Category: PTSD

Death of a Thousand Cuts: young people and trauma

— Amanda Robins

When we hear the word trauma we often think of a terrible life-threatening event – a car accident, natural disaster or an act of violence which changes us forever. But psychological trauma needn’t be caused by a single event – it can be – and often is – the result of a cumulative process of traumatic interactions in childhood which can permanently change the brain and leave young people with a vulnerability to mental illness. As trauma theorist Bessel van der Kolk puts it:

“Chronic trauma interferes with neurobiological development and the capacity to integrate sensory, emotional and cognitive information into a cohesive whole. Developmental trauma sets the stage for unfocused responses to subsequent stress leading to dramatic increases in the use of medical, correctional, social and mental health services.”

Trauma such as this (complex developmental trauma) occurs during particularly sensitive periods in a child’s development – usually from birth to 3 years. This is the period during which important regulatory functions are developed and brain structures, pathways and connections are formed or “turned off.” The important experience-dependent development which occurs at this early stage allows us to adapt to our social environment, helping us learn to regulate ourselves and recognise our own and others’ emotions. Although the brain does remain plastic into adulthood, certain functions and pathways set in motion during this early period are difficult to change and can influence our ability to handle stress and manage our emotions across the lifespan.

So what happens when something goes wrong? (Click below for the full article)

Source: Death of a Thousand Cuts: young people and trauma

Post Election Stress Disorder: Is It a Thing? | Psychology Today

 The American Psychological Association (APA) has conducted a yearly “Stress in America” survey during the past decade and just released Part 1 of their findings for 2016-17. The results are not pretty. Overall, stress levels among Americans have increased and are higher than at any time during the past 10 years (including the recession years starting in 2008). Americans are simply stressed out! The majority of Americans in the survey pointed to our nation’s political climate as a source of increased stress



The American Psychological Association (APA) has conducted a yearly “Stress in America” survey during the past decade and just released Part 1 of their findings for 2016-17. The results are not pretty. Overall, stress levels among Americans have increased and are higher than at any time during the past 10 years (including the recession years starting in 2008). Americans are simply stressed out!

The majority of Americans in the survey pointed to our nation’s political climate as a source of increased stress with more Democrats than Republicans feeling stressed by politics. But the majority of both Republicans and Democrats admitted that they were stressed by concerns regarding the future of our country. The report found that increased stress levels have also resulted in higher incidences of both physical and mental health symptoms including headaches, feeling overwhelmed, anxiousness, and depression. Respondents also had much more concerns for their personal safety than in the past as well.

All this has led some to speculate that many are experiencing what has now been called Post Election Stress Disorder (PESD). While quality evidence-based research takes time to complete and publish (especially with our peer review system used in the sciences) preliminary data seems to suggest that this notion of PESD is real and is “a thing.” So many people seem to feel disheartened, discombobulated, and distressed by our political climate and the future of the nation. And their stress symptoms may lead to potential troubles in their personal, social, and occupational functioning as well. (Read the rest at the link below)


Source: Post Election Stress Disorder: Is It a Thing? | Psychology Today

Letting Go of Victimization

The paradox of victimhood

There’s a real conundrum in trauma therapy. People with unresolved and still resolving complex developmental trauma move toward familiar and undesirable roles as a result of unconscious “programming”—traditionally victim, perpetrator or abuser, and bystander. This isn’t because we want to, but because we are conditioned to, even to take on these roles as a matter of survival.

For example, someone who was routinely abused as a child is likely to have learned to acquiesce to the abuser, and conform her or himself to the expectations of the abuser and the experience of the abuse in ways which were most self-protective—even when that meant possibly seeking out the abuse as a way to predict, control and diminish the impact. The victim may, for example, have learned that to go along with it still meant the bad thing would happen, but maybe not additional bad things. He may have learned to suppress feelings to cry if crying resulted in harsher punishment, leading to adult difficult accessing emotions. She may have learned to believe that she was at fault and deserving of punishment for “doing something wrong”, when that something wrong was essentially ordinary and unavoidable, since children are not adults, and adults aren’t perfect, anyway. People need time to learn. [click below for rest of article]


Continue: Letting Go of Victimization

Misconceptions About Dissociative Identity Disorder | The Mighty

By Chris Alter

There are a lot of misconceptions about dissociative identity disorder (DID). Here are some common ones I’ve heard:

1. “DID is so rare, you can’t possibly have it!”

It isn’t actually as rare as you may think. The ISSTD (International Society for the Study of Trauma and Dissociation) accept that up to one to three percent of the general population have DID, this is roughly the same amountof people who possess the “ginger” gene!

2. “If you really had DID, you wouldn’t know about your alters!”

