Comments on: Trauma: A Misunderstood Phenomenon http://www.goodtherapy.org/blog/complex-post-traumatic-stress/ Exploring Healthy Psychotherapy Sun, 21 Mar 2010 09:46:54 +0000 http://wordpress.org/?v=2.9 hourly 1 By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-11445 Dr. Arthur Becker-Weidman Mon, 15 Sep 2008 20:20:20 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-11445 Ben, I believe you are right. I've worked with a number of persons convicted of DWI and vehicular homicide, and they, too, often are traumatized by what they have done. Thanks for the comment. Ben,

I believe you are right. I’ve worked with a number of persons convicted of DWI and vehicular homicide, and they, too, often are traumatized by what they have done.

Thanks for the comment.

]]> By: Ben http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-11415 Ben Mon, 15 Sep 2008 08:17:22 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-11415 In a number of road accidents, I believe people causing them are as traumatised as the victims involved in it. Especially where the victim has died. The cumulative stress in today's life makes a person constantly tired. The physical and mental exhaustion of the day's events causes road rage and careless driving. In a number of road accidents, I believe people causing them are as traumatised as the victims involved in it. Especially where the victim has died. The cumulative stress in today’s life makes a person constantly tired. The physical and mental exhaustion of the day’s events causes road rage and careless driving.

]]> By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-11131 Dr. Arthur Becker-Weidman Thu, 04 Sep 2008 22:32:41 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-11131 Johnson, Yes, it is awful. I would hope that they might qualify for some government insurance such as Child Health Plus or Family Health Plus (New York State programs) or Medicaide or Medicare... Art Johnson,

Yes, it is awful. I would hope that they might qualify for some government insurance such as Child Health Plus or Family Health Plus (New York State programs) or Medicaide or Medicare…

Art

]]> By: Johnson http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-11095 Johnson Thu, 04 Sep 2008 11:56:49 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-11095 What a shame that lack of health insurance keeps someone in need from getting the medical treatment that he needs. What a shame that lack of health insurance keeps someone in need from getting the medical treatment that he needs.

]]> By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10911 Dr. Arthur Becker-Weidman Sun, 31 Aug 2008 22:56:41 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10911 Dear Michael, I am so sorry about your plight. No insurance leaves few options. However, sometimes the local Community Mental Health Clinics may be a resource. In NY many of the mental health clinics have specific PTSD treatment programs and they accept health insurance, Medicaid and Medicare, and have reasonable sliding scales. So, I'd suggest contacting the local CMHC to see what they have to offer. In addition, you may qualify for Family Health Plus or another governmental health plan. I hope this is helpful...let me know. regards Art Dear Michael,

I am so sorry about your plight. No insurance leaves few options. However, sometimes the local Community Mental Health Clinics may be a resource. In NY many of the mental health clinics have specific PTSD treatment programs and they accept health insurance, Medicaid and Medicare, and have reasonable sliding scales. So, I’d suggest contacting the local CMHC to see what they have to offer. In addition, you may qualify for Family Health Plus or another governmental health plan.

I hope this is helpful…let me know.

regards
Art

]]> By: Michael http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10899 Michael Sun, 31 Aug 2008 21:50:47 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10899 Well you stated the big problem. No private health insurance and the VA center in our area is very tough to get in for appointments unless it is deemed a "physical" problem. Seems there is no recognition of mental issues there. Any other suggestions? Well you stated the big problem. No private health insurance and the VA center in our area is very tough to get in for appointments unless it is deemed a “physical” problem. Seems there is no recognition of mental issues there. Any other suggestions?

]]> By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10881 Dr. Arthur Becker-Weidman Sun, 31 Aug 2008 17:48:13 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10881 Dear Michael, I'd hope your friend's father is receiving treatment as there is good and effective treatment for PTSD, especially when combat related. While the VA may have a very long waiting list for services, if they have private insurance, they may be able to find good treatment quickly. One approach that is quite useful in such instances as you describe is EMDR. regards, Art Dear Michael,

I’d hope your friend’s father is receiving treatment as there is good and effective treatment for PTSD, especially when combat related. While the VA may have a very long waiting list for services, if they have private insurance, they may be able to find good treatment quickly. One approach that is quite useful in such instances as you describe is EMDR.

regards,
Art

]]> By: Michael http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10829 Michael Sat, 30 Aug 2008 11:59:28 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10829 I have a friend whose father, a war veteran, has had his entire life crippled from the effects of PTSD as has the entire family as a result. I am glad to see that there is progress being made in the research behind this mental illness, but there is still a lot of work to be done to ensure that veterans and really anyone who suffers with this is able to get the treatment and recovery resources that they need as well as deserve. This is something that I have watched firsthand devastate the lives of so many and I am hopeful that this new research will put it back in the forefront so that those with PTSD have to suffer no longer. I have a friend whose father, a war veteran, has had his entire life crippled from the effects of PTSD as has the entire family as a result. I am glad to see that there is progress being made in the research behind this mental illness, but there is still a lot of work to be done to ensure that veterans and really anyone who suffers with this is able to get the treatment and recovery resources that they need as well as deserve. This is something that I have watched firsthand devastate the lives of so many and I am hopeful that this new research will put it back in the forefront so that those with PTSD have to suffer no longer.

