Treatments for Posttraumatic Stress Disorder

Phobia Release Program

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Ptsd And Fast Phobia Relief Self-help Audio Program

This audio home study program was developed by Robert Mantell, the founder and executive director of BrightLife Phobia And Anxiety Release Center. With this audio program, you'll get 3 full-length CDs and more than 180 minutes of revolutionary mental repatterning tools, strategies and techniques. You'll learn the basics about fear and anxiety, how to neutralize past fears and how to condition yourself for success and self-confidence. How to Free Yourself from Trauma, Phobias And Anxiety in 7 Days Or Less! introduces Imagination Creation Accelerated Personal Breakthrough Technology that will lead to quick and easy relief. Free yourself from anxiety, fears, phobias and post-traumatic stress disorder (Ptsd) with the help of How to Free Yourself from Trauma, Phobias And Anxiety in 7 Days Or Less!

Ptsd And Fast Phobia Relief Selfhelp Audio Program Summary

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Post Traumatic Stress Disorder PTSD

Some people who experience severe psychological trauma develop post-traumatic stress disorder, a condition characterized by recur- T3_ ring, intrusive memories of the traumatic event. These memories are highly persistent and interfere with the process of acquiring new information, consolidating memories, and remembering information that is unrelated to the trauma. Sustained levels of stress stimulate the release of a hormone called Cortisol, which can ultimately damage brain structures that are important for memory. In fact, patients with PTSD have been found to have structural changes in the hippocampus and possibly other areas of the limbic system. High levels of cortisol can also cause memory problems in people without PTSD. In one study, healthy adults were given a supplemental dose of cortisol once a day for four days. The people were divided into two groups. One group was given a low dose of cortisol about the level that the body naturally releases in response to ordinary...

Posttraumatic stress disorder

Post-traumatic stress disorder (PTSD) An emotional condition that often occurs after direct or indirect exposure to a terrifying event in which a child witnessed or actually experienced physical harm. Traumatic events that can cause post-traumatic stress disorder (PTSD) include violent assaults, physical or sexual abuse, shootings, natural disasters, or car accidents. one out of 13 Americans will develop PTSD during their lifetime, which is especially common among girls and women, who are about twice as likely as boys or men to develop PTSD. This may be due to the fact that girls and women tend to experience domestic violence, rape, or abuse more often. Most children with PTSD try to avoid any reminders or thoughts of the trauma, but despite this, they often reexperience the ordeal in intense flashbacks, memories, nightmares, or frightening thoughts. Feelings of guilt from surviving an event in which friends or family died is also often a common feature of PTSD. Any traumatic event...

Obsessive Compulsive Disorder

Post-Traumatic Stress Disorder Children who experience a physical or emotional trauma, such as witnessing a shooting, surviving physical or sexual abuse, or being in a car accident, may develop post-traumatic stress disorder (PTSD). Children are more easily traumatized than adults An event that may not be traumatic to an adult might be to a child, such as a turbulent plane ride. As a result of the trauma, a child may reexperi-ence the event through nightmares, constant thoughts about what happened, or by reenacting the event while playing. A child with PTSD will experience symptoms of general anxiety, including trouble sleeping and eating or being irritable. Many children may exhibit other physical symptoms as well, such as being easily startled.

Hoanalysis as a Scientific Theory

When researchers test psychoanalytic ideas outside of the therapeutic setting, other difficulties emerge. Most psychological tests rely on self-report measures, in which people say what they experience. These are problematic, however, since psychoanalytic theory itself is based on the premise that people have little insight into their own psychodynamics. Projective tests such as the Rorschach inkblot test (Pichot, 1984), which are commonly used to measure unconscious motivations, have low reliability, which impedes research. Nonetheless, some striking results have been reported with the Rorschach test. In one study, the medical school Rorschach protocols of those physicians who later committed suicide or came down with cancer were strikingly distinctive (Thomas, 1988). In another, Rorschach tests of women who killed their abusive husbands were found to be similar to tests of combat veterans suffering from posttraumatic stress disorder (Kaser-Boyd, 1993)- Rorschach tests have also been...

