TSHP360: PTSD – Anxiety following a traumatic event

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What’s Coming This Episode?

Over the last few weeks we have been diverted from our planned series on anxiety to deal with various Covid19 issues that have arisen as the lockdown has, in different ways, affected us all. This weeks podcast completes our anxiety series and topically examines the disturbed and unresolved feelings that are a results of the events that many will have witnessed, especially our frontline workers.

Enjoy the show and take care, it’s The Self Help Podcast!

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PTSD – Anxiety following a traumatic event

Over the last few weeks we have been diverted from our planned series on anxiety to deal with various Covid19 issues that have arisen as the lockdown has, in different ways, affected us all. This weeks podcast completes our anxiety series and topically examines the disturbed and unresolved feelings that are the results of the events that many will have witnessed, especially our frontline workers. The effects of Covid19, that is not yet over, will have an emotional ripple effect that may last for several years.  The symptoms of unresolved trauma are multiple but commonly include some flashbacks and problems with concentration, difficult emotional regulation, disturbed sleep and eating patterns and disrupted relationships. The question is what is trauma and what is it that we can do about it?

Trauma, is a Greek word meaning “wound”. Originally this was related to a physical injury. With the development of psychology and our understanding of the inner person we now say that a wound can be considered to be physical, mental, emotional, financial and so on. The concept of trauma comes from the idea that the wound, or event that is being experienced, is greater than the  resources that we have to deal with it. In that sense we have been overwhelmed. However, there is a difference between experiencing trauma and being traumatised.

Traumatised, or traumatisation is when the overwhelming experience/trauma creates an amount of stress that is so great that it exceeds our ability to deal with the emotions aroused. This is clearly an emotional issue. Trauma or traumatic disorders are always emotional even if they come from physical damage.

Post trauma is the emotional fall out that stays with us after the experience has ended. This may be short term. It is our recovery time in which we process our emotions, this may take hours, days or weeks. In most cases the emotional effects of a trauma will be normalised within four weeks and sometimes extends to eight or ten weeks. The important thing is that is does subside as the emotional arousal is desensitised.

Repressed trauma can happen when an event is too difficult for us to deal with in the present and we hide it in the recesses of the mind. When this happens we may have no direct memory of the event that caused the trauma though it may still effect who we are, how we experience the world and, our behaviour. It is assumed that the mind repression developed to protect us from that which was too difficult to contemplate. In repression the victim will often fall sleep after the incident. In the the post incident sleeping process the R.E.M. (rapid eye movement) part of the sleep cycle, similar to dreaming, allows the memory to be coded and hidden or repressed in the back of our mind.

Recovered memory may be delayed by weeks, months, years, or even decades. Though when it does emerge the original repressed emotions are released as though the event has only just taken place. Therapeutically this release of emotion and memory is termed an ‘abreaction’ and involves the re-experiencing of the trauma physically, emotionally and mentally. This may occur many years after the original incident.

Emotional responses Although in repression the cognitive memory is lost to the consciousness mind it does have a constant effect on everyday life and experience and may appear as irrational fears, anxiety, depression, phobia etc. This is described and ‘something within us but outside of our control’. Perhaps you feel a sense of panic when you see the colour green. This may seem irrational because there is no logical reason for, or understanding why, this might be happening. Yet, the emotions related to the repressed memory remain active.

Post Traumatic Stress Disorder (PTSD) is when the emotional responses are not repressed but are also not processed. When the effects of the incident remain active after six to weeks it is given the PTSD diagnosis. As acknowledged above trauma may take eight to ten weeks to process. This means that definitions and diagnosis of PTSD can be difficult in the first instance. When we are looking at symptoms continuing after months or years we are definitely talking about PTSD.

PTSD Symptoms will vary but will include finding it difficult to forget the incident or event that happened. There may be flashbacks, daymares or nightmares about the incident. Unstable and irrational emotional responses such as anger, tears, anxiety, depression, phobias, disturbed sleep/eating patterns, and so on.