]]> By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10807 Dr. Arthur Becker-Weidman Fri, 29 Aug 2008 15:18:42 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10807 Many individuals who experience Complex Trauma, which is a clinical formulation and not a DSM-IV diagnosis, or PTSD, which is a psychiatric diagnosis, have depressive symptoms. A significant majority, in fact. However, regarding how many people who meet the DSM criteria for any of the depression diagnosis have Complex Trauma or PTSD, that is a good question and I just don't know the answer to that. regards Art Many individuals who experience Complex Trauma, which is a clinical formulation and not a DSM-IV diagnosis, or PTSD, which is a psychiatric diagnosis, have depressive symptoms. A significant majority, in fact. However, regarding how many people who meet the DSM criteria for any of the depression diagnosis have Complex Trauma or PTSD, that is a good question and I just don’t know the answer to that.

regards

Art

]]> By: Shannon http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10797 Shannon Fri, 29 Aug 2008 12:07:05 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10797 Does anyone know the numbers about what percentage of people who go through a depressive episode it boils down to being a result of some trauma they have experienced in their lifetime? This would be interesting data to track. Does anyone know the numbers about what percentage of people who go through a depressive episode it boils down to being a result of some trauma they have experienced in their lifetime? This would be interesting data to track.

]]> By: Courtney http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10765 Courtney Thu, 28 Aug 2008 18:44:52 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10765 All of this is very fascinating. It is amazing how many things are so interrelated that may have never made sense before but now do all of a sudden. Thanks for the great insight. All of this is very fascinating. It is amazing how many things are so interrelated that may have never made sense before but now do all of a sudden. Thanks for the great insight.

]]> By: Dr. Arthur Becker-Weidman http://www.goodtherapy.org/blog/complex-post-traumatic-stress/comment-page-1/#comment-10759 Dr. Arthur Becker-Weidman Thu, 28 Aug 2008 16:15:44 +0000 http://www.goodtherapy.org/custom/blog/?p=725#comment-10759 Dear Patti, Your article makes some excellent points. The DSM-IV-TR category of PTSD often does not capture the full impact of chronic early maltreatment within a care-giving relationship; which is the basic definition of Complex Trauma or Developmental Trauma Disorder. This chronic early maltreatment within a caregiving relationship causes very pervasive damage across a broad range of domains...PTSD does not capture the full extent to the range of impairments in the domains of 1. Self-regulation 2. Interpersonal relating including the capacity to trust and secure comfort 3. Attachment 4. Biology, resulting in somatization 5. Affect regulation 6. Increased use of defensive mechanisms, such as dissociation 7. Behavioural control 8. Cognitive functions, including the regulation of attention, interests and other executive functions 9. Self-concept. For a full description of this concept see: Cook, A., Blaustein, M., Spinazolla, J. & van der Kolk, B. (2003) Complex Trauma in Children and Adolescents.White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force.National Center for ChildTraumatic Stress, Los Angeles, CA. Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M. et al. (2005) Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398. The pervasiveness of these impairments requires a treatment that addresses these areas. Dyadic Developmental Psychotherapy is an empirically supported evidence-based treatment for children with trauma and attachment disorders. See, for example: Becker-Weidman, A., & Hughes, D., (2008) Dyadic Developmental Psychotherapy: an evidence-based treatment for children with complex trauma and disorders of attachment. Child and Family Social Work, 13, pp. 329-337. For a sort of treatment manual about Dyadic Developmental Psychotherapy see: Hughes, D., (2007) Attachment Focused Family Therapy, Norton, NY Becker-Weidman, A., & Shell, D., Creating Capacity for Attachment, Wood N Barnes, Oklahoma City, OK. Thanks for a very good article that describes a complicated set issues quite clearly. Art Dear Patti,

Your article makes some excellent points. The DSM-IV-TR category of PTSD often does not capture the full impact of chronic early maltreatment within a care-giving relationship; which is the basic definition of Complex Trauma or Developmental Trauma Disorder. This chronic early maltreatment within a caregiving relationship causes very pervasive damage across a broad range of domains…PTSD does not capture the full extent to the range of impairments in the domains of
1. Self-regulation
2. Interpersonal relating including the capacity to trust and secure comfort
3. Attachment
4. Biology, resulting in somatization
5. Affect regulation
6. Increased use of defensive mechanisms, such as dissociation
7. Behavioural control
8. Cognitive functions, including the regulation of attention, interests and other executive functions
9. Self-concept.
For a full description of this concept see:
Cook, A., Blaustein, M., Spinazolla, J. & van der Kolk, B. (2003) Complex Trauma in Children and Adolescents.White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force.National Center for ChildTraumatic Stress, Los Angeles, CA.
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M. et al. (2005) Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.

The pervasiveness of these impairments requires a treatment that addresses these areas. Dyadic Developmental Psychotherapy is an empirically supported evidence-based treatment for children with trauma and attachment disorders. See, for example:
Becker-Weidman, A., & Hughes, D., (2008) Dyadic Developmental Psychotherapy: an evidence-based treatment for children with complex trauma and disorders of attachment. Child and Family Social Work, 13, pp. 329-337.
For a sort of treatment manual about Dyadic Developmental Psychotherapy see:
Hughes, D., (2007) Attachment Focused Family Therapy, Norton, NY
Becker-Weidman, A., & Shell, D., Creating Capacity for Attachment, Wood N Barnes, Oklahoma City, OK.

Thanks for a very good article that describes a complicated set issues quite clearly.
Art

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