I came across a question today regarding the treatment of PTSD, someone else then gave a long winded response regarding the treatment modalities for PTSD and concluded that there is no end to severe PTSD. In short the advocacy for CBT and EMDR was simply an advocacy for treatments that temporarily help relieve symptoms.
Sufferers of PTSD to include severe cases of PTSD can experience full recovery. It all boils down to what you believe. A common example given for the cause of PTSD is war. A veteran who suffers from PTSD as a result of combat makes sense. War is bad, war is bad because engaging in hostilities against other human beings resulting in the killing of those human beings is detrimental for the mind. Human beings are inherently good, this is why we function the best when we feel good, and we feel really good when we are helpful towards other people. Furthermore, people who experience good feelings from committing any form of harm towards other people are seen as mentally ill, with labels of sociopaths and psychopaths assigned to their character.
So you take a good person, introduce said person to propaganda about how awful another group of people are, train them for combat and then send them into combat. After everything has been said and done, they come to realize that they are not at peace with their actions. Those who are more astute realize that the people they fought against are also people like themselves who were fed similar propaganda against themselves and trained to engage in combat for what they believe was a good and greater cause. To make things even more complicated, most veterans who suffer from PTSD, will encounter people who strongly believe in combat against other groups of people and will praise them for their past actions. This creates a dissonance, where they receive significant acceptance and recognition for actions they have come to disagree with, which also contributes to their illness, and potential rejection if they voice their disagreement for their previous actions.
PTSD can be cured, it is a duel process of utilizing EMDR to engage both hemispheres in getting past the difficult feelings associated with the trauma and using CBT to address detrimental beliefs and practice new and healthier beliefs.
Consider another example, let’s a say you have two men who experience extreme physical assaults and both men develop PTSD. Of the two men, the one the most least likely to fully recover from the incident is the man with rigid beliefs associated with the assault he experienced. For example, if the idea of being assaulted signifies a blow to his manhood, and he continues to hold unto these beliefs throughout treatment, the best EMDR will do for him is to temporary alleviate his symptoms before his next meltdown. He will then experience a meltdown every time he reminded about being humiliated. Such meltdowns can easily be triggered by consumption of media or association with people who voice reminders of his rigid beliefs he still holds unto.
While if the other man is more flexible with his beliefs associated with the physical assault, he is most likely to experience a full recovery. This is because after he has learned to move past his difficult feelings related to his ordeal, he is least likely to be triggered into an emotional meltdown. He is least likely to be triggered because it would be relatively easy for him to abandon any beliefs and values that prevent him from accepting the true nature of his ordeal.
Ugochukwu is a psychotherapist and owner of Road 2 Resolutions PLLC
I recently came across an article regarding a neuroscientific intervention for sleep paralysis. What I find fascinating about the article is the heavy reliance of mindfulness and meditation the neuroscientist prescribes for sleep paralysis.
Sleep paralysis occurs when you find yourself awake but unable to move. This lack of movement can last from several seconds to a few minutes as the sufferers’ experience sheer terror and agony in their inability to move their bodies. In some cases, people who suffer from sleep paralysis also experience hallucinations, most commonly reported is a shadowy presence in the bedroom.
The four steps for regaining control of one’s body during sleep paralysis are:
- Reappraisal of the meaning of the attack
- Psychological and emotional distancing
- Inward focused-attention
- Muscle relaxation
Step 1, “reappraisal of the meaning of the attack” is another way of saying that you should give the attack another label. The idea of waking up from sleep without the ability to move is so terrifying for most people that some sufferers develop extreme anxiety about going to sleep in the first place. For some people they spend the entire experience of their paralysis in a state of fright until they are able to move again. This leads to learned dread and a host of other issues. By relabeling the paralysis, you begin to experience a shift in your perception of what’s going on. For example, if you found yourself in this situation, you could tell yourself that you are experiencing a phenomenon that occurs in 20% of the population and is temporary.