Unconscious Influences and the Body

Freud's work began in neurology, and it became psychological because the clinical phenomena he confronted were incomprehensible with the medical knowledge of that time. Today, neurologists suggest that some of the clinical symptoms Freud observed do have a neurological basis. For example, consider traumatic memory loss. Traumatic experience, in Freud's theory, can cause repression of the traumatic events, so they are unavailable to memory. Neural imaging of the brain shows decreased functioning in the hippocampus and some other areas in people who have been exposed to combat stress and other traumas (Conway & Pleydell-Pearce, 2000). We know from controlled studies that when experimental animals are exposed to very high levels of stress, the brain responds physiologically in ways that can alter memoiy, producing amnesia. In studies of rats, stress that was created by a painful shock to the animals' feet caused them to forget how to escape from a tank of water. Unshocked rats swam to a...

Cultural Models of Health and Illness

Cross-cultural differences in presentation of symptoms have been linked to differential rates of somatization, to posttraumatic stress disorder in immigrants and refugees, and to clinical depression (Castillo et al. 1995). Latinos may be at risk for misdiagnosis or inappropriate interventions because of a lack of sensitivity by medical professionals to culturally based somatoform symptoms. Furthermore, Latinos tend to associate a stigma with certain illnesses such as cancer (Perez-Stable et al. 1992b). Recommendations regard

Referral to Mental Health Professionals

Several types of mental health professionals are available, including psychiatrists, psychologists, social workers, and nurse therapists. The nature of the clinical problem should determine which of these is most appropriate to treat an anxious patient. For example, prompt referral to a psychiatrist is indicated if the patient has severe symptoms that impair daily functioning or are associated with suicidal thoughts. A psychiatrist should also be selected when there is diagnostic uncertainty when advice is needed about medications when the patient has complicated medical comorbidity when another psychiatric condition, such as major depression, substance abuse, or personality disorder, is present and when the anxiety is due to OCD or posttraumatic stress disorder. In addition, psychiatrists should be able to design pharmacologic treatments for patients whose disorder has failed to respond completely to initial medication trials by primary care physicians.

Incidence of Mental Illness

In 1996, a large-scale nationwide mental health and substance abuse epidemiological study was conducted by researchers from the University of Antioquia and the University CES of Medellin. Funded by the Ministry of Health and working with a national team of more than 100 interviewers, the researchers interviewed a random sample of 15,046 individuals older than 12 years of age across the country, using the Clinical Diagnostic Inventory II questionnaire, which is based on the DSM-IV classification. This is the most comprehensive mental health study ever conducted in Colombia. The lifetime prevalence of diagnosable disorders was as follows nicotine dependency, 28 major depression, 19.3 alcohol abuse and dependency (combined), 16.6 posttraumatic stress disorder, 4.5 somatization, 4.3 generalized anxiety, 3.8 and schizophrenia, 1.4 . The lifetime use of marijuana was 7.8 and of cocaine 2.5 (Torres and Montoya 1997). Suicide is also a public health problem in 1995, a total of 58,830 suicides...

Acculturation and Mental Health Symptoms

As the result of migration, some Colombian families tend to present marital conflicts, difficulties in communication with their teenage children, and symptoms of posttraumatic stress disorder. Alcoholism tends to be common in males depression occurs frequently in women (Leon 1993). Colombians also show frequent symptoms of somatization, resulting from postmigration stress. Escobar (1987 Escobar et al. 1983) documented higher somatization indexes among Colombian patients with major depression compared to North American patients.

Issues of Clinical Relevance

The most prevalent diagnoses among Nicaraguans in the United States are depression, anxiety, and posttraumatic stress disorder (PTSD). The following case vignettes have been selected to illustrate psychiatric issues that are pertinent to the Nicaraguan community. The following case examples illustrate the importance of having a through understanding of patients' life circumstances in a patient with paranoia, a social marker of distress, and a patient with PTSD. Mr. J, a Nicaraguan man in his 40s, developed severe insomnia, flashbacks, and extreme apprehension several months after he arrived in the United States. His history revealed that while in Nicaragua, he had been imprisoned and subjected to subhuman, crowded conditions while incarcerated. He also developed intrusive, obsessional thinking and symptomatology of depression. He was given a diagnosis of PTSD. After brief psychotherapeutic intervention and temporary treatment with a sedative-hypnotic, Mr. J's symptoms remitted, and he...

