Monday, November 14, 2011

The Destruction of my C.D. Plan


I was left in the National Park,
my family drove away,
laughter from the car tore myself apart.
"Some one love me, some one won't leave Me."
The car banked the turn and I fell where I stood.

I watched through the trees,
the station wagon would lean,
as it curved out of each turn.
The voices so merry,
and I was so forlorn, to death did I grasp.

I was left in the dark,
I was left to go check
to see if anything had been left behind
on this picnic of mine.

I did not know that the thing was me.
They all piled in and screeching I heard.
I ran so fast,I thought I got back,
but all I did see were the tail lights,
no brakes lights lite up,
no doors opened to say,
"Run little sister they mean to kill you today."

I scream in myself, it's been years since this day,
and today I can't breath, for the memory is me.
I was not even Three, they left me to see.
when I fell to my knees, I thought of the time,
that I lived through this bind.

One year or forty, fifty or sixty years, the years could pass,
the pain it does last, for once you've left, you never look back.
Your blinded by pain, if you ever run back, there is emptiness always; You stare.
Until this moment you will not know what its like,
so don't ask the questions, of God or fuck christ,
I stood alone and I had already fallen twice in this zone.

TIMES DOES NOT HEAL THESE KINDS OF WOUNDS!

Human Beings are the cruelest of creatures I know,
they leave not scars but they burn in and char,
whatever they are.
I'll never forget, you Rebecca Mae Dyas, I live in the present,
who would live in this past.
You forget it so fast, you fall for it again and again and again.
It's people like you that lead me down there,
I never suspect, it happens so fast.
You bring on the monsters that haunt me from then
I don't live inside places that scare me so much that the terror becomes my nightmares,
and day mares are back.

You assume with your pompous regime of degree,
and one day you'll know that you never knew me.
Your description of sickness, its sterile from you,
"I will not change," you said this, with what part of your mind,
could even imagine I'd live where I died? 
Is this your presume? Your preference to me?
I try everyday to never remind, let alone remember to any degree,
that I was left behind, In the night with no cars,
there were no people, the park was closed and we were the last to exit that night.

Who would live in a time to remind themselves of,
the family who never loved them,
from birth to this day,
they curse me and say,
"She is possessed and the Beast 666, she is, we know, 'cause we are the best."
they do not protest, they know this for certain and repeat it for zest.
My Family that is, just in case you're confused by all of this news.

Why would I remind myself of this pain,
I ran and I ran, I run till I can,
find peace in my mind,
and kindness from some.
All you have done Rebecca Mae,
is drag up in my mind, pulled me back into time,
that screaming inside can't be heard from beyond,
'cause god forbid it still hurt to be left in the dirt,
face down where it hurts.

Screaming in silence with tears that don't come,
but today they did pour,
after suffering a bag that suffocated the fact,
that air is not needed, you just have to stand back.
Understand what has happened,
 and be mad that you missed,
what seem to have hissed at such a fast pace,
I jumped and I missed.
And Rebecca you're great, you and your emails of hatred and more,
made me recount what happened from birth till Ed was a boy.
Destroyed what was healed,
for the sake or the need to say, "Please stop I can feel."

I hope it was worth it for you to do and leave me in side of a place,
in my mind, that is so very unkind,
you don't know it exists this place in my brain.
Why would I tell you of such lifetime pain.
I would have ruined you before you turned Nine.

You never spent years with me, helping me with anything,
You went off to College, got drunk and did drugs,
fucked boys, went to my Mother's on Holidays and Summers.
Went out with Sarah your Aunt,
before you were legal to drink in a Bar.

Last time I saw you, I told you my truth,
diagnosed as a kid, I thought it would heal.
Make you laugh, it was stupid and not such a big deal.
A genius I said, I joked so you'd feel at ease with the fact,
that I was so young when it happened like that.
You screamed at me saying, "It doesn't count if Dennis said that!"
What a strange response from an eldest daughter: I prompt!

