If You Really Listen: A message from a critically ill child – By Lorie Hood

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If you really listen you can hear me. If you look beyond what your eyes are telling you and what you think I need, you can see me. I know it’s hard because I know how much you love me. I know how much you need me but you see, right now, I need you.

I need you to remember that there is a me. Yes, I came through you and in this world you and I are connected but I am not you.

Don’t lose me. Don’t lose me in your pain and fear. Don’t let me become another expression of your needs or perceived failures. Try, please try.

Try to see past the blinking lights and monitors; the therapists and nurses. Try to see me. I am looking for you and I am trying to help you see me. I am not just this body with its secretions to be suctioned and lungs that need to be thumped and forced to cough. I am not just my cancer that may or may not come back. I am not just the child on whom you calculate odds so you can plan your life or your grief. I am here and I am trying so hard to communicate with you.

Look at me. Look at ME. Not my body, not my hand or mouth or other part that needs attention. Look into my eyes and let me look back. I need to look back. I need see that you see me.

Listen with your eyes. Listen with everything. Listen carefully with all of your senses. I am trying to communicate all the time. I am forcing myself to stay awake despite being so sleepy. I am forcing myself to stay awake just so I can catch your eye but when I do, it’s only for a second and you flit away to attend to another body part of mine or monitor or to discuss me or my progress with someone else.

Please listen. Please see me. I miss you and I feel so alone.

Basic Science (emphasis on basic) behind Trauma Informed Work

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Western science generally separates the human mind into two broad categories; the conscious mind and the subconscious mind. The conscious mind is responsible for things like short-term memory, logical and analytical thinking, and decision making (as in thinking on one’s feet); it is the part of our mind of which we are aware. The subconscious mind holds long-term memory, belief systems, associations, perceptions (and a whole lot more) and is the part of our mind that is, well, not so accessible. The conscious mind is able to process about 40 bits of information per second while the subconscious mind is believed to process upwards of 40 million bits per second. The take away here is not how many “bits” of information an average conscious or subconscious mind can process per second (after all, what constitutes a “bit” of information  depends on an operational definition). The take away is the phrase “a whole lot.” The unconscious mind processes information a whole lot faster than the conscious mind (see “emphasis on basic” in above title).

“Why should I care about my subconscious mind and what does it have to do with trauma?”

Our conscious and subconscious minds process information very differently and without training, do not communicate with one another effectively. When we are stressed, our subconscious minds take over and we lose partial (or complete) access to our more conscious processes. This is how our subconscious mind doing its job.

Our subconscious mind has evolved to keep us safe. When we feel unsafe (and it is largely our unconscious mind that makes this determination) we transition into a more defensive state of consciousness that can feel like wariness on one end of a spectrum to a state of complete overwhelm known as fight or flight, on the other. The degree to which we our subconscious mind takes over and we move to the fight/flight end of the continuum is commensurate with access to our conscious mind – the more we transition into fight/flight, the less access we have to our conscious processes.

 

 

 

What Causes PTSD? 

Explanations of PTSD focus primarily on the way that the mind is affected by traumatic experiences. Theorists speculate upon facing overwhelming trauma, the mind is unable to process information and feelings in a normal way. It is as if the thoughts and feelings at the time of the traumatic event take on a life of their own, later intruding into consciousness and causing distress. Pre-traumatic psychological factors (for example, low self-esteem) may make this process worse (for example, low self-esteem may be reinforced by a brutal rape). Post-traumatic reactions by others (for example, a raped woman who is viewed by family as “dirty”) and by the self (for example, physical discomfort caused by memories of the rape) may also play a role in influencing whether such symptoms persist. It is hypothesized that only after successful reprocessing of the traumatic event(s) do PTSD symptoms decrease. In addition, powerful new techniques for studying the brain, its structures and its chemicals

Source: What Causes PTSD? | Psych Central

What the New York Times gets wrong about PTSD 

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Believe it or not, both the public and policy-makers often get their ideas from the media. When those ideas are formed about something as serious and impactful as posttraumatic stress disorder, it’s important for the media to tell the story in the right way.

With that in mind, Drexel researchers examined how the country’s most influential paper, the New York Times, portrayed posttraumatic stress disorder (PTSD) from the year it was first added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (1980) to present day (2015).

“Mass media shape public awareness about mental health issues and affect mental illness problem recognition, management, and treatment-seeking by providing information about risk factors, symptoms, coping strategies, and treatment options,” said Jonathan Purtle, DrPH, assistant professor in Drexel’s Dornsife School of Public Health and the study’s principle investigator. “Mass media also influence community attitudes about mental illness and educate policymakers about whether and how to address them.”

