Tag Archives: Psychology

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

A15INTJ — Architect —  Imaginative & strategic thinkers with a plan for everything.

INTP — Logician — Innovative inventors with an unquenchable thirst for knowledge.

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

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

Diplomats

A26INFJ — Advocates — Quiet and mystical, yet very inspiring and tireless idealists.

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

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

ENFP — Campaigner — 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.

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

ESTJ — Executive — Excellent administrators, unsurpassed at managing things and people.

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

Explorers

A28ISTP — Virtuoso — Bold and masterful experimenters, handy with all kinds of tools.

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

ESTP — Entrepreneur — 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

POLICE INTERROGATIONS – THE 9 STEP REID TECHNIQUE

AZ18The psychology of effective police interrogation is complex. Today’s interrogators train in communication, human behavioural science, and legal procedures. They hone their skills through years of practice. But regardless of how smooth-talking a detective may be, the secret to success in securing admissible confessions will always lie in being a good listener, mentally manipulating the suspect, and using common sense.

AZ27In my years as a homicide investigator and dealing with suspects, I’ve worked with excellent interrogators. RCMP Polygraphist Don Adam was one of the best. Don was a natural in getting suspects to talk. I was fortunate to learn from guys like Don in mastering techniques that got confessions that’d stick in court. There’s a point where natural talent and learned techniques intertwine. That produces a good interrogator who produces good evidence.

Courts in the civilized world have a basic criteria for admitting confessions from accused persons as evidence. This pertains to statements made to persons in authority, ie – cops:

  1. Statements must be voluntary. Suspects can’t be threatened in any way or promised a favor in return for talking.
  2. Suspects must be aware of their legal rights and waive an opportunity to exercise them.
  3. Their rights are to remain silent and to consult a lawyer, if they choose.

AZ22The reasons for these strict rules are to avoid the chance of false confessions being used to convict people and ensuring an ethical theater in law enforcement. Interrogations are usually done in an accusatory, guilt presumptive process and not in an objective environment. So they begin with a definite bias – not like a court proceeding which operates with a presumption of innocence.

It’s also vitally important that confessions to crimes be corroborated in some way that verifies their truthfulness. Corroboration means backing up the confession with some form of evidence that proves the subject is being truthful and not elicited into making a false confession. Examples of corroboration are turning over a murder weapon, directing investigators to the location of a hidden body or divulging some key fact(s) known only to the perpetrator and the investigators. Corroboration is a must in verifying truthfulness and avoiding the chance of false confessions being used to convict an accused.

I’ve seen a lot of unscientific techniques applied in interrogations. The oldest one is the good cop – bad cop thing. Sometimes it works. Sometimes it backfires. Buddy-buddying the suspect only succeeds if there’s common ground. Minimization – Maximization. Cat & mouse. Outright deception to a subject is dangerous. If the interrogator is caught lying – it’s pretty much over. Torture – mental or physical – is completely unacceptable and would probably end with the cop in jail.

So what’s the best interrogation procedure?

AZ9Well, it’s been around for a long time since an American polygraphist by the name of John E. Reid figured out a 9 Step formula of psychological manipulation which is known as the Reid Technique.

The basic premise of interrogation is to manipulate the suspect into talking and then listen to what they’re saying.  Once they start talking, it’s hard for them to stop. Once they start telling the truth, it’s harder to continue lying.

In the Reid Technique, interrogation is an accusatory process where the interrogator opens by telling the suspect that there’s no doubt about their guilt. The interrogator delivers a monologue rather than a question and answer format and the composure is understanding, patient, and non-demeaning. The goal is making the suspect progressively more and more comfortable with acknowledging the truth about what they’ve done. This is accomplished by the interrogator first imagining and then offering the subject various psychological constructs as justification for their behavior.

AZ12For example, an admission of guilt might be prompted by the question, “Did you plan this out or did it just happen on the spur of the moment?” This technique uses a loaded question that contains the unspoken, implicit assumption of guilt. The idea is that the suspect must catch the hidden assumption and contest it to avoid the trap.

But the psychological manipulation begins before the interrogator even opens his mouth, though.