But thanks to you, you caused an erupt,
left you did, just like it was then,
a National Park I was in: KNOT!
This time I sat on a couch without even one friend.
I was all alone, yet it happened again.
I opened your note, excited to see,
it had been so long since you had been near or written to me.
The pain was the same,
 the memory had not hit,
I forgot all the things that happened from then,
I could not even remember the when.
But today is the day and early it starts,
it takes it all day to even begin.
So, as the Bell Tolls,
 as that ball begins to roll,
down memory lane we take that stroll,
I live not in those yesterdays,
for if I did, I would be dead today.

The pain is so deep and it rips when I see,
the car pull away or the note and your say.
"So live in the present," you said, it was mean.
It is what you wrote,
but know that your words, if that's what you mean,
took yet one more life and I'm tired of it always being mine.
Related you are to the ones that did leave,
the small girl that was left, sadly, was me.

No possible way could you ever be mine,
 to say that you're my daughter,
would be a mistake,
and obvious change has caused us to break our relate.
You will know that your name I did give,
Rebecca Mae has caused an alliance,
the death of her mother in mind and in spirit, in heart and in Soul,
thank goodness for that, for I doth not own the last two destroyed from out of this home,
my body does shriek.

I dumped long ago.
One Soul it was sold to my mother in blood,
the Heart I gave away, not to long after, I knew it was not needed,
in a place that found laughter at the cost of a life in obvious strife. 

I am sorry James Blunt, I held high hopes for myself once, in fact many did joke,
that they have danced by your side, met you in person.
The very same crowd that I speak of on here, told me this so clear.
Now that it's over, Rebecca destroyed, five years of planning,
so I would not run and maybe find out what love was about.
And then I could possibly be brave enough to hold a mans hand,
not yours, I'm not stupid.
But as I have said before, my family, my sisters, my no more friends,
rammed down my throat they did,
apparently they thought I wanted just you,
no other would do for me they said.




I used to believe that dreams do come true,
I used to believe that if you do what you are meant to,
if you work really hard, you will deserve and earn a good heart.
That what you do sow, is what you will reap,
that if your dreams have some balance,
then magic may help,
if life's been to much and all you really, really need,
is a little bit of help.

In a dream that I had I knew I did not
want for one thing to happen again,
to be left alone, standing with out a hand or a friend.

The tears they do flow, from those times to these,
the ages of Two and of Three, I cannot take this, what have I done?
But to ruin a Man, I don't even know, I can't hear his music,
it's gone with the flow, of all the hard work to take me away,
in my mind from the pain, I would turn him up loud,
James Blunt sang away, deaf I became, to hurt and the pain.
His heart in the front and he was my plan,
so that I could stay in the moment of now.

I never wanted to lose myself again to the ages,
 of times or in memories that cause me so much fear.
Before I was Ten,
when beatings were fine,
rape was O.K.,
I was the trash can for all of them.
They'd say so casually,  "She don't belong to anyone, anyway."
Let her scream, she might, but who really cares,
she's dead in her mind and she's mine to do with as, as I please anyhow!

Don't worry your mind,
Rebecca Mae,
James Blunt will not care,
he is a Pop Star, a singer from England.

I thought he was cool and really kind of handsome too.
He is busy with his own life, he doesn't read these stupid things that I write.
Least of all care of the pains of a woman, even if I was a fan,
named Set_Zero, I'm gone..

Have a wonderful life,
my Becky Mae of Sunny Brook Farm,
with memories so clean,
"No Regrets" your address, just like my mother.
More importantly so, I loved my mother regardless,
I just did not understand her, it's impossible too.
But know this for now,
you have done and accomplished what it took Five Years to do.
I have not one friend, on a C.D. or in person, or you.
So thank you for destroying me yet once again,
it's been nice to know that I cannot breath from terror of whats been.
I'm older now, you would think I could deal,
but it just gets worse because it's so real.

Shake from the inside,
 I am having flashbacks that are kept in films that are wrapped,
in the back of my mind,
it was the design,
the first time that terror came and left from behind.
It is Nature that makes it so that you will,
never forget the pain and until,
the perfect situation, like this to recall,
in vivid reality what happened, it was raw.

Pink Floyd will rock me tonight I believe,
right out of my mind and into my need,
of peace and sanity, so that I can survive yet one more night.
Have you heard it, it's mine.
Titled,
"Wish You Were Here"

May you believe in what you never see,
but what has never haunted me; Stay. 
So I am never alone again,
I know that I'll never know sin.