Rumination is the symptom builder. We know psychologically that, ‘what we think about we bring about’ and that ‘thoughts become things’. When we continually go over the traumatic incident we are unable to let it go. The more we ruminate on them the more it becomes intensely embedded in our unconscious and conscious mind because we as keep thinking about, and we are  reinforcing it in our mind/brain.

The MindBrain is where the software of the psychological mind and the hardware of the brain interface. The main aspect of the brain that effects our emotional self is the limbic system in the centre of the brain. Within the limbic system is a little organ call the amygdala. In this organ are templates of cells that relate to out emotional responses.

Let say that when I am young I watch my mother reacting phobic-ally to spiders, I then build a template of cells in my amygdala so that when I see a spider the template of cells release chemistry and so I also react to the spiders as a phobia. Over time my spider template will become hotter and more embedded the more I visit it. ‘What you feed grows and what you starve dies’. With rumination the issues will only ever get bigger.

All emotional responses are like this, even the positive ones. So, that if I see the object of my love the love template of cells in my Amygdala become hot and release the chemistry that make me feel loving. If on the other hand I see the object of my hatred, that template will then become hot and release the chemistry anger, hatred etc.

It normally takes about five repetitions of an emotional experience to set up a template in the amygdala which is then built and embedded as we revisit it. If an event is so intense then the template is punched in traumatically and the template is created immediately. Once a traumatic template has been established it will remain hot and active and become ever more embedded over time unless, or until, it is treated and desensitised.

Treatment for trauma is a variable feast and will depend on where you live and the therapy that is available to you or which is fashionable at the time. Cognitive therapies such as CBT (cognitive behavioural therapy) are not that good at dealing with trauma in the longterm. They do have a short term effectiveness by putting in place cognitive tools that often repress the emotion. This has the immediate effect of creating a feeling of relief and assumed cure. However, when this happens the emotions are not processed but held in check leaving them to often reappear at a later date.

EMDR or Eye movement desensitisation and reprocessing is a therapy that mimics the rapid eye movements that happen during the dream cycle in the sleep pattern. As the emotional trauma is often encoded into the MindBrain using the same part of the system EMDR is surprisingly effective in the majority of cases.

Rewinding is by far in my opinion the best option as it uses the very same process to desensitise a template in the amygdala that was used to put it there in the first place, this is visualisation. When we revisit a trauma it is through the senses of sight, smell, tastes and touch, none of which are cognitive. During rewind therapy the emotional memories are address directly and desensitised.

Mindful meditation is becoming main stream psychology. Mindfulness is the best prevention for all forms of stress and provides the resources needed at the point of trauma. The process of mindfulness is relaxation, contemplation, concentration and meditation a process that is in itself therapeutic. Consistent meditators become their own therapists and counsellors and are able to overcome many things that may overwhelm others. When used with PTSD this needs to be a guided process with an experienced therapist. In the first instance the process of stilling the mind can allow repression’s, flashback and lost memories to appear from the recesses of the mind. When the subject is not prepared and supported though this stage it can simply reactivate the events and the emotional responses and recreate the trauma. When use well Mindfulness allows the subject to revisit those events that were overwhelming and deal with them and desensitise them.

Medication has to be the last on my list. I am not against medication on this basis, if I have a headache I will do all that I can to get rid of it, as a last resort I will take an aspirin. There are medications that can help with anxiety, depression, panic, high blood pressure and so on. There are also natural alternatives that maybe gentler on the system both psychologically and physiologically. If you do suffer trauma never suffer alone psychotherapy is a good and powerful thing.

The positive use of medication is when it runs alongside psychotherapy. When medication is used as a prop that can hold us up emotionally while we complete the desensitisation it has done its job and we can let the medication go. Many people are given the medication after a traumatic event but do not get the psychotherapy. This usually ends up with people becoming long term users and taking medication for many years when it should really have only been used for a few months.

