Posts Tagged ‘Dissociation’

4 Possible Subtypes of PTSD Powerful statistical tools advance our understanding of critical issues. Grant Hilary Brenner MD, FAPA Posted Jan 30, 2020



Except: Full article here:

Precision medicine” leverages technology and mathematical tools to individualize care. Precision-medicine approaches are on the cutting edge of medicine, and as such are not always ready for primetime. They are often the subject of controversy. Some clinicians and patients are eager to try new things right away, while others prefer to wait to see if they work and if they cause unexpected adverse reactions, also known as “side effects.”

The current study used “latent class analysis” with the National Epidemiological Survey on Alcohol and Related Conditions (NESARC III). This survey collected data from a representative sample to reflect the general U.S. population. Of the over 36,000 participants, almost 2,400 met criteria for PTSD at some point in their lives.

1. Dysphoric (23.8 percent): Intrusive thoughts; avoidance of situations and thoughts related to the trauma; negative thoughts and feelings; isolation, numbing and irritability; and difficulty with sleep and concentration.

They were more likely to be younger, and male. They were less likely to have experienced combat. They were less likely to receive medication for PTSD. They were more likely to be diagnosed with depression, and less likely to be diagnosed with anxiety. They were more likely to use nicotine.

2. Threat (26.1 percent): Increased re-experiencing symptoms; high self-blame and negative emotion; lower levels of loss of interest, numbing, isolation and irritability; and high levels of physiologic arousal (“hyperarousal”). They were more likely to be older, and less likely to have recent homelessness or unemployment.

They were more likely to have personally experienced natural disasters, and had illnesses or injury to people close to them. They were less likely to report childhood sexual abuse as their worst trauma, and reported better mental health. They tended to have fewer additional psychiatric diagnoses.

3. High Symptom (33.7 percent): Elevated levels of all symptoms except trauma-related amnesia and high-risk behaviors. They were more likely to be female, less likely to be White, reported lower education and income levels, and were more likely to have recent public assistance, homelessness, and unemployment. They were more likely to report combat and childhood sexual abuse as their worst trauma, were younger when they developed PTSD and had it longer, and reported worse mental and physical health.

They were more likely to have received therapy and/or medication treatment for PTSD. They had higher rates of other psychiatric conditions, including anxiety disorders, bipolar disorder, chronic depression, marijuana and alcohol use disorders, and personality disorders including Borderline, Schizotypal and Antisocial. This group most closely resembles cPTSD.

4. Low Symptom (16.3 percent): Lower levels of all symptoms, except for intrusive thoughts, negative emotions, and hypervigilance. People in this group were more likely to have higher income levels. They were more likely to report the worst trauma to someone close to them, rather than to themselves personally, and were less likely to report personal war trauma.

They tended to be older and have PTSD for a shorter time, and to have better mental and physical health. They were less likely to have received treatment with therapy and/or medications. They were less likely to have other psychiatric diagnoses, and less likely to have personality disorders.



Happiness and Time: a different look



Man created the clock, being late, showing up early, the past and the future. None of these times can help you experience happiness.

Happiness only exists in one time frame, now, the present moment, not in the past and surely not in the future.

Remembering a past event can bring a joyful moment, any more time and energy spent, robs us of this moment.

Predicting future happiness is a thought, nothing real and definitely not accurate. Even if this prediction comes true, that joy is fleeting.

What we can achieve can be lost, all impermanent possessions change meaning and worth with time.

That promotion may bring resentment and jealousy from your peers. Protecting your title may bring worry and stress.

If you accept that happiness (wellbeing) only inhabits this present moment, how will you adjust your behavior, your thoughts or actions?

All that seeking for external ways to find happiness seem misguided.

Happiness is not an emotion, not something we can achieve or accomplish with actions, it is an internal way of being, of living in the moment.

If we hunt for happiness, it will always be a stranger .

If we can be happy without needing to change or achieve a thing, will you stop seeking happiness out there.

If you are searching, try exploring your inner world, it is the core of happiness.