I would rather be with what I know well,
then feel compelled to take a life,
with an email or two.

~

A Twin Soul Death



Our lives are just extensions of what has been,
we rail from the roads of time in the Universe.
Look up my friends and see where you've been.
Do not separate yourself from when you were then.

It is the innocence of such a leap,
 that is made before we're sheep.
We realize that magic's real,
that we are unique and have made this trip, it's meant to be neat.

Somehow, someway we loose our way,
unfortunately we are smashed to pieces when we say.
That there is more to life than just religious belief,
but rather we stand for liberty and peace.

Our minds don't need to stretch, to see,
that it is our imaginative thought you seek to be.
Resources forced down our throats each day,
to pray and kneel to you and your real.

No God above or Dark Lord below,
would ever force such horrid dread,
upon the focus of a child,
just asking why or acting silly.

Twin Souls, Soul Mates, even just friends,
destroyed ideas that keep you; Blend.
It's more and more impossible; 
I can't help it but I do deplore.

To find a happy Man or more.
Who cares if a Twin Soul speaks out there.
At you or them, they hang onto,
the might, the sight of what just like.
If Twin Souls do not hear the call,
then Soul Mates die and marriage will fall.

It will go so very quick, the signs, surreal, it will be sick.
I said a Man was my Knight.
I do not joke, my life needs sight.

Should this happen, should he have seen,
this would have been like magic to me.
The only one who really cared,
was a person who was very, very scared.

That is why the children scream,
I do say lets be unseen,
don't come back to what this is,
there is no belief or faith to stream.

Why bother then to try to love.
If what you dream is not for love.
The work it takes to look and see,
will be the end of you and me.

Stuck I am, I stepped in gum,
but that's O.K. I must be dumb.
Go mute I will and then we'll see,
that a World needed thee.

To smile,
to laugh,
to dream of things.
Like magic,
and stories filled with Love.

Brought together by chance, not Bars.
A Wild Romance from belief in one Man.
He is to busy to see with the Worlds Review,
that he could bring peace to someone new.
To live with safety and not cause strife,
for every person in her life.


Post Traumatic Stress Disorder and Dissociative Disorder: by Babette Rothschild, MSW, LCSW



Post-Traumatic Stress Disorder:


Identification and Diagnosis


Invited article for Soziale Arbeit Schweiz (The Swiss Journal of Social Work), February 1998.
By Babette Rothschild, MSW, LCSW   © 1997

Members:  

International Society for Traumatic Stress Studies (ISTSS)

European Society for Traumatic Stress Studies (ESTSS)

National Association of Social Workers (NASW)

Post-traumatic Stress Disorder (PTSD) disrupts the functioning of those afflicted by it, interfering with the ability to meet their daily needs and perform the most basic tasks. Trauma continues to intrude on the lives of people with PTSD as they relive the life-threatening experiences they have suffered with visual, auditory and/or somatic reality, reacting in mind and body as though such events were still occurring. Not everyone experiencing traumatic events develops PTSD; it is a complex psychobiological condition that can emerge in the wake of life-threatening experiences when normal psychological and somatic stress responses to a traumatic event are not resolved and released. In this paper it is proposed that Autonomic Nervous System hyperarousal is at the core of PTSD and the driving force behind phenomena such as dissociation, freezing and flashbacks. Acute traumatic reactions are differentiated from PTSD and strategies for intervention are suggested.


   Index for this Article

• Introduction

• Post Traumatic Stress Disorder (PTSD)

• PTSD Diagnosis

• Symptoms of PTSD

• Survival and the Autonomic Nervous System (ANS)

• Defensive Response in the Absence of Threat

• Dissociation, Freezing and PTSD

• Consequences of Trauma and PTSD

• Distinguishing Acute Trauma from PTSD

• Conclusion

• References

    INTRODUCTION


Events that are threatening to life or bodily integrity will produce traumatic stress in its victim. This is a normal, adaptive response of the mind and body to protect the individual by preparing him to respond to the the threat by fighting or fleeing. If the fight or flight is successful, the traumatic stress will usually be released or dissipated allowing the victim to return to a normal level of functioning. PTSD develops: when fight or flight is not possible; the threat persists over a long period of time; and/or the threat is so extreme that the instinctive response of the victim is to freeze.