Covid19 and PTSD

In the aftermath of this pandemic there will be many people who carry post trauma from their experiences. The survivor who wakes in intensive care to find themselves anchored to a bed with tubes and wires attended by people dressed in PPE, will develop some level of trauma. The frontline workers and triple nine workers that have experienced multiple deaths will have a lot of emotional and visual material to process and may become easily overwhelmed. Anyone who has lost people around them may also experience post trauma. However, everyone who listens to the news, goes to the shops, has to wear masks, is unable to associate or socialise or live their normal life in the normal way can become traumatised. The longer this goes on the more PTSD issue and cases will develop.

It is so important that we stay actively involved if only through social media, that we keep our bodies moving and do anything that we can to make ourselves and those around us happy.

Take care, stay safe, wash your hands, stay home, and do what you can to be happy

Sean x

TSHP359: What to you choose? Fear, Learning or Growth?

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What’s Coming This Episode?

The lockdown continues. Week 4 in the UK and some new habits are forming. The excitement has worn off and reality is setting in. As ever though, we have a choice as to how we respond. Sean and Ed do their best to help you choose learning and growth…

Enjoy the show and take care, it’s The Self Help Podcast!

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359 How am I responding to Covid 19?

This week I was sent a Twitter link which had this interesting diagram attached, it got me thinking about our responses to what is going on for us right now in dealing with either lockdown, shielding or attempting to maintain a working pattern on the front line. As we, as a society, become more stressed with Covid 19 the pressure is on us. In all things this principle is true…

It is never what happens to us that is important

What is important is how we respond

I was listening to an Italian psychologist talking about the Italian public responding to their lockdown. He described how that in the first instance there was fear and then it was all excitement and novelty with the idea of doing all those things that were on the to do list. Then it was all the online communication, catching up with old friends and creating a online community. Then came the online exercise, keep fit, yoga, learning courses and craft classes. The world became full of box sets and re-runs of old TV series. Then came the boredom, the frustration and the cabin fever. By the fourth week people were really struggling and the levels of depression and anxiety were starting to rise.

I guess that very few of us came into lockdown ready and prepared. For most is was fear then novelty followed by shock. The diagram forwarded to me is really interesting as it suggests that, with a little self control we can create purpose and fulfilment, whatever our situation, including the current lockdown. If we go back to the diagram it shows three zones of human experience. I could say the zones are our choices though you have to first realise that you do have a choice.

Zone One: Fear

Can you remember all those people shopping like crazy for toilet rolls and stripping the supermarket shelves of food (you may have been one of them). At this point people are invested in self survival and have often lost the sense of community and care. Complaints, frustrations and angers come from not being in control, from being stuck in a situation where we are unable to do what we would normally do. At this point alcohol consumption increase as does bad behaviours and domestic violence and abuse. When fear is turned outwards it can manifest as aggression. When fear is turned inwards it can manifest as either depression or anxiety especially when it is overlaid with feelings of helplessness. Often binge eating begins with a reliance on carbs to boost the brains serotonin levels to try and raise our mood.

Zone Two: Learning

This is where the choice begins. Do we wallow in the depression, become over agitated with anxiety or do we use the situation to learn and grow. The decision to grow from our experience is the choice that we can make…

We don’t have problems we have learning opportunities

Taking a bit of time to stop and observe what we are doing, how we are reacting and what we are thinking and feeling will tell us a lot about ourselves and may raise areas that we might like to change, develop or grow. In the learning phase we can decide to stop being negative to stop putting our energy into unproductive thoughts and feelings and focus of the good things around us…

What you feed grow and what you starve dies

If you spend your time listening to news broadcasts and death statistics, chasing negative feeds through social media or Google then the world can become a very dark place full of despair.

What is positive? Captain Tom and his amazing walk to raise money for the NHS?

The positive mind says..

“wow isn’t that amazing that he has done it and that so many people have come together in the country to support him and the NHS”.

