PTSD
Exploring the Functional Nature of Symptoms
Instructor: Dr. Dawn-Elise Snipes LPC-MHSP, LMHC, CCDRC
Executive Director: AllCEUs
Host: Counselor Toolbox and Happiness Isn’t Brain Surgery Podcasts
Objectives
~ Review PTSD Symptoms and explore their functional nature
Purpose
~ By understanding the function of symptoms we can
~ Normalize the behavior
~ Identify alternate ways to meet that same need or address the issue
~ Re-Experiencing
~ Trying to replay it to figure out how to integrate into your schema (like fitting a puzzle piece)
~ Reminding the person of similar situations to “protect” them
Purpose
~ Avoidance
~ The system is already over taxed. Avoiding upsetting stimuli by blocking out most stimuli, memories of the event.
~ Avoiding unnecessary use of energy by not getting “excited.”
~ Changes in Beliefs
~ Protects against future “surprises”
~ Tries to assimilate the experience into schema
~ Increased Arousal
~ Protects the individual
Re-Experiencing
~ You re-experience things every day
~ Access schema that guide your actions
~ When you go to work
~ When you encounter a particularly volatile client
~ When you approach a stop light
~ Re-Experiencing in PTSD
~ The context is often overgeneralized
~ The precipitating factors are often unknown
~ In many cases the resolution was not one of empowerment, resulting in trying to continually figure out how to not be disempowered
Re-Experiencing: Assimilation or Accommodation
~ Intrusive distressing memories of the traumatic events
~ In children repetitive play may occur in which themes or aspects of the traumatic events are expressed.
~ Recurrent distressing dreams in which the content or feeling of the dream is related to the events
~ In children there may be frightening dreams without recognizable content.
~ Flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring
~ In children trauma-specific reenactment may occur in play.
Re-Experiencing
~ Intense or prolonged psychological or physiological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
~ The event represents a time in which the person experienced or witnessed something horrifying
~ The brain is trying to help the client
~ Avoid future similar situations
~ Learn how to protect during future similar situations
Avoidance
~ Purpose: Avoidance of Recurrence of Pain or Arousal of Stress Response System
~ Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
~ Inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
~ Purpose: An exhausted system conserves energy in case there is another threat
~ Markedly diminished interest or participation in significant activities
~ Feelings of detachment or estrangement from others
~ Persistent inability to experience positive emotions
Hypocortisolism
~ Cortisol is the stress chemical
~ After extreme stress and/or under chronic stress the brain may reduce the responsiveness of the stress response system by reducing the cortisol
~ This is protective, it keeps the organism from using precious resources by getting “excited” about anything (including pleasure)
~ Due to fear conditioning, when a stressor is detected, the stress response is exaggerated.
Changes in Beliefs
~ Purpose: The need for order and meaning (Regaining control, Ability to predict)
~ Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
~ “I am bad”
~ “No one can be trusted”
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