The following are examples of people with PTSD:

○ A firefighter quits his job two years short of retirement because of persistent fiery nightmares and chest pains.

○ A young girl has become hyperactive since her tonsillectomy nine months before.

○ A previously studious teenaged boy is no longer able to concentrate on his school work and is failing his classes since the death of his grandmother last year. He no longer enjoys going to school, and is becoming increasingly house-bound.

○ A Middle Eastern refugee is arrested after a fight in a bar. He says all he remembers is a smell that reminded him of the prison where he was tortured, then he woke up in a police cell.

○ A war veteran still awakes screaming from nightmares of combat, thirty years after he was discharged from service.

○ A woman who was molested when she was six years old begins to be disturbingly over-protective of her own six year old daughter.

○ A man seeks psychotherapy because he is suffering from persistent anxiety and panic attacks.

○ A boy is observed aggressively trying to stick pencils and crayons under the tails of his stuffed animals.


    POST TRAUMATIC STRESS DISORDER (PTSD)


There is a mistaken assumption that anyone experiencing a traumatic event will have PTSD. This is far from true. Studies vary, but confirm that only a fraction of those facing trauma will develop PTSD (Elliott 1997, Kulka et al 1990, Breslau et al 1991). What distinguishes those who do not is still a hot topic of discussion, but there are many clues. Factors mediating traumatic stress appear to include: preparation for expected stress (when possible), successful fight or flight responses, prior experience, internal resources, support from family, community, and social networks, debriefing, emotional release, and psychotherapy.


    PTSD DIAGNOSIS


PTSD is a relatively new diagnostic category in the history of psychology. The diagnosis of PTSD first appeared in 1980 in the internationally accepted authority on PTSD, the DSM (Diagnostic and Statistical Manual of the American Psychological Association), 3rd Edition (APA 1980). At that time the DSM had a limited view of what could cause PTSD, defining it as developing from an experience that anyone would find traumatic, leaving no room for individual perception or experience of an event. This definition was expanded when the DSM III was revised in 1987, and the DSM IV (APA 1994) provides even broader criteria.

The currently accepted definition of PTSD as presented in the DSM IV accepts that PTSD develops in response to events that are threatening to life or bodily integrity, witnessing threatening or deadly events, and hearing of violence to or the unexpected or violent death of close associates. Events that could qualify as traumatic,according to the DSM IV, include: combat, sexual and physical assault, being held hostage or imprisoned, terrorism, torture, natural and man made disasters, accidents, and receiving a diagnosis of a life threatening illness. PTSD can also develop in children who have experienced sexual molestation, even if this is not violent or life-threatening. The DSM IV adds, "The disorder may be especially severe or long lasting when the stressor is of human design (e.g. torture, rape)." (APA 1994)

    SYMPTOMS OF PTSD


Symptoms associated with PTSD include, 1) reexperiencing the event in varying sensory forms such as flashbacks, 2) avoiding reminders associated with the trauma, and, 3) chronic hyperarousal in the Autonomic Nervous System (ANS). PTSD is present when these symptoms last more than one month and are combined with loss of function in areas such as job or social relationships. (APA 1994)

I believe that at the core of PTSD is the last symptom - increased ANS arousal. People who suffer from PTSD are plagued with frightening body symptoms which are characteristic of hyperarousal: accelerated heart beat, cold sweating, rapid breathing, heart palpitations, hypervigilance, and hyper startle response (jumpiness). These symptoms lead to sleep disturbances, loss of appetite, sexual dysfunction and difficulties in concentrating, which are further hallmarks of PTSD. Hyperarousal both instigates flashbacks and is also increased by them, and hyperarousal is the underlying cause of the symptom of avoidance, as traumatic reminders increase ANS arousal. Through understanding hyperarousal, the phenomenon of PTSD becomes comprehendible.