The negative mind says…

“it is disgusting that an old man should need to do all that walking and that people should have to give their hard earned money to support a health service that we pay taxes for anyway. This is bad government, who can we blame”.

Remember it is not what happens it is how we respond that is important

Zone Three: Growth

When we enter the growth zone we stop complaining and ruminating on negative things and begin to develop positive action, thoughts and feelings. We stop looking inwards and complaining and begin looking outwards to see what we can do, give, to see how we can help. There are so many people now entering the growth zone. Social media is full of people doing their best to help others and allowing themselves to be helped…

If we all look after each other we will all be okay

These three zones are about our entire life. Where are you at the moment? Which zone describes how you thing, feel and act?

If we are going to be in some form of lockdown for a while we could do a lot of positive things for ourself, for those that we are locked down with and for those around us in our community. This podcast and blog come out on a Thursday, which in my head has been renamed ‘Clap day’. It is the day when we say thank you to other people who are doing all that they can to look after us, run all our services and to keep us safe. Perhaps we could adopt Clap day forever in the future as the one day each week when we stop, check where we are up to, adjust any negative behaviours that we have and, say thank you to those around us.

Thursday, Clap day, Thank You Day.

Take care, stay safe, stay home.

Sean x

TSHP358: Happy being alone? Lockdown can teach us a lot

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What’s Coming This Episode?

An update from the UK as we continue with restrictions on movement and everyday life. Are things getting tougher or easier? Let’s have a chat and don’t be shy about getting in touch, guys.

Enjoy the show and take care, it’s The Self Help Podcast!

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358 Happy being alone?

Lockdown is on us and may be here for a few weeks yet.  How are you doing?

Some people love the opportunity to spend time alone with themselves or with just the few people that they normally have around them. Though, for many people this is the definition of hell, anxiety and fear. I guess that we are naturally social animals and to be alone could be seen as odd. In evolution the group, heard, troop or pack represented our safety – ‘there is safety in numbers’, or so we say. To be pushed out of the group and to be solitary was a dangerous place to be and left us open to predation. Within the group we were protected.

With the coronavirus, the current lockdown means that many of us are cut off from others. Most will be locked down in family units but a lot of people will really be just alone. For many people who live alone, their workplace, or simply the daily trip to the shops allows them to feel connected and that they belong to the larger group or the society that they life in. In lockdown they can be denied this contact.

In psychological terms we talk about attachment or our need to be or feel connected. John Bowlby, the father of attachment theory, is well worth a read. The theory goes something like this. We grow in the womb that provides safety and sustenance for us though the first nine months of our existence. At the moment of birth we have our first experience of separation. If the birth goes well we do not develop anxiety or feel separated from our primary care giver, our mother. If the birth does not go so well and, for whatever reason, we are separated from our mother we can develop attachment anxiety. We know that good births and attentive mothers develop balanced children and eventually balanced adults. When things don’t go so well, if we felt abandoned, unwanted or unloved, even at that very early age, we can develop attachment disorders.

The developmental and attachment effects of the bond between the mother, and also the secondary carer, often the father, will go on throughout our formative years and will dictate how we feel about being alone, being with lots of people or small groups and the style and quality of the relationships that we develop later in life.

Good attachment is described as ‘secure attachment’. A securely attached person does not worry about being abandoned by partners or friends, they do do not fear periods of alone-ness. Their security is their inner emotional belief that others will be their for them and will not let them down. Those with insecure attachment are often fearful of abandonment and may be worried that their partner may leave them or that their friends will let them down. Those that that have anxiety disorders often have insecure attachment that originates with a parental figure letting them down when they were younger.

When we are comfortable being alone with ourself we have secure attachment. That could mean that we had good childhoods filling us with self confidence or that we have successfully had therapy to overcome our childhood attachment anxieties.

