Tag Archives: Psychiatry

FORENSIC HYPNOSIS FOR MEMORY ENHANCEMENT

A6Forensic hypnosis is the scientific application of memory enhancement—an investigational aid to law enforcement leads and admissible courtroom evidence. Hypnotic recall assists witnesses to reliably relay hidden details of events and descriptions that aren’t extracted through conventional interview techniques.

In my police career, I’ve had many cases using hypnotic memory enhancement. Several had amazing success.

A5I’m fascinated with the human mind. I think modern medicine and psychiatry are just beginning to understand the complexity of how our consciousness works. Hypnosis is a tool to assist in entering our subconscious and unlock the vault where memory is stored. Its magic is the ability to alter the subject’s state of consciousness which is what Shamanism is all about. But, then, Shamanism is for another discussion.

The best forensic hypnotherapist I’ve had the pleasure to work with is Dr. Lee Pulos of Vancouver, British Columbia, Canada. Here’s how Dr. Pulos explains it.

A1“Hypnosis is a natural state of consciousness that we drift in and out of quite regularly. For example, while driving along a highway and then suddenly discovering that you ‘lost’ several miles without being aware of it. This can also happen during reading when you may notice that you have ‘read’ a chapter or two without being mindful of the content. Hypnosis is basically a technique for focusing consciousness by entering a deep state of absorption. It allows you to shift from your outer to inner awareness and tap deeper levels of consciousness so we can re-educate and reprogram the subconscious with empowering suggestions or beliefs.”

The word hypnosis comes from the name of a Greek god Hypnos, who presided over sleep. In the late1700s, Anton Mesmer brought the technique into popular consciousness in Europe and in 1843 Scottish physician James Braid coined the term hypnotism for the experience that was passing in many circles as animal magnetism.

A8Hypnosis places a person in a trance state that can resemble sleep, but instead is an altered state of consciousness more akin to lucid dreams. Often, people in a trance are quite alert but focused in a way that differs from their normal conscious state. Contrary to popular notions, subjects in a light trance are aware of everything going on.

A7I’ve seen a rough and tough biker-witness under hypnosis who was instructed to play “patty-cake” by clapping his hands on his knees.  He couldn’t stop laughing at the fact that he couldn’t control his hands, though he seemed perfectly conscious in a way that ought to have enabled him to resist the instruction. His hands changed to patting his head and stomach at the hypnotist’s instruction. They looked at each other the whole time and even had a conversation with his hands patting about.

The trance-state, which has its own ebb and flow, is the result of a trusting and cooperative process between the subject and the hypnotist. It’s not one person controlling another and there’s no way the hypnotist can make the subject do something they would not do while they’re in a normal state, such as an illegal or immoral act.

A9“Hypnosis,” says Kevin McConkey, President of the Australian Psychological Society and co-author of Hypnosis, Memory, and Behavior in Criminal Investigation, “is essentially a phenomenon that reflects genuinely experienced alterations of reality in response to suggestions administered by a hypnotist. The subject’s testimony is what confirms the trance, although susceptibility varies among individuals. Those who are highly suggestive will behave as if going through truly significant cognitive alterations.”

Hypnosis involves concentration that is heightened to the point where one can recall details that seemed to elude that same person in a conscious state. It’s a powerful forensic tool for criminal investigation, although some researchers challenge the notion that hypnosis leads to significant increases in memory.

There are two basic purposes for using forensic hypnosis.

The most common is inducing relaxation when anxiety and stress may obstruct a witness’s ability to recall as much information as possible. The second occurs when retrieval of information from witnesses cannot be acquired through other means.

A4The first court case involving forensic hypnosis was Cornell v. Superior Court of San Diego in 1959. Although forensic hypnosis is mostly used by prosecutors, in this particular court case, it was the defense that used hypnosis as an aid in preparing its strategy. Since then, many famous cases have used hypnosis as an aid, including the Boston Strangler, Ted Bundy, and Sam Sheperd.

