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- Date: 12-02-91 7:28
- From: Robin Gober
- Subj: Professional Approach,
-
- John HI! Thought I would post this for everybody.
-
- Diagnostic criteria for Post-traumatic Stress Disorder.
-
- A. The person has experienced an event that is outside the range of usual
- human experience and that would be markedly distressing to almost anyone,
- e.g., serious threat to one's life or physical intergrity; serious threat
- or harm to one's childern, spouse, or other close relatives and friends;
- sudden destruction of one's home or community; or seeing another person
- who has recently been, or is being, seriously injured or killed as the
- result of an accident or physical violence.
-
- B. The traumatic event is persistenly reexperienced in at least one of the
- following ways:
- (1) recurrent and intrusive distressing recollections of the event (in
- young children, repetitive play in which the themes or aspects of the
- trauma are expressed)
- (2) recurrent distressing dreams of the event
- (3) sudden acting or feeling as if the traumtic event were recurring
- (includes a sense of reliving the experience, illusions,
- hallucinations, and dissociative [flashback] episodes, even those
- that occur upon awakening or when intoxicated.
- (4) intense psychological distress at exposure to events that symbolize
- or resemble an aspect of the traumatic even, including
- anniversaries of the trauma.
-
- C. Persistent avoidance of stimuli associated with the trauma or numbing
- of general responsiveness (not present before the trauma), as indicated
- by at least three of the following:
- (1) efforts to avoid thoughts or feelings associated with the trauma
- (2) efforts to avoid activities or situations that arouse
- recollections of the trauma.
- (4) markedly diminished interest in significant activities (in young
- children, loss of recently acquired developmental skills such as
- toilet training or language skills)
- (5) feeling of detachment or estrangement from others
- (6) restricted range of affect, e.g., unable tohave loving feelings
- (7) sense of a foreshorted future, e.g., does not expect to have a
- career, marriage, or children, or long life
-
- D. Persistent symptoms of increased arousal,not present before the trauma,
- indicated by at least two of the following:
- (1) difficulty falling or staying asleep
- (2) irritability or outbust of anger
- (3) difficulty concentrating
- (4) hypervigilance
- (5) exaggerated stratle response
- (6) physiologic reactivity upon exposure to events that symbolize or
- resemble an aspect of the traumatic event (e.g.,a woman who was raped
- in an elevator breaks out in a sweat when entering any elevator)
-
- E. Duration of the disturbance (symptoms in B,C, and D) of at least one
- month.
-
- Specify delayed onset if the onset of symptoms was at least six months
- after the trauma.
-
-
- "Growth of Co-dependence
-
- 1. Invalidation and repression of internal cues, such as our
- observations, feelings and reations
-
- 2. Neglecting our needs
-
- 3. Beginning to stifle our Child Within
-
- 4. Denial of a family or other secret
-
- 5. Increasing tolerance of and numbness to emotional pain
-
- 6. Inability to grieve a loss to completion
-
- 7. Blocking of growth (mental,emotional,spiritual)
-
- 8. Compulsive behaviors in order to lessen pain
-
- 9. Progressive shame and loss of self-esteem
-
- 10. Feeling out of control. Need to control more
-
- 11. Delusion and projection of pain
-
- 12. Stress-related illness develops
-
- 13. Compulsions worsen
-
- 14. Progessive deterioration
-
- Extreme mood swings
- Difficuty with intimate relationships
- Chronic unhappiness
-
- To get to the point of recovery, we must survive. Survivors are by
- necessity co-dependents. We use many coping skills and ego defenses to do
- this. .... survive by dodging, hiding, negotiating, taking care of others,
- pretending, denying and learning and adapting to stay alive using any
- method that works. They learn other often unhealthy ego defense
- mechanisms, as describe by Anna Freud (1936) and summarized by
- Vaillant(1977) These include: intellectualization, repression,
- disassociation, displacement and reaction formation (all of which if
- overused can be considered neurotic) and projection, passive-aggressive
- behavior, acting out, hypochondriasis, grandiosity and denial (all of
- which if overused can be considered immature and at times psychotic)."
- _Healing the Child Within_ Charles L. Whitfield M.D.