In the current lockdown, when our ability to interact with others is limited, attachment anxiety comes to the fore and will effect many people in many ways. In these situations anxiety and depression can become common bed fellows. We need to be aware of both of these and deal with them should they develop. That may mean contacting your GP dealing 111 or seeking professional help from a registered therapist.

However, this can be a time of self growth and development. If we can adopt the attitude of “we don’t have problems here we just have learning opportunities” we could turn the alone-ness of lockdown into a time when we can grow and develop and create greater happiness for ourself.

We should have a lot of gratitude for the creative human mind that has produced the hardware and software that is the internet and social media. We can now all stay in touch with others. We can even talk face to face with people on the other side of the world using apps such as Skype. While, apps like Zoom allow groups or family conversations to take place. While the connection online, even when it is visual, is never truly the same as real face to face contact it is very close and can help us avoid the feelings of alone-ness during lockdown.

Using media on a phone, tablet or laptop can offer other facilities as well. Online courses that might be about practical skills or crafts, may also be about self development, mindfulness, self discovery and so on. Once we can connect to the internet we have a window on the world that if we choose to look through it we might find wonders and delights.

The other use of such media is therapy. I have been working at least 50% of the time online for a good few years now, seeing people all over the world, across Europe, though the Middle East over in Canada and the USA right down to Aus and NZ. I even drop behind the Iron Curtain. With the development of online media the world has shrunk. It has shrunk to the size of your imagination. What can you imagine? Many therapist have gone online during this time.

In lockdown you can order food, take a course, learn a skill, engage in therapy, learn to meditate, write a book, create a movie, start a blog, become a social influencer, the opportunities are endless.

However, we do also need to be aware of those in our area who are really alone, perhaps they are old and have no internet or knowledge of the internet. These people will need our support and care. That might be giving people some time, even if it is through a window. Doing shopping or running errands. You might have a spare tablet to give or lend to a child, games or books that you can also give or lend.

Bottom line is who needs our help and support…

If we all look after each other we will all be okay

Looking after each other also includes you looking after you. What do you need? Where can you get it? To answer these questions you may need to go online and have a session with Google and see what is around. Remember, ‘the world is your oyster’ you can just as easily join a group in Japan as one that is around the corner.

However long this goes on for we could come out better off, more whole, and more at peace than when it all began.

Take care, be mindful, stay safe and stay at home.

Sean x

TSHP357: Staying Positive During the Lockdown

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What’s Coming This Episode?

The lockdown continues in the UK and around the world – it will be with us for a while. New routines and habits are being formed. Struggles remain, but hope exists and good things are a’happening. Sean and Ed take a look at some of the positives from #COVID19…

Enjoy the show and take care, it’s The Self Help Podcast!

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Love that virus

There are a few times in life when the negative can be seen as a positive. Yet that is the nature of life. In a world where we do not have problems we only have learning opportunities, there are no negatives only different versions of positive. And, so it is with Covid-19.

When we learn to focus on the negatives we learn to fail to see any positives. That is just where we are at the moment. Collectively if we, as a nation, as a kingdom and as a species have learned to continually focus on the negative and give it so much importance then we fail to see any positive.

Every time we turn on the news we are assailed with information that feeds the negative. Unless we know how to deal with this and see it for what it is. The good news is actually better, more than and greater than the negative. When we focus on the negative we forget this.

It is the same when we look at the screen inside our head – what do we see? It is actually very easy to create a positive vision and image if the world that is here and the world that is yet to come. It is this simple…

What you feed grows and what you feed dies

The alternative is that you focus on the negative and we can all feel as bad as we like. Being positive is a habit.

The reality is that however difficult the virus is, it will pass. The world will go on and there will come a time when this is the past.

Previous generations have dealt with difficult times. This is our difficult time. What will we do with it?

Any difficult time will have hurts, losses, sadnesses, there will be grief, sadness and unhappiness. As hard as this is it is not the point.

It is not what happens to us, it is how we respond to it that counts

It will always be this way. It will never be any different.

Positivity and happiness is a decision, it is a choice.

