Workings of the Mind: PTSD - POST TRAUMATIC STRESS DISORDER

Wednesday, August 3, 2011

PTSD - POST TRAUMATIC STRESS DISORDER

PTSD is such an important issue for both our military and folks in general. In essence, something so terrible happens to the individual that their capacity to "deal", handle it is overwhelmed. Results of a study done by VA has looked at the "usual" treatment for PTSD; the use of anti psychotic drugs. This study helps us see that drugs were minimally helpful and that human connection through therapy is to be preferred. Especially, because this particular class of drugs has very significant side effects. You can view a review of the study at: http://www.msnbc.msn.com/id/43994382/ns/health-health_care/
also see and perhaps listen at: http://kuow.org/program.php?id=24142

THE THERAPY PROCESS

Therapy is about talking, thinking, feeling and caring. In essence therapy is an inquiry into experience; yet, it is much more. It is about folks deciding to solve the real problems in their lives so it is about courage and love. Therapy consists of the participants creating a special kind of dialogue. The therapist asks the patient (or client) what hurts, what isn't working, what happened as a starting point. The patient begins to try to speak to the question. Sometimes he/she is clear about a specific fear or hurt or frustration, sometimes he/she is describing more a feeling or mood of despair and helplessness. These beginning answers are rooted in things we have "learned" growing up and painful experiences we have suffered along the way. Just like how the small child learns not to touch the hot plate, we learn to avoid painful "things". Learning guided by avoidance and fear and shame is the most ineffective way to learn; this kind of learning handicaps us in creating a decent life. These handicaps especially get in the way in creating realistic, loving relationships. So what does this "special kind of dialogue" sound and look like? The client often talks about "what I felt", "what I did", "what I thought", "what I said or expressed", and usually "what the other did" and "what the other said or expressed". These words are guided by the "I", the conscious self. Some New Things need to be added to this dialogue for growth to occur because guidance by the conscious "I" has lead to the problems. How to get something new added to the dialogue becomes the framework for the therapy. First, for "I" to consider something outside of "my"own thoughts requires the "I" to feel safe. Second, the "I" has to find a way to accept at least tentatively, that there is "more" to me than my conscious, focused self. And that the arrival of non-intended thoughts, memories, images, and feelings are important to share with the therapist. So, what does the therapist do to create this special dialogue. The therapist asks the patient to give voice to additional thoughts and feelings that are in the background or that arrive without having searched for them or intended them consciously. The therapist must listen and absorb what the client is expressing. Sometimes the therapist can facilitate the patient's communicating by asking questions such as "what was in your mind when you said that?" The therapist via empathy opens himself up to the kinds of interactions the patient is communicating. This empathy generates an internal presentation of experiences from the therapist's own life (these allow the therapist to "get" what the patient is describing) and also the arrival of prior articulations by the client (as the patient and therapist get to know each other these "arrivals" help to link things together to provide a sharper and better picture of the problem). The dialogue will begin to be organized by the client's unintended thoughts, feelings, images, memories, and sensations; and a sensitive sharing by the therapist of his/her empathic responses to these. Out of this inquiry into experience, the client begins to see and feel how he/she interprets the world, feels the wishes and yearnings present in the background, senses the presence and the absences of needs, and feels the propulsive forces effecting his/her choices. Through the creation of this kind of talking together, the patient gains new ways of feeling and thinking and the opportunity of choosing a different life.

A Framework for talking about the Workings of the Mind

Each of us looks out upon the world. We are centers of experience. Our "I" and "me" bring together perceptions, sensations, auditory and visual images, memories, feelings, associations and the self definitions others put out to us about who we are. The "I" and "me" are the core referents of the self . Our whole "Being" surrounds, carries, and bears the self. So our whole being is more than our conscious self. In a way this blog is an attempt to talk about the relationships between Self and Being and Actuality.

Medications

Since the 80's and especially in the 21 century, psychiatry and the the medical community have emphasized that psychological disturbance and pain are to be approached from the point of view of juggling the brain chemistry of the individual to get it to function "better". Although there is some merit in accepting that the brain's chemical functioning is somehow related to experience, as a psychotherapist I find it very inadequate and often misleading.

I will try to outline my criticism of the medical model of treatment in developing this blog.

Initially though, the reader may find value in an article written by Marcia Angell in the New York Review of Books. She has a two part article called "The Illusions of Psychiatry" see: http://www.nybooks.com/issues/2011/jul/14/

Workings of the Mind

THERAPY

Wednesday, August 3, 2011

PTSD - POST TRAUMATIC STRESS DISORDER

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