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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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Recovery: Exposure Therapy Q: Dear Frank, Can you explain exposure therapy? A support pal is considering doing EMDR with a therapist and wants to know more about it. A: Dear Joyce, Exposure therapy refers to many different techniques that mental health professionals use to help people overcome symptoms of PTSD and related conditions. The symptoms include anxiety, avoidance, flashbacks, and phobias. In some cases, the client has been afraid of objects or conditions that never caused them physical harm - like spiders or heights or public speaking. In other cases, the client is terrified of her or his own memory, usually of an event that occurred and that re-occurs in dreams or in vivid recollection. Exposure means that the therapist gains the client's confidence and manages to have them encounter the object or the situation that they dread, but this is done in ways that enable the person to experience mastery, overcoming the emotion of terror or disgust. Usually it requires lessons in "self-soothing" so that relaxation is achieved and sustained while fearful stimuli are experienced. There are two radically different schools of thought about experiencing dreaded stimuli. One school recommends creating a hierarchy from minimal to maximal stimulation, taking small steps to advance from mild to major stressors. A woman who was mauled by a large dog and who cannot go near a German Shepherd without collapsing in a state of terror begins looking at pictures of puppies. She does this with a trusted therapist near by. She breathes slowly and steadily. She is congratulated and encouraged. A week later, she looks at pictures of a medium sized dog. Eventually, she spends 20 minutes near a barking dog behind an electronic fence. In this approach, she never experiences terror or horror. She moves through successive approximations from tolerable exposure to major confrontation. The psychologist Joseph Wolpe emphasized pairing relaxation training with this climb up a ladder of carefully arranged rungs, one small step at a time. He called it "reciprocal inhibition," since relaxation was paired with stressful stimulation. It worked for phobias and fears - but it didn't always last very long. Psychiatrist Isaac Marks discovered that staying in the presence of a dreaded stimulus for 40 to 45 minutes caused great anxiety, but eventually the fear response ended on its own. That was called "flooding." If you didn't drown in the flood of fear, you came out of the session with a cure that lasted. But this technique required considerable courage - courage on the part of the patient and the doctor! To prepare for a session of living with your worst fear, you needed to trust the therapist and you needed to learn ways to reduce the physical and mental components of anxiety. In the 30 years following the creation of the PTSD diagnosis, and the recognition that millions of survivors were not only anxious, but were also prone to unwanted memories of dangerous, deadly and degrading encounters, several new techniques of exposure were invented. EMDR requires the client to follow a moving finger while holding a fearful image in the mind. Ochberg's Counting Method requires the client to silently recall a dreadful event while the therapist counts to 100. Virtual reality techniques take the client to scenes of war or disaster, while in the sanctuary of a safe place. The exposure in these situations is to a memory or an image of something fearful, but that exposure is coupled with something that is soothing or comforting or predictable. The client tolerates stress and fear is extinguished. Exposure is NOT psychoanalysis - in which unconscious fears are brought to the surface and exposed. Exposure is NOT cognitive behavioral therapy - in which thoughts are modified from self-stigmatizing references to self-confident references. Exposure IS an encounter with an object or an image or a memory that evokes powerful negative emotion, but that encounter is made tolerable. And once a person can tolerate a trigger, the trigger loses its power to deliver a bullet. The stress response is disarmed. Tweet Was this helpful to you? If so, please consider supporting our work.

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