It’s fairly common for those with DID to know about their alters. Many report hearing others talking inside and can be aware of other “selves,” even in childhood. Many individuals will not remember what they have been doing for periods of time and can behave completely out of character. This is an extremely confusing experience, especially prior to receiving psychiatric support. Internal communication between alters is often worked on and improved through therapy.

3. “Do you have an evil alter? I’ve heard people with DID are dangerous!”

This is a common misconception which isn’t helped by media portrayals of “split personalities” like the characters Jekyll and Hyde and sensationalized films like the 2017 movie, “Split.” Those with DID (like most mental illnesses) are more likely to be a danger to themselves, not others. There are no evil alters. There can be destructive alters, but they need the same amount of compassion as any other member of the system!

4. “You can develop DID as an adult!”

The only possible time that DID can form is in early childhood, generally accepted to be before age of six and nine at the latest, because normal personality development that occurs at this age is interrupted by trauma. Traumatic experiences that occur later than this age can lead to other conditions, such as post-traumatic stress disorder (PTSD), but not DID.

5. “DID is the same as schizophrenia!”

They are two very different disorders. According to the ISSTD, DID is a dissociative disorder developed through chronic childhood trauma and characterized by “the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.”

Schizophrenia, on the other hand, is a psychotic disorder potentially caused by a number of factors including genetics, biology of the brain and stress. It is characterized by delusions, hallucinations, paranoia, disorganized speech, etc. which causes significant social or occupational dysfunction.

6. “DID isn’t real! Stop pretending!” 

DID is very real and there is a lot of evidence supporting it. Despite this, it remains a controversial diagnosis to some professionals. Despite having a diagnosis of DID, a psychiatrist on an acute psychiatric ward once told me it doesn’t exist, that I was lying and it is “the stuff of Hollywood movies!” Stigma surrounding this disorder can unfortunately sometimes include professionals, despite DID being a recognized psychological condition in diagnostic manuals worldwide.

7. “You can’t have DID, I would have noticed!”

Often switches between alters are not obvious to those who don’t know what to look for. If you know someone with DID well, you may notice slight differences in body language, vocal differences, differences in handwriting, differences in vocabulary etc. that would otherwise go unnoticed.

Click here to read the rest of this article: Misconceptions About Dissociative Identity Disorder | The Mighty

What to Know About People With Dissociative Identity Disorder | The Mighty

By Iain C

(Note: This appears to be an interesting site. Link is below.)

Not long ago I was doing pizza and movie night with some friends when that thing I hate happened. A character in the movie, wild-eyed and demented, was revealed to have… dissociative identity disorder! (cue the creepy music)

Some of my friends shuttered, some laughed, others scoffed. They didn’t know someone with dissociative identity disorder, or DID, was sitting right there on the couch, slice of pizza halfway to my mouth. I wanted to tell them DID isn’t like that. I wanted to explain it’s really just another way of being human. It’s our way of managing life and not a joke or a threat to them. In the end, I realized my friends didn’t know enough about DID for me to even begin the conversation.

Here’s a list of what I wish everyone knew so we could really talk.

1. We’re not all ax-murderers like you see on TV. We were overwhelmed by pain and suffering when we were children. It changed us and now our minds work differently than yours. But just like you, we want to have a good life.

2. We have different identities/alters inside one body. They are different ages, have different feelings, ideas, talents and agendas. We work very hard to maintain a functional system that gets us through the day.

3. Switching between identities/alters isn’t very dramatic. Most of the time the switches are internal, seamless and invisible. And, unless you’re our therapist or a really close friend, they’re none of your business. We’re handling things the best we can.

4. When we lose time, it’s really lost. We’re not faking. If anything, we’re pretending we know more about what happened than we really do.

5. If a teenaged identity/alter takes over, they’re not an adult pretending to be a teenager. They’re a real teenager. Demanding they think, act or decide like an adult isn’t going to work. Relate to them based on their age and unique personality.

6. The adult out front isn’t the real us. They are the identity/alter who’s best at getting along in the world. The real us is all of us together.

7. If you’re dealing with us in a crisis and kid identities/alters come out, don’t ignore them and try to force an adult identity/alter out instead. If we could get an adult out front to run things, we would. Help the kids feel safe and our system will stabilize.

8. When the system feels threatened, protector identities/alters can come out. They may be angry, cold or determined to escape. Please don’t take this personally — we’re just overwhelmed. The best way to help is to back off and let us get safe.

9. We already know DID is “controversial.” You don’t need to remind us some people think it doesn’t exist — which sounds a lot like we shouldn’t exist — which sounds a lot like what we heard from our abusers. Not good.

10. There’s nothing wrong with the way I am. We’re different in some ways and like you in lots of others. We share the same world and want the same good things you want. We’re not “crazy” or weird — just a little complicated.

