Sunday, July 7, 2019

Dread: The Essential Emotional Experience of Complex PTSD

I just spent 45 minutes in vipassana (insight) meditation looking at -- meaning feeling -- the body's affective, sensory experience of dread. I just used the 10 StEPs of Emotion Processing along with Pat Ogden's Sensorimotor Processing for Trauma to sit and feel the sensations... as well as observe the thoughts that came up and the impulses to act upon the thoughts and feelings. The entire pantheon of autonomic affects came up, including the Fight, Flight, Freeze, Faint, Feign and Fawn Responses that -- if left ignored, repressed or dissociated into diverse "compartments" can lead in time to the sympathetic branch's awful Fry and Freak syndromes.
I am a very motivated meditator. I spent a total of 30 months in segments as long as eight on two occasions, and eleven on a third, in Fry and Freak Complex PTSD during the nine years from 1994 to 2003. When the "Hindu Goddess" physician recognized it for what it actually was and changed my medication package 180 degrees from what it had been to the very simple regimen that actually worked to relieve the worst of the terror, I vowed that I would find The Door once and for all. This earlier post summarizes that process and the arrival at the 10 StEPs + SP4T six years ago. I have never looked back, so to speak. But actually, my "Observing Self " has looked back -- or at least in -- a lot.
There are other paths, and they should be noted. Because "one size of shoe never fits every foot." The other psychotherapies listed in section seven of that same earlier post were helpful to me on my path, and one or more of them may prove to be the "magic bullet" that puts another on The Path.
But regardless of which path (or collection thereof) one elects to take, it does seem to the "alter" in my mind today that is the result of having used the 10 StEPs and SP4T for these past six years... that "exposure" -- or direct observation -- is the starting point. For me, at least, followed by...
noticing (of what is observed),
recognition (of what is noticed),
acknowledgement (of what is recognized),
acceptance (of what is acknowledged),
ownership (of what is accepted as being "what just is"), appreciation (of what is accepted and owned), and
experiential -- rather than merely intellectual or conceptual -- understanding thereof is what sets the mind at the elective doorstep of
interoception that facilitates the
digestion and discharge of the neuroemotional (or neuroaffective) energy of dread
that is stored in the enteric and default mode neural networks that include the limbic emotion regulation system in the mid- and fore-brain.

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Someone asked, "Can you expand on the sympathetic branch's fry and freak syndromes? I have not encountered this language before, and a quick Google search for 'fry and freak syndrome' has yielded nothing."

I answered, "Frying is akin to the process of allostatic loading as described by Bruce McEwen, Sonya Lupien and others. Freak is being in a very high SUDS state of abject terror recycling -- or "fear of fear" -- that may not abate with medication and can ultimately only be treated with one or more of the cognitive-behavioral therapies like those listed in section 7a of this earlier post, often requiring the addition of one of the mindfulness-based CBTs like those listed in section 7b."
- - - - - -

