Phobias : Understanding POST-TRAUMATIC STRESS DISORDER
One large mystery remains to be solved: who becomes a phobic and who doesn't? Many people are exposed as children and young adults to potentially phobic signals paired with traumatic or subtraumatic events: they are bitten by large dogs, are involved in auto accidents, throw up in public. But only a few develop phobias. Most show a transient disturbance that dissipates in time.
The behavioral account does not now provide us with a way of
telling in advance if a disturbance will become a phobia. A complete explanation
of phobias will need to account for such individual differences as
preparedness and proneness to spontaneous panic attacks.
POST-TRAUMATIC STRESS DISORDER
Phobia, as we saw, is a disorder in which fear is triggered by a specific object.
There is a second emotional disorder that is also precipitated by a specific
event: post-traumatic stress disorder. In phobia, the objects or events that
set off the phobia are quite commonplace, for example, crowds, embarrassment,
cats, and illness. But the precipitant of a post-traumatic stress disorder,
in contrast, is a catastrophic event beyond the normal range of
human suffering, for example, an earthquake, a rape, combat, or imprisonment
in a concentration camp.
Three symptoms that result from the catastrophe define the disorder:
(1) the person becomes numb to the world; (2)
the person relives the trauma over and over in memory and in dreams; and
(3) the person experiences symptoms of anxiety. The anxiety symptoms include
excessive arousal, over-alertness, trouble concentrating, memory impairment,
and phobic avoidance of situations that are reminders of the
trauma. In addition, the individual may be wracked with guilt about surviving
the catastrophe when others did not.
NATURALLY OCCURRING DISASTERS
The Buffalo Creek Flood of 1972 produced devastation and death in a small
West Virginia Community, setting off many cases of post-traumatic stress
disorder among its survivors (Erikson, 1976). In the early morning of' February
26, 1972, the dam on Buffalo Creek in the coal region of West Virginia
collapsed, and within a few seconds, 132 million gallons of the sludge-filled
black water roared down upon the residents of the mountain hollows below.
Wilbur, his wife Deborah, and their four children managed to survive. What
happened to them is described below...
For some reason, I opened the inside door and looked up the road-and there it
came. Just a big black cloud. It looked like 12 or 15 foot of water ...
Well,my neighbor's house was coming right up to where we live, coming down
the creek ... It was coming slow, but my wifewas still asleep with the baby-she
was about seven years old at the time-and the other kids were still asleep upstairs.
I screamed for my wife in a bad tone of voice so I could get her attention real
quick ... I don't know how she got the girls downstairs so fast, but she run up
there in her slip tail and she got the children out of bed and downstairs ...
We headed up the road ... My wifeand some of the children went up between
the gons [railwaygondonas]; me and my baby went under them because wedidn't
have much time ... I looked around and our house was done gone. It didn't wash
plumb away. It washed down about four or five house lots from where it was setting,
tore all to pieces.
Two years after the disaster, Wilbur and Deborah describe their psychological
scars, the defining symptoms of a post-traumatic stress disorder.
First, Wilbur experiences symptoms of anxiety, including hyper-alertness
and phobic reactions to events that remind him of the flood, such as rain and impending bad weather:
... I listen to the news, and if there is a storm warning out, why I don't go to bed
that night. I sit up. I tell my wife, "Don't undress our little girls; just let them lay
down like they are and go to bed and go to sleep and then if! see anything goingto
happen, I'll wake you in plenty of time to get you out of the house." I don't go to
bed. I stay up. My nerves is a problem. Every time it rains, every time it storms, I just can't
take it. I walk the floor. I get so nervous I break out in a rash. I am taking shots for
it now ...
Second, Wilbur relives the trauma repeatedly in his dreams:
What I went through on Buffalo Creek is the cause of my problem. The whole
thing happens over to me even in my dreams, when I retire for the night. In my
dreams, I run from water all the time, all the time. The whole thing just happens
over and over in my dreams ...
Third, Wilbur and Deborah have become numb psychologically. Affect is
blunted and they are emotionally anesthetized to the sorrows and joys of the
world around them.
Wilbur says:
I didn't even go to the cemetary when my father died (about a year after the flood).
It didn't dawn on me that he was gone forever. And those people that dies around
me now, it don't bother me like it did before the disaster ... It just didn't bother
me that my dad was dead and never would be back. I don't have the feeling I used
to have about something like death. It just don't affect me like it used to.And Deborah says:
I am neglecting my children. Ijust simply quit cooking. I don't do no housework. I
just won't do nothing. Can't sleep. Can't eat. Just wantto take me a lot of pills and
just go to bed and go to sleep and not wake up. I enjoyed my home and my family,
but outside of them to me, everything else in life that I had any interest in is destroyed.
I loved to cook. I loved to sew. I loved to keep house. I was all the time
working in making improvements in my home. But now I just got to the point
where it don't mean a thing in the world to me. I haven't cooked a hot meal and
put it on the table for my children in almost three weeks.