Currently, no overriding judgment has been handed down regarding the admissibility of evidence achieved through forensic hypnosis and the use of hypnotic evidence varies between jurisdictions. Adding to the reliability problem is that solid evidence can be devalued as a result of unprofessional circumstances in obtaining evidence through hypnosis.

I remember one judge rejecting evidence from a witness who had been subject to hypnotic recall stating “There’s nothing more unreliable than an eyewitness, never mind one who is tainted by hocus-pocus.” One the other hand, I recall another judge being fascinated by the process and readily accepting witness evidence, particularly because the information obtained under hypnosis was corroborated by independent facts.

As in all types of evidence, the key is reliability.

To ensure solid forensic hypnosis used in criminal investigations is not devalued, it’s become standard and vital operating procedure that all hypnosis sessions are video/audio recorded and the session is witnessed by independent observers. To strengthen the case, the hypnosis must be performed by a trained forensic hypnotist.

A10

Before a forensic hypnotist is allowed to begin a session, one very important condition must be met. The subject must be assured that during the hypnotic session no attempt shall be made to elicit any information that is not directly relevant to the investigation. In addition, the forensic hypnotist must also assure the subject that no information retrieved will lead to self-incrimination.

Critics of forensic hypnotism center their attacks on the accuracy and reliability of the evidence that’s obtained. The concern is that suggestion(s) implanted during hypnotism may create false memories through the use of leading questions.

A11

One thing that a forensic hypnotist cannot do, and is never called to do, is to help a suspect confess to a crime. Not only is this impossible, but any confession arrived at through hypnosis would never be admissible in court.

Here’s a true case I investigated where forensic hypnosis for memory enhancement led to a break through in solving the crime. It was conducted by Dr. Lee Pulos.

A12In wintery April, a lady was alone in her cabin on a remote gold claim in northern British Columbia. A masked man with a handgun appeared at her door, demanding she hand over her gold stash. She refused. He proceeded to blindfold and hog-tie her, then began torturing by burning her hands and ribs with a red-hot knife heated on her wood stove.

Now this lady was one tough old bird, as you’d expect a gold miner to be. She later stated she’d worked so hard to build her gold stash that she’d “rather die than turn it over to this asshole.” Realizing his interrogation technique was going nowhere, the bad guy quit in frustration. He set the cabin on fire with her still tied, blindfolded, and left her to die. She was able to wiggle over and boot the door, then crawl outside where she laid in excruciating pain on the snow in sub-zero temperature until her husband returned.

Because this was such a horrific crime, we “pulled the stops”.

A13We flew her to Vancouver to undergo hypnosis with Lee Pulos. He was able to extract two things that led to solving the case. One, she recalled the bad guy was using a two-way radio or ‘communicator’, as she called it. Second, he used the term for her gold stash as being ‘squirreled away’.

A14Now knowing an accomplice was involved, we focused the investigation on a neighbor who’d been involved with a gold claim boundary dispute. We identified the suspect as a Hells Angels striker who’d been hired by the neighbor, so we ran a wiretap which caught him using the term ‘squirreled away’. This led to an elaborate, clandestine sting operation resulting in his confession to an undercover agent. He was convicted and got twenty years.

Like I said, I’ve always been fascinated with how the human mind works. One thing I’m positive about—there’s more to consciousness than modern medicine and psychiatry know—except for the Shamans.

A15

Dr. Leslie Gray is a professor at UCLA Berkley and the Core Shaman who’s altered states of consciousness teachings inspired “No Witnesses To Nothing”. Her website is www.WoodfishInstitute.com in San Fransisco.

But, then, Shamanism is for another discussion.

WHAT’S YOUR MYERS-BRIGGS PERSONALITY TYPE?

A20“The Myers-Briggs Type Indicator® (MBTI®) is the best known and most trusted personality assessment in the world. It’s helped develop effective work teams, build stronger families, and create successful careers. The MBTI assessment improves quality of life for you and your organization. Giving you this personalized way to take the assessment fulfills our mission: bringing lives “closer to our heart’s desire.”

