<?xml version="1.0" encoding="UTF-8"?>
<rss version="2.0"
	xmlns:content="http://purl.org/rss/1.0/modules/content/"
	xmlns:wfw="http://wellformedweb.org/CommentAPI/"
	xmlns:dc="http://purl.org/dc/elements/1.1/"
	xmlns:atom="http://www.w3.org/2005/Atom"
	xmlns:sy="http://purl.org/rss/1.0/modules/syndication/"
	xmlns:slash="http://purl.org/rss/1.0/modules/slash/"
	>

<channel>
	<title>John C. Flanagan, LCSW</title>
	<atom:link href="http://johncflanaganlcsw.com/feed/" rel="self" type="application/rss+xml" />
	<link>http://johncflanaganlcsw.com</link>
	<description></description>
	<lastBuildDate>Sat, 25 Feb 2012 22:57:48 +0000</lastBuildDate>
	<language>en</language>
	<sy:updatePeriod>hourly</sy:updatePeriod>
	<sy:updateFrequency>1</sy:updateFrequency>
	<generator>http://wordpress.org/?v=3.3.1</generator>
		<item>
		<title>Victim Identity?</title>
		<link>http://johncflanaganlcsw.com/victim-identity/</link>
		<comments>http://johncflanaganlcsw.com/victim-identity/#comments</comments>
		<pubDate>Sat, 06 Mar 2010 08:00:12 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[coping with ptsd]]></category>
		<category><![CDATA[dealing with ptsd]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[portland ptsd therapist]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[ptsd trigger]]></category>
		<category><![CDATA[ptsd victim]]></category>
		<category><![CDATA[reactivity]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[traumatic]]></category>
		<category><![CDATA[victim identity]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=76</guid>
		<description><![CDATA[Are we motivated to cling to our status as trauma victim? Even if we call ourself a trauma survivor or even a trauma thriver, we are still focused on the trauma. Why is overcoming the effects of our trauma and functioning normally so difficult for us? Obviously there are many answers to this question including [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Are we motivated to cling to our status as trauma victim? Even if we call ourself a trauma survivor or even a trauma thriver, we are still focused on the trauma. Why is overcoming the effects of our trauma and functioning normally so difficult for us? Obviously there are many answers to this question including the fact that there are physiological changes in our brain due to the trauma. Unfortunately these changes contribute in a big way to our attitudes and behaviors. But, is there another factor operating here? Do we take at least some of our sense of identity from the fact that we have a history of trauma? How important to us is this sense of identity as a trauma victim? How big a role does it play in our overall sense of ourselves? What problems would it pose for us if we decided to give that up? Would we feel that we were not being true to ourselves?</p>
<p>If we could choose to give up our identity as a person with a history of trauma, would we feel like we were abandoning a part of ourself? <span id="more-76"></span>We did suffer trauma. We did go through Hell. And, for most of us that Hell has continued in one form or another throughout our entire life. Now all of a sudden we are supposed to stop having PTSD and start functioning normally? I don’t think so! And yet I want that more than anything. I want that for me and I want that for you. If we could have that, or even, more realistically, just some of that, could we do so with a sense that we were being true to ourselves?</p>
<p>I think that part of the problem here is that we are each one of us many selves. That is to say that there are many facets or parts to us that may be in fact fairly diverse. This is more obvious in the person with multiple personalities where each of these personalities has a separate identity. But whether our mind is configured like that or not, we have been and therefore still are several different people. Therefore we have, somewhere inside of us the little child who existed unblemished before any trauma occurred. For some of us this little child began being traumatized so early that we have no recollection of this pristine state. Nevertheless, it did exist, even if only in theory, even if only in utero.</p>
<p>The question therefore becomes, which of ourselves do we want to be true to? Do we want to be true to the self that was traumatized, the self that survived, the self that we have become or the self that existed before the trauma? I wonder if we can be true to all of these in some way? Wouldn’t it be great if at least at times, from time to time, we could just be normal? Wouldn’t it be great if we could feel normal? I submit that when we do this, if we do it, we are being true to that pristine little child who existed before the trauma and to the adult that child would have become without the trauma. I challenge you to at least at times let yourself be true to this part of yourself.</p>
<p>The problem however, is that we did suffer trauma and we are still struggling with the after effects of that trauma. We need also to be true to that part of ourselves. I think a big part of being true to that part of ourselves is doing what I call trauma management. This is a big umbrella term that includes everything from going to therapy and belonging to a support group for trauma survivors to honoring our triggers and avoiding those things that we know might tend to set us off. I think that it does not feel like we are being true to ourselves if we try to deny this part.</p>