    SURVIVAL AND THE AUTONOMIC NERVOUS SYSTEM (ANS)


Arousal, and therefore hyperarousal, is mediated by the Limbic System which is located in the center of the brain between the brain stem and the cortex. This part of the brain regulates survival behaviors and emotional expression, being primarily concerned with tasks of survival such as eating, sexual reproduction and the instinctive defenses of fight and flight. It also plays a central role in memory processing.

The Limbic System has an intimate relationship with the Autonomic Nervous System (ANS). The ANS regulates smooth muscles and other viscera: heart and circulatory system, kidneys, lungs, intestines, bladder, bowel, pupils. It has two branches, the Sympathetic branch (SNS) and the Parasympathetic branch (PNS), which usually function in balance with each other, meaning when one is activated, the other is suppressed. The SNS is primarily aroused in states of stress, both positive and negative. Signs of SNS arousal include increased heart rate and respiration, cold and pale skin, dilated pupils, raised blood pressure. The PNS is primarily aroused in states of rest and relaxation. Signs of PNS arousal include decreased heart rate and respiration, warm and flushed skin, normally reactive pupils, lowered blood pressure.

The Limbic System responds to extreme traumatic threat, in part, by releasing hormones that tell the body to prepare for defensive action, activating the SNS, which prepares the body for fight or flight through increasing respiration and heart rate to provide more oxygen, sending blood away from the skin and into the muscles for quick movement. When death may be imminent or the traumatic threat is prolonged (as with torture, rape, etc.), the Limbic system can simultaneously release hormones to activate the PNS and a state of freezing can result - like a mouse going dead when caught by a cat, or a frightened bird becoming stiff (Gallup 1977, Levine1997).

These nervous system responses - fight, flight and freeze - are survival reflexes. If perception in the Limbic System is that there is adequate strength, time and space for flight, then the body breaks into a run. If the Limbic perception is that there is not time to flee, but there is adequate strength to defend, then the body will fight. If the Limbic System perceives that there is neither time nor strength for fight or flight and death could be imminent, then the body will freeze. In this state, the victim of trauma enters an altered reality - it is one form of dissociation. Time slows down and there is no fear or pain. In this state, if harm or death do occur, the impact is not so great. People who have fallen from great heights, such as over cliffs, and survived, report just such a reaction. This freezing response may also increase chances of survival. If the cause of the freeze is an attack by man or beast, the attacker may lose interest when the prey has gone dead, as a cat will lose interest in a lifeless mouse.

It is important to understand that these Limbic System/ANS responses are instinctive, not chosen by thoughtful consideration, but are reflex actions. Many who have suffered trauma feel great guilt about freezing or "going dead" and not doing more to protect themselves or others by fighting back or running away. Understanding that freezing is a reflex often helps the process of self-forgiveness.

    DEFENSIVE RESPONSE IN THE ABSENCE OF THREAT


When the Limbic System of the brain activates the ANS to meet the threat of a traumatic event, it is a normal, healthy, adaptive survival response. When the ANS continues to be chronically aroused even though the threat has passed and has been survived, that is PTSD. The body continues to respond as though it were under threat. This is the most perplexing feature of PTSD.

Within the Limbic System of the brain are two related areas that are central in memory storage: the hippocampus and the amygdala. The last few years have produced a growing body of research that indicates these two parts of the brain are essentially involved in response to, and memory of, traumatic events (van der Kolk 1994, Nadel & Jacobs 1996). It is believed that the amygdala stores highly charged emotional memories, such as terror and horror and it has been shown that the amygdala becomes very active when there is a traumatic threat.

The hippocampus, on the other hand, stores memory of time and space - puts our memories into their proper perspective and place in our life's time line. During traumatic threat, it has been shown, the hippocampus becomes suppressed. Its usual function of placing a memory into the past is not active. The traumatic event is prevented from becoming a memory in the past, causing it to seem to float in time, often invading the present. It is this mechanism that is behind the aforementioned PTSD symptom of "flashback" - episodes of reliving the trauma.

    DISSOCIATION, FREEZING AND PTSD


Dissociation, a splitting in awareness, is not mentioned by either the DSM III or DSM IV as a symptom of PTSD, but there is growing debate in the professional literature as to whether PTSD is a Dissociative Disorder (Brett, EA. 1996) - it is currently classified in the DSM IV under Anxiety Disorders. There is also research that is beginning to point to the possibility that dissociation during a traumatic event may be a predictor of PTSD (Bremmer, et. al. 1992, Marmar, et.al. 1994).