Step 2, “psychological and emotional distancing” means that you should practice adopting an objective view of the situation. Since you have already told yourself that this is something 20% of population already experiences and is temporary, you should readily observe that your feelings of fright and panic are understandable but irrational.
Step 3, “inward focused-attention” this means that you should practice positive thinking. The author of the article recommends focusing on a loved one or a positive event. I would recommend you envisioning yourself getting out of bed and walking about. A mindset that can help with this vision is to inform yourself that while your mind is awake, your brain and your body haven’t yet received the signal to awake and move and are merely playing catch up. So soon you will be out of the bed and walking about.
Step 4, “muscle relaxation” from what clients who have struggled with sleep paralysis have told me, while they may not be able to move, they discover that there are aspects of their body that they can still control, such as their breathing and their ability to flex certain muscle groups. As tempting as it may be, forcing yourself to move only worsens the experience. Instead you are recommended to practice easy breathing and relax your muscles, by doing this you are adopting an attitude of acceptance towards the entire situation, which reduces the likelihood of experiencing a panic attack during the paralysis and shortens the duration of the paralysis.
The more people are able to successfully practice these steps during sleep paralysis, the less dread and anxiety they will have about sleeping, which in all likelihood will reduce the frequencies of the sleep paralysis.
This is the link to the article.
Ugo is a therapistand professional life coach.
It is not uncommon for people to go through a period of difficulty in their lives, in which they find themselves trapped in a vicious cycle of anxious thoughts and feelings. They habitually ruminate about what could go wrong in their lives and what is currently going wrong in their lives, with no resolution in sight. A common symptom of this vicious cycle is poor sleep, this is because the brain remains active well into the night ruminating over anxious thoughts, preventing the anxious person from getting a good night’s sleep.
In this post I shall detail a three step process on how to bring an end to your anxious thoughts.
The first step is to write down your anxious thoughts on a piece of paper. This might be problematic since if you have multiple anxious thoughts competing for space in your mind. The solution to this is to start with one thought, usually the most pressing one. By writing down the anxious thoughts on paper, it helps you to put things into proper perspective, and removes the factor of becoming easily overwhelmed.
Now that you have your most pressing anxious thoughts on paper, write down the most realistic worst case scenarios for that anxious thought. It is best to limit your worst case scenarios to three. So take for example, in your place of work, your supervisor just announced that the company will be downsizing, and to make matters more worrisome a few of your coworkers have already been laid off. Your primary anxiety maybe your fear of losing your job. While your worst case scenario may by that you will lose your ability to support yourself and perhaps a family. The problem with ruminating over your fear of losing your job along with your ability to support yourself is that it will negatively affect your ability to fall asleep at night. If you fall into a pattern of getting by on less sleep than you are used to, your cognitive abilities and your body’s ability to produce energy will become impaired. Which may lead to your worst fears coming true due to reduced performance on your job.
The second step is to accept this problem as a part of your reality. Fundamentally this is the most challenging step in the process, as most people have hidden beliefs which dictate that they either “should not” suffer or are “above” suffering. One method of coming to place of acceptance with your situation is to write down on a piece of paper the following statement: “I accept this situation as is, this is my challenge and this is currently where I belong.”
Once you write this statement down, take ten slow breaths, breathing in through your nostrils and slowly exhaling through your mouth. Then pay attention to how you feel about the words you have just written down. If you find yourself still experiencing difficulty coming to a place of peace with these words, then you will probably benefit from working with a therapist to address what your core beliefs about challenges are.
If you find yourself feeling more peaceful with the primary thought which provoked feelings of anxiety for you, then you are ready to benefit from the next step.
Step three is about exploring solutions to your challenges. Notice the language has changed from anxious thoughts to challenges. This change will be seamless in your mind once you come to a place of acceptance about your worrisome thoughts. Now that you have written down your thought along with your worst fears and you have come to accept this as a proper part of your reality, exploring potential solutions is something that occurs spontaneously in your mind. In my professional experience, clients who come to a genuine place of acceptance with the challenges they experience will often come up with reasonable solutions on their own.