A8This descriptor is from the home page of the Myers-Briggs Foundation—an organization that furthers the 1940’s work of psychologists Katharine Briggs and her daughter, Isabel Briggs-Myers who futhered Carl Jung’s theory. They categorized people into four principal psychological functions by which humans experience the world—sensation, intuition, feeling, and thinking—and that one of these four functions is dominant for a person most of the time.

Sounds familiar… I took this personality test a few years ago and jotted the score in my notebook. Hmmm… might make a good blog topic so I’ll take it again and compare to the old score… lemme take another look at what this thing’s all about.

Myers & Briggs developed an “introspective, self-report questionnaire designed to indicate psychological preferences and typing how people perceive the world and make decisions”.

A6Paraphrasing from Wikepedia (this is not-so-exciting stuff – promise it’ll get livlier) — “Carl Jung’s typology theories postulated a sequence of 4 cognitive functions (thinking, feeling, sensation, and intuition), each having 1 of 2 polar orientations (extraversion or introversion), giving a total of 8 dominant functions. The purpose of the Myers-Briggs Type Indicator personality inventory is to make the theory of psychological types described by Jung understandable and useful in people’s lives.” (I hope so, because this is a pretty wordy explanation.)

The theory’s essence is that seemingly random variation in behaviors is actually quite orderly and consistent, due to basic differences in the ways individuals use their perception and judgment.

Wiki goes on “Perception involves ways of becoming aware of things, people, happenings, or ideas. Judgment involves ways of coming to conclusions about what’s been perceived. If people differ systematically in what they perceive, and in how they reach conclusions, then it is only reasonable for them to differ correspondingly in their interests, reactions, values, motivations, and skills.”

Okay. Starting to make sense to me. Tell me more about these 8 functions.

A14“In developing the Myers-Briggs Type Indicator, the aim was to make the insights of type theory accessible to individuals and groups. They addressed 2 related goals in the developments and application of the MBTI instrument:

  • The identification of basic preferences of each of the four dichotomies specified or implicit in Jung’s theory.

  • The identification and description of the 16 distinctive personality types that result from the interactions among the preferences.”

Whoa. 16? Thought there was 8? Not following the math.

“Stick with us,” they said. “We evolved  — 4X4=16.”

Huh?

A17

 “We took Jung’s base and turned it into four questions:

  • What’s your favorite world? — Do you prefer to focus on the outer world, or on your own inner world? This is called Extraversion (E) or Introversion (I).

  • How do you absorb information? — Do you prefer to focus on the basic information you take in, or do you prefer to interpret and add meaning? This is called Sensing (S) or Intuition (N).

  • How do you make decisions? —  When making decisions, do you prefer to first look at logic and consistency, or first look at the people and special circumstances? This is called Thinking (T) or Feeling (F).

  • How do you structure? — In dealing with the outside world, do you prefer to get things decided, or do you prefer to stay open to new information and options? This is called Judging (J) or Perceiving (P).

A9When you decide on your preference in each category, you have your own personality type, which is expressed as a four letter code. The 16 personality types of the Myers-Briggs Type Indicator instrument are listed here as they are often shown in what is called a “type table”. Casually, they’re grouped into four personalities:

Analysts

A15INTJArchitect —  Imaginative & strategic thinkers with a plan for everything.

INTPLogician — Innovative inventors with an unquenchable thirst for knowledge.

ENTJCommander — Bold, imaginative, and strong-willed leaders who will find or make a way.

ENTPDebater — Smart and curious thinkers who cannot resist an intellectual challenge.

Diplomats

A26INFJAdvocates — Quiet and mystical, yet very inspiring and tireless idealists.

INFP Mediator — Poetic, kind, and altruistic, always eager to help a good cause.

ENFJProtagonist — Charismatic and inspiring leaders who are able to mesmerize followers.

ENFPCampaigner — Eager, creative, and socially free-spirits who always find a way to smile.