<p>We want to overcome and are trying to overcome the effect of our trauma. It does not feel like we are being very true to ourselves if we dwell in it, wallow in it or allow ourselves to be ruled by it. If we try to deny the effects of our trauma, then trying to overcome the effects of our trauma may feel like a betrayal of ourselves. It may feel like we are pretending that the trauma never happened. Or as we try to overcome our trauma effects, it may feel like we are admitting that it wasn’t that bad or that we made it up or exaggerated it as a play for attention or sympathy. For many of us, this message has of course been reinforced by the denials of those around us. I am reminded of my first therapist, who, not knowing the whole story, concluded that what had happened to me was “normal sibling rivalry”.</p>
<p>The challenge is to find the balance that honors and is true to all the parts of ourselves. The question is how? How can we be true to ourselves in every way? It is a big challenge. We want neither to renounce the part of ourselves that suffers PTSD nor the part that existed before the trauma and the person we would have become if there had been no trauma. We want to acknowledge and embrace all these parts and respond to them in an integrated way. This is a daunting task, but I think that it can be done. Let’s explore how to do this!</p>
<p>Therapy is the key. I am a therapist not only because I have an innate curiosity about people, but also because I love helping people and I have a great believe in the beneficial effects of the therapeutic relationship. In trauma therapy the first and most important thing is to establish a warm and trusting relationship between therapist and client. Once this has been established, then the client with the assistance of the therapist, can explore the various aspect of their psyche and move in successive approximations toward a state of integration in which all of the parts of the psyche are recognized, acknowledged and validated. This is the only way that I can see that any of us can ever reach a point of satisfactory integration in the face of a history of trauma.</p>
<p>There is no way to unring that bell once we have suffered trauma. It is counter-productive to try to deny that part of ourselves. What we have to do is identify, recognize and integrate all the parts of ourselves into a functioning complete person who has been impacted by trauma but is not ruled by that history. We need to be true to all the parts of ourselves and not allow ourselves to be ruled by any one part no matter how justified that may seem one way or another.</p>
<p>Desired Outcome: Recognizing and acknowledging all the parts of ourselves and finding a way to be true to all our parts simultaneously.</p>
<p>Discussion Starters: Can you remember who you were and how you were before your trauma? If not, can you imagine that little person? It can be very helpful to look at an early picture of yourself if you have one. Now can you imagine how that person would have developed and who they would have become had there been no trauma? Can you be true to that person? How would you go about doing that? Given the existence of that separate reality, can you find a way to be true to both that person and the person you have become as a result of your trauma? How will you accomplish this balance? Does this feel true? What would help make it fell more true?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/victim-identity-copyright-20091.pdf">Victim Identity</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/victim-identity/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Catastrophizing</title>
		<link>http://johncflanaganlcsw.com/catastrophizing/</link>
		<comments>http://johncflanaganlcsw.com/catastrophizing/#comments</comments>
		<pubDate>Thu, 05 Mar 2009 20:22:23 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[catastrophizing]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=53</guid>
		<description><![CDATA[Awhile back I went to the dermatologist because I was having a strange rash that was not responding to treatment. After examining it she said that I might have “Bullous Pemphigoid”. I’m guessing that most people have never heard of it. I never had. After the doc left the room I asked the nurse how [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Awhile back I went to the dermatologist because I was having a strange rash that was not responding to treatment. After examining it she said that I might have “Bullous Pemphigoid”. I’m guessing that most people have never heard of it. I never had. After the doc left the room I asked the nurse how to spell it. She said, “Now don’t go looking it up on the internet!” Yes, of-course, that is exactly what I did. Well, Bullous Pemphigoid is an autoimmune disease that is sometimes (rarely) fatal. I remember talking to my friend, John, and telling him about it and crying. I was dying…. Well, no, I wasn’t dying. I was Catastrophizing. It turns out that I’m allergic to Sudafed and was having a “focused drug reaction”, which I also never heard of. It’s really quite interesting, but that’s another story.</p>
<p>Catastrophizing can take many forms. It can be reading too much into what or how a doctor tells us about an illness. It can be assuming that our spouse or partner, because he or she gets home later than expected or otherwise behaves oddly, is having an affair. <span id="more-53"></span>Essentially catastrophizing is making extreme assumptions about what’s going on based on very limited or circumstantial evidence. It is assuming a more dire conclusion than we have adequate evidence to support. And it is having an emotional reaction proportional to that dire conclusion. In 2001, I found myself catastrophizing about the war in Iraq. I thought that our government had grossly miscalculated and that the war was going to go on for years, just like Viet Nam. A lot more people were going to die and it was going to bankrupt the country. Unfortunately sometimes catastrophes do come true.</p>
