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Posttraumatic Stress Disorder

Psychological distress is considered a normal and natural reaction to trauma.  However, a small proportion of trauma survivors may go on to develop trauma associated disorders which have a significant impact on their functioning and quality of life. Individuals with Post Traumatic Stress Disorder (PTSD) often struggle with painful and unwanted memories, thoughts and feelings.  They may, quite naturally, spend a lot of energy on avoiding or escaping these painful private experiences and situations or cues related to the trauma (Walser & Hayes, 2006). This avoidance is considered to be a core psychological process in both the development and maintenance of PTSD (Orsillo & Batten, 2005).

Acceptance and Commitment Therapy (ACT) is a behaviourally based and empirically validated intervention that is well suited to the treatment of PTSD. It targets decreasing experiential avoidance, including unwanted feelings, thoughts or memories, while increasing acceptance of these painful experiences in order to move in a valued direction.

Therapy Dogs and Posttraumatic Stress Disorder

By Dr Stan Steindl

As the 100th anniversary of the Battle of Gallipoli approaches, we are inspired by the great heroics of soldiers in combat serving and protecting our nation, and we are humbled by the enormous sacrifices they’ve made. Many men and women over the last 100 years have made the ultimate sacrifice for their country, and we remember them. A great many other men and women who returned from the various wars and overseas missions have gone on to live under the heavy burden of posttraumatic stress disorder (PTSD).

Though for a long time not formally recognised, the psychological effects of combat-related trauma have been observed and documented throughout the twentieth century. ‘Shell shock’, ‘combat fatigue’ and other more disparaging terms have been used to describe combat veterans suffering from PTSD. References to this condition can be found in many writings from Ancient Greek texts through to Shakespeare’s works, through to articles at the time of the American Civil War. However, PTSD became a recognised psychiatric condition in the early 1980s after our experience of veterans returning from the Vietnam War.

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Life-shattering events: The debriefing debate

Recent debate over the effectiveness of psychological debriefing following trauma has sparked some interesting opinions, discusses Dr Stan Steindl, director of Psychology Consultants.

Having completed his PhD in post-traumatic stress disorder (PTSD), Dr Stan Steindl said there is significant debate among researchers as to the efficacy of psychological debriefing immediately following a traumatic event. Some analysts even believe that providing immediate debriefing routinely may actually cause harm to some of the people involved.

Psychological debriefing or critical incident debriefing is a meeting with people affected by an incident, not a therapy session per se. It aims to give participants an opportunity to discuss what has happened, allow expression of emotions, and understand what are ‘normal’ reactions to trauma.

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Responding to people’s trauma

Trauma regularly touches our community. Events like car accidents, assaults, hold ups, and natural and man made disasters seem to happen all too often. Experiencing a traumatic event can have a marked impact on people’s lives.

The possible psychological effects of trauma are now fairly well defined. While some people are able to get on with their lives, others may have great difficulty “forgetting” the memory, causing them to develop a number of symptoms that are collectively referred to as posttraumatic stress disorder, or PTSD.

If a person has experienced an event in which they were exposed to death or serious injury and felt intense fear, helplessness or horror during the event, then further assessment of their mental state is recommended.

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A case of complex posttraumatic stress disorder

Probably one of the more challenging cases a psychologist can face is treating “complex posttraumatic stress disorder”. This usually involves clients who have an already established, yet often unidentified, personality disorder when they face a traumatic event.

The result is a complex interplay between both: the PTSD activating the personality disorder, and the personality disorder fueling the PTSD.

A recent case was a truck driver who was involved in a single vehicle accident, which resulted in severe physical injuries. After assessing the driver, it was clear that he had a pre-morbid antisocial personality disorder.

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Managing Anger

By Dr Stan Steindl

Simon is a 45 year-old happily married man with two daughters. A litigation lawyer, he seems successful and has many friends.

However, recently at a school P&C function, Simon became verbally and physically threatening towards a friend about an issue which had been brewing for some time. Making a terrible scene in front of school acquaintances, Simon was extremely embarrassed about his behaviour.

Although his wife said not to worry about the incident, Simon decided to see a psychologist to prevent such an outburst reoccurring.

After our meeting, Simon discovered several life patterns where anger and aggression were present. At work, he can be aggressive as a part of his role. Socially, he recalled incidences of aggressively throwing golf clubs after a poor shot and getting very upset when a friend made fun of his football team.

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