Wilbur also suffers from survival guilt:
At that time, why, I heard somebody holler at me, and I looked around and saw
Mrs. Constable. She had a little baby in her arms and she was hollering, "Hey,
Wilbur, come and help me; if you can't help me, come get my baby." But I didn't
give it a thought to go back and help her. I blame myself a whole lot for that yet.
She had her baby in her arms and looked as though she were going to throw it to
me. Well, I never thought to go help that lady. I was thinking about my own family.
They all six got drowned in that house. She was standing in water up to her
waist, and they all got drowned.
MANMADE CATASTROPHES
The catastrophe that brings about a post-traumatic stress reaction need not
be a naturally occurring one like the Buffalo Creek Flood. Human beings
have made a hell of the lives ofother human beings since time immemorial;
concentration camps, war, and torture ruin the lives of their victims long
after the victims have ceased to experience the original trauma. Unfortu-'
nateiy, the disorders following these catastrophes may be even more severe
and long-lasting than those following natural disasters; it may be easier for
us to deal with the "acts of God" than with the acts of men.
The survivors of the Nazi concentration camps illustrate how long-lasting
and severe the post-traumatic stress reaction can be. In a study of 149 camp
survivors, 142 (or 97 percent) were still troubled with anxiety twenty years
after they were freed from the camps (Krystal, 1968). Phobic symptoms
were marked: 31 percent were troubled with fears that something terrible
would happen to their mates or their children whenever they were out of
sight. Many of them were phobic about certain people whose appearance or
behavior reminded them of their jailors; for example, the sight of a uniformed
policeman or the inquisitive behavior of a doctor might be enough
to set offpanic. Seven percent had such severe panic attacks that the individual
became confused and disoriented, entering a dream like state in which he
believed him self to be back in the concentration camp.
The survivors relived the trauma in dreams for twenty years; 71 percent of
these patients had anxiety dreams and nightmares, with 41 percent having
severe ones. These nightmares were usually reruns of their persecution. Particularly
terrifying were dreams in which only one detail was changed from
the reality; for example, dreaming that their children who had not yet been
born at the time of the camps, had been imprisoned with them in the camps.
Eighty percent of the patients suffered survivor guilt, depression, and crying
spells.
NOTE: Survival guilt was especially strong when the patient's children
had been killed; those who were the most severely depressed had lost an only
child or had lost all of their children, with no children being born since.
Ninety-two percent expressed self-reproach for failing to save their relatives,
and 14 percent wished they had been killed instead of their relatives (Krystal,
1968).
The behavioral account does not now provide us with a way of
telling in advance if a disturbance will become a phobia. A complete explanation
of phobias will need to account for such individual differences as
preparedness and proneness to spontaneous panic attacks.
POST-TRAUMATIC STRESS DISORDER
Phobia, as we saw, is a disorder in which fear is triggered by a specific object.
There is a second emotional disorder that is also precipitated by a specific
event: post-traumatic stress disorder. In phobia, the objects or events that
set off the phobia are quite commonplace, for example, crowds, embarrassment,
cats, and illness. But the precipitant of a post-traumatic stress disorder,
in contrast, is a catastrophic event beyond the normal range of
human suffering, for example, an earthquake, a rape, combat, or imprisonment
in a concentration camp.
Three symptoms that result from the catastrophe define the disorder:
(1) the person becomes numb to the world; (2)
the person relives the trauma over and over in memory and in dreams; and
(3) the person experiences symptoms of anxiety. The anxiety symptoms include
excessive arousal, over-alertness, trouble concentrating, memory impairment,
and phobic avoidance of situations that are reminders of the
trauma. In addition, the individual may be wracked with guilt about surviving
the catastrophe when others did not.
NATURALLY OCCURRING DISASTERS
The Buffalo Creek Flood of 1972 produced devastation and death in a small
West Virginia Community, setting off many cases of post-traumatic stress
disorder among its survivors (Erikson, 1976). In the early morning of' February
26, 1972, the dam on Buffalo Creek in the coal region of West Virginia
collapsed, and within a few seconds, 132 million gallons of the sludge-filled
black water roared down upon the residents of the mountain hollows below.
Wilbur, his wife Deborah, and their four children managed to survive. What
happened to them is described below...
For some reason, I opened the inside door and looked up the road-and there it
came. Just a big black cloud. It looked like 12 or 15 foot of water ...
Well,my neighbor's house was coming right up to where we live, coming down
the creek ... It was coming slow, but my wifewas still asleep with the baby-she
was about seven years old at the time-and the other kids were still asleep upstairs.
I screamed for my wife in a bad tone of voice so I could get her attention real
quick ... I don't know how she got the girls downstairs so fast, but she run up
there in her slip tail and she got the children out of bed and downstairs ...
We headed up the road ... My wifeand some of the children went up between
the gons [railwaygondonas]; me and my baby went under them because wedidn't
have much time ... I looked around and our house was done gone. It didn't wash
plumb away. It washed down about four or five house lots from where it was setting,
tore all to pieces.
Two years after the disaster, Wilbur and Deborah describe their psychological
scars, the defining symptoms of a post-traumatic stress disorder.