Sentinals

A25ISTJ Logicistian — Practical and fact minded individuals who’s integrity cannot be doubted.

ISFJDefender — Very dedicated and warm protectors, always ready to protect loved ones.

ESTJExecutive — Excellent administrators, unsurpassed at managing things and people.

ESFJConsul — Extraordinarily caring, social and popular people, always ready to help.

Explorers

A28ISTPVirtuoso — Bold and masterful experimenters, handy with all kinds of tools.

ISFPAdventurer — Flexible and charming artists, always wanting to explore or experience something new.

ESTPEntrepreneur — Smart, energetic, and highly perceptive people who truly enjoy living on the edge.

ESFP Entertainer — Spontaneous, enthusiastic, and energetic people; life is never boring around them.

Interesting, I thought. I’ll take the test again and show DyingWords followers what makes me tick. So I googled around and found three different FREE approaches to the M-B test and took them all:

I also checked the Myers-Briggs site at http://www.myersbriggs.org/ but they want $150 to sign-in, although it comes with an hour of shrink time.

So how’d I make out?

INTJ — Every frikkin’ time, including the one I did a few years ago.

So how accurate is it? You be the judge. Here’s my INTJ psychological diagnosis from the Myers-Briggs Type Indicator:

A5The INTJ personality type is the Introverted Intuition with Extraverted Thinking type. Individuals that exhibit the INTJ personality type are knowledgeable, inventive, and theoretical, whether they’re working on long-term personal goals or creative projects in their professions. They are “big-picture” thinkers, creating constructive ambitions and planning for them accordingly. Myers-Briggs test INTJ types hold a clear idea of what they would like to accomplish in their future, and they use that vision as motivation to complete all of the necessary steps to obtain their dreams. This dedication to their visions and their ability to find ways to achieve them make INTJ types high-functioning employees:
  • Their looking-towards-the-future mentality helps them to create original and inspiring ideas for companies, as well as a well-thought-out plans for achieving these goals.
  • Value the intellectual ability of themselves and those of others, and place a high importance on it.
  • Can be adamant and commanding when the professional environment requires a certain level of authority.
  • Because of their ability to think long-term, they are often placed in (or place themselves in) authoritative positions in business and groups.
  • Quick to find solutions to challenges, whether that requires basing their solutions on pre-conceived knowledge or finding new information to base their decisions off of.
  • Can relate newly gathered information to the bigger picture.
  • Enjoy complicated problems, utilizing both book and street smarts (logical and hypothetical ideas) to find solutions.

They’re Strong Planners With Great Follow-Through

A21INTJ personality types are long-term goal-setters, creating plans to bring their goals to completion, and then following this plan using thought-out approaches and procedures devised by the INTJ. They are self-reliant, individualistic, and self-secure. INTJ personality types have a large amount of faith in their own competence and intelligence, even if others openly disagree or the opposite proves true. This also makes Myers-Briggs Type Indicator-assessed INTJ types their own worst critics, as they hold themselves to the highest standards. They dislike turbulence, perplexity, clutter, and when others waste their time and/or energy on something unimportant. This MBTI type is also succinct, analytical, discerning, and definitive.
A24In their personal lives, Myers-Briggs test INTJ types exhibit many of the same behaviors that they do in their professional lives. They expect competence from their peers and are more than willing to share their intelligence or ideas with those around them. Occasionally, INTJ personality types may find it difficult to hold their own in social situations, whether that is due to their actions or their opinions. To others, MBTI Assessment  Test -assessed INTJ types seem set in their ways or opinions because of their high respect for themselves, but oftentimes reality is just the opposite, with the INTJ type taking in new tidbits of information at all times, evaluating their own opinions and ideas accordingly. They are also often seen as a tad distant, closed off from others emotionally but not intellectually.