Resources & References
Abramowitz, J.: the stress less workbook: Simple Strategies to Relieve Pressure, Manage Commitments and Minimize Conflicts; New York: The Guilford Press, 2012.
Agarwal, N.: fMRI Shows Trauma Affects Neural Circuitry, in Clinical Psychiatry News, Vol. 37, No. 3, March 2009.
Alladen, A.: Integrative CBT for Anxiety Disorders: An Evidence-Based Approach to Enhancing Cognitive Behavioural Therapy with Mindfulness and Hypnotherapy, Hoboken, NJ: Wiley-Blackwell, 2016.
Andersen, S.; Teicher, M.: Desperately Driven and No Brakes: Developmental Stress Exposure and Subsequent Risk for Substance Abuse, in Neuroscience of Behavior Review, Vol. 33, No. 4, April 2009.
Antoniak, S.: Inmates with PTSD have higher scores for mood, anxiety, somatoform, substance use, psychotic, eating, conduct, and adjustment disorders, in Clinical Psychiatry News, Vol. 38, No. 1, January 2010.
Arsenault, L.: The persistent and pervasive impact of being bullied in childhood and adolescence: implications for policy and practice, in Journal of Child Psychology and Psychiatry, Vol. 59, No. 4, November 2017.
Aviezer, H.; Trope, Y.; Todorov, A.: Body Cues, Not Facial Expressions, Discriminate Between Intense Positive and Negative Emotions, in Science, Vol. 338, No. 6111, November 2012.
Baker, R,; Gale, L.; et al: Emotional Processing Therapy for post traumatic stress disorder, in Counselling Psychology Quarterly (UK), Vol. 26, No. 3/4, 2013.
Bandura, A.: Self-Efficacy: The Exercise of Control, San Francisco: W. H. Freeman, 1997.
Baumeister, R.; Heatherton, T.: Self-Regulation Failure: An Overview, in Journal of Psychological Inquiry, Vol. 7, No. 1, 1996.
Bazarko, D.; Cate, R.; Azocar, F.; Kreitzer, M.: The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting, in Journal of Workplace Behavioral Health, Vol. 28, No. 2, February 2013.
Begley, S.: Train Your Mind, Change Your Brain: How Science Reveals our Extraordinary Potential to Transform Ourselves, New York: Ballantine Books, 2007.
Benson, H.: The Relaxation Response, New York: Morrow, 1975.
Berntson, D.; Johannessen, K.; Thomsen, Y.; et al: Peace and War: Trajectories of Posttraumatic Stress Disorder Symptoms Before, During and After Military Deployment in Afghanistan, in Psychological Science, Vol. 23, No. 11, November 2012.
Block, S.; Block, C.: Come to Your Senses: Demystifying the Mind-Body Connection, New York: Atria Books / Beyond Words (Simon & Schuster), 2005, 2007.
Block, S.; Block, C.: Mind-Body Workbook for PTSD, Oakland, CA: New Harbinger, 2010.
Block, S.; Block, C.: Mind-Body Workbook for Stress, Oakland, CA: New Harbinger, 2012.
Block, S.; Block, C.: Mind-Body Workbook for Anger, Oakland, CA: New Harbinger, 2013.
Block, S.; Block, C.: Mind-Body Workbook for Anxiety, Oakland, CA: New Harbinger, 2015.
Bond, A.; Mason, H.; et al: Embodied health: the effects of a mind–body course for medical students, in Medical Education Online, Vol. 18, 2013.
Boraxbekk, C.; et al: Neuroplasticity in response to cognitive behavior therapy for social anxiety disorder, in Translational Psychiatry, February 2016.
Brach, T.: Radical Acceptance: Embracing Your Life with the Heart of a Buddha, New York: Random House / Bantam, 2004.
Branden, N.: The Disowned Self, New York: Bantam Books, 1976.
Briere, J.: Therapy for Adults Molested as Children: Beyond Survival (Revised and Expanded Edition), New York: Springer, 1996.
Buczynski, R.; Levine, P.; Van der Kolk, B.; Porges, S.; Ogden, P.; Siegel, D.; Fisher, S.; Rethinking Trauma: The Right Interventions Can Make Trauma Treatment Faster and More Effective, a webinar, National Institute for the Clinical Application of Behavioral Medicine, October-November, 2014.
Buhler, K.; Heim, G.: General introduction to the psychotherapy of Pierre Janet, in American Journal of Psychotherapy, 2001.
Burghardt, N.; Sigurdsson, T.; Gorman, J.; McEwen, B.; LeDoux, J.: Chronic Antidepressant Treatment Impairs the Acquisition of Fear Extinction, in Biological Psychiatry, Vol. 73, No. 11, November 2013.
Carlson, N.: Physiology of Behavior, 7th Ed., Boston: Allyn and Bacon, 2001.
