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Gift From Within - Questions & Answers with Frank Ochberg on PTSD

	PTSD: Definition of PTSD How Common, Who Gets PTSD Is PTSD a normal event? Does PTSD Affect The Brain? Duration Emotional Abuse Childhood Trauma & Intrusive Images Revisiting The Scene Of Trauma And Abuse Pregnancy Delayed Onset PTSD PTSD Symptoms: Anger Flashbacks Loneliness Feelings Of Loss And Sense Of Self Anxiety Numbing Re-Traumatization Depression Memory Loss Chronic PTSD Relationships: Helping Friends Explaining PTSD To Children Workplace Issues False Memory Toxic Family Of Origin Caregivers/Partners with PTSD Protection From Unwanted Contact Recovery: Frank Ochberg's Color Wheel of Postive Emotion Triggers Rebuilding Self Esteem Life After Trauma Coping During The Holidays Substance Abuse Improving A Damaged Self-Concept Explaining PTSD is a Responsibility Exposure Therapy Grief & Loss from a Tragic Death Managing Past Intense Feelings with Complex PTSD Therapy: Dialectical Behavior Therapy (DBT) Inadequate Therapy When to End Therapy Repeating Your Trauma Story Veterans & PTSD: PTSD A Disease Seasonal PTSD & Anniversary Reaction. Emotional Injury Therapy Sessions Active Listening for Moms and Friends Professionals: Compassion Fatigue Consequences Of Emotional Numbing School Teachers And PTSD Using The Counting Method with Clients Other Conditions: Borderline Personality Disorder Social Phobia Complex PTSD Dissociation Obsessive-compulsive disorder (OCD) Cutting & Self Harm Link between PTSD, BPD and Bi-Polar Somatization Disorder or Briquet's Syndrome
		Questions & Answers with Joyce Boaz & Dr. Frank Ochberg Read "Survivor Psalm" by Frank Ochberg
				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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