Hi everybody I'm Michele and welcome to You Therapy
this is video 2 of the PTSD series in today's video I'm going to go through
the criteria for post-traumatic stress disorder. I'm going to read through it as
listed by the DSM the way I do with clients when we suspect PTSD may be
happening. So if you're not sure what PTSD is please see Volume one of this
series -you can google PTSD... and today's video is really about getting into the
nitty-gritty of what criteria meets the diagnosis for PTSD so these criteria are
divided up in two letters first of all and then numbers after so I'm going to
guide you through just the way I do my clients you may want to have some paper
and pen ready in order to make notes for yourself which of these you fit and that
might be something you want to share with a therapist I would encourage you
to do so if you're experiencing many of these really uncomfortable very
distressing symptoms so let's just get right to it.
Criteria A begins with a stresser -a traumatic event- a very bad event. The
person was exposed to a death, a threatened death, an actual or threatened
serious injury, or actual or threatened sexual violence, as followed by: One,
direct exposure, Two, witnessing that trauma in person Three, indirectly by
learning about it from someone very close to you
who was exposed to the trauma. And it could be number 4, a direct exposure to
aversive details of this traumatic, very bad, distressing
event, usually in the course of professional duties. Someone like me
like who is a professional counselor, first responders ,someone who collects a
body, other professionals who are repeatedly exposed to details say of
abuse. So, direct exposure, witnessing it in person, indirectly through someone close
to you, or hearing the aversive details in the course of professional duties.
That is criteria A, so obviously you're going to begin with a traumatic event
Criteria B then will be intrusive symptoms. The traumatic event is
persistently re- experienced in the following ways. The first one is
intrusive thoughts- recurrent involuntary and intrusive memories. So for instance
you can't stop thinking about some piece of the trauma over and over and over. It
does not let go. Two, nightmares. Three, dissociative reactions. So you're
outside of your body. You may be experiencing flashbacks. It could occur
on a continuum from brief episodes to a complete loss of consciousness. And I'm
going to do another video about what what dissociation is -it's a very common
traumatic symptom but a dissociation is kind of a separation from self and
feeling about being outside of oneself. Four, intense or prolonged
distress after exposure to traumatic reminders. Oftentimes people tell me it's
a smell, it could be words, it could be someone who has certain characteristics
of the person who was abusive. And they feel an intense distress about that, and
five is marked, physiologic reactivity after exposure to trauma related stimuli.
So physiologic, in your body, and so that can be intense heart rate, sweating, your
body just feels like it's in fight-or-flight. So of criteria B,
intrusive symptoms, only one is required to meet that criteria. And there's a lot
that's going to be listed here obviously you just rewind the video as many times
as you need to to make sense of what you're hearing and also feel free to ask
any questions in the comments about what I've explained here because it can be
Clinical and that's what we're doing, we're making it very clinical. We're sort of
taking some of the emotional intensity out of it by being right into the DSM
wording so criteria criterion C is avoidance. Avoidance of trauma related
stimuli after the trauma in the following way: So one is trauma related
thoughts or feelings just refusing refusing refusing to think about it,
refusing to feel. People oftentimes shut down and say they don't feel anything.
They feel numb or they just will not go there, they will not go into sometimes
even a general discussion of what happened- avoidance. It's just too scary
to go there. Trauma related external reminders: people, places, conversations,
activities, objects, or situations. There's an avoidance of going near a hospital where
something really terrible happened, going near, you know, a sports event
because something bad happened related to that type of event I mean the
possibilities are endless as far as what those external reminders could be so
again the avoidance piece one is required to meet the criteria. Criterion
D: negative alterations in cognition. So that's your thoughts and mood. Negative
thoughts or feelings that began or worsened after the trauma in the
following ways: One,
inability to recall features of the trauma. So it's a dissociative amnesia,
and it's not due to it head injury alcohol or drugs. Again, that really is
related to dissociation Part of that memory is just gone. Two, overly and often
distorted negative thoughts and assumptions about oneself or the world.
So for instance: I am bad. I am worthless. I am less than other people, or the world
is completely dangerous. No one can be trusted
Those type of irrational thoughts that are understandable but they are not
rational and they cause us a lot of pain to have those thoughts. Three, exaggerated
blame of self or others for causing the trauma event or resulting
consequences. Four, negative affect- affect is your mood, like mad,
glad, sad, afraid, ashamed. Negative trauma related emotions: fear, horror, guilt, shame.
Number 5: decreased interest in activities that you enjoyed before the
trauma. Number 6, feeling isolated. A detachment or an estrangement from other
people. And number 7 is difficulty experiencing positive affect or positive
emotions. A persistent inability to experience them. So of these seven
criterion only two are required.
Criterion E, alteration alterations in your arousal and reactivity.
So trauma related alterations in the way you behave and the way you feel that
began or worsened after the trauma in the following ways: irritability or
aggression, risky or destructive behavior, hyper-vigilance -so always checking. You
know, oftentimes all you know, I hear from people that they're constantly checking
the windows, checking their doors, checking around them for safety. Number
four: heightened startled reaction. So someone comes up behind you and taps you
on the shoulder, and you know you feel like you jump five feet each time that
happens. Number five: difficulty concentrating, and
Six difficulty sleeping. So I feel like I might have missed one so I'm gonna say
them over again just to be sure I didn't miss any. Irritability or aggression is
one. Two, risky or destructive behavior that's what I missed. Three hyper-vigilance- always
checking for safety, four, heightened startled reaction, five difficulty
concentrating, and I think that's what happened to me -and six is difficulty
sleeping. So of criterion E, two are required
just to meet the diagnosis. Criterion F is the duration. So that means that these
symptoms that you may have experienced and checked off as I have gone through
this list, you've experienced them for at least a month. And criterion G, which is a
new one for the new DSM is functional significance, which means that the
symptoms create distress or an impairment you know in your social life,
in your occupational life, they really get in the way. Criterion H is an
exclusion- the symptoms are not due to medications, substance abuse, or some
other illness which are causing those symptoms. You could also have
dissociative symptoms along with this, and I think I'll just skip this part for
now. As you can probably guess I'm reading all these criteria. I
think that dissociative symptoms are something worth a separate video to
really address in a deeper way. And there also can be delayed expression. Full
diagnosis is not met until at least six months after the trauma. Although you may
start having the symptoms right away, immediately, we don't start to say yes
this is PTSD until at least six months after, hence the Post piece of this. So
that is the criteria for post-traumatic stress disorder. I know I went through it
quickly. I know it's very involved. This can be googled very easily but I
think there is something about having a therapist say it to you and being able
to kind of hear a person connect to you even if it's just through a screen
talking to you about what these symptoms are, versus reading them, But I invite you
to do any further research that you may need to do to understand these symptoms
and also please don't hesitate to leave any questions that you may have for me
in the comments about PTSD. The next video is going to be brighter because
it's going to be about treatments. The treatments that have been
shown through research to help these PTSD symptoms. And so I'm going to try to
go into some detail and describe each of these treatments that are currently
being used to help those that have these symptoms. So thank you for being here
with me today. Thank you for having the courage to listen and go through these
criteria. I know that's not an easy thing to do, and it is a very brave thing to do.
It is one step toward helping yourself to feel better, to increase compassion
for yourself, and to increase the possibility that these symptoms are
going to kind of start to get out of your way in your life. So thank you for
watching I look forward to seeing you in the next video. Take care and be well.
Không có nhận xét nào:
Đăng nhận xét