When we look around us right now we will see so many examples of wonderful responses, behaviours, caring and love. If we feed that it will grow.

So today and everyday that you live you have a choice. Will you feed the positive or the negative? Your decision will create the future that we will all share.

In the end ‘Love is all there is’. If this virus is the motive force that turns humanity to acting in positive ways then some good may come from our suffering.

Take care, stay safe, and share the love

Sean x

TSHP356: Finding the Positives

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What’s Coming This Episode?

Well, we’re all settling in to our new way of living. It’s hard, for sure. Many feel trapped or disillusioned. Some feel a deep sense of loneliness or loss. However, are there some upsides to our new world? Is it OK to embrace certain aspects of it?

Enjoy the show and take care, it’s The Self Help Podcast!

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Imagine where we could be after Covid-19

Our series on anxiety and the various forms that it takes has been overtaken by Covid-19 but in reality they both are feeding each other. The continual news about the spread of the virus and the potential devastation that it is causing are swamping the news media. It is strange that we report the amount of people affected or who have died but we do not report how many people left hospital today, having survived. Because there are also many thousands of people who are surviving the virus.

In the end more people will survive Covid-19 than will die from it but we don’t focus on that. I am not saying that we should not be sad or grieve for those that succumb to the virus. Many people will be lost to us who will be seen to have died before their time. It is easy at this point for us to be insanely angry about government, medical services, manufacturers, pollution, stupid people, meat eaters, I have heard all of these and many more. Sadly I have also heard so many negative feelings about Chinese people. To the point where Chinese restaurants have been boycotted, well they were before all eateries were closed. This makes me so sad and also quite angry. ‘If’ the virus did begin in a Wuhan market and ‘if’ this was due to eating animals that other people in the world would or do not eat it is not the fault of the Chinese. It would be the behaviour of a few people. All countries have people who do things that the rest of the country could not deal with but they do represent the entire country.

Surely with everything that is currently happening, we all to need to learn to look after each other like we have never done before. We can see just how a negative virus can spread across the world. Can we make a positive emotional and psychological virus of love, care, compassion and support? Could we spread a new way of looking at the world? Or, will it be business as usual? What sort of world would you like to create?

Imagine there’s no countries..

Imagine by John Lennon offered some very powerful images of how the world could look. If we get beyond the image of countries and borders and embraced the idea that we are all one there would be no them and us. We could really share and look after each other. I like that idea that whatever the colour of your skin, the shape of your face or the country that you live in we are all genetically virtually the same, we all have the same feelings, thoughts and aspirations, we have similar needs, desires, dreams and hopes, and we all bleed the same red blood.

Perhaps after this we could revisit the idea of the United Nations as a reality of sharing and cooperation.

Imagine there’s no money…

I wonder at what point humanity will realise that capitalism does not work. Well, it works for the few. The fact that there are poor and starving is a product of capitalism. Or the shortages and lack of supply, selfishness, greed and hoarding are all functions of the capitalist mindset. In a world where we all are equal, where all are caring and sharing there are no rich and no poor.

Perhaps after this we could look at the ideas of a universal living wage for all people on the planet.

Imagine no religion…

Many wars, discord, disharmony, terrorism and terror attacks are the product of religious sectarianism. The idea that ‘we’ are right and ‘you’ are wrong separates people into good and bad and creates prejudice.

Perhaps we could replace religion with spirituality, where all recognise that spark of universal life within each person and respect and honour each other with unconditional positive regard.

What could you imagine?

What about…

People using less air travel?

People using less car travel?

More people working from home?

Online working creating no difference between remote country and big towns?

Greater awareness of those around us that need our support and help?

More people walking?

More people using bikes?

More exercise?

Less illness?

Better mental health?

Re-creation of community?

So, what could you imagine? In a world where thoughts become things, what we imagine we can create. If we work together and share together and find common images we could create heaven on Earth. Thoughts become things.

Take care, stay safe and stay positive.

Sean