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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

PTSD Questions & Answers with Joyce Boaz & Dr. Frank Ochberg, M.D. Read "Survivor Psalm" by Frank Ochberg

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PTSD Symptoms: Anger. Q: Dear Frank, A support pal with PTSD asked me how to deal with her PTSD symptoms, particularly anger and irritability. She gets angry and then takes it out on the people around her even though they are not the ones who traumatized her in childhood. It is distressing to her because she doesn't want to hurt those dear to her and she doesn't want to lose her friends and the family she does talk to. A: Dear Joyce, I'm encouraged by this GFW support pal's recognition of her anger. That is a very important first step. Many people with PTSD are easily irritated and the irritation can be way out of proportion, reaching states of rage and violence. There is a condition called Intermittent Explosive Disorder or IED. My veterans returning from Iraq and Afghanistan think of IEDs as roadside bombs that kill their buddies. But they, themselves, can feel like a ticking time-bomb. When a person with PTSD reports this type of anger management problem to me, I evaluate their risk for deadly outburst very carefully. We need a plan to reduce immediate access to deadly weapons (not an easy task when the person is a veteran who feels very insecure when separated from a "tool of the trade" that confers a sense of safety). We need to work together to identify situations likely to result in aggression, such as classroom discussions in which he feels defensive or humiliated by a cock-sure student advocate for some change in military policy, having never served in combat. We need to limit binge drinking. We need to bring helpful friends and family into the equation, giving a buffer zone to help diffuse explosive feelings. I have had patients who confided homicidal impulses. Believe me, it isn't easy to find yourself being the one who works as an intimate advisor, who keeps confidences, who helps someone else develop a longer fuse. No quick fix, here. No sure-fire pill. This GFW pen pal is not a veteran with an explosive personality, She is honest with herself, aware of her behavior, and looking for ways to help tame the tiger within. Good! Physical fitness is often the best place to begin. Are you in good shape? If not, why not? If so, can you add a bit of energy to your routine? Exercise does wonders. Even if you are limited by injury or money or cold weather or a habit of avoiding exercise. There is always something you can do to improve your strength, endurance, flexibility, muscle tone and sense of physical fitness. Are you reading this and saying, "not for me?" Or are you saying, "I can start today." Take a brisk walk. Sweat. Shower. Tell yourself you are on the path. Stay on the path. If you read the web, find a site that speaks to you about getting in better shape. Working out is the best first step for anger management. The adrenalin that drives your PTSD set of anxiety and anger symptoms is put to good use. You sleep better. You have healthy rather than unhealthy cycles of arousal and repose. When you start feeling more fit, you have physical and emotional rewards. Your anger fuse lengthens. Analyze your sources of irritation. For a while, you will be easily moved to snapping back and lashing out. That comes with the PTSD territory. But you have already accepted responsibility. It's you and your PTSD, not every one else's problem. Do what you can to increase your contacts with people and places and activities that give you peace and pleasure. Do what you can to limit your exposure to Kryptonite - the stuff from a previous life that makes you weak and vulnerable. Sound simple? It isn't. But others have done it. Other's who visit the GFW pages have done it. Tune in. Share ideas. Apply them to yourself in specific ways. Read a bit on DBT - dialectical behavioral treatment. I've discussed it briefly elsewhere. Here's a user friendly link: http://www.dbtselfhelp.com/ Although DBT was created for people with borderline personality, it works well for PTSD anger. You learn how to be mindful. You learn how to modulate emotion. You take responsibility without putting yourself down or blaming others. There are medications that help some, but the usual PTSD anger can be managed without meds. I always explain the use of medication to establish a normal sleep pattern, to control panic-type anxiety, to overcome severe depression and, sometimes, to help break an addiction to alcohol or abusive drugs. I'm not anti-drug. But there is not a standard drug for anger control. It takes careful diagnosis and caring prescription. There are anger management classes. Often these classes help a person become assertive without becoming aggressive. A decent therapist can often provide these skills -- and the therapist need not be a trauma specialist. When anger is clearly a component of PTSD, wholistic treatment for PTSD will help reduce all the symptoms, including the anger. Here's my chapter on treatment: http://www.giftfromwithin.org/html/trauma.html It was written a couple of decades ago, but it still has relevance. I hope it helps you. If not, its OK to be angry with me. A little. Tweet Was this helpful to you? If so, please consider supporting our work.

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