<p>A distinction needs to be made between a crisis and a catastrophe. A crisis is when something bad happens that needs to be dealt with in an expeditious manner. A catastrophe is when something extremely bad happens and there is very little one can do about it. Mostly one just has to suffer through it. It’s a bigger bad thing that has less that can be done about it. Catastrophizing is essentially turning a crisis into a catastrophe. In the example at the top of the page, the rash was a “concern”. The doctor’s inability to diagnose it was a crisis. And my sense that I was going to die from it was catastrophizing. In this example, there was no actual catastrophe. However, it is still catastrophizing any time we think a crisis is a catastrophe, even if it later becomes a catastrophe.</p>
<p>So why do we catastrophize? I think that people catastrophize for a variety of different reasons at various times. In part we catastrophize because our society teaches us to do it. For example during the “war on terror” the country was put on red alert because of a suspected terrorist attack using biological or chemical weapons. We were advised to buy duct tape and sheets of plastic with which to seal up our houses. It sounded like a catastrophe but it wasn’t, especially for the duct tape and plastic sheeting industries. So maybe we catastrophize because it is what we are used to, especially if we grew up in a dysfunctional family. Our whole lives have been or seemed to us to be catastrophes. Maybe it is because that is what we dread. Our childhood was a catastrophe. But we have diligently striven to make our adult lives placid and uncomplicated. We have done all sorts of things to give ourselves a sense of control. And now something hints of spinning out of control and it panics us. Our house of cards, for if we are honest with ourselves, that is what it feels to us like we have built, is about to collapse.</p>
<p>Or maybe we have been waiting our whole lives for a “real” catastrophe to happen to us so that we can feel justified. We suffer. We have suffered all of our lives. But we have never felt entirely certain that we had ample reason to suffer. Now here comes this catastrophe. We are finally validated in our suffering. I am reminded of clients that I have known who were strangely relieved to have some horrible illness or other disaster befall them. Another reason for this kind of reaction, for reaction it is, might be that these events make us feel like those around us finally recognize our suffering. The world around us finally sees that our pain is legitimate. Or maybe the catastrophe seems to legitimatize our eccentric and inappropriate behaviors, our reactivity, which stem from our original catastrophe, our traumatic childhood.</p>
<p>Sometimes our tendency to catastrophize about certain things can be a useful tool to teach us about ourselves. Just like any other symptom, its character may stem from our original trauma and therefore may shed light on what that trauma was and how it impacted us. For example, maybe a person tends to catastrophize about illness because it was only when he or she was ill that attention was given. Or contrariwise, maybe he or she was shamed for illnesses and therefore only feels like a very serious one is legitimate.</p>
<p>What can we do to catastrophize less? My mind tends to respond to this question by turning to several of our old standbys. We need to turn to the tools in our tool chest and apply them liberally. We have learned that whenever we notice ourselves being reactive, we need to question our reactivity. We need to journal, meditate, visualize and say affirmations. We need to look at the situation through the eyes of a third party, either in our imagination or literally through our relationships. We need to follow our intuitions and insights.<br />
It is helpful to keep reminding ourselves of the need for adequate information before trying to reach any conclusions. I love the story that Carl Sagan told in the Cosmos series about the early astronomers. They were looking at the planet Venus and saw that it was covered with clouds. They concluded that it must be a tropical rain forest type atmosphere much like when dinosaurs roamed the earth. Sagan says, “Observation, we can’t see a thing. Conclusion, dinosaurs.” It is always helpful to get more data.</p>
<p>Desired Outcome: Become able to catastrophize less often, less severely and for shorter periods of time.</p>
<p>Discussion Starters: What instances can I remember when I have catastrophized? Under what circumstances do I tend to catastrophize? How does the pattern of my catastrophizing relate to my history? What tools do I have or can I develop to help me catastrophize less? What ways do I have or can I develop to help me detach from this kind of extreme thinking?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/catastrophizing-copyright-2009.pdf">Catastrophizing</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/catastrophizing/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Anniversary Reactions</title>
		<link>http://johncflanaganlcsw.com/anniversary-reactions/</link>
		<comments>http://johncflanaganlcsw.com/anniversary-reactions/#comments</comments>