Postnatal transmission See transmission

Post-traumatic stress syndrome (PTSD) A clinical psychological disorder that arises in response to a catastrophic, or traumatic, event. The best-known instances are those of men traumatized in combat, but it also afflicts those who have survived or witnessed other extremely traumatic events. PTSD responses may be acute, chronic, or delayed. Their central feature is that the survivor reexperi-

Memory For Valenced Material Moodcongruent Memory

Clearly, the idea of memory bias in favour of material that is congruent with the emotional state has clinical implications. In terms of maintenance, any distortions in cognitive processing that favour material that is likely to have a negative impact on mood are likely to maintain negative mood states and, in the worst cases, emotional disorder. Furthermore, Although mood-congruent memory effects are a relatively robust finding in association with depression, the evidence with respect to anxiety and anxiety disorders is far less clear cut. There seems to be some evidence for a memory bias in favour of threatening information in panic disorder patients (e.g. Becker et al., 1999) and patients with PTSD (e.g. Moradi et al., 2000). However, the data for high levels of subclinical trait) anxiety and for generalized anxious states such as generalized anxiety disorder (GAD) is much weaker (for review, see Williams et al., 1997). In sum, research on mood-congruence effects suggests that...

Autobiographical Memory Style

More overgeneral memories that are categorical in nature, e.g. to the cue word party , instead of saying, I remember my best friend's 30th birthday party when we all went out for a meal , they might say, All of the parties I've been to in the last 5 years have made me miserable . This tendency to generate overgeneral autobiographical memories seems to be a relatively robust finding (Healy & Williams, 1999). Perhaps more importantly, the number of overgeneral memories generated while an individual is in an emotionally distressed state seems to predict poorer long-term outcome, over and above baseline symptom measures (Brittlebank et al., 1993 Dalgleish et al., 2001). These data suggest that the tendency to generate overgeneral memories is not just an epiphenomenon of emotional distress, but rather reflects something more fundamental about the maintenance of distressed states. As was the case with mood-congruent memory, overgeneral memory effects are more reliably associated with...

Note On Intrusive Memories

As well as difficulties with the intentional recall of either general or emotionally valent materials, individuals in emotional distress are characterized by unintentional (intrusive) memories of past experiences (e.g. Uleman & Bargh, 1989). For certain disorders, such as PTSD, acute stress disorder and adjustment disorder, intrusive experiences are part of the diagnostic profile (APA, 1994). For other types of emotional distress, such as depression, intrusive memories are common (e.g. Brewin et al., 1996) but are not necessary for a diagnosis.

Abused Women and the Health Care System

The battered woman's syndrome is a commonly used term for the psychological sequelae of repeated abuse and violence (Walker 1979). This concept incorporates ideas about learned helplessness and characterizes victims as passive, hopeless, and developing low self-esteem as a result of the abuse. Another way of understanding the psychological responses of victims is through the diagnostic construct of posttraumatic stress disorder (PTSD) (Browne 1993). It is argued that repeated violence and abuse may result in typical symptoms of PTSD, including fear, flashbacks, denial, avoidance, loss of memory, anxiety, and hypervigilance. Ultimately, these constructs may provide only limited guidance given the diversity of experiences and psychological adaptations of abuse survivors.

Principles of Substance Abuse Treatment

Review of the literature by Schuckit (Brown and Schuckit 1988 Schuckit and Hesselbrock 1994) indicated that about 60 -70 of the people who develop serious alcohol or drug problems do not have a major preexisting psychiatric disorder. Their substance abuse is actually the primary disorder and often leads to the development of secondary psychiatric symptoms. If this appears to be the case after taking a careful history and delineating the temporal sequence of symptoms in a patient, it is helpful to inform the patient that symptoms of depression or anxiety may be temporary and disappear on their own with abstinence. Note, however, that certain psychiatric diagnoses in Hispan-ics, especially posttraumatic stress disorder, often are associated with a significant degree of self-medication with alcohol and drugs. All patients must therefore be followed up once they achieve abstinence to ensure that their psychiatric symptoms remit. If symptoms remain, a psychiatric assessment is certainly...