First, Wilbur experiences symptoms of anxiety, including hyper-alertness
and phobic reactions to events that remind him of the flood, such as rain and impending bad weather:
... I listen to the news, and if there is a storm warning out, why I don't go to bed
that night. I sit up. I tell my wife, "Don't undress our little girls; just let them lay
down like they are and go to bed and go to sleep and then if! see anything goingto
happen, I'll wake you in plenty of time to get you out of the house." I don't go to
bed. I stay up. My nerves is a problem. Every time it rains, every time it storms, I just can't
take it. I walk the floor. I get so nervous I break out in a rash. I am taking shots for
it now ...
Second, Wilbur relives the trauma repeatedly in his dreams:
What I went through on Buffalo Creek is the cause of my problem. The whole
thing happens over to me even in my dreams, when I retire for the night. In my
dreams, I run from water all the time, all the time. The whole thing just happens
over and over in my dreams ...
Third, Wilbur and Deborah have become numb psychologically. Affect is
blunted and they are emotionally anesthetized to the sorrows and joys of the
world around them.
Wilbur says:
I didn't even go to the cemetary when my father died (about a year after the flood).
It didn't dawn on me that he was gone forever. And those people that dies around
me now, it don't bother me like it did before the disaster ... It just didn't bother
me that my dad was dead and never would be back. I don't have the feeling I used
to have about something like death. It just don't affect me like it used to.And Deborah says:
I am neglecting my children. Ijust simply quit cooking. I don't do no housework. I
just won't do nothing. Can't sleep. Can't eat. Just wantto take me a lot of pills and
just go to bed and go to sleep and not wake up. I enjoyed my home and my family,
but outside of them to me, everything else in life that I had any interest in is destroyed.
I loved to cook. I loved to sew. I loved to keep house. I was all the time
working in making improvements in my home. But now I just got to the point
where it don't mean a thing in the world to me. I haven't cooked a hot meal and
put it on the table for my children in almost three weeks.
Wilbur also suffers from survival guilt:
At that time, why, I heard somebody holler at me, and I looked around and saw
Mrs. Constable. She had a little baby in her arms and she was hollering, "Hey,
Wilbur, come and help me; if you can't help me, come get my baby." But I didn't
give it a thought to go back and help her. I blame myself a whole lot for that yet.
She had her baby in her arms and looked as though she were going to throw it to
me. Well, I never thought to go help that lady. I was thinking about my own family.
They all six got drowned in that house. She was standing in water up to her
waist, and they all got drowned.
MANMADE CATASTROPHES
The catastrophe that brings about a post-traumatic stress reaction need not
be a naturally occurring one like the Buffalo Creek Flood. Human beings
have made a hell of the lives ofother human beings since time immemorial;
concentration camps, war, and torture ruin the lives of their victims long
after the victims have ceased to experience the original trauma. Unfortu-'
nateiy, the disorders following these catastrophes may be even more severe
and long-lasting than those following natural disasters; it may be easier for
us to deal with the "acts of God" than with the acts of men.
The survivors of the Nazi concentration camps illustrate how long-lasting
and severe the post-traumatic stress reaction can be. In a study of 149 camp
survivors, 142 (or 97 percent) were still troubled with anxiety twenty years
after they were freed from the camps (Krystal, 1968). Phobic symptoms
were marked: 31 percent were troubled with fears that something terrible
would happen to their mates or their children whenever they were out of
sight. Many of them were phobic about certain people whose appearance or
behavior reminded them of their jailors; for example, the sight of a uniformed
policeman or the inquisitive behavior of a doctor might be enough
to set offpanic. Seven percent had such severe panic attacks that the individual
became confused and disoriented, entering a dream like state in which he
believed him self to be back in the concentration camp.
The survivors relived the trauma in dreams for twenty years; 71 percent of
these patients had anxiety dreams and nightmares, with 41 percent having
severe ones. These nightmares were usually reruns of their persecution. Particularly
terrifying were dreams in which only one detail was changed from
the reality; for example, dreaming that their children who had not yet been
born at the time of the camps, had been imprisoned with them in the camps.
Eighty percent of the patients suffered survivor guilt, depression, and crying
spells.
NOTE: Survival guilt was especially strong when the patient's children
had been killed; those who were the most severely depressed had lost an only
child or had lost all of their children, with no children being born since.
Ninety-two percent expressed self-reproach for failing to save their relatives,
and 14 percent wished they had been killed instead of their relatives (Krystal,
1968).
Treating Social Anxiety
Generalized Anxiety Treatment
Treating Panic Disorder
Agoraphobia Treatment
More at:
http://social-anxiety-treatment-cure.weebly.com/
Of course you know the treatment method I recommend!
http://theliberatormethod.com/Welcome.html
END
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~~~~~~~~~~~~~~
Generalized Anxiety Treatment
Treating Panic Disorder
Agoraphobia Treatment
More at:
http://social-anxiety-treatment-cure.weebly.com/
Of course you know the treatment method I recommend!
http://theliberatormethod.com/Welcome.html
END
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~