Steve Andreas – You’re Not Good Enough
Description
There are a huge number of people with PTSD and there is an urgent need for quick and effective ways to work with them. Most modern treatment approaches are simplistic and highly ineffective. When I asked a veterinarian in Iraq I recently worked with about her previous 5 years of treatment, she said:
I think I saw 8 or 9 different psychiatrists and all they wanted to do was give me medicine, and then they had all these stupid things they wanted to do, like tapping when you thought about war, and they were doing this tapping and that was to reduce it. And they had this thing with a finger, follow your finger while you think about the bad – it was stupid! It didn’t lead to anything, it just pissed me off, and then sent me to the next psychiatrist. It was a waste of my time. … I love having the tools (which I taught her) now because they didn’t give you any of these when we got back. … Now I have a way to deal with everything — to do something, at least to make it better.
The term PTSD is sometimes applied very loosely to any unpleasant memory of an event that continues to bother someone. Being deprived of childhood, repeated failures in school or business, or being abandoned by a lover can be very frustrating, but it usually isn’t life-threatening. The DSM 5 criteria for PTSD are quite specific: exposure to a terrifying life-threatening event, followed by a variety of symptoms that persist and do not disappear over time. (For more detailed diagnostic criteria, see the section at the end of this article.)
Bill was driving the front Hummer in a convoy in Iraq when an improvised explosive device detonated on the side of the road, killing several people in the car. Since then, Bill has started having trouble sleeping due to nightmares experiencing an explosion and frequent daytime memories when he hears a loud noise. Since then, he has been isolated, drank too much, felt depressed, and sometimes went into a rage.
Bill’s experience meets all the DSM 5 criteria for PTSD: the core of PTSD is essentially a phobic response to the horrific event itself, and can usually be successfully treated with NLP phobia treatment, in which Bill can learn to look at the event as if he was an uninvolved bystander, seeing himself passing through him from the outside. This is the core of PTSD, and for some sufferers, that’s all there is. An example is John’s description in chapter 7 of The Heart of the Mind (pp. 61-63). One treatment for the phobia resolved all of his symptoms.
However, there are many other aspects that contribute to the development of PTSD, and they are often confused with the main phobic response, even by “experts” in the field. These additional aspects are very different from the basic phobic response, and each requires a different intervention to achieve resolution. Some of these are closely related to the incident itself, while others occur before or after the traumatic event. Let’s take a closer look at Bill’s experience to illustrate these additional aspects.
Aspects closely related in time.
Bill knew that a fizzy bottle on the side of the road could serve as a signal for an improvised explosive device, but he chose not to pay attention to it, so he regrets not stopping, and constantly berates himself for his poor judgment, and feels guilty for death. which led to this. Bill’s best friend was killed in the Hammer blast, and Bill mourns the loss. In the fury of the ensuing attack, Bill fired at everything that moved, including two women and several children, and was very ashamed to kill them.
Aspects that have developed subsequently.
Bill’s lower limbs were severely injured in the blast and had to be amputated, so Bill also grieves over this loss of many different valuable sports and activities. In addition, he has a traumatic brain injury (TBI) and is overwhelmed by the enormous challenge of adapting to these disabled people. He was engaged to a woman with whom he was deeply involved. When she found out about his wounds, she threw him like a hot stone, and it was as if part of him had died, robbing him of love and support when he needed it most. It was then that he started drinking too much and his fits of rage got worse and more frequent.
Aspects that have developed in advance.
Long before Bill joined the military, he was repeatedly verbally (and some physical) abused by his father, and he internalized that voice that constantly criticized him no matter what he did. Bill spent almost a year in the red zone, under constant threat of attack 24/7. Constant anxiety has already made him habitually hypersensitive, sleep poorly and instantly reacting to any surprise, becoming fully alert and ready to respond with violence. Bill joined the army as an idealistic fanatical warrior, but he was already disillusioned with the harsh reality of war and decided that it was a tragic and useless waste of time, making his burden completely meaningless.
Regret, grief, guilt, shame, physical disability, loneliness, insomnia, rage, drug use, self-criticism, depression, generalized anxiety, increased alertness, violence, frustration – all of these (and more) can be part of what is often referred to as PTSD … Each of these tends to exacerbate other aspects in the “perfect storm,” which often appears to the sufferer as part of one tangled and entangled ball of chaos and emotional instability. This training teaches how to separate these different aspects and how to work with each of them using different processes that are suitable for successfully working with each of them.
The Summary of Diagnostic Criteria for DSM 5 identifies a PTSD trigger as exposure to actual or impending death, serious injury, or sexual assault. The impact must be caused by one or more of the following scenarios in which the individual:
directly experiencing the traumatic event;
witnesses of the traumatic event in person;
learns that the traumatic event happened to a close family member or close friend (and the actual or threatened death was either violent or accidental); or
First-hand experiences of repeated or extreme exposure to hideous details of the traumatic event (not through the media, photographs, television, or films, unless it is work-related).
DSM-5 focuses more on the behavioral symptoms associated with PTSD and offers four different diagnostic clusters instead of three. They are described as re-experiencing, avoidance, cognitive and mood negative, and arousal.
Re-experiencing encompasses spontaneous memories of a traumatic event, recurring dreams associated with it, memories, or other intense or prolonged psychological distress.
Avoidance refers to unpleasant memories, thoughts, feelings, or external reminders of an event.
Negative cognitive abilities and moods represent a myriad of feelings, from persistent and distorted feelings of guilt towards oneself or others, to alienation from others or markedly reduced interest in activities, to an inability to remember key aspects of an event.
Finally, arousal is characterized by aggressive, reckless, or self-destructive behavior, sleep disturbances, hypervision, or related problems. This includes the “fight” aspect of PTSD as well as the “escape” aspect.
tristian –
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