Research on Birth Order

Also are more trusting and innovative (Jefferson, Herbst, & McCrae, 1998). In a study of early memories, later-born children were more likely than first-borns to include family members in their recollections, whereas first-borns were more likely to recall people outside the family and traumatic events such as injury otherwise, the memories were similar (Fakouri & Hafner, 1984).

Assessment of Language

B is a 20-year-old Salvadoran male, who was hospitalized on an inpatient psychiatric unit. He identified himself as being bilingual. Upon evaluation by the Spanish-speaking nursing staff, the Spanish-speaking staff who saw him as hypomanic questioned why the English-speaking psychiatrist was planning to treat him with antidepressants. A case conference was held in which the doctor interviewed Mr. B in English. During the interview the patient spoke in slow, halting English his affect was flat, and his thoughts were incomplete. His answers to questions were succinct, and he provided scant information. The psychiatrist's diagnostic impression was that Mr. Martinez was depressed, with a psychotic thought process. When the Spanish-speaking staff interviewed Mr. B in Spanish, there was a dramatic change in his presentation. He became expansive in his responses and was quite delusional and labile. He provided a complete history, including details of having witnessed his brother killed...

Psychological Consequences of War Trauma

Individuals who themselves were victims or whose family members were victims of the political violence in El Salvador frequently manifest various forms of psychological problems after arrival and settlement in the United States. Victims of torture often have the symptoms of posttraumatic stress disorder (PTSD). They include severe depression, guilt, nightmares, flashbacks, hy-peralertness, insomnia, suicidal tendencies, and withdrawal. The psychiatric evaluation of Central Americans conducted at refugee centers throughout the San Francisco Bay area concluded that a large number of people there suffered from PTSD (Cordova 1987). Ms. F, a 28-year-old woman, sought psychiatric treatment after she began to experience insomnia, recurring dreams of past traumatic events, and the inability to concentrate. She had been living in the San Francisco Bay area for a brief period and was a domestic worker. Her children were scheduled to arrive from El Salvador soon, and she feared that her...

The Recovered Memory Controversy

Two points are established beyond controversy Sexual abuse of children occurs all too frequently, and it has long-term negative effects on psychological functioning (Cahill, Llewelyn, & Pearson, 1991). David Finkelhor and his colleagues report a national survey of Americans in which 27 percent of the women and 16 percent of the men reported some type of sexual abuse when they were children. Overall, 13 percent of the women and 9 percent of the men reported a history of actual or attempted intercourse (Finkelhor et al., 1990). Those who have been sexually abused as children are at increased risk for a variety of disorders, including posttraumatic stress disorder, anxiety, depression, suicide, borderline personality disorder, multiple personality disorder, dissociation, drug and alcohol abuse, sexual victimization, difficulty in relationships, and poor self-esteem (Alter-Reid et al., 1986 Barnard & Hirsch, 1985 Browne & Finkelhor, 1986 Connors & Morse, 1993 deChesnay, 1985...

The Importance of Childhood Experiences

Horney believed that neurotic conflict can stem from ahnost any developmental stage, but childhood is the age from which the vast majority of problems arise. A variety of traumatic events, such as sexual abuse, beatings, open rejection, or pervasive neglect, may leave their impressions on a child's future development but Horney (1937) insisted that these debilitating experiences can ahnost invariably be traced to lack of genuine warmth and affection. Horney's own lack of love from her father and her close relationship with her mother must have had a powerful effect on her personal development as well as on her theoretical ideas.


Similarly, the credibility of recovered memories of childhood abuse has been called into question. In a typical case of recovered memory, an adult in psychotherapy may begin to experience memories of traumatic events related to very early childhood. Retrospective analysis of how some of these memories were unearthed has raised questions about possible suggestive techniques used in the therapy process. Recovered memories are most often cited in cases of early childhood trauma in which the victim was assumed to have unconsciously repressed a horrific experience, keeping it locked away from conscious awareness for years. Proponents of recovered memory believe that the experience of the traumatic memory is provoked, either gradually or abruptly, by an event or another stimulus that the person consciously or unconsciously associates with the trauma. Sigmund Freud believed that repressed memory formed the basis for neurosis. Some psychotherapists facilitate the recovery of buried memories...