Source: What to Know About People With Dissociative Identity Disorder | The Mighty

New attention for an old therapy to treat PTSD, anxiety, and more – The Boston Globe

Eye Movement Desensitization and Reprocessing is seen as effective treatment for post-traumatic stress disorder

Steve Girard couldn’t shake the memory of recovering a 3-year-old girl during an underwater search and rescue mission, and handing her dead body to her grieving parents.

A 50-year-old Army veteran who served in the Joint Special Operations Task Force in Iraq, Girard kept seeing the little girl’s face in excruciatingly sharp focus. For nearly 16 years, this memory and the suffering he saw later on a humanitarian mission to Guatemala tormented him, interrupting his sleep and pushing him to quit his commission as a police officer in Chesterfield. “I couldn’t adapt to my own family,’’ he said. “I wasn’t the same person who left and came back.’’

Then Girard sought treatment for post-traumatic stress disorder at the Northampton VA Medical Center. Girard hasn’t forgotten the little girl, but he no longer sees her face nor suffers from the memory. He credits the relief to Eye Movement Desensitization and Reprocessing, or EMDR. The therapy typically requires the patient to focus on blinking lights or a practitioner’s finger moving back and forth, usually for a few minutes at a time, while recalling the disturbing memories. In some instances, alternating tones in the ears or electrical pulses in the palms are used instead of visual cues.

Once highly controversial, EMDR has made gains in acceptance. In 2004, both the American Psychiatric Association and the Department of Defense recommended it as an effective treatment for PTSD. In May, the federal Substance Abuse and Mental Health Services Administration, an agency of the Department of Health and Human Services, recognized EMDR as an evidence-based treatment for depression and anxiety as well as for PTSD.

Critics of the treatment still have reservations – even for the treatment of PTSD in combat veterans, the VA ranks EMDR only third as a recommended treatment, behind cognitive behavioral therapy and exposure therapy.

And no one knows exactly how EMDR works. The general theory is that mentally revisiting traumatizing experiences while different parts of the brain are stimulated by the alternating sensations helps the patient overwrite the stored memory with one that has lost its pain and intensity.

Used first in 1987, EMDR has been the subject of dozens of clinical and research studies, including one 1997 randomized clinical trial funded by the managed health care organization Kaiser Permanente, which found that among 67 subjects in an HMO setting, all single-trauma and 77 percent of multiple-trauma patients no longer had PTSD after six 50-minute sessions.

The recognition by the federal mental health agency is important because it will likely make funding available to study EMDR, says Deborah Korn, a Cambridge psychologist who was a co-investigator on a 2007 randomized clinical trial of 77 patients that compared EMDR with Prozac. The study, led by Bessel van der Kolk – past president of the International Society for Traumatic Stress Studies and medical director of the Trauma Center at Justice Resource Institute in Brookline – found that six months after treatment stopped, EMDR patients had fewer symptoms of PTSD and depression than the patients who had been on Prozac.

Korn says that some form of trauma is often at the heart of mental and emotional problems. Sometimes it’s a complex trauma, like child or spousal abuse, but it can also be a single event, such as a car accident, bereavement, or a painful divorce.

“You can sometimes see transformation in three sessions, sometimes in 20 minutes,’’ she says. “Other people, it takes months and months. Sometimes it’s a matter of unhooking something that opens up information processing in a way that allows for transformation.’’

Maureen Richardson, a licensed mental heath counselor and registered nurse who uses EMDR in her practice at Interfaith Social Services in Quincy, points to the case of a 63-year-old woman who had suffered from a panic disorder for 10 years.

Although the patient had been prescribed Paxil, she would wake up in the middle of the night with night sweats, unable to breathe. A childhood victim of abuse by family members, she had suffered from anxiety for years.

Richardson suggested EMDR therapy. After four sessions, the patient started feeling better. Her anger dissipated and the night sweats went away.

Richardson says EMDR allowed the patient to reprocess the emotions associated with the memory. “She began to realize it wasn’t her fault and that some one should have attended to it. . . . She wasn’t a bad person, she was just a child.’’

Girard, the Army veteran, says that EMDR changed the visual images in his brain. “It made my memory like picture frames in a movie. The film was still going by, but I had the opportunity to slow it down and change it, in a better way.’’

Harvard sleep researcher Robert Stickgold believes that the constant shifting of focus in the eye movements alters brain chemicals and puts it in a state similar to REM sleep, the natural process where the brain deals with the day’s events.

“If the brain can’t process the trauma and transform it somehow, you are stuck with that raw memory in its original form,’’ he said.

Steven Silver, a Marine and Army National Guard veteran, psychologist, and coauthor of a book on EMDR, “Light in the Heart of Darkness,’’ points to brain imaging data supporting the REM sleep theory.

Silver also notes studies on patients undergoing EMDR have shown physical changes in the brain, including an expansion in the hippocampus – an area that shrinks in people with chronic PTSD.