Sometimes INTJ Types Are Too Confident

A10This distance associated with this MBTI test-assessed personality type can occasionally progress to the point of negativity. INTJ types can close themselves off so much that they stop revealing what they are thinking/how they are coming to certain conclusions, which can make it seem as though they are simply rushing through a task. They can often do just that—jumping to underdeveloped endings without considering all new or present information. This flaw can also cause Myers-Briggs test assessed INTJ types to overlook important data and facts necessary to achieve their goals.
Their high level of competence coupled with their big-picture way of thinking can sometimes cause problems for this Myers-Briggs type. Because so many of their ideas are long-term, INTJ type ideas can occasionally lack the ability to fully come to fruition.
A31In their relationships with others, MBTI Test-assessed INTJ Personality Types may come off as judgmental, especially to those who aren’t as openly enthusiastic about the INTJ types ideas or intelligence. If they feel that  others are not viewing them as highly as they view themselves, there is also a chance that they will not necessarily provide the level of feedback that that individual may need. However, by concentrating on developing their Sensing and Feeling, the INTJ type may fashion more intimate connections with their peers, spending less time in their heads and more time engaging with the world around them.
The Myers-Briggs Type Indicator INTJ personality type uses their big-picture thinking along with their logical problem-solving skills to succeed in a variety of occupations, usually those requiring scientific reasoning/understanding and those that involve building or creating something scientifically tangible. For these reasons, Myers-Briggs Test assessed INTJ types often find themselves choosing careers such as plant scientist, engineer, medical scientist, internist, or architect. MBTI test INTJ types also find themselves leaning towards those professions that require them to hold an authoritative position or a leadership role, such as a management consultant or a top executive.
A27To be successful in these problem-solving careers, Myers-Briggs test INTJ types must learn to consider short-term goals and opportunities as well as their already over-arching, long-term goals. This can include immediate priorities, career choices that the INTJ values but may not consider rational, and present values that INTJ type may be neglecting in favor of their long-term vision. Creating immediate and long-reaching goals for yourself can help you level your thinking and focus more on the moment.
Furthermore, this MBTI personality type may have a hard time dealing with sudden life changes or events. By allowing yourself time to think about immediate goals and surprising situations without focusing solely on the long-term outcome, you can be ready for unforeseen circumstances that may come their way.
A34One of the most important strategies that the Myers Briggs Type Indicator test INTJ type can implement to be successful in the workplace is to open themselves up to new people, new experiences, and new ideas. If you find yourself closed off or antisocial in the work environment, slowly opening yourself to other networks and creating personal relationships with those around you can help you become a more well-rounded employee.

How accurate is this?

Actually, it makes me look like a bit of an asshole. Far from perfect. A  bit of a get-er-dun prima-donna when, in fact, my biggest criticism over the years is that I’m too nice of a guy for my own good. Anyway, it was a good mental exercise which made me think for awhile, and I got a kick outa being matched with notable characters with the same personality. Factual ones were Rudy Giuliani, John F. Kennedy, and Hannibal— leader of the Carthaginians. Fictional characters were the protagonist and antagonist in Silence Of The Lambs, Clarise Starling and…. yeah — Hannibal Lector.

So I challenge you. You can have a FREE psychological analysis just like mine. Go ahead and take the Myers-Briggs Type Indicator® Test at:

At very least, it’s a buncha fun. C’mon DyingWords group. Take the test ‘n tell us who you are!

MB Test

POST-TRAUMATIC STRESS DISORDER IS A NASTY BITCH

PTSD1CLast month another police officer took his own life after a lengthy battle with Post-Traumatic Stress Disorder. I’ve handled lots of suicide cases over the years, but this one hit close to home –  I knew Corporal Ken Barker. We’d worked together prior to the events which brought on Ken’s PTSD.

Ken was one of the best-liked, most approachable Royal Canadian Mounted Police members I ever met. He certainly wasn’t the stereotype who’d you think would suffer a PTSD mental illness. Wait – there’s no such thing as a stereotype PTSD sufferer and, yes, PTSD is a mental illness.

PTSD2There’s a higher awareness of PTSD today than back in the 1990’s when I was posted with Ken. Personally, I’ve experienced events as a cop and a coroner which should have brought on PTSD in me, but didn’t. I was very aware of the disorder and knew to recognize the signs. Also, I wasn’t scared to talk about PTSD and I think that’s the best form of prevention and treatment.