The physical layout of an interrogation room is designed to maximize a suspect’s discomfort and sense of powerlessness from the moment they step inside. The classic interrogation manual Criminal Interrogation and Confessions, which was co-written by John Reid, recommends a small, soundproof room with only two or three chairs, a desk, and nothing on the walls. This creates a sense of exposure, unfamiliarity, and isolation. It heightens the suspect’s “get me out of here” sensation throughout the interrogation.

AZ1The manual also suggests that the suspect should be seated in an uncomfortable chair, out of reach of any controls like light switches or thermostats, furthering his discomfort and setting up a feeling of dependence. A one-way mirror and/or closed circuit TV are great additions to the room, because they increases the suspect’s anxiety and allows other interrogators to watch the process and help the principle interrogator figure out which techniques are working and which aren’t.

Before the 9 Steps of the Reid Technique begin, there’s an initial interview to determine guilt or innocence. During this time, the interrogator attempts to develop a rapport with the suspect, using casual conversation to create a non-threatening atmosphere. People tend to like and trust people who are like them, so the interrogator may claim to share some of the suspect’s interests or beliefs. If the suspect starts talking to the interrogator about harmless things, it becomes harder to stop talking or start lying later when the discussion turns to the crime.

AZ10During this initial conversation, the interrogator observes the suspect’s reactions, both verbal and non-verbal, to establish a baseline reaction before the real stress begins. The interrogator will later use this baseline as a control or comparison point. One method of creating a baseline involves asking questions that cause the suspect to access different parts of their brain.

Non-threatening questions are asked that require memory (simple recall) and questions that require thinking (creativity). When the suspect is remembering something, their eyes often move to the right. This is an outward manifestation of their brain activating the memory center. When they’re thinking about something, the eyes will move upward or to the left, reflecting activation of the cognitive center. A trained, experienced interrogator makes a mental note of the suspect’s eye activity.

The next step is turning to the question at hand.

AZ25The interrogator asks basic questions about the crime and compares the suspect’s reactions to the baseline. This is quite an accurate determination if the suspect is truthful or deceptive. For example, if the interrogator asks the suspect where they were the night of the crime and they answer truthfully, they’ll honestly be remembering so their eyes will move to the right. If they’re concocting an alibi, they’re thinking, so the eyes will go up or to the left. If the interrogator determines that the suspect’s reactions indicate deception and all other evidence points to guilt, then a structured interrogation of the suspect begins.

The Reid Technique lays out a proven blueprint of 9 Steps or issues guiding an interrogation. Many of these steps overlap and there is no such thing as a “typical” interrogation. Here’s how it should go.

1.Confrontation

AZ3The interrogator presents the facts of the case and informs the suspect of the evidence against them implying in a confident manner that the suspect is involved in the crime. The suspect’s stress level increases and the interrogator may move around the room, invading the suspect’s personal space to increase the discomfort. If the suspect starts fidgeting, licking lips, and/or grooming themselves (running his hand through their hair, for instance), the interrogator notes these as deception indicators confirming their on the right track.

2. Theme Development

The interrogator creates a story about why the suspect committed the crime. Theme development is about looking through the eyes of the suspect to figure out why they did it. The interrogator lays out a theme or a story that the suspect can latch on to in order to either excuse or justify their part in the crime and the interrogator observes the suspect to see if they’re buying the theme. Are they paying closer attention than before? Nodding their head? If so, the interrogator will continue developing that theme; if not, they’ll pick a new theme and start over. Theme development is in the background throughout the interrogation. When developing themes, the interrogator speaks in a soft, soothing voice to appear non-threatening and to lull the suspect into a false sense of security.

3. Stopping Denials

AZ5Letting the suspect deny their guilt will increase their confidence, so the interrogator tries to interrupt all denials, sometimes telling the suspect it’ll be their turn to talk in a moment, but right now, they need to listen. From the start of the interrogation, the interrogator watches for denials and stops the suspect before they can voice them. In addition to keeping the suspect’s confidence low, stopping denials also helps quiet the suspect so they don’t have a chance to ask for a lawyer. If there are no denials during theme development, the interrogator takes this as a positive indicator of guilt. If initial attempts at denial slow down or stop during theme development, the interrogator knows they’ve found a good theme and that the suspect is getting closer to confessing.