No one really knows what dissociation is or how it occurs, though there is much speculation. It appears to be, not one thing, but a set of related splitting responses. Bennett Braun, M.D. has studied dissociation for many years, treating clients with a variety of Dissociative Disorders. He proposes a continuum of dissociation that begins with simple forgetting, includes amnesia and PTSD and ends at the extreme of Multiple Personality, now referred to as Dissociative Identity Disorder (Braun 1988).

The kind of dissociation described by those with PTSD - altered sense of time, reduced sensations of pain, absence of terror or horror - resembles the characteristics of those who have responded with freezing to a traumatic threat. There will need to be more research before it can be known if the freezing reflex is a form of dissociation, but it looks as though it is. This is important because it appears that the greatest consequences of PTSD result from dissociation. While dissociation is an instinctive response to save the self from suffering - and it does this very well - it also exacts a high price in return.

    CONSEQUENCES OF TRAUMA AND PTSD


The consequences of trauma and PTSD vary greatly depending on the age of the victim, the nature of the trauma, the response to the trauma and the support to the victim in the aftermath. In general, victims of PTSD suffer reduced quality of life due to the intrusive symptoms which restrict their ability to function. They may alternate periods of overactivity with periods of exhaustion as their bodies suffer the effects of hyperarousal. Reminders of the trauma they suffered may appear suddenly, causing instant panic, and possible flashbacks. They become fearful, not only of the trauma itself, but of their own reactions to the trauma. Body signals that were once providers of essential information, become dangerous. For example, heart beat acceleration that might indicate over-exertion or excitement, becomes a danger signal in itself because it is a reminder of the trauma response, and therefore is associated with the trauma.

The ability to orient to safety and danger becomes decreased when many things, or even everything, in the environment become perceived as dangerous. When the reminders of trauma become extreme, freezing or dissociation can be activated, just as if the trauma was occurring in the present. It can become a terribly vicious circle. Victims of PTSD can become extremely restricted, fearing to be together with others or go out of their homes.

Child victims of trauma are a special area for study. Robert Pynoos at the University of California at Los Angeles is a pioneer in researching the impact of trauma on children and adolescents. Psychological and motor development can be arrested in child victims of trauma, leading to increasingly negative impact on their lives if they continue to mature without intervention to restore lost or undeveloped resources and skills (Pynoos 1993).


    DISTINGUISHING ACUTE TRAUMA FROM PTSD


Discussion with professionals who work with both the acute and the long-term aftermath of trauma has led me to conclude that aside from physical injury due to trauma, acute traumatic reactions may be indistinguishable from PTSD in the body and behavior of the victim. The same disorientation, fear, and indications of ANS activations - elevations in heart rate, blood pressure, respiration, shaking, etc. - may be present.

In the aftermath of a disaster, for example, most of those suffering from acute trauma will be easy to spot. Those who have been injured will be obvious. Among the uninjured there will also be many who look stunned, appear pale and faint, or be shaking. Some of those who appear to be suffering from trauma may not even be the actual victims of the disaster, but witnesses or rescuers who may be deeply affected by what they have or are seeing. Some may not be immediately identifiable, they may be highly active - looking for others or after others, organizing help and rescue. A percentage of these may, in the next days or weeks, develop symptoms of trauma.

Months or years later, the vast majority of the survivors, witnesses and rescuers will no longer be suffering psychologically from the after effects of the event. However, a minority will be suffering to an extreme degree, their lives decreased in quality, and a diagnosis of PTSD will be appropriate.

While symptoms of acute trauma and PTSD may not differ very much, response to these must differ significantly. Response to acute trauma may include emergency medical intervention for treatment of injuries and/or medical shock. On the psychological side reassurance and comfort will be the key. Often talking about what happened will be important for the survivor in the immediate aftermath of the event. Telling and re-telling the story to caring individuals may help prevent dissociation, and aid in integrating the experience. Providing physical support - holding, an arm around the shoulders, a comforting hand - may be appropriate, especially if the survivor is hysterical or shaking violently. The victim may be cold and in need of blankets and warm beverages. The victim may need to be reminded that the event is passed and they have survived it, "You're safe now." The more complete and appropriate the response to acute trauma, the greater the chance of preventing subsequent PTSD.

