In 1986, an experiment was conducted at the University of Texas. Professor and Department Chair of the Psychology Department James Pennebaker asked students to recall personal experiences that involved stress or psychological trauma. He then divided the course into 3 groups and gave each a task:
- the first group had to write about what is happening in life now;
- the second is to describe the details of the traumatic event;
- the third is to write about your feelings and emotions and how this event affected your current life.
Over the course of four days, each student set aside 15 minutes to write. During the experiment, many shared their secrets that they had never told anyone before.
It turned out that the free writing method has a beneficial effect on the immune system by reducing the level of chronic stress.
Carnegie Mellon University of Pennsylvania also conducted a similar experiment. This time, the students were divided into 2 groups and asked to complete a difficult task, which the majority failed to complete. Those who failed were harshly criticized. After this, the first group was asked to write about how they felt, but the second group was not given such an opportunity. For the first, within a few minutes the pulse stabilized, they let go of the situation, and for the second, it took a long time to come to their senses.
These experiments clearly show how useful it can be to write about what concerns us. In this article we will talk about how to make writing as effective as possible for healing from psychological trauma.
Safety precautions
The writing method isn't for everyone, and that's okay. But if you enjoy writing and find that you feel better after putting your thoughts into words, this is likely the tool for you.
You may love to write, but not be ready for independent work. This happens when the experiences are too painful or the protective mechanisms of the psyche do not allow us to touch the most important things.
Then you need to experience the healing process next to someone else. It is best if it is a psychotherapist who will help you process your strong emotions. It is very important not to take on too painful situations to work through on your own. Start small - that is, with what is relevant to you now and causes unpleasant (but tolerable) feelings.
PSYCHOLOGICAL REHABILITATION OF PERSONS WITH POST-TRAUMATIC STRESS DISORDERS
Vokhmyanina
M.M.
BUZ of the Voronezh region "Voronezh Regional Clinical Narcological Dispensary"
Russia, Voronezh
Khabarova T.Yu.
Candidate of Psychology, Associate Professor, Department of Psychiatry and Neurology, Institute of Postgraduate Education
FSBEI HE VSMU named after. NN. Burdenko Ministry of Health R.F.
Annotation.
The article is devoted to the concept of post-traumatic disorder (PTSD), the characteristics of the course of PTSD in adults and children, and the main directions of psychotherapy.
Keywords:
Post-traumatic stress disorder, trigger, psychological rehabilitation.
Relevance of the problem.
A person, as an object of the life process, is exposed to various life events, both positive and negative. Such as traumatic events or situations, after which psychological resources are exhausted and he needs help, are also not excluded.
Post-traumatic stress disorder
(PTSD) is a disruption of the normal functioning of the psyche as a result of a single or repeated traumatic situation. Among the circumstances that provoke the development of PTSD are participation in hostilities, sexual violence, severe physical injuries, exposure to life-threatening situations caused by natural or man-made disasters, etc. PTSD is characterized by increased anxiety and intrusive memories of a traumatic event with persistent avoidance thoughts, feelings, conversations and situations that are somehow related to trauma [1].
Post-traumatic stress disorder in children
As already mentioned, the risk of developing PTSD in children is much higher than in adults - the child’s psyche is much more receptive and sensitive to traumatic situations that leave their mark for the rest of their lives.
Similar to adults, children try to avoid triggers, when they encounter them they experience emotional experiences, manifested by screaming, crying, and inappropriate behavior, especially at night. A characteristic feature of childhood PTSD is the desire to re-experience a traumatic situation, which is reflected in games, drawings and behavior. Such children often take an aggressive leadership position with their peers.
The child becomes withdrawn, irritable, and develops a serious attachment to “mother’s skirt.” It is possible that regression may develop in the mental development of a small patient - the child seems to be refusing to go back: self-care skills disappear, the vocabulary is impoverished.
In the case of chronic PTSD, over the years children develop a lag in mental and physical development, irreparable formation of character traits that determine antisocial behavior, and the development of various addictions.
If the following symptoms of post-traumatic stress disorder occur in children, urgent help from a specialist is needed - parents may not always be aware that their child is being exposed to a traumatic event:
Frequent nightmares, enuresis,
appetite disturbances,
· similar games or drawings with strange, constantly repeating content,
· too strong and long-term reaction to everyday stimuli,
· disappearance of previously acquired life skills, return to behavior characteristic of a younger age,
sudden appearance of fear of separation from mother,
· categorical refusal from kindergarten, school,
· sharp decline in academic performance, teachers’ complaints about the child’s aggressive behavior,
loss of interest in activities that previously brought satisfaction,
lethargy, drowsiness during the day, trying to avoid contact with peers and strangers,
· more frequent domestic accidents involving children.