4. Overcoming Objections

Once the interrogator has fully developed a theme that the suspect relates to, the suspect may offer logic-based objections as opposed to simple denials, like “I could never rape somebody — my sister was raped and I saw how much pain it caused. I would never do that to someone.” The interrogator handles these differently than denials because these objections can give information to turn around and use against the suspect. The interrogator might say something like, “See, that’s good, you’re telling me you would never plan this, that it was out of your control. You care about women like your sister — it was just a one-time mistake, not a recurring thing.” If the interrogator does his job right, an objection ends up looking more like an admission of guilt.

5. Getting Suspect’s Attention

AZ6At this point, the suspect should be frustrated and unsure of themselves. They may be looking for someone to help him escape the situation. The interrogator tries to capitalize on that insecurity by pretending to be the suspect’s ally. They’ll try to appear even more sincere in their continued theme development and may get physically closer to the suspect, making it harder for the suspect to detach from the situation. The interrogator may offer physical gestures of camaraderie and concern, such as touching the suspect’s shoulder or patting his back.

6. Suspect Looses Resolve

If the suspect’s body language indicates surrender – head in his hands, elbows on knees, shoulders hunched — the interrogator seizes the opportunity to start leading the suspect into confession. It transitions from theme development to motive alternatives that force the suspect to choose a reason why they committed the crime. At this stage, the interrogator makes every effort to establish eye contact with the suspect to increase the suspect’s stress level and desire to escape. If, at this point, the suspect cries, the interrogator knows it’s a positive indicator of guilt.

7. Alternatives

AZ7The interrogator offers two contrasting motives for some aspect of the crime, sometimes beginning with a minor aspect so it’s less threatening to the suspect. One alternative is socially acceptable (“It was a crime of passion”), and the other is morally repugnant (“You killed her for the money”). The interrogator builds up the contrast between the two alternatives until the suspect gives an indicator of choosing one, like a nod of the head or increased signs of surrender. Then, the interrogator speeds things up.

8. Bringing Suspect Into Conversation

Once the suspect chooses an alternative, the confession has begun. The interrogator encourages the suspect to talk about the crime and might arrange for a second interrogator in room to increase the suspect’s stress level and his desire to give up and tell the truth. A new person into the room also forces the suspect to reassert his socially acceptable reason for the crime, reinforcing the idea that the confession is a done deal.

9. The Confession

AZ8The final stage of an interrogation is all about getting a truthful confession that will be admitted as evidence at trial. Virtually all interrogations today are recorded on audio/visual and transcripts are developed. There are further evidentiary tools used during confession besides words. Having the suspect draw maps or sketches of the scene, confess to secondary parties, write letters of apology, and returning the suspect back to the scene and re-enact the crime are commonly used. It’s vitally important to back-up the truthfulness of the confession with independent, corroborating evidence such as disclosing ‘key facts’ of the crime which would only be known to the perpetrator and investigators, or turning over critically implicating evidence like the murder weapon.

These steps represent some of the psychological techniques that interrogators use to get confessions from suspects, but real interrogations don’t always follow the textbook.

AZ16Critics of the Reid Technique claim that it too easily produces false confessions, especially with young people. The use of the Reid Technique on youths is prohibited in several European countries because of the incidence of false confessions and wrongful convictions that result.

Although it’s widely used and accepted in the USA, the Canadian courts are careful in admissibility of confessions extracted in this method, ruling that “stripped to its bare essentials, the Reid Technique is a guilt-presumptive, confrontational, psychologically manipulative procedure whose purpose is to extract a confession, not necessarily a truthful confession.” John E. Reid and Associates, the Chicago firm that holds rights to the technique and its teachings maintains that “it’s not the technique that causes false or coerced confessions, but police detectives who apply improper interrogation procedures.”

I’ve seen the Reid Technique put into practice many times with great success.

AZ20The best example of a textbook Reid Technique interrogation is the case of Colonel Russell Williams, a Canadian Air Force commander who confessed to two sex-murders. The interrogator was Detective Sergeant Jim Smyth of the Ontario Provincial Police’s Behavioral Science Unit. The skill employed by Det. Sgt. Smyth is nothing short of magic. Smyth made sure this confession’s truthfulness was verified.

Here’s the YouTube link to the two hour and forty minute video. It’s well worth the watch.  https://www.youtube.com/watch?v=zLJzNpVrcGU

And here’s the link to John E. Reid & Associates website.  http://www.reid.com/AZ2

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.