		<pubDate>Sun, 01 Mar 2009 18:21:25 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[divorce]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[traumatic]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=58</guid>
		<description><![CDATA[Generally we think of anniversaries as good things. They are times to remember and celebrate cherished events such as births, graduations, weddings, the start of a business or a career, or even the birth of a nation. However, other less pleasant events also have anniversaries. We remember these as well, but we don’t usually celebrate [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Generally we think of anniversaries as good things. They are times to remember and celebrate cherished events such as births, graduations, weddings, the start of a business or a career, or even the birth of a nation. However, other less pleasant events also have anniversaries. We remember these as well, but we don’t usually celebrate them. However, we may have some ritual that we observe to acknowledge the day, for example, taking flowers to the grave of a loved one.</p>
<p>An anniversary reaction is a very different thing. It is an unpleasant emotional response to a certain day or time of year. It is caused by one or more<span id="more-58"></span> specific traumatic events having happened at that time of year at some point in the past. Or it can also be caused by a traumatic event or events being associated with a certain date or time of year. There are a number of different types of anniversary reactions. We could have a reaction to the date of birth or death of someone associated with some form of trauma that we suffered. We could have a reaction to the date or time of year when we lost someone important to us through death, divorce, incarceration or abandonment.</p>
<p>Anniversary reactions can be to an event that only occurred once or they can be to a pattern of events that occurred repeatedly at a certain time of year. An example of this would be reactivity to Christmas due to dysfunctional and destructive behaviors of one or more family members that tended to occur ever year at Christmas time such as a violent and reactive father tearing up the Christmas tree. Obviously events such as this are very likely to cause anniversary reactions.</p>
<p>An anniversary reaction can also occur not because of something that happened but because of something that didn’t happen. An example of this might be reacting to one’s own birthday due to the fact that one’s family didn’t celebrate it or because they only celebrated it nominally. The lack of enthusiasm for the celebration only served to underscore a pervasive pattern of rejection or neglect. That day of all the days of the year stood as a stark reminder of what was missing as far as love, nurturing, caring, or feeling like a wanted child.</p>
<p>Anniversary reactions can range from mild to severe and may occur at any time after the event. If the survivor doesn&#8217;t recognize this as one of the symptoms of PTSD, he or she may feel like Scrooge instead of like a normal human being who went through a very abnormal and bad experience at a certain time of the year. Family and friends may react to a survivor of childhood trauma’s Scrooge-like behavior in an unsympathetic manner, which only adds to one’s own sense of being bad or wrong and to one’s feeling of isolation.</p>
<p>Anniversary reactions tend to be the sort of triggers that sneak up on us. At first and maybe for many years we have them and don’t realize what’s happening. Perhaps we attribute our reactive state to some current event or events. There are usually plenty of day-to-day stressors that we can scapegoat in this way. Eventually as the pattern repeats over and over again we figure out that we are having an anniversary reaction. But very often we forget from one year to the next that a certain time of year is difficult for us. Or we think that because we figured this out last year that it won’t be a problem for us this year.</p>
<p>Anniversary reactions tend to cause us to behave in ways that we regret and that make us feel discouraged about ourselves and about our progress in overcoming our PTSD. Because we are already triggered, we tend to be more reactive to other things to which we might otherwise not react. This may tend to make us feel like we are losing ground.</p>
<p>Anniversary reactions tend to compound themselves over the years. Because they tend to make us behave in ways that are counter-productive, we tend to do things that bring upon us new traumas. For example our reactivity may cause us to behave in a way that alienates a friend. The loss of that friendship then becomes an additional trauma that is associated with that time of year.</p>
<p>Like so many PTSD symptoms, anniversary reactions tend to not go away. And as with so many PTSD symptoms, the best we can hope for is to get better and better at managing our symptoms. We would probably be wise to mark our calendars a year in advance to remind us to be aware and prepare. This could be done in a playful way with a statement in our calendar a few days in advance such as “rough road ahead”.</p>
<p>Our preparation might include one or more of the numerous coping strategies that we are learning to help us cope with our PTSD. We could change the scene, for example by planning to be out of town maybe on vacation at that time or by planning an all-consuming volunteer activity for that time. We could line up a support person to help monitor how we are doing and help keep us on track. We could take up a new activity or hobby, learn a new skill or reinvest ourselves in improving on a skill we already have. We could even choose to reengage in therapy or start a new course of therapy to help us weather these difficult times.</p>