A core feature of post-traumatic stress disorder (PTSD), a condition that can develop after a person experiences a traumatic event (for example, sexual assault or war), is the persistent intrusion of unwanted memories. With PTSD, persistent memories assume the form of flashbacks and nightmares of the traumatic event, causing a person to relive the ordeal. A flashback is a special form of memory in which the individual loses contact with present reality and is thrust back in time to the traumatic situation the psychological distance that characterizes normal mem-40, ory is lost. Many people with phobias and PTSD learn to control persistent memories through therapy that involves guided imagery, or visualization. With this technique, a therapist helps the person learn to envision the object of the phobia or the traumatic incident in a graduated approach, which precludes the experience of intense fear. Once the emotional response to the stimulus diminishes, the memory of it becomes less...


* Patients with chronic anxiety about their health (hypochondriasis) are discussed in Chapter 5. Patients with anxiety after severe physical or emotional trauma (posttraumatic stress disorder) often have flashbacks and nightmares and should be referred to a psychiatrist for treatment.


In laboratory research (Wegner, Schneider, Carter, & White, 1987), subjects were told to avoid thinking about a white bear. LTnfortunately, that was difficult to do thoughts of white bears intruded into their later thinking. That classic study provided the name for a self-report measure used to measure suppression, the White Bear Suppression Inventory, which is correlated with obsessive thoughts, depression, and anxiety (Wegner & Zanakos, 1994). Laboratory research indicates that people can learn to suppress unwanted thoughts. However, a rebound effect often occurs later, and the unwanted thoughts return with greater frequency (Kelly & Nauta, 1997 Wegner, Erber, & Zanakos, 1993)- Rebound effects have been demonstrated for many different phenomena, including emotional stimuli, memories, stereotypes, and cravings for tobacco and alcohol (Wenzlaff & Wegner, 2000). Furthermore, people who are suffering from posttraumatic stress disorder following rape and people suffering high levels of...

Michael D Kopelman

Psychologically-based amnesia encompasses instances of persistent memory impairment, such as occurs in depression or (in extreme form) in a depressive pseudodementia. Alternatively, it can entail transient or discrete episodes of memory loss. The effects of depression on memory are considered in Chapter 20, and transient episodes of psychogenic memory loss are the subject of the present account. Such transient amnesias can be situation-specific, as occurs in amnesia for offences, fragments of recall in posttraumatic stress disorder, and in amnesia for childhood sexual abuse. In other cases, the transient amnesia can involve a more global memory deficit, often accompanied by a loss of the sense of personal identity, such as occurs in a psychogenic fugue state. Whilst these latter instances are the stuff of film and fiction (usually in grossly distorted form), it is important to recognize that situation-specific amnesia is much more commonplace, coming to the attention of clinical and...


Migration may have several antecedents. Although often it is propelled by economic need, other factors must be considered. For example, the role of migration in Puerto Rican culture may be a response to interpersonal stresses such as divorce, illness, or conflict of cross-generational values. Parents often send a teenager from the island to New York or vice versa to deal with an adolescent crisis. Precipitants may be a romantic relationship that the parents disapprove of, trouble with school, or trouble with the law. Economic difficulties may cause a parent to send children to live with grandparents or other relatives. Although this may relieve the situation in the short run, the children or adolescents may be left without important supports and may have to cope with numerous new stresses as a result of the move (Bernal and Flores-Ortiz 1982). If migration follows major traumatic events, such as parental loss, sexual assault, or war, the move and need to adapt to a new social milieu...

Peptidergic Systems

Cell bodies and dendrites, but not with astrocytes (135). It has an extensive distribution in the forebrain, and is only one of at least six prohormone convertases thus far identified in rat brain. The isoform, PC5-A, has been shown to process NT, nerve growth factor, brain-derived neurotrophic factor, and other signaling proteins (135,136). It is probable that secreted endopeptidases or endoproteases, bound to the cell membranes bordering the ECS, act in the EC environment, to enhance or terminate NP signaling, through the formation of active or inactive fragments, respectively, as already suggested for galanin and galanin fragments (137,138). EC enzymes, attached to the plasma membrane and or present in the ECS, are themselves regionally distributed in brain in a differential manner, thus creating, in the case of NPs, neuro-chemical networks for VT molecules. In the clinic, increased activity of prolyl-endopeptidase has been measured in serum from patients with posttraumatic stress...