Psychotherapeutic work with patients with PTSD, according to modern ideas, should be aimed at:
· creation of a new cognitive model of life activity;
· affective processing and revaluation of traumatic experience;
· restoration of a sense of integrity of one’s own personality;
· restoration of the ability to continue existing in the world.
Cognitive behavioral therapy when working with children and adolescents with PTSD
In psychotherapeutic work with children and adolescents around the world, the gold standard is cognitive behavioral psychotherapy focused on working with psychological trauma.
The purpose of cognitive behavioral psychotherapy:
· Reducing negative emotional and behavioral reactions, which may be reactive in nature as a result of psychological trauma.
· Provide support and teach skills for effectively coping with emotional distress and depressive episodes in parents.
· Train parents in the skills to optimally respond to children’s problems and support their children. [3]
Sand therapy when working with children and adolescents with PTSD
The advantage of sand therapy is that it allows the client to recreate various aspects of the problem in sand, using symbolic objects that can be manipulated and easily changed. By playing out a situation in a psychological sandbox, a child, teenager, or adult has the opportunity to look at it from the outside. This play process moves the client from feeling like a “victim” to feeling like a “creator” of their life.[2]
Conclusion
In situations where stress is not experienced naturally, a time-delayed reaction to a frustrating situation is formed, i.e. post-traumatic disorder, or trauma. A traumatic experience is formed by a person if in a stressful situation he found himself helpless, was unable to cope with the situation, and did not receive support and help from the outside.
Literature:
1.
Enikolopov S.N. Psychotherapy for psychotraumatic stress disorders // Russian Psychiatric Journal. 1998, No. 3 p. 50-56
2. Zinkevich - Evstigneeva T.D., Grabenko T.M. Miracles on the sand. Workshop on sand therapy. - St. Petersburg: Publishing house "Rech", 2005.- 340: ill.
3. Kutashov V.A., Khabarova T.Yu., Ulyanova O.V. Organization of a procedure for studying medical, social, psychological and neurological characteristics of patients with affective disorders // “System analysis and management in biomedical systems.” 2015. Volume 14, No. 3. pp. 588-592.
4. Melekhin A.I. Game-based cognitive-behavioral therapy// Modern content of preschool education: variation, initiative, sustainable development. Irkutsk ICPT “Mix”, 2016. pp. 68-71.
Psychological rehabilitation of persons with post-traumatic stress disorders
MM Vokhmyanina “Voronezh Regional Clinical Narcological Dispensary” Voronezh Region, Voronezh, Russia
T.Yu. Khabarova PhD in Psychology, the senior lecturer of chair of psychiatry and neurology IDPO FGBOU in VSMU them. NN. Burdenko RF Ministry of Health.
Abstract
The article is devoted to the concept of posttraumatic disorder (PTS), peculiarities of PTSD in adults and children, the main directions of psychotherapy.
Key words:
Post-traumatic stress disorder, trigger, psychological rehabilitation.
References:
1.Enikolopov SN Psychotherapy for psychotraumatic stress disorders / / Russian Psychiatric Magazine.1998, No. 3 p.50-56
2.Zinkevich-Evstigneeva TD, Grabenko TM Miracles on the sand. Workshop on sand therapy. - SPb.: Publishing House “Rech”, 2005.- 340: ill.
3. Kutashov V.A., Khabarova T.Yu., Ulyanova O.V. Organization of the procedure for the study of medical-socio-psychological and neurological characteristics of patients with affective disorders // “System analysis and management in biomedical systems.” 2015. Volume 14, No. 3. pp. 588-592.
4. Melekhin AI Game cognitive-behavioral therapy // Contemporary content of preschool education: variant, initiative, sustainable development. Irkutsk ICTSTI “Mix”, 2016. From 68-71.
How does psychological trauma work?
Before we work through the injury, let’s figure out how it works.
Injury
- this is harm caused to a person’s mental health as a result of intense exposure to unfavorable environmental factors or stressful effects on his psyche. It is often associated with physical trauma that threatens life or violates the sense of safety.
Trauma is an interrupted grieving process. We want everything to be the same so much that we repress the traumatic event and the experience of it. This often happens automatically and unconsciously. We try not to touch on a sore subject: we avoid conversations, try not to remember, and if we do remember, we do not immerse ourselves in feelings. It turns out that trauma thus protects our psyche from the intolerable.
At the same time, such protection affects our lives: in order to keep our experiences locked up, we need to put in a lot of effort. This threatens our body with tension, exhaustion and anxiety. Also, just because we don't think about a traumatic event doesn't mean it didn't happen. It can be reminded of by various situations that associatively lead to places where it is intolerable to look. Thus, again and again, against our will, we plunge into strong experiences associated with the past. This can be expressed in nightmares, in excessive reactions to what is happening, in outbursts of anger or tears.