<p>As always, we need to keep processing our experiences of the past. We can do this in therapy, we can do this by meditating on the events of the past, we can do this by journaling, we can do this by reading self-help books and we can do this by talking with a trusted friend about it. Ultimately we probably get farther when we are able to reconnect with the emotions that we had during the trauma.</p>
<p>For many of us reconnecting with the emotional content of the trauma is very difficult. We had gotten very good at repressing our emotions as a way of getting through a traumatic time. We got so good in fact that it is now very difficult for us to reconnect with them at all. We repressed them because they were so enormously uncomfortable and because we didn’t get the responses that we wanted from those around us. But because we repressed them we never got to finish processing them. Thus they remain buried within us as unfinished business. As long as these emotions remain unprocessed, our anniversary reactions will continue to plague us.</p>
<p>The challenge and the solution is to face the painful experiences that we have had in the past and make our peace with them. Time heals all wounds, but only if we use that time wisely. Hiding from our experiences and the feelings associated with them is tempting. However, at least once a year on the anniversaries of traumatic events we will re-experience them in some way unless we do the processing that is necessary to overcome, in so far as we are able, the impact that those experiences had on us. Anniversary reactions are reminders that we still have work to do and we would do well to respond by addressing our unfinished business.</p>
<p>Desired Outcome: Gain a better understanding of how a specific time of year may be a trigger for us and begin to look for ways to diminish these anniversary reactions.</p>
<p>Discussion Starters: What anniversary reactions am I aware of having? Was there a time when I was having this reaction and didn’t know it? Do I have any anniversary reactions that are due to a specific single traumatic event? Do I have any that are due to recurring yearly traumatic situations? To what extent am I able to reconnect to the emotions I had when the trauma occurred? What strategies have I used to cope with anniversary reactions? What has worked and what has not worked? What new strategies can I try?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/anniversary-reactions-copyright-2009.pdf">Anniversary Reactions</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/anniversary-reactions/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Reactivity</title>
		<link>http://johncflanaganlcsw.com/reactivity/</link>
		<comments>http://johncflanaganlcsw.com/reactivity/#comments</comments>
		<pubDate>Tue, 24 Feb 2009 18:39:09 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[reactivity]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[triggers]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=71</guid>
		<description><![CDATA[In PTSD, once we have been triggered, what follows may be termed reactivity. It is a combination of thoughts, emotions and physiological responses to the triggering. Being triggered and reacting is a very natural process. It is also a very primitive process. In PTSD, due to the fact that our higher brain functions shut down [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>In PTSD, once we have been triggered, what follows may be termed reactivity. It is a combination of thoughts, emotions and physiological responses to the triggering. Being triggered and reacting is a very natural process. It is also a very primitive process. In PTSD, due to the fact that our higher brain functions shut down under stress, we tend often to react in very primitive ways. And of course this very frequently gets us into trouble. For example we may lash out and behave in a way that we really don’t want.</p>
<p>This reactivity is actually a reactive sequence. It is as if there is an alarm center in our brain. I picture it as a big empty room with monitors in the center and posters plastered all over the walls, ceiling and floor. At least for us with PTSD there are a lot of posters, maybe even filing cabinets full of them. These posters depict images of past traumas in great detail including sights, sounds, smells, tastes and physical sensations. Watching the monitors are two big dumb guys that don&#8217;t have a lick of sense between them, Tweedle Dum and Tweedle Dee. <span id="more-71"></span>All they do is watch the monitors and look for anything that looks suspiciously like anything on any of the posters. Whenever they spot a similarity, without thinking, they sound the alarm. This message goes directly to another part of the brain that is the fail safe for the alarm system. Its job is to filter out false alarms. But during childhood trauma this part has gotten damaged. Consequently, it doesn&#8217;t filter nearly as well as it should and a lot of false alarms get through.<br />
Reactivity first manifests as physiological sensations and then emotions before any thought process takes place. Studies of brain function have demonstrated that in persons with PTSD when they are stressed, the primitive brain stem, the reactive lizard brain, gets activated. It is only some time later that the thinking part of the brain, the cerebral cortex, comes back on line. In people who don’t have PTSD, the filtering body does its job correctly and the cerebral cortex gets activated right away to begin to process the stress and deal constructively and successfully with it.</p>