Today, I watch with caution as my son’s career in the Canadian Army unfolds and the suicide deaths of soldiers pile up into a national crisis. There are more Canadian soldiers who died of PTSD related suicides than were killed in ten years of active combat in Afghanistan.

So who is this Post-Traumatic Stress Disorder bitch?

Clinically, PTSD is classified as a trauma and stress related disorder stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV. 

It’s simply summarized as:

1. Exposure to a traumatic event.

This includes both physical harm, or the risk of serious injury or death to self or others, and a response to the event that involved intense fear, horror, or helplessness. The traumatic event should be of a type that would cause significant symptoms of distress in almost anyone, and that the event was outside the range of usual human experience.

2. Persistent re-experiencing.

PTSD3One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any reminder of the traumatic event(s).

A. Persistent avoidance and emotional numbing.

PTSD4This involves a sufficient level of avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s) and avoidance of behaviours, places, or people that might lead to distressing memories as well as the disturbing memories, dreams, flashbacks, and intense psychological or physiological distress. It includes the inability to recall major parts of the trauma(s), or decreased involvement in significant life activities as well as a decreased capacity (down to complete inability) to feel certain feelings, and an expectation that one’s future will be somehow constrained in ways not normal to other people.

B. Persistent symptoms of increased arousal not present before.

These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hyper-vigilance. Additional symptoms include irritability, angry outbursts, increased startle response, and concentration or sleep problems.

C. Duration of symptoms for more than 1 month.

If all other criteria are present but 30 days have not elapsed, the individual is diagnosed with acute stress disorder. Anything longer would be considered chronic.

D. Significant impairment.

The symptoms reported must lead to clinically significant distress or impairment of major domains of life activity, such as social relations, occupational activities, or other important areas of functioning.

PTSD5Although most people with PTSD will develop symptoms within three months of the traumatic event, some people don’t notice any symptoms until years after. A major increase in stress, or exposure to a reminder of the trauma, can trigger symptoms to appear months or years later.

Who’s susceptible to PTSD?

Generally, at highest risk are those who experience traumatic events more frequently and for longer exposure. Combat personnel (soldiers, sailors, and airmen) are at the forefront, followed by emergency responders like police, firefighters, and medical professionals.

PTSD6There are other risk groups. Survivors of violent acts like sexual assault and attempted murder commonly experience post-traumatic stress. This extends to accident victims and witnesses of violent incidents.

What’s the medical reason for PTSD?

Three areas of the brain which control and administer PTSD have been identified. They’re the prefrontal cortex, the amygdala, and the medial prefrontal cortex.

Traumatic events cause an over-reactive adrenaline response, which creates deep neurological patterns in the brain.

PTSD7These patterns can persist long after the event that triggered the fear, making an individual hyper-responsive to future fearful situations. During traumatic experiences, the high levels of stress hormones secreted suppressed hypothalamic activity that may be a major factor toward the development of PTSD.

These biochemical changes in the brain and body differ from other psychiatric disorders such as major depression and bi-polar. Individuals diagnosed with PTSD respond more strongly to a dexamethasone suppression test than individuals diagnosed with clinical depressions.

PTSD8In addition, most people with PTSD also show a low secretion of cortisol and high secretion of catecholamines in urine with a norepinephrine / cortisol ratio consequently higher than comparable non-diagnosed individuals. This contrasts to the normal fight-or-flight response, in which both catecholamine and cortisol levels are elevated after exposure to stress.

Getting clinical – brain catecholamine levels are high and corticotropin concentrations are high. Together, these create an abnormality in the hypothalamic-pituitary-adrenal (HPA) axis.

The HPA axis is responsible for coordinating the hormonal response to stress. Given the strong cortisol suppression to dexamethasone in PTSD, HPA axis abnormalities are predicated on strong negative feedback inhibition of cortisol, itself likely due to an increased sensitivity of glucocorticoid receptors.