Later, working with those who do develop PTSD may resemble some of the aspects of response to acute trauma. Certainly a reassuring and comforting attitude on the part of the psychotherapist is important. But when the trauma is long past, simple comfort and reassurance will not be enough. The victim of PTSD will feel unable to contain his traumatic experience(s), will have become afraid of his body, and will have lost the sense of what was then and what is now. It is these three areas - containment, positive body awareness, dual time awareness - that must first be strengthened, before addressing the memory of a traumatic event can be done productively.

Containment of out-of-control emotions and thinking processes will help restore a feeling of control over the psychological self. Positive body-awareness will help restore a sense of the body and its sensations as friend, not foe. Dual time awareness will help to separate that the trauma occurred in the past even though it feels as if it is occurring now (Rothschild 1996, Rothschild 1997).


    CONCLUSION


Identification of a portion of those suffering from PTSD will be straightforward. But others may be difficult to spot owing to complicated life or defensive systems. Evaluation of the state of the ANS will assist in the diagnosis of PTSD and in setting treatment objectives where appropriate.


    REFERENCES


American Psychiatric Association (APA), Diagnostic and Statistical Manual of Mental Disorders, Third Edition, 1980.

American Psychiatric Association (APA), Diagnostic and Statistical Manual of Mental Disorders DSM-IV, Fourth Edition, 1994.

Bloch, George, Ph.D., Body and Self: Elements of Human Biology, Behavior and Health. William Kaufmann, Inc., 1985

Braun, Bennett G., M.D., The BASK Model of Dissociation, Dissociation, 1:1, March 1988.

Bremmer, JD, Southwick, S, Brett, E, Fontana, A, Rosenheck, R & Charney, DS, Dissociation and Posttraumatic Stress Disorder in Vietnam Combat Veterans, American Journal of Psychiatry , 149, 1992.

Breslau, N, Davis, GC, Andreski, P & Peterson, E, Traumatic Events and Posttraumatic Stress Disorder in an Urban Population of Young Adults, Archives of General Psychiatry, 48, 1991.

Brett, EA, "The Classification of Posttraumatic Stress Disorder," in van der Kolk, BA, McFarlane, AC, & Weisaeth, L (Eds.), Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, Guilford Press 1996.

Diamond, MC, Scheibel, AB, & Elson, LM, The Human Brain Coloring Book, Harper Perenial 1985.

Elliott, Diana M, Traumatic Events: Prevalence and Delayed Recall in the General Population, Journal of Consulting and Clinical Psychology, 65, 811-820, 1997.

Figley, Charles R., Ph.D., Trauma and Its Wake (Brunner Mazel Psychosocial Stress, No. 4): Volume I: The Study and Treatment of Post-Traumatic Stress Disorder, Brunner/Mazel, 1985.

Gallup, Gordon G., Jr., and Maser, Jack D., "Tonic Immobility: Evolutionary Underpinnings of Human Catalepsy and Catatonia", in Seligman, Martin E. P., and Masser, Jack D., Psychopathology: Experimental Models, San Francisco: W.H. Freeman and Company, 1977.

Herman, Judith L., MD, Trauma and Recovery: The Aftermath of Violence — from Domestic Abuse to Political Terror, Basic Books, 1992.

Jorgensen, Steen, Cand. Psych., Bodynamic Analytic Work with Shock/Post-Traumatic Stress, Energy and Character, Vol. 23, No. 2, September 1992.

Kluka, RA, Schlenger, WE, Fairbank, JA, Hough, RL, Jordan, BK, Marmar, CR,, & Weiss, DS, Trauma And The Vietnam War Generation: Report Of Findings From The National Vietnam Veterans Readjustment Study, New York: Brunner/Mazel 1990.

Levine, Peter, Ph.D., Waking the Tiger : Healing Trauma : The Innate Capacity to Transform Overwhelming Experiences, 1997

Loewenstein, Richard, J., M.D., Dissociation, Development and the Psychobiology of Trauma, Journal of the American Academy of Psychoanalysis, 21(4), 1993.