<p>You may be wondering why we have this mechanism in our brain that functions in a way that bypasses thought. It is essential to keep us from falling down all the time. If every time you tripped on an uneven place in the sidewalk you had to take time to think what to do to regain your balance, you would keep landing on the pavement. There is no time for the relatively slow process of thinking and deciding. So these automatic parts of the brain do their jobs and keep us safe. But somehow in childhood trauma they get messed up. The alarm center becomes over active and the filtering center becomes less effective. We have been conditioned to be on guard for danger and to not rule out anything that might harm us.</p>
<p>Another interesting aspect of our reactivity is that it first reaches consciousness when we feel something going on in our bodies. We feel sensations that are like what we felt when something bad happened before. We feel these sensations and we have thoughts in response to the sensations and not the other way around. But often times we act as if it were the other way around because at other times that also happens, i.e. we have thoughts and those lead to feelings that then produce sensations in our body. When the sensations occur first, we experience them and then we interpret them. Our tendency is to assume that we are feeling the emotion that corresponds with the bodily sensations that we are having. If our body is doing a &#8220;slow burn&#8221; then we tend to assume that we are mad. If our body is feeling queasy then we think that we are scared. And so on.</p>
<p>Each of us has a particular set of reactions that is unique to us. This is because our reactivity is directly tied to the nature of our trauma. One person screams another complains, a third argues and a fourth falls silent. Each of these reactions is characteristic to that particular person and is based on the nature of their traumatic situation. Physiological reactions are also specific and related to our trauma history. Do we get a headache, a stomach ache, a back ache, a queasy feeling, a dizzy feeling, etc.? Whichever it is, each of these can be tied to some aspect of our trauma history.</p>
<p>Questioning our reactivity is a very helpful tool in managing our PTSD. Questioning our reactivity is the antidote for acting on it and doing something we may regret. Incidentally, questioning other&#8217;s reactivity is the antidote for being triggered by their behavior and reacting to it in a way that we may regret. When we are reactive it is because we have been triggered. When other people are reactive it is because they have been triggered.</p>
<p>Questioning our reactivity means not assuming that our bodily sensations are a true reflection of our thoughts and emotions. Instead of telling ourselves that we must be scared or angry or sad or whatever because our body is feeling thus and so, we should tell ourselves that we have probably been triggered. We should start wondering what has triggered us and exploring the connections between whatever happened and our trauma histories. This will give us a great many more options besides just being reactive. And of course then we will be able to have a much better outcome as being reactive almost always produces a bad outcome unless we are in real immediate danger. It the case of true danger, reactivity is exactly what we need. It is important to be able to jump out of the way of a speeding bus.</p>
<p>Desired Outcome: To learn to recognize reactivity as such, to question it and to redirect our behavior whenever we are triggered and reactive.</p>
<p>Discussion Starters: How has my reactivity has taken me into behaviors that I have regretted? What are the sources in my history of my particular forms of reactivity? What are my bodily sensations when I’m being reactive? How could I make myself more aware of these sensations as being part of my reactivity? What are the interpretations that I give to these bodily sensations? How could I be more aware of these interpretations? In what other ways might I be able to break this sequence of reactivity? What mnemonic devices might I use to help remind me to question my reactivity?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/reactivity-copyright-2009.pdf">Reactivity</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/reactivity/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Triggers</title>
		<link>http://johncflanaganlcsw.com/triggers/</link>
		<comments>http://johncflanaganlcsw.com/triggers/#comments</comments>
		<pubDate>Sun, 22 Feb 2009 19:04:32 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[coping with ptsd]]></category>
		<category><![CDATA[dealing with ptsd]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[portland ptsd therapist]]></category>
		<category><![CDATA[portland therapist]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[ptsd trigger]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[triggers]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=74</guid>
