Posts Tagged ‘C-PTSD’

MINDFULNESS SKILLS WORKBOOK FOR CLINICIANS AND CLIENTS 111 Tools, Techniques, Activities & Worksheets by Debra E Burdick, LCSWR,

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Cultivate a Witnessing Awareness THEORY:
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“Being “aware of awareness” is a revolutionary idea for many people.
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The idea is to notice what’s arising as it is arising.
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This includes awareness of thoughts, feelings, body sensations, and physical surroundings.
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It involves paying attention to what is happening in this moment and acknowledging and dismissing distractions.
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The goal is to remain aware without trying to change anything.
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Observe and accept what you observe.
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Awareness is the first step in eventually being able to change unwanted patterns.”
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Letting go

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Storm Clouds, Utah
Photograph by Steven Besserman, My Shot
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.We must be willing to let go of the life we’ve planned,
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so as to have the life that is waiting for us.
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– Joseph Campbell
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Exploring Our inner World

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Tulip Farm, Tasmania
Photograph by Anthony Crehan, Your Shot
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Mindfulness is a tool, a focus exercise that allows us to explore our inner world.
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The two pauses, after the inhale and exhale, bring our bodies into a sort of suspended animation stage.
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The mind and body are still, nothing moving, a pure opportunity to notice, to observe any sensation, tightness, agitation, sound, twitch or inner feeling.
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Maybe we observe complete silence, a deep quiet, or extreme agitation, or internal anxiety or mild tingling sensations.
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We are detectives, tasked with mapping our emotions internally.
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Where does fear, worry, anxiety, and anger reside, manifest themselves in the body.
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Some  emotions maybe acute, sharp, while others are dull or diffuse, while other are choppy, scary and others agitate the nervous system.

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It maybe the throat area, solar plexus, between the shoulder blades or in the groin area.
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Become friends with your fear, your fight or flight mechanism and life will calm down.
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Mindfulness has far more power and application than you could ever imagine.
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If happiness is an internal condition, it follows we should explore and become familiar with our inner world.
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Systematic Desensitization (SD or Desensitization) .

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To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy.
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Systematic desensitization is sometimes called graduated exposure therapy.
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Clinical Procedure
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Specific phobias are one class of mental illness often treated through cognitive-behavioral therapy and the process of Systematic Desensitization (SD). When individuals possess irrational fears of an object, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, patients’ behavior to reduce fear is reinforced through negative reinforcement, a concept defined in operant conditioning. The goal of Systematic Desensitization is to overcome this avoidance pattern by gradually exposing patients to the phobic object until it can be tolerated. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli).
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Prior to exposure, the therapist teaches the patient cognitive strategies to cope with anxiety. This is necessary because it provides the patient with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation, is one type of coping strategy. Patients might be taught to focus on their breathing or to think about happy situations. Another means of relaxation is cognitive reappraisal of imagined outcomes. The psychotherapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome. For example, a patient with a snake phobia might realize that they imagine any snake they encounter would coil itself around their neck and strangle them, when this would not actually occur.
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The second component of systematic desensitization is gradual exposure to the feared object. Continuing with the snake example, the therapist would begin by asking their patient to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 5 of 100, while having several live snakes crawling on one’s neck would be the most fearful experience possible. Once the patient had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the patient is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes.
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Research has shown that systematic desensitization can be effective in treating fears, phobias, other anxiety disorders, and a wide variety of other mental health and behavior problems. The effectiveness of systematic desensitization does not appear to depend on the intensity of your anxiety or problem, the duration of your anxiety, or on whether the anxiety was acquired suddenly or gradually.
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Affirmation addressing PTSD symptoms

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In this present moment, right now,
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I accept all of me,
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the anxious and the calm,
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the proud and the shamed,
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the perfect and the flawed,
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the powerful and the vulnerable
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the extrovert and the introvert
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the clear and the confused.
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Stuck Parts and healing

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Forest, Serbia
Photograph by Misko Kordic, Your Shot
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I am currently working on my stuck parts along with my daily, healthy, functioning parts. So far I have identified these parts: Warrior, Helper, Curious part, Giver (compassionate), Doer, Critic, Ashamed part, Worrier.
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The stuck parts are Critic, Ashamed child and Worrier.
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The trick is to prop up the healthy parts to support and integrate the stuck parts.
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Helper parts give the frightened, stuck parts a safe and secure atmosphere to work in. We soothe and caress our critic thus slowing down the hopeless, helpless feelings of the shamed and worrier parts.
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My shame part developed in childhood and was stored at that early stage.
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Meditating allows me to relax, to access the ultimate safe place, to breathe into my anxious, nervous system.
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Mindfulness helps with emotional regulation, with dissipating cortisol, with firing the parasympathetic nervous system, with applying the brakes to our nervous system.
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Our minds can be the cause of our suffering or the reason we heal and prosper.
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The Nine-Step Method for Transforming Trauma: Peter Levine

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The first thing is to create a sense of relative safety. You have to help the person feel just safe enough to begin to go into their bodies.
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Then, from that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations. And we do it, again, only a little bit at a time, so they “touch into their sensations” then come back into the room, into themselves.
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“From that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations.” The third step is a process I call “pendulation.” That’s a word I made up – what it means is that when people first begin to experience their body sensations, they actually feel worse for a moment. It is probably largely because they have avoided their sensations. So when they feel them, they feel worse.
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This is like a contraction. But what I have discovered is when you help support people, they discover that with every contraction there is an expansion. So if they learn to stay with these sensations just momentarily long enough, it will contract but then it will expand. And the rhythm between contraction and expansion, that gives people the sense of, “Oh my God, I’m going to be able to master this!” you know?
“Pendulation is the rhythm between contraction and expansion . . . titration is about carefully touching into the smallest drop of survival-based arousal.”
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So, again, when they get the sense or rhythm of contraction/expansion, it needn’t then become threatening. It just becomes, “Oh, okay, I’m contracting, and now I’m expanding.”
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The fourth step, which is really the first, and the second, and the third, and the fourth, fifth, sixth, seventh and eighth, is what I call “titration.” And by titrating, by just dosing one small amount of experience at a time, this creates an increase in stability, resilience, and reorganization of the nervous system. So titration is about carefully touching into the smallest drop of survival-based arousal.
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Dr. Buczynski: So sort of like a homeopathic approach to trauma? A homeopathic dose level of approaching body experiences?
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Dr. Levine: Yes! Yes, that’s it! Yes, that is a really good analogy – and it may be more than just an analogy. You know, we have a number of homeopaths, particularly in the European and South American trainings – and, you know, they get it, they really get it; you know, the idea of the smallest amount of stimulus that get the body engaged in its own self-defense mechanisms.
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Then the fifth step is to provide corrective experiences by helping them have active experience that supplants or contradicts the passive response of collapse and helplessness. So as they recover active responses, they can feel empowered – they develop active defensive responses.
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“As they recover active responses, they can feel empowered – they develop active defensive responses.” When animals are in the immobility response, when they are in the shut-down state, it’s normally time-limited.
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Continued in response section.
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