Translating this reaction to human conditions gives a patho-physiological explanation for PTSD by a maladaptive learning pathway to fear response through a hyper-sensitive, hyper-reactive, and hyper-responsive HPA axis.

PTSD9Low cortisol levels may also predispose individuals to PTSD and studies indicate that people that suffer from PTSD have chronically low levels of serotonin, which contributes to the commonly associated behavioral symptoms such as anxiety, ruminations, irritability, aggression, suicidality, and impulsivity. Serotonin also contributes to the stabilization of glucocorticoid production.

Insufficient dopamine levels in patients with PTSD can contribute to anhedonia, apathy, impaired attention and moto-skill defects. Increased levels of dopamine leads to psychosis, agitation, and restlessness.

Why are flashbacks so common in PTSD sufferers?

In a traumatic experience, the mind processes and stores the memory differently than it stores regular experiences.

Sensory information about the trauma – smells, sights, sounds, tastes, and the feel of things – is given high priority in the mind and is remembered as something threatening.

PTSD10Once this happens, whenever the sufferer is faced with a touch, a taste, a smell, a feel, or a sight that reminds them of the trauma, the memory (and the feeling of threat) comes back up and vivid memories or flashbacks about the trauma occur.

Getting all clinical again, a hyper-responsiveness in norepinephrine receptors in the prefrontal cortex is connected to the flashbacks. A decrease in other norepinephrine functions prevents the memory mechanisms in the brain from processing that the experience and emotions the person is experiencing during a flashback are not associated with the current environment. In other words, it takes them right back to the trauma time and it seems very, very real.

What can be done about it?

Many sufferers feel guilt or shame around PTSD because they’re often told they should just ‘suck-it-up’ to get over difficult experiences. Others feel embarrassed in talking with others. Some feel like it’s somehow their own fault.

Here’s the common treatments.

Counselling

PTSD11Cognitive-behavioural therapy (CBT) is effective. Very effective. CBT teaches how thoughts, feelings, and behaviours work together and how to deal with problems and stress. Relaxation techniques, such as meditation and hypnosis are used. This exposure therapy helps the sufferer talk about their experience and helps reduce avoidance.

In my experience, this stuff works. But the sufferer has to know the disorder before accepting the treatment.

Medication

A number of medications can prevent PTSD or reducing its incidence, especially when given in close proximity to a traumatic event. These include:

SSRIs (Selective Serotonin Reuptake Inhibitors)

SSRIs are considered to be a first-line drug treatment. They include citalopram, escitalopram, fluoxetine, paroxetine, and sertraline.

Tricyclic antidepressants 

Amitriptyline benefits distress and avoidance symptoms. Imipramine is effective for intrusive symptoms.

Alpha-adrenergic antagonists

In a study of combat veterans, prazosin shows substantial benefit in relieving or reducing nightmares. Clonidine helps with startle, hyper-arousal, and general autonomic hyper-excitability.

Anti-convulsants, mood stabilizers, and anti-aggression agents

PTSD12Carbamazepine reduces arousal symptoms involving noxious affect, as well as mood or aggression factors. Topiramate is effective in achieving major reductions in flashbacks and nightmares. Zolpidem proves useful in treating sleep disturbances. Lamotrigine reduces re-experiencing symptoms as well as avoidance and emotional numbing. Valproic acid reduces symptoms of irritability, aggression, impulsiveness, and reducing flashbacks. Similarly, lithium carbide works well to control mood and aggressions (but not anxiety) symptoms. Buspirone has an effect similar to lithium, with the additional benefit of reducing hyper-arousal symptoms.

Antipsychotics

Risperidone is the main medication for dissociation, mood issues, and aggression issues while cyproheptadine, a serotonin antagonist, helps with sleep disorders and nightmares.

Atypical antidepressants

Nefazodone works with sleep disturbance symptoms, secondary depression, anxiety, and sexual dysfunction symptoms. Trazodone reduces or eliminates problems with anger, anxiety, and disturbed sleep.