		<description><![CDATA[A colleague who specializes in PTSD once told me that it was no use trying to learn what all ones triggers were because there are so many that we couldn’t possibly learn them all. His advice was to focus on other ways of dealing with PTSD. I think there is a lot of truth to [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>A colleague who specializes in PTSD once told me that it was no use trying to learn what all ones triggers were because there are so many that we couldn’t possibly learn them all. His advice was to focus on other ways of dealing with PTSD. I think there is a lot of truth to what he says except for his conclusion that we shouldn’t try to learn our triggers. There are a lot of triggers and we couldn’t possibly ever learn them all. On the other hand the more we understand about our triggers, the better chance we have of heading them off. This same therapist on another occasion, told me that “all roads lead to Rome” meaning that we should be open to using any and all avenues available to us to gain our objective of overcoming the effects of our PTSD. Well one of those roads to Rome is learning our triggers. Okay! It’s not the royal road to recovery, but it is a help and as such should not be discarded.</p>
<p>So what is a trigger? A trigger is anything that reminds us, consciously or unconsciously, of some aspect of our trauma. Honestly, it could probably be almost anything. I tried to think of something that would never be a trigger for anyone. But <span id="more-74"></span>everything I thought of, I could immediately think of a way that it might be triggering for someone. I tried to think of something placid, tranquil and unchanging, and I thought of the moon. Well! Forget that! The moon is obviously a major trigger. Luna means moon. Lunatic means… well you get the point. The connection between a trigger and a trauma can be very direct and obvious or very indirect and obscure. It could be as direct and obvious as a person looking exactly like our perpetrator. It could be as indirect and obscure as a fear of bridges because I crossed a bridge on my way to the hospital. Never mind that I crossed bridges a thousand other times on my way to a thousand other places.</p>
<p>Another way of thinking about triggers is that they are clues. By way of example there was the client who was triggered by her husband running the clothes washer at night. She told him and herself that the noise bothered her. He couldn’t understand this, as it wasn’t noisy. And she herself didn’t quite believe her own explanation. It wasn’t until she did some trauma journaling as part of her therapy that she realized that this trigger had to do with her stepfather running the washer to cover the possible sounds of his molesting her. In this case, understanding the history helped to identify that the washer was a trigger. It can also go the other way, where recognizing that something is a trigger can help piece together a part of the history. Either way, the challenge is to make these connections between past traumas and current triggers. Often times, when we make these connections, the triggers involved lose their power over us. That is exactly what happened in the case of this client. Her husband running the washer at night no longer bothered her.</p>
<p>It is helpful to think about what might trigger us. It is helpful to recognize that there is always a possibility that we may have been triggered whenever we find ourselves being reactive. We should ask,”I wonder if something has triggered me?” It is good to think about what was going on just before we started getting reactive. There is a good chance that the first thing that comes to mind when we ask this question is the right answer. Sometimes our reactivity is very subtle and unless we are paying attention to triggers, we are very apt to rationalize away our reactivity. For example, sometime when we meet someone new, we have an immediate dislike for him or her without giving ourselves a chance to get to know the person. Chances are this dislike is because we have been triggered. Something about them consciously or unconsciously reminds us of our trauma.</p>
<p>The difference between a trigger and a normal reaction is that a trigger always has a tie to our trauma history. A trigger is an abnormal reaction based on our trauma history, but we have lived with this history for so long that we don’t have a good read on what is and is not normal. It is helpful to have people we can confide in who can be objective and help us sort out trauma reactions from normal reactions. This can be a close family member, close friend or a professional such as a trusted teacher, doctor, member of clergy or therapist.</p>
<p>The faster we get at recognizing triggers when they occur, the better off we are. If we recognize a trigger before it starts to affect us, we don’t have to go into a reactive state. If we recognize that we have been triggered when we find ourselves being reactive, we can have a chance to get out of our reactive state. Even if we only figure out the trigger after the fact, we have a better chance the next time to head off a reaction and avoid some unnecessary unpleasantness.</p>
<p>Desired Outcome: To become more conscious of our triggers and better able to identify them and use them to help us understand the connection between our trauma and our current behavior.</p>
<p>Discussion Starters: Are there times when I feel that I have over-reacted, become very emotional, tranced out, or become extremely angry that may be related to my triggers from my childhood trauma? Where do I feel it when I get into a “bad space” or a triggered place? Do I feel it in my stomach, do I get light-headed, does my heart race, fists clench, teeth grind, or do I feel numb? When do I surprise myself and not get upset about things that normally would trigger me? What do I understand about my triggers and how has this knowledge helped me? How can I determine when I’ve been triggered vs. when I am having a normal response? As I think about the concept of triggers, what new insights do I have about my triggers? What new connections can I make between my triggers and my trauma history?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/triggers-copyright-2009.pdf">Triggers</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/triggers/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Trust</title>
