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Gift From Within - PTSD Questions & Answers with Frank Ochberg, M.D.

PTSD: Definition of PTSD How Common, Who Gets PTSD? Is PTSD a normal event? Does PTSD Affect The Brain? Duration Pregnancy Delayed Onset PTSD PTSD Tip Sheet for your Doctor Medications for PTSD Distinguishing PTSD from BPD Generalized Anxiety Disorder Can the Wounds of PTSD Heal? Complex/Chronic PTSD: CPTSD Explanation Long Term Prognosis & Complex PTSD PTSD vs. CPTSD Managing Past Intense Feelings Overcoming Complex PTSD PTSD Symptoms: Anger and Brain Injury Anger Flashbacks Loneliness Feelings Of Loss And Sense Of Self Anxiety Numbing Re-Traumatization Differences bet. Depression, Dysthemia, Major Depression Depression vs. Sadness and Grief Biological Depression Memory Loss Triggers and Body Sensations PTSD & Facial Tics Emotional & Physical Reactions Delayed Stress Response after Experiencing a Shock Can A False Memory Happen? Differences Between Hypervigilance and Hyperarousal Negativity & Pessismism after Trauma PTSD/PTSI Insomnia: Not Being Able To Sleep PTSD/PTSI & Psychosis Relationships: Peer Support Issues Explaining PTSD To Children False Memory Toxic Family Of Origin Protection From Unwanted Contact Preventing Intergenerational PTSD Numbing in Male Survivors of Domestic Violence How To Increase Social Support Caregivers/Partners with PTSD: Starting a Conversation about PTSD Both Partners with PTSD & its Complications Fiancé Doesn't Believe in Therapy Managing PTSD After Partner Pushes Too Hard Childhood Abuse: Emotional Abuse Childhood Trauma & Intrusive Images Revisiting The Scene Of Trauma And Abuse Gaslighting Stockholm Syndrome & Child Abuse Survivors Can a Child be Born Depressed Childhood Survivors and Being a Parent Work Issues: Disability Letter for Attorney-Sample Low Stress Jobs Doctor's letter for Employer Sample Dealing with Co-Workers Job Searching with PTSD Recovery: Frank Ochberg's Color Wheel of Positive Emotion Triggers Rebuilding Self Esteem Life After Trauma Coping During The Holidays Substance Abuse Improving A Damaged Self-Concept Explaining PTSD is a Responsibility Grief & Loss from a Tragic Death The Trauma Bond & Forgiveness Sudden Panic, Anxiety & Flashbacks Stockholm Syndrome, Trauma Bond and Undue Influence Therapy: Dialectical Behavior Therapy (DBT) Inadequate Therapy When to End Therapy Repeating Your Trauma Story PTSD Symptoms After The Therapy Hour Exposure Therapy Service/Therapy Dogs & PTSD ECT (Electro-Convulsive-Therapy) Bipolar & ECT Therapy: An Interview Telling Trauma Story to Therapist PTSD Client Expectations from Therapy Sessions Veterans & PTSD: PTSD A Disease Seasonal PTSD & Anniversary Reaction. Emotional Injury Therapy Sessions Active Listening for Moms and Friends Military Sexual Assault Professionals: Compassion Fatigue Consequences Of Emotional Numbing School Teachers And PTSD Using The Counting Method with Clients Helping Clients with PTSD Other Conditions: Borderline Personality Disorder Social Phobia Dissociation Obsessive-compulsive disorder (OCD) Cutting & Self Harm Link between PTSD, BPD and Bi-Polar Somatization Disorder or Briquet's Syndrome Stockholm Syndrome & Child Abuse Survivors Dealing with Psychopaths & Narcissists
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				Dissociation Q: Dear Dr. Ochberg, My name is Patti. I'm a Gift From Within support pal. I've never paid much attention to dissociation as it relates to trauma, until I've begun having times here lately where I zone out. My therapist confirmed that there is always some dissociation associated with trauma. I'd like to understand how it manifests itself, what type of symptoms, and also why they begin so long after the trauma. Could you discuss this? A: Dear Patti, Dissociation is one of the least understood symptoms in psychiatry. It means an altered state of consciousness and can be very subtle, like deja vu, or quite frightening, like derealization. In deja vu, a common occurrence, a person has the sense of being in a familiar place, or having a familiar sensation, but they cannot remember the original scene. It is as though that part of the brain that gives us the sensation of similarity has been stimulated, without any good reason for the sensation to occur. In derealization, the surroundings are distorted. Objects may be larger or smaller; sounds may change volume or tone. The flaw is not in the organs of sense. Nothing wrong with the ear, the eyes or the receptors in the skin. The problem is in the brain, where perceptions are received, organized and interpreted. Derealization is episodic, not constant. Feeling "zoned out" -entering a trance-like state- is relatively common during or after severe trauma. The term "shell shock" refers to battlefield conditions with soldiers wandering in a daze after comrades are killed and the echoes of gunfire and mortar rounds slowly subside. Dissociation can be thought of as a defense against panic and terror. Instead of having acute awareness of the surrounding danger, instead of having accurate recollection of a devastating event, one has a hypnotic reverie, like being drugged. One of my traumatized patients experiences dissociative fugue. She drives long distances without knowing why or where. She awakens with no clear memory of the trip. But she is not psychotic. She can interact with people along the way, get gas, count change and appear to be perfectly normal. These varieties of dissociative states (deja vu, derealization, trance, fugue) do not respond well to medication and are not easy to treat with psychotherapy. Specialists in dissociation overlap with specialists in PTSD. When "zoning out" is a relatively minor component of PTSD, as it frequently is, the general principle of post-traumatic therapy apply (see http://www.giftfromwithin.org/html/trauma.html ). Any symptom of PTSD can appear long after the original trauma. Entering a trance or a fugue can be your body's way of avoiding anxiety. Coping with the cause of that anxiety is the best way to eliminate dissociation. Dissociation may feel better than anxiety, but it is not an effective way to face the world. Tweet Was this helpful to you? If so, please consider supporting our work.
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