The healing process begins when our resources are redirected from defense to processing the situation. That is, when we gain the courage to look at what happened and experience our feelings associated with these events.
It is important to do this in a safe environment. Therefore, writing is a good way to cope with living: it provides security, helps to express emotions and to appropriate one's experience. If for verbal processing we need a person nearby so that we can stay in touch with our emotions, then writing allows us to keep our attention on our experiences by returning to the text.
Concept and mechanism of psychological trauma
Even Sigmund Freud in 1920 wrote that trauma is an unexpected excessive impact, due to excessiveness, during which the full functioning of the mental apparatus is powerless and the Ego becomes helpless. A person faces situations that are difficult for him to survive. They go beyond ordinary life and have a strong impact on the psyche.
Any injury is an unfinished and unprocessed action by our psyche. For example, psychological trauma in a child affects his subsequent development. How psychological traumas of childhood will affect the behavior patterns of an adult remains a big question. How much in the moments when the child experienced this. did he have psychological support, did he have enough resources for this? Psychological trauma can be caused completely by accident. In addition, it is important to note that the same event is traumatic and difficult to experience for one person, but not for another. It depends on the individual characteristics of the individual. First of all, it depends on the adaptive resources of the body and the human psyche.
After the onset of psychological trauma, the body as a whole is mobilized. All resources that are available at the moment are directed towards overcoming what is happening. More precisely, accommodation. A person who finds himself in an extreme situation experiences many conflicting emotions. This means there is no way to recycle them. The point is that any blocking of experienced feelings does not allow them to be released, take root, and can be repressed to the subconscious level. In addition, situations of psychological trauma can cause the development of psychosomatic diseases. This happens if a person keeps everything to himself for a long enough time and denies what is happening. In this case, there is no psychological release.
Trauma is perceived by the individual as something that should not happen and goes beyond the usual reality to which the person is adapted.
If we talk about developmental trauma, it is important to note that a person encounters opposition or adverse environmental influences. In this case, the child becomes limited in the use of his resources. For example, if something unpleasant happened that the child experienced difficultly, then the next time he finds himself in a similar situation, he will be more tense and cautious. There is a high probability that the child will perceive the new situation he finds himself in in a certain way. This event will be similar to one in which the child experienced a number of intolerable emotions. They are very similar to those experienced before. We can say that after suffering a trauma, a person becomes more adapted to the world. This is due to acquired and experienced experience.
What else will help?
Rescripting technique
The good thing about a letter is that you can use it not only to state what happened. Writing allows you to transform events. You can rewrite the event as you please: change the ending, add strength or helpers, rewrite your reaction. The brain doesn’t care how everything actually happened; it cares how you perceived it. And you can work with this perception. Here's how to use the rescripting technique.
Choose a situation you would like to work through. Let it be something that does not cause too painful feelings (for example, the experience of violence or recent loss is better to work through together with a psychotherapist).
Imagine a person who could give you now what you needed then. For example, a mother who would listen, a friend who would protect. It doesn’t have to be a real person; you can take a movie character or invent him yourself.
Find the appropriate security image. It is important to know what supports you have and what you can turn to if something goes wrong during practice. An image of safety can be a comfortable place you can go to physically (or in your imagination) or a meaningful support object that you can touch to feel safe.
Imagine the situation as it happened in reality. At any time you can press the "Stop" button in your imagination and the scene will stop. Once what is happening freezes, you can transform it. For example, call a defender for help and see how he comes and changes the situation in your favor.
Check to see if all your needs have been met. We evaluate how your character feels in your imaginary situation as a result of playing an alternative scenario. Was he satisfied, did he need anything more? You can add helping actions. For example, a defender, having dealt with the threat, came up to you, hugged you and offered to take care of you.
Do something for yourself in reality from the actions of a defender. For example, make yourself some delicious hot tea, wrap yourself in a blanket and lie down, addressing yourself with words of care, like the protector from your story.
With the help of such rescripting, you can artificially create an alternative experience of the past - and thus affect your sense of self in the present and your relationships with other people.
Journaling
Set aside half an hour of time every day and write everything that comes to mind. Or take notes in your phone as needed. This text should not be published publicly, but fragments can be used in the future, for example, to write a book.
Returning to the place where it all happened
It often happens that we remember a traumatic event and can even tell others about it, but our emotions are still inaccessible to us. We turn memories into a dry story and cannot immerse ourselves in feelings. In this case, the letter will help convey to others the very fact of the event and even its details - but it will no longer be able to help in living through the traumatic experience.
To awaken the body and emotional sphere, you can return to the places where painful experiences occurred. But before you go there, it is important to consider safety precautions.