Cayoun, B.; Francis, S.; Shires, A.: The Clinical Handbook of Mindfulness-integrated Cognitive Behavior Therapy: A Step-by-Step Guide for Therapists, Hoboken, NJ: Wiley-Blackwell, 2018.
Centers for Disease Control and Prevention: The Effects of Childhood Stress Across the Lifespan, Atlanta, GA: CDC, 2008.
Chapman, A.; Gratz, K.; Tull, M.: The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD & Other Anxiety Symptoms, Oakland CA: New Harbinger, 2011.
Chapman, A.; Gratz, K.; Tull, M.: The Dialectical Behavior Therapy Skills Workbook for Anger: Using DBT Mindfulness & Emotion Regulation Skills to Manage Anger, Oakland CA: New Harbinger, 2015.
Chodron, P.: The Places That Scare You: A Guide to Fearlessness in Difficult Times, Boston: Shambhala, 2001.
Chodron, P.: Taking the Leap: Freeing Ourselves from Old Habits and Fears, Boston: Shambala, 2010.
Cooper, M.: Existential Therapies, London: Sage Publications, 2003.
Copeland, W.; Keeler, G.; et al: Traumatic events and posttraumatic stress in childhood, in Archives of General Psychiatry, Vol. 64, 2007.
Courtois, C.: Guidelines for the Treatment of Adults Abused or Possibly Abused as Children (with Attention to Issues of Delayed or Recovered Memory), Washington, DC: The Psychiatric Institute of Washington, 1997.
Courtois, C.; Ford, J.; ed.: Treatment of Complex Traumatic Stress: A Sequenced, Relationship-Based Approach, New York: Guilford Press, 2012.
Courtois, C.; Ford, J.; ed.: Treating Complex Post-Traumatic Stress Disorder in Children and Adolescents, New York: Guilford Press, 2013.
Courtois, C.: It's Not You: It's What Happened to You: Complex Trauma and Treatment, Dublin, OH: Telemachus Press, 2014.
Cozolino, L.: The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain, New York: W. W. Norton, 2002.
Craig, A. D.: How do you feel? Interoception: the sense of the physiological condition of the body, in National review of Neuroscience, Vol. 3, No. 8, August 2002.
Damasio, A.: Feelings of Emotion and the Self, in Annals of the New York Academy of Science, Vol. 100, No. 1, October 2003.
Damasio, A.: The Feeling of What Happens: Body and Emotion in the Making of Consciousness, New York: Harcourt, 1999
Damasio, A.: Self Comes to Mind: Constructing the Conscious Brain, New York: Pantheon, 2010.
Davidson, R.; Lutz, A.: Buddha’s Brain: Neuroplasticity and Meditation, in IEEE Signal Processing Magazine, Vol. 25, No. 1, Jan 2008.
DeBellis, M.: Developmental Traumatology: Neurobiological Development in Maltreated Children with PTSD, in Psychiatric Times, Vol. 16, No. 11, 1999.
Deikman, A.: Personal Freedom: On Finding Your Way to the Real World, New York: Bantam, 1976.
Deikman, A.: The Observing Self: Mysticism and Psychotherapy, Boston: Beacon Press, 1982.
de Mello, A.: Awareness: The Perils and Opportunities of Reality, New York: Doubleday / Image, 1990.
Diener, S.; Nees, F.; et al: Reduced amygdala responsivity during conditioning to trauma-related stimuli in posttraumatic stress disorder, in Psychophysiology, Vol. 53, No. 10, October 2016.
Dimeff, L.; Koerner, K.: Dialectal Behavior Therapy in Clinical Practice: Applications Across Disorders and Settings, New York: The Guilford Press, 2007.
Dinse, H.; Kattenstroth, J.; et al: The stress hormone cortisol blocks perceptual learning in humans, in Psychoneuroendocrinology, Vol. 77, March 2017.
Doctor, J.; Zoellner, L.; Feeny, N.: Predictors of Health-Related Quality-of-Life Utilities Among Persons With Posttraumatic Stress Disorder, in Psychiatric Services, Vol. 62, No. 3, March 2011.
Drury, S.: Children Under Age Six Are Vulnerable to PTSD, in Clinical Psychiatry News, Vol. 38, No. 5, May 2010.
Duman, R.: Neural plasticity: consequences of stress and actions of antidepressant treatment, in Dialogues of Clinical Neuroscience, Volume 6, 2004.
Dutra, L.; Callahan, K.; Herman, J., et al: Core schemas and suicidality in chronically traumatized population, in Journal of Nervous & Mental Disease, Vol. 196, No. 1, January 2008.
That's just the first four letters of the alphabet

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