure I don't experience the same event again. Number five, I have feelings of guilt associated with the traumatic event. Number six, I have the feeling of being unreal and the world is unreal. Number seven, I feel alienated or isolated from others.

Number eight, I get irritated or angry a lot. Number nine, I have flashbacks of the event, like feeling like the past events happening all over again in the present. Number 10, I have trouble find asleep or staying asleep because memories of the event come into my mind. Number 11, I have memory difficulties and trouble concentrating these days. Number 12, I'm easily startled when I hear a loud noise and when danger seems imminent. And number 13, I have been relying increasingly on alcohol or drugs to get through the day.

So again, if you marked yes to seven or more, you know what? It might be helpful to go talk to a professional and see if that could be some help. And if it is PTSD that you're going through, it's not so much, you know, about getting connected to like, oh, that's my diagnosis. It's just understanding like, oh, that's what's going on. You know, I didn't have a name. I didn't know what the heck was going on.

I don't know why I felt so bad. I didn't realize maybe the event even affected me as strongly as it did. But you know what the good news is? There's help. And I can go get some help and I can get past this and not let it control my life for the rest of my life. Because you deserve better. You deserve to be happy and you can get through it. Lots of success with people with PTSD. They go get the help that they need and again, have the courage and the strength to say, yeah, you know what, I'm not handling this really well, even though I was hoping I was telling myself that.

But I'm going to use my strengths to go create the life that I want and to be able to do that, I need to have some help to get through this and having that self compassion for yourself to make that decision. So even getting to the place of deciding I want help or I need help. Right. Either or is, you know, use your CBT tools you got now, you know, what are my thoughts that are keeping me from maybe being honest with myself?

What are my thoughts that are holding me back from getting professional help? Right. Am I worried about how it's going to look? It makes me feel weak. What are other people going to think? I'm the strong person everyone looks up to. What are they going to think if I need to go get help? These are all there's just so many thoughts. Remember, we got 80 to 90000, there's a lot of stuff going on in our head that gets in the way of getting the help we need and doing what's best for us.

And if you're using the alcohol or drugs, it's just a Band-Aid, because when you're not drinking or using those memories, the nightmare is whatever maybe your physical symptoms are going to be, you know, coming back. So I really encourage you to be honest with yourself and to make decisions based what's best for you, not how you feel.

So that's it for today. I hope this was helpful for you or maybe a loved one that is struggling.

If you have any therapy questions you would love answered, please email me at MyCBTPodcast@gmail.com. Again, you can always rest easily knowing I'll always keep your name confidential if I share it. Or I will check in with you beforehand to see if I can share your name.

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Thanks for joining me. Stay safe. I'll see you next week.

And again, make decisions based on what's best for you, not how you feel.

And my other mantra I love, especially in this situation with PTSD, is instead of saying, Why Me? you want to ask yourself, What Now? instead of saying Why Me? And not to be stuck in that victim mode, because maybe you really were a victim and that's why you even have PTSD, but to say to yourself, what now? Which gives you the freedom to live the life that you deserve and to get the help that you need.

So that's my other mantra that can be very helpful, especially when you have been victimized.

Have a good week.