Think about what usually helps you cope with strong emotions and make a list of techniques - for example, write down in advance the names of people you can contact if you need help and their phone numbers.
You can mentally return to the place where everything happened by closing your eyes. You can look through photographs from those times or open Google maps.
The strongest practice can be actually returning to the scene of events. Having encountered your experiences, try not to ignore them, but to live them: cry, get angry, if you want. If you are in a living space, pillows or upholstered furniture (they can be hit or thrown to express physical aggression) will help you release steam. If space allows, shout; To avoid embarrassing people nearby, you can use a pillow - it absorbs sound.
Writing will be an excellent tool for expressing feelings. It maintains the dissociation that is needed to feel safe - when you describe a situation, everything seems to be happening not to you, but to the person in the letter - while the text leaves you in contact with the experience.
If your emotions are so intense that you can’t cope with them on your own, seek help from a specialist.
Author-guide
To support yourself as you process your experience, seek out companions. This could be a friend with whom you will regularly meet, tell him about the work you have done and the difficulties you have encountered in the writing process. Or maybe an author whose work inspires you and serves as a guide. Reading his books can tell you how and where to move next.
Blog
Today I will share with you my psychotherapeutic experience - I will talk about the stages that need to be passed in order to recover psychologically.
For clarity, let's look at the example of post-traumatic stress disorder.
The client is a former participant in military operations in Chechnya.
Complaints: high anxiety, fears.
Anxiety and fear in the present are not lived fears in the past.
That is, there was a situation in which it was scary, but the person did not live through this fear.
He distracted himself with the present, calmed himself down with meditation, and tried his best to forget everything.
It is so IMPOSSIBLE to “forget” the pain. Just when it seemed to us that we had managed it and everything was behind us, a situation similar to 1% (the sound of a helicopter) takes us back to the past. A wave of wild fear and despair sweeps throughout the body. The brain tells us - remember this past, stay in it, live through these emotions.
But we misinterpret our reactions and again struggle to calm down. If none of the methods help, we “sit down” on pills.
IT IS POSSIBLE to “forget” the past only through experiencing ALL the painful emotions that accompanied the event.
Signs that we HAVE LIVED fear are the absence of unreasonable states of anxiety in the present - once. And two – when remembering an event from the past, we are not afraid. It feels like we are just watching a movie, and for the 20th time in a row. There is logic, but no emotions.
Let's return to our client.
So, therapy includes 5 stages of work (see the picture on the cover of the article):
1. FEAR. The first stage of the work is to experience the emotion of fear, which arises when we are immersed in the past. I remember what happened and I want to shrink so hard that I can disappear, I feel my legs and arms getting cold. When we correctly “squeeze out” fear, it decreases and we begin to feel the second emotion -
2. PAIN. “How is it possible... why did this happen, it’s so unfair...”
We correctly “squeeze out” the PAIN and move on to the third stage -
3. ANGER. "I hate! I hate those teenagers who beat me and to whom I wanted to prove by participating in hostilities that I was something!”
We correctly “squeeze out” ANGER and feel again
4. PAIN. Remains of tears.
And only after all this emotional cocktail comes -
5. TRUE ACCEPTANCE OF THE PAST – “What can we take from them, their parents are alcoholics, they humiliated their children. What the children received was sown around them. Sick people. I was just unlucky - I was in the wrong place at the wrong time.”
Looking at these stages of psychotherapeutic work, the following metaphor suggests itself.
Remember stories about temples?
They wash the walls - one layer is washed off, a second, and under the third they find images of saints.
It’s the same here - we “erase” 1. fear, 2. pain, 3. anger, 4. pain and discover behind all this 5. love and acceptance.
By the way, when we independently try to cope with the trauma of the past, we strive directly from point A (1.fear) to get to point B (5.acceptance).
This is IMPOSSIBLE without fully experiencing 1. FEAR, 2. PAIN, 3. ANGER, 4. PAIN.
I would like to place special emphasis on the fifth stage of work - “Acceptance”. I find it truly wonderful:
No matter how much pain or resentment we work with, we always eventually come to acceptance and love . It’s surprising, and many won’t believe me, but even when we work with violence, the client at the end of the work comes to accept the behavior of the rapist, he reports, “What can we take from him, his mother threw cats out the window.”
Friends! Thanks to the achievements of psychology, it is absolutely possible to forgive parents for their “happy” childhood, for the betrayal of their ex, to understand why they behaved this way towards us and to accept them as they are!
I hope I have inspired you to work with a psychologist! It's work, but it's rewarding work!
Sincerely yours, #psychologist Anna Yakovleva
PS Welcome to personal and Skype meetings!
Tags: psychotherapy be healthy emotion management PTSD