“We don’t know exactly how psychotherapy works either. But with EMDR, because of all the brain-based studies, we have a better idea. We’re no longer arguing about whether EMDR works, but what causes it to work,’’ he says.

Therapists stress that EMDR therapy is not a cure for everything. Richardson says she is cautious about using it, for fear of bringing up memories patients are not prepared to deal with. Christine Wolff, a psychologist in Waltham, says that she uses EMDR therapy in only about 10 percent of her patients. She considers EMDR a useful tool because so many different mental health problems are trauma-based – “but if you have a long history of problems in your life, it won’t cure you in 10 sessions,’’ she says.

Back at the Northampton VA Medical Center, the administration increased the number of therapists trained in EMDR from one last year to 10 this year. Theodore Olejnik , the therapist who brought EMDR to the center, is the suicide prevention coordinator. As such, he says, he sees only the most dire cases.

During 24 years of active duty with the Air Force, Olejnik recalls treating PTSD victims in the early years strictly with talk therapy and cognitive behavioral therapy, which focus on breaking dysfunctional patterns of thought. “I kept thinking there had to be a better, quicker method.’’

After treatment with EMDR, he says, “so many combat veterans here have said, ‘Ted, you literally brought me out of my ashes, made me whole again.’ ’’

Jan Brogan can be reached at

Source: New attention for an old therapy to treat PTSD, anxiety, and more – The Boston Globe

PTSD from Motor Vehicle-related Accidents

Researchers are looking more closely at motor vehicle accidents (MVAs) as a common cause of traumatic stress. In one large study, accidents were shown to be the traumatic event most frequently experienced by males (25%) and the second most frequent traumatic event experienced by females (13%) in the United States. Over 100 billion dollars are spent every year to take care of the damage caused by auto accidents. Survivors of MVAs often also experience emotional distress as a result of such accidents. Mental health difficulties such as posttraumatic stress, depression, and anxiety are problems survivors of severe MVAs may exhibit. This fact sheet addresses important issues related to MVAs, including how many people experience serious MVAs, how many people develop MVA-related Posttraumatic Stress Disorder (PTSD) and other psychological reactions, what the risk factors are for MVA-related PTSD, and what kind of treatments help MVA-related PTSD.

Below are some articles and resources for survivors of accidents and other forms of trauma.

The Trauma Tool Kit






What Is a Dissociative Disorder?

Dissociative Identity Disorder (DID) (known in the past as Multiple Personality Disorder-MPD) and other Dissociative Disorders are now understood to be fairly common effects of severe trauma in early childhood. The most common cause is extreme, repeated physical, sexual, and/or emotional abuse.

People with Dissociative Disorders may experience any of the following: depression, mood swings, suicidal thoughts or attempts, sleep disorders (insomnia, night terrors, and sleep walking), panic attacks and phobias (flashbacks, reactions to reminders of the trauma), alcohol and drug abuse, compulsions and rituals, psychotic-like symptoms, and eating disorders. In addition, individuals can experience headaches, amnesias, time loss, trances, and “out-of-body experiences.” Some people with Dissociative Disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed).

Source: What Is a Dissociative Disorder? (From the Sidran Foundation)

Signs and Symptoms (from

While the official DID symptom list is short, the signs of DID are numerous. Dissociative behavior is divided into two categories: detachment and compartmentalization. Detachment is “a voluntary or involuntary feeling or emotion that accompanies a sense of separation from normal associations or environment” while compartmentalization isolation or splitting off of part of the personality or mind with lack of communication and consistency between the parts.”

People with DID often also suffer from borderline personality disorder characteristics, somatization disorder (physical symptoms without cause), major depression, posttraumatic stress disorder and suicide attempts.

The signs of dissociative identity disorder include a number of characteristics regarding the multiple personalities including:

  • Personalities are discrepant (disagreeing) and often opposite.
  • Each personality is well-ingrained with its own memories, behavioral patterns and social relationships that govern its behavior.
  • Transition from one personality to another is often sudden and brought on by stress.

Other signs of DID include:

  • Amnesia or blackouts (in the absence of substance use)
  • Being called by a strange name by someone who claims to know the person well
  • Finding oneself somewhere when no memory of getting there (absent substance use)
  • The person referring to him or herself as “we”
  • The person being told that they did certain things to don’t recall.
  • The person feeling they have been accused of lying when they truly believe they haven’t.
  • The person may find unfamiliar objects or samples of strange handwriting or drawing.
  • Sleepwalking and automatic writing (such as those in fugue states)
  • Auditory hallucinations
  • Phobias; fear, often undifferentiated
  • Difficulty in parenting and responding to own children
  • Problems trusting others
  • Hostility and anger
  • A sense of betrayal
  • Problems with sexual adjustment
  • Increased levels of sexual behavior
  • Prostitution
  • Substance abuse