For example, reasonable solutions for the possibility of being laid off, is to review your spending habits, cut back on frivolous expenses, while beginning the process of exploring other job opportunities. It is amazing how clear our thinking becomes when we transition from a place of anxiety to a place of genuine calmness. Also, even if you are having a difficult time coming up with some solutions to what you are going through, it is important to remember that there exist people who have experienced the same types of challenges you have experienced before and subsequently found effective solutions to these challenges.
Ugo is a psychotherapist and life coach.
I recently came across a two year article about the popularity of Xanax, and it reminded me of the number of patients I have worked with who had already been taking medication for months and sometimes years, before they decided to try the therapeutic route. I suspect that most people who stick with their medication, even past the point of diminishing returns are unaware about the specifics of how anxiety and panic attacks are typically addressed in therapy.
When treating anxiety, there are three therapeutic models, I use interchangeably , the cognitive behavioral model, the exposure model and the hidden emotion model.
The cognitive behavioral model approaches anxiety from the idea that it is the beliefs and subsequent actions of the person that is making the person anxious. So when the person holds unto beliefs that create anxiety, that person becomes sensitized to situations that can arose anxious thoughts, with the anxious thoughts being a product of what he believes. Take for example, if a person believes that all dogs are dangerous and vicious. This person then becomes aroused by concerns for his safety whenever he finds himself in the presence of a dog, or when he learns that there is a dog close by. Furthermore this person’s anxiety might become even more amplified if he engages in behavior he believes will keep him safe from the dog. So in this situation, we can say that the person’s anxious thoughts are caused by his beliefs about dogs. So in order to help the person get past his fear of dogs, we have to work on helping him adopt a more healthier belief about dogs. In the short term we will get him to practice healthier behaviors to cope with his anxious thoughts about dogs, when he is in the presence of dogs.
The exposure model approaches anxiety from the idea that the anxiety is being caused by the person’s decision to avoid her identified stimuli for the anxiety. An example would be a fear of negotiating one’s way through a crowd of people. So the person’s anxiety would be triggered every time she encounters what she considers a crowd. Using the exposure model, the person would be encouraged to gradually immerse herself into crowed situations, during which she will go through the process becoming desensitized to crowds.
The hidden emotion model approaches anxiety from the idea that anxiety is caused by a fear of confrontation with others. As a result, people who fear confrontation mask their emotions through a facade of being nice. The hidden emotion model posits that through the chronic process of forcing niceness, people sweep their true feelings “under the rug.” Which leads to the repressed feelings being expressed through chronic anxiety and in worse cases, panic attacks. The hidden emotion model addresses anxiety through a process of helping the person become more aware of his feelings, alongside strategies for helping him become more assertive through the practice of assertive building strategies.
In practice what I have learned is that regardless of which model I use to address a client’s needs, it all comes down to identifying maladaptive beliefs the person holds unto and helping the person adopt and practice healthier beliefs. Anxiety is treatable, and in worse cases such as recurring panic attacks, a person can learn to bring the episodes of panic attacks to an end.
Ugo is a psychotherapist and life coach.
So what is an impossible reality? An impossible realities can be best described as an experience that you have determined to be detrimental to your well being. However this is an experience you have actively pursued, and quite possibly prepared for your entire life. An example would be an abusive relationship or a toxic work place.
What makes experiences like these impossible realities is that you will most likely have strong beliefs and values that encourage you to continue with the experience despite the fact that in the long run you will not benefit from the experience. In the video below I discuss more about impossible realities, how they lead to mental health issues such as panic attacks and how to get past impossible realities.
Ugo is a psychotherapist and author of
How to end your panic attacks is now published and available for download as an ebook at the following ebook retailers:
Barnes & Noble
Baker & Taylor
In this video I briefly discuss what to expect when reading this book.
Ugo is a psychotherapist and life coach.