Beta Blockers 

Propranolol has demonstrated possibilities in reducing hyper-arousal symptoms, including sleep disturbances – but the jury’s out.

Benzodiazepines

PTSD13These drugs are not recommended by clinical guidelines for the treatment of PTSD due to a lack of evidence of benefit. Nevertheless, some doctors use benzodiazepines with caution for short-term anxiety relief of hyper-arousal and sleep disturbance, and believe that the use of benzodiazepines is proper for acute stress, as this group of drugs promotes dissociation and ulterior revivals. While benzodiazepines can alleviate acute anxiety, there is no consistent evidence that they can stop the development of PTSD, or are at all effective in the treatment of posttraumatic stress disorder.

Additionally, benzodiazepines may reduce the effectiveness of psychotherapeutic interventions, and there’s some evidence that benzodiazepines contribute to the development and chronification of PTSD. Other drawbacks include the risk of developing a benzodiazepine dependence and withdrawal syndrome. Additionally, individuals with PTSD are at an increased risk of abusing benzodiazepines.

Glucocorticoids

High-dose corticosterone administration was recently found to reduce ‘PTSD-like’ behaviours in a rat models. In this study, corticosterone impaired memory performance, suggesting that it may reduce risk for PTSD by interfering with consolidation of traumatic memories. The neurodegenerative effects of the glucocorticoids, however, may prove this treatment counterproductive.

That’s great lab-rat stuff which I’m not going to try myself. However, the next stuff is something that I think ‘where’s there’s smoke – there’s fire”.

Cannabis

PTSD14There’s a study underway between a University and one of Canada’s largest producers of medicinal cannabis, suggesting that the active ingredients in marihuana – tetrahydrocannabinol and cannabinoids – may be very effective in reducing PTSD symptoms. Many PTSD sufferers self-medicate through black-market cannabis and swear by it. It’ll be interesting to see this clinical study’s results.

Support groups

PTSD15Support groups definitely help. Here people share experiences and learn from others. Connecting with people who understand what the sufferer goes through is probably the most effective form of treatment and this leads to identifying other forms of treatment such as medication and psychological intervention.

PTSD awareness is much greater in the twenty-first century, but the disorder is long known and buried. Historically they called it battle fatigue, shell-shock, and the thousand-yard stare. Soldiers were actually shot by their own command for perceived cowardness. I’ll bet the majority weren’t afraid – they were just suffering a nasty bitch of a disorder.

PTSD16On a personal note – looking back – I believe my dad suffered from PTSD. He was a gunner on a RCAF Lancaster bomber during World War II; the veteran of 113 operational runs. If that doesn’t do something to the psyche, I don’t know what would. I remember him sitting for long periods… on a big flat rock in our yard… in that thousand-yard stare… until his cigarette… burned down to his fingers… and snapped him back to reality.

After nearly six decades of life experience and being exposed to more traumatic life & death exposures than I can count, I can’t say that I’ve experienced PTSD.

Grief, yes. Compassion; in spades. Fear – I’ve been absolutely shit-scared, bewildered, and abhorred; being down on my belly under gunfire and questioning the existence and authority of Infinite Intelligence. But I’ve never experienced guilt and I don’t know much about it. Guilt seems like an evil, degenitive force who’s metaphysical purpose is to destruct. A lot more needs to be known about the psychological effects of guilt.

I think guilt is the nasty bitch in PTSD and I think that guilt walks hand-in-hand with shame.

Post-Traumatic Stress Disorder is a complex mix of psychological, physiological, and metaphysical workings and it’s nothing to be guilty about or ashamed of. It’s a naturally-occurring, mental illness. With proper support and effective treatment, PTSD sufferers can fully recover.

Remember, PTSD isn’t about what’s wrong. It’s about what’s happened.

Please leave your comments, ask questions, or tell about your experiences. It’s okay to talk about PTSD and raising awareness is the best form of treatment… and prevention.