Between 1980 and 2015, 871 news articles mentioned PTSD. In theirAmerican Journal of Orthopsychiatry paper, Purtle and his co-authors, Katherine Lynn and Marshal Malik, pointed out three specific issues in the Times’ coverage that could have negative consequences.

“New York Times portrayals of populations affected by PTSD do not reflect the epidemiology of the disorder.”

The Drexel team found that 50.6 percent of the Times’ articles focused on military cases of PTSD, including 63.5 percent of the articles published in the last 10 years.

In actuality, Purtle’s past research showed that most PTSD cases are related to noncombat traumas in civilians. The number of civilians affected by PTSD is 13 times larger than the number of military personnel affected by the disorder.

Occurrences are also much more likely in those who survive non-combat traumas, which include sexual assault (30-80 percent of survivors develop PTSD), nonsexual assault (23-39 percent develop it), disasters (30-40 percent) and car crashes (25-33 percent), among other causes. Veterans of the wars in Afghanistan and Iraq have just a 20 percent occurrence of PTSD.

However, coverage like that in the Times leads the general public to believe that a PTSD diagnosis requires some military component. And 91.4 percent of all legislative proposals involving PTSD between 1989 and 2009 focused only on military populations, with 81.7 percent focusing on combat as a cause (the next highest cause was sexual assault, at 5.5 percent).

“PTSD was negatively framed in many articles.”

Self-stigma attached to PTSD has been identified as a strong barrier to seeking treatment.

As such, with fewer and fewer articles over the years mentioning treatment options (decreasing from 19.4 percent of all PTSD-focused articles in 1980-1995 to just 5.7 percent in 2005-2015), it is particularly harmful when articles focused on negative portrayals of those with PTSD.

Purtle and his researchers found that 16.6 percent of the articles were about court cases in which the defendant potentially had PTSD, while 11.5 percent of other articles talked about substance abuse.

“These negative themes could create misconceptions that people who have PTSD are dangerous and discourage employers from hiring prospective employees with the disorder,” Purtle said.

“Most themes in the New York Times PTSD articles pertained to proximal causes and consequences of the disorder.”

Most articles in the study’s 35-year focus centered on the traumatic exposure that led to PTSD, as well as the symptoms that result from the disorder. They rarely told stories of survivors and prevention.

Although nearly three quarters of articles mentioned a traumatic cause of PTSD, concepts such as risk/protective factors or prevention were barely mentioned. Risk/protective factors were only mentioned in 2.6 percent of articles and prevention was only mentioned in 2.5 percent.

Almost a third of the articles reviewed discussed some kind of symptom — nightmares (13.1 percent of the time), depression (12.3 percent) and flashbacks (11.7 percent) being most common.

“This narrow focus could inhibit awareness about PTSD resilience and recovery and constrain discourse about the social determinants of traumatic stress, which is needed to garner political support for policy interventions,” the Drexel team wrote.

What Can Be Done?

Purtle, Lynn and Malik believe that broadening the discourse on PTSD can lead to better outcomes. Some ways that that can be achieved are focusing on survivor narratives that discussing resiliency and recovery, or talking about research that doesn’t wholly focus on the military causes of the disorder.


Story Source:

The above post is reprinted from materials provided by Drexel University. The original item was written by Frank Otto. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jonathan Purtle, Katherine Lynn, Mashal Malik. ‘Calculating the Toll of Trauma’ in the Headlines: Portrayals of Posttraumatic Stress Disorder in the New York Times (1980–2015).. American Journal of Orthopsychiatry, 2016; DOI: 10.1037/ort0000187

In analyzing the articles the New York Times has written about post-traumatic stress disorder over the last 35 years, researchers found some troubling trends in the influential paper’s coverage.

Source: What the New York Times gets wrong about PTSD — ScienceDaily

Size of Brain Region May Impact How Well Exposure Therapy Works for PTSD | 

New research suggests that PTSD patients with a larger region of the brain that helps distinguish between safety and threat are more likely to respond to exposure-based therapy. The study expands upon prior research that discovered having a smaller hippocampus is associated with increased risk of PTSD. In the current study, researchers at Columbia University Medical Center (CUMC) and New York State Psychiatric Institute (NYSPI), examined the relationship between hippocampus volume, and response to treatment in 50 participants with PTSD and 36 trauma-exposed healthy controls. The volume or size of the hippocampus was measured with magnetic resonance imaging. The participants were evaluated at baseline and after 10 weeks, during which time the PTSD group had prolonged exposure therapy. Exposure therapy is a type of cognitive-behavioral therapy that has been shown to help patients with PTSD discriminate between real and imagined trauma. The study, published online in Psychiatry Research:

Source: Size of Brain Region May Impact How Well Exposure Therapy Works for PTSD | Psych Central News