What Doesn't Kill Us by Stephen Joseph

Author:Stephen Joseph
Language: eng
Format: epub
Publisher: Basic Books
Published: 2011-10-06T04:00:00+00:00

It is common for people who have been through a traumatic experience to want to avoid thoughts, places, activities, or people who remind them of their experience. Given the wide range of traumatic experiences that a person may encounter, attempts to cope through avoidance can amount to an extensive list. Avoidance behaviors stop patients from getting on with their lives and if left untreated can lead to further problems later on. A particular exposure procedure often used by psychologists to help people who are avoidant is desensitization, whereby patients are exposed, a little at a time, to the thing that triggers fears in them and that they are avoiding. For example, someone who is afraid to use public transportation might first be asked to imagine stepping onto a bus. Over one or two sessions, she might mentally visualize herself walking to the bus stop, seeing the bus coming closer, and getting onto the bus. Then, in subsequent sessions, the therapist might accompany the person on an actual bus trip. Over time (assuming that these trips are uneventful), the associations in her mind between bus rides and danger are extinguished.

Consider the case of Susan, who was driving home from work when a speeding car collided with a heavy truck behind her. In the subsequent chaos, her car was spun across the highway into the path of oncoming cars. Though not injured, she had to be cut out of her car by emergency workers, a process that took almost thirty minutes.

After a few days of recuperation, Susan returned to work using a company car. Over the next few weeks, although she was driving more cautiously than usual and avoiding highways as much as possible, she found herself becoming increasingly anxious while inside the car, even as a passenger. By the fourth week she had almost stopped driving altogether. This inevitably affected her work and social life. She avoided talking about the accident and gradually cut herself off from friends and relatives. Susan’s avoidance and anxiety were adaptive in the short term. In the longer term, however, her avoidance only worsened her problem. Realizing what she was doing, but finding it hard to do otherwise, Susan sought professional help.

For Susan, recovery entailed, first, just sitting in a car. Once she was comfortable doing this, the next step was to sit in a car with the engine running; then to drive very short distances in familiar settings; then to increase her driving time and distances in unfamiliar settings, building up to driving on unfamiliar roads in quiet times and, eventually, to driving on familiar roads at busy times.

Desensitization can be very helpful to people with PTSD. Sometimes it can be performed by patients themselves, without any professional help. An example is provided by Patricia, a trauma survivor who developed a fear of going outside that was interfering with her life. She knew she had to confront this fear, and she did so gradually, working up to it in stages. First she stepped out into

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.