Hippocampal function

Chronically, stressful conditions and elevated H PA activity are associated with selective atrophy in the human brain, based upon MRI imaging. The conditions in which hippocampal atrophy has been reported include Cushing's syndrome, posttraumatic stress disorder, recurrent depressive illness, normal aging preceding dementia, and Alzheimer's disease (McEwen, 1997). Hippocampal shrinkage is usually accompanied by deficits in declarative, episodic, spatial, and contextual memory performance, and the hip-pocampal changes provide a neural substrate for changes in cognitive function that have been recognized to accompany these various conditions. The hippocampus has long been known as a target of stress hormones, and it is an especially plastic and vulnerable region of the brain. However, the prominence of the hippocampus as a glucocorticoid target has obscured the fact that other factors besides glucocorti-coid hormones are involved in the process of hippocampal atrophy. Excitatory amino...

Psychic Determinism

At first, Freud (1895 1966b) tried to understand how psychic factors, such as traumatic events, produced physical changes in the nervous system. For example, he postulated that the anxiety of a traumatic sexual encounter could, by modifying connections in the nervous system, produce anxiety symptoms in later life. Freud realized that the microscope would not be an appropriate investigative tool for his theory. Neurologists would not know where to look after all, these changes were far more subtle than the gross lesions with which they generally dealt. So Freud turned to less direct investigative methods through the analysis of clinical material. The clinical method is well accepted within neurology, where nerve damage is often diagnosed on the basis of behavioral symptoms such as paralysis and pain rather than by physical examination of the neurons.


While Freud's theory suggests that dreams respond to life's events, they don't do so in a clear and obvious way. Dreams reported by people who have experienced traumatic events don't even reveal the realistic kind of trauma (Brenneis, 1997). In order to understand the emotional meaning of dreams, it is necessary to follow the dreamer's associations to see where they lead. Freud, for example, asked an American woman who had written him a letter about a troubling dream to tell what the name Mildred Dowl meant. In the dream, the woman's romantic partner had sent her a cruel note saying he had married Miss Mildred Dowl, and she had (in the dream) stabbed herself in despair. As Freud said, without knowing the source of the name, only a limited interpretation of the dream was possible (Benjamin & Dixon, 1996). Psychoanalysts emphasize the importance of dreams as ways of dealing with emotions, such as the anxiety and guilt that may follow traumatic events (Hartmann, 1998 Hartmann et al,...

Bruce S Mcewen

Developmentally programmed sex differences are also seen in the hippocampus. Suppression of dentate gyrus neurogenesis and atrophy of dendrites of hippocampal pyramidal neurons are produced by chronic psychosocial stress, involving the actions of adrenal steroids acting in concert with excitatory amino acid neurotransmitters. As far as we can tell, these changes are reversible as long as stress is terminated after a number of weeks. However, there are also reports that much longer durations of psychosocial stress leads to permanent loss of hippocampal pyramidal neurons. In the human hippocampus, MRI studies along with neuropsychological testing have revealed memory impairment and atrophy of the whole human hippocampus in some individuals as they age. This is reminiscent of individual differences in aging in rodents, which appear to reflect life-long patterns of stress hormone reactivity that are developmentally programmed, although a developmental influence on human individual...

Step 3 Plaques Form

In an attempt to wall off this inflammation, the body signals the smooth muscle cells to proliferate and to make more fibrous material to contain the process. Eventually, a cap forms over the inflammation. This is the birth of a plaque that can narrow the artery. Plaques vary in size, and there is evidence that some early stages of plaque formation are reversible, whereas later stages are permanent. Most of us probably form and resolve small plaques throughout much of our lives. Studies in teenagers who have died from traumatic events, such as car accidents, have shown early-stage plaques in the arteries of even these very young men and women.