Marmar, CR, Weiss, DS, Schlenger, WE, Fairbank, JA, Jorday, K, Kulka, RA, &Hough, RL, Peritraumatic Dissociation and Posttraumatic Stress in Male Vietnam Theater Veterans, American Journal of Psychiatry , 151, 1994.

Nadel, L & Jacobs, WJ, "The role of the Hippocampus in PTSD, Panic, and Phobia." In N. Kato (Ed.), The Hippocampus: Functions and Clinical Relevance, Amsterdam: Elsevier Science B.V. 1996.

Ornstein, Robert & Thompson, Richard, The Amazing Brain, Houghton Mifflin, USA, 1986

Puglisi-Allegra, Stephan, and Oliverio, Alberto, Psychobiology of Stress (Nato Science Series), Kluwer Academic Publishers, 1990.

Pynoos, Robert S., "Traumatic Stress and Developmental Psychopathology in Children and Adolescents", in Posttraumatic Stress Disorder: A Clinical Review, American Psychiatric Press Review of Psychiatry, Vol. 12, 1993.

Rothschild, Babette, M.S.W., A Shock Primer for the Bodypsychotherapist, Energy and Character, Vol. 24, No. 1, April 1993.

Rothschild, Babette, M.S.W., Defining Shock and Trauma in Bodypsychotherapy, Energy and Character, Vol. 26, No.2, September 1995.

Rothschild, Babette, M.S.W., Applying the Brakes: Theory and Tools for Understanding, Slowing Down and Reducing Autonomic Nervous System Activation in Traumatized Clients, Paper presented at the Tenth Scandinavian Conference for Psychotherapists working with Traumatized Refugees, 24-26 May 1996, íbo, Finland.

Rothschild, Babette, M.S.W., A Trauma Case History, Somatics, Fall 1996/Spring 1997.

Rothschild, Babette, M.S.W., "Slowing Down and Controlling Traumatic Hyperarousal," in, Vanderberger, L (Ed.) "The Many Faces of Trauma: International Perspectives", (in press). 1997

Scrignar, C. B., M.D., Post Traumatic Stress Disorder: Diagnosis, Treatment and Legal Issues, Bruno Press, Louisiana, USA, 1988.

Selye, Hans, M.D., The Stress of Life, McGraw-Hill Book Co., 1984.

van der Kolk, Bessel A, M.D., and Fisher, Rita E., Ed.M., "The Biologic Basis of Posttraumatic Stress", Primary Care, Vol. 20, No. 2, 1993; van der Kolk, Bessel, M.D. (1996a), The Body Keeps the Score: Memory and the Evolving Psychobiology of Post-traumatic Stress, Harvard Psychiatric Review, Vol., 1, 1994.

van der Kolk, BA, McFarlane, AC, & Weisaeth, L (Eds.) Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, Guilford Press 1996.

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BABETTE ROTHSCHILD, M.S.W., L.C.S.W. has been a practicing psychotherapist and body-psychotherapist since 1976. She has held a California license as a Clinical Social Worker since 1978. She is a member of the International and European Societies for Traumatic Stress Studies, the Association for Traumatic Stress Specialists and the National Association of Social Workers (USA) .

Babette has trained extensively inTransactional Analysis, Gestalt Therapy, Psychodrama and Somatic Experiencing, and is a certified Bodynamic Analyst and certified Radix Teacher. After living 9 years in Denmark, she returned to Los Angeles, California (her home town) where she maintains a private practice while she continues traveling to Europe three times a year, offering professional training and therapy workshops, professional consultations and supervision.

Institutions sponsoring her trainings have included: hospital, rehabilitation, refugee, dance, athletic, children and psychotherapy centers in Austria, Belgium, Denmark, England, France, Germany, Norway, Scotland, Switzerland and the USA.

Written by
BABETTE ROTHSCHILD, M.S.W., L.C.S.W.


She can be reached at:

PO Box 241783
Los Angeles, California   90024, USA
Tel: (+1) 310 281 9646
Fax: (+1) 310 281 9729
E-mail:    babette@trauma.cc
Website: Somatic Trauma Therapy



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