Mindfulness versus Selfishness



A mindful existence resembles a giver, a person with a healthy list of things he/she is grateful for. A selfish existence brings a sense of lack, a takers mentality.

Kindness, compassion and empathy are other traits a mindful person strives to incorporate into daily life.

Selfishness could be considered as the antithesis of mindfulness.

Mindfulness strives to do no harm, first to ourselves, then to all we meet.

Selfishness leads to suffering, a heightened sense of lack haunts us.

Happiness is not found out there, that sense of lack is created by our unworthy “Ego”.

Change your behavior, be kind instead of selfish, be a giver not a taker, use compassion, be a helper instead of a harsh critic.

Possessions, status, and power are fleeting, kindness to others, giving, lasts beyond our death.

We are on this journey together, not in competition.

There is plenty for all of us, realize happiness is tied to how we treat those less fortunate.

Release that sense of lack, increase your awareness of the gratitude before you.

Smile, be kind, be compassionate, give and be happy.



I, me, mine: Can you refrain from using them this week?



We create an identity, a collection of how others see us, treat us, combined with how we see ourselves, blended together into an “Ego” (I, me, mine).

The problem with this created “Ego” is he/she never feels equal to another “Ego”.

Example: Two millionaires or billionaires Trump and Bloomberg trade adolescent barbs. One insults the other calling him short, while the other responds with your hair is ridiculous and your fat.

Men of great power and status succumb to the their “Egos” desire to rule others.

Our “Ego” has the disposition of an adolescent when challenged by another “Ego”.

We struggle while placating our own “Egos” childish desires.

Most “Egos” are similar to a peacock, wanting to display those beautiful feathers in public at every opportunity.

In a Mindfulness/Meditation practice, we try to calm our “Ego” back into the minor role it was created for, identity.

Our “Ego” is the culprit when we feel disrespected, angry, resentful, jealous, superior or unworthy.

These are sentiments that lead to suffering.

Does your “Ego” enhance life or bring unworthiness and drama?

Can you resist using I, me , mine today or a week?

See how often you use I, me, mine in a day.



Trauma, PTSD traveled everywhere with me



It took an agonizing long time for me to heal. I did not have clear direction or the right tools.

As most sufferers, I tried to avoid being triggered at all costs. That strategy ended with me agoraphobic, locked in my garage for six months.

To my amazement, my triggers still fired inside my dark garage. Trauma had followed me.

I could not run from my mind, there was nowhere to hide.

PTSD was an invisible prison, no one else could see the bars, but my life narrowed.

Healing has nothing to do with avoiding, hiding or dissociating.

My salvation came when I realized the power of focusing on my breath.

My breath was always present with my mind.

To my amazement, my breath controlled my nervous system.

Without therapy I could calm my fight or flight mechanism, dissipate cortisol and adrenaline.

Going from terrified, anxious and panicked to calm and secure was a miracle, I thought.

It is free and always available, like your trauma symptoms.




Can we influence Desire!



Witnessing peoples desires, puzzles me.

The desire to heal rarely matches the desire to do the daily work.

Human nature explains that but suffering is the result.

In my opinion less than 5% commit to daily action.

The question becomes, are you one of the 5%?

What is different about these doers?

What can you do to join these ranks?

Any suggestions or comments.



How do we deal with Change



Nothing we can achieve stays the same. The perceived importance of my baseball career is a distant memory of little importance.

When I was young, I saw myself as a pro athlete, my “Egos” assumed identity. Seems such a narrow and rigid description of me now.

That must be wrong, my broken body filled with chronic pain has little athletic talent left.

Who am I, then.

I sure am not the “Ego” I created.

Where do we find purpose after our original creation of “Ego” no longer fits.

If I perceive myself as this or that, does my behavior have to mirror that creation?

Am I a failure if my creation fails to live up to the hype.

Seems I have created a prison of thought for myself.

No worries, we can drop the pretense of importance and just be present.

I am happiest when thought is let go and my senses dominate my consciousness.



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