Clinician's Guide to PTSD: A Cognitive-Behavioral Approach, by Steven Taylor

[rachelmanija]

Reading for one of my trauma classes. I’m not summarizing the whole thing, just bits I found especially interesting.

Chapter One: Clinical Features of PTSD. Nothing new here.

Chapter Two: Cognitive and Behavioral Features of PTSD.

Amnesia. People rarely have global amnesia for traumatic events (not even knowing it happened or having no memories

Comments

[angevin2]

I am fortunate enough not to have any direct experience with PTSD, but I do have Taylor's book on health anxiety (assuming it's the same Steven Taylor; I suppose it's a pretty common name). I've found it incredibly helpful in talking myself out of "omg I have a headache I AM GOING TO DIIIIIIIIIE" spirals.

[rachelmanija]

Thanks for mentioning that - I hadn't heard of that book before. A quick Amazon check suggests it's the same guy.

[angevin2]

Yeah, I clicked through his name on the Amazon link and it was the first one listed (I have the one for laypeople, not the one for clinicians, since, you know. Not that kind of doctor). Anyway, it has a lot of good worksheets and case studies, and it was all a good way of getting some perspective on my occasional health-related freakouts -- I bought it around the time I was defending my dissertation and it was useful in helping me remind myself that the weird physical symptoms I'd been having were way more likely to be caused by stress over, you know, defending my dissertation.

[lady_ganesh]

That is good to know!

[naomikritzer]

I have a RL friend, Elizabeth, who witnessed a murder when she was in her early 20s. She wrote a play about it some years back, and performed it at a festival of religious plays held in town for a couple of years. In the play she tells the story of what happened, and describes the aftermath for her personally

[rachelmanija]

What a sad story. I hope she eventually gave herself credit for acting in an extremely heroic and selfless manner, even though she didn't succeed.

But that itself suggests how the whole thing works: had she done nothing, she undoubtedly would have beaten herself up for being a coward and standing by while someone got killed. In fact, she courageously stepped forward... but only recalls her "mistakes."

[naomikritzer]

She did, definitely. I think it took her a while to get there. (I met her ten years or so after this happened -- our daughters were in the same Kindergarten class and shared a bus stop and bonded.)

[asakiyume]

And this: the fact that heroism doesn't always succeed in its objectives, but that doesn't make it any less heroic, or mean that the attempt was pointless or wrong. Things can be good even if they fail. Note to self: remember this.

[swan_tower]

Maaaaan . . . given my tendency to fall into those kinds of biases/distortion over events that don't produce PTSD, I've got a pretty good idea of what will happen if I ever do suffer trauma of that kind.

I'm working on training myself out of those habits of thought, but it's slow going.

[rachelmanija]

They're really common cognitive distortions, which are often applied to more ordinary situations:

Focusing only on imaginary good outcomes of actions you didn’t take. “If I’d asked him out, he definitely would have said yes, and then we'd be happily married now.”

But, of course, they gather more force when they're applied to more serious situations.

[anderyn]

Interesting. I don't recall a *huge* amount of my childhood, though I understand from being told so that a lot of my trauma is due to spending the first five years of my life in and out of the hospital, due to being a six-month-gestated baby. I've always had odd panic attacks, too. Wonder if hospitalization is enough to cause that kind of reaction...

[rachelmanija]

Hospital stays can certainly be traumatic, especially for children too young to really understand what's happening to them.

It's hard to say what's going on with memory for early childhood, though, because how much people remember of it varies wildly, even without trauma. My early childhood (as opposed to my later childhood) was quite nice, from the memories I do have and from what I've been told. But I have only one or two memories from before about age three or four, and not a whole lot from before six or seven.

[mikeda]

I'm not sure I have any genuine memories of anything before fifth grade or so. And not that much of the next few years. I'm practically certain this doesn't have anything to do with any sort of trauma or major unpleasantness.

[nipernaadiagain]

The not remembering bothers me very much

[rachelmanija]

That sounds terrifying.

If this book is correct, the reason you don't remember may be because you were so completely focused on saving yourself and your children, that you had no attention to spare for the collision itself.

Maybe the only way you could have recalled the collision would have been if you'd been less focused on steering... and then maybe you would have had the head-on collision, after all.

[nipernaadiagain]

Your explanation helps me to understand my terror.

As I cannnot learn from something I do not remember and so I have stopped driving - as I have no memory of the collision itself and the unknown is scarier than the known.

One can deal with the known, even with the worst of it, but how does one deal just with a hole where a memory should be?

[rachelmanija]

If you wanted to drive again, there is specialized therapy that deals with exactly this sort of issue: a phobia caused by trauma. It's usually very successful.

I cannnot learn from something I do not remember

I'm not sure that the collision itself, even if you could retrieve it, would be anything you could learn from. Any potential learning probably comes from the parts you already remember - the parts leading up to the collision, in which you were taking effective and life-saving action, not the collision itself.

I don't know what your particular collision was like, but I've been in several car crashes, including one very serious one in which I was driving. They all felt exactly the same: a tremendous sense of impact, simultaneously shocking and inevitable, painless and terrifying and over by the time you've registered that it happened.

Have you ever asked your children what it felt like to them?