		<link>http://johncflanaganlcsw.com/trust/</link>
		<comments>http://johncflanaganlcsw.com/trust/#comments</comments>
		<pubDate>Sun, 25 Jan 2009 19:13:06 +0000</pubDate>
		<dc:creator>John C. Flanagan LCSW</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[coping with ptsd]]></category>
		<category><![CDATA[dealing with ptsd]]></category>
		<category><![CDATA[John Flanagan]]></category>
		<category><![CDATA[portland ptsd therapist]]></category>
		<category><![CDATA[portland therapist]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[ptsd trigger]]></category>
		<category><![CDATA[ptsd victim]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[trust]]></category>
		<category><![CDATA[trust issues]]></category>

		<guid isPermaLink="false">http://www.trauma-therapist.dreamhosters.com/?p=78</guid>
		<description><![CDATA[I figure you should approach life like everybody&#8217;s your friend or nobody is. Don&#8217;t make much difference. Kevin Kline as “Paden” in Silverado, 1985 Yes at the beginning of a relationship it doesn’t make much difference whether you think you trust the other person or you think you don’t. Either way is okay as long [...]]]></description>
			<content:encoded><![CDATA[<p></p><blockquote><p>I figure you should approach life like everybody&#8217;s your friend or nobody is. Don&#8217;t make much difference.<br />
<span style="color: #999999;"><em>Kevin Kline as </em>“Paden”<em> in Silverado, 1985</em></span></p></blockquote>
<p>Yes at the beginning of a relationship it doesn’t make much difference whether you think you trust the other person or you think you don’t. Either way is okay as long as you keep your own counsel and as long as you recognize that you are jumping to conclusions based on woefully inadequate information. At the start, you don’t know enough about the other person to decide whether or not to trust them, or more accurately to know how to trust them.</p>
<p>In thinking about the topic of trust there are several things to consider. What do we mean by trust? How does trust develop? How do we earn or build trust? How is trust lost? How is trust regained? Is it “blind trust” or are we really talking about something else? So often when I hear clients use the word “trust”, it feels like we need to stop and define our terms. One says, “I can’t trust him anymore.” Or, “I trust her completely.” I think it’s not as black and white as this makes it sound. It is foolish to totally trust or to totally mistrust. When we totally trust we <span id="more-78"></span>deny shortcomings and when we totally mistrust we deny areas of functionality. Either way we are distorting the reality with which we are trying to deal. This puts an unnecessary strain on us.</p>
<p>I propose that we define trust as knowing a person well enough to know what they will do in a given circumstance. If a person is always on time, we trust them to be on time. If they are always late we trust them to be late. If you can accept my definition, then the rest falls into place. Trust develops as we get to know someone. We earn trust by consistently behaving well. We lose trust by behaving badly. We regain trust by not letting it happen again. However, other factors come into play. There is the matter of intermittent reinforcement being stronger than consistent reinforcement. If someone is inconsistent, we don’t know what to expect. Therefore it is harder to feel a sense of trust for what they will do. We tend to feel less kindly disposed towards the person who is late half the time than toward the one who is always late.</p>
<p>In the case of those of us with histories of trauma, our history comes into play. There were people who abused us, misused us and confused us. They probably are the primary source of our confusion about trust as well as of our tendencies to see issues of trust in black and white terms. Mostly our trust issues are really about trusting our own ability to correctly size up a person or situation. It is this lack of trust in our own assessment abilities that is at the core of most of the difficulties that we have with trust.</p>
<p>We try to remedy our lack of confidence in our own abilities to assess what another person will do by replacing our judgment with a set of rules. We decide to trust everyone until they prove themselves unworthy. We decide to trust no one unless they prove themselves worthy. We trust someone completely until they make a misstep and then we don’t trust them at all. We decide to trust blue-eyed people but not brown-eyed ones. Then we don’t know what to do if someone has hazel eyes. We make up tests to assess someone’s trustworthiness. We trick him into lying to us just so that we can prove that he’s not trustworthy.</p>
<p>I think that we would do better if we recognized that we know what we know, and that we can make an adequate assessment if we have enough data. If we can’t make up our minds or if we are indulging in black and white thinking, then we probably don’t have enough data. We need to keep our minds open and our options open until we do have enough data. We need to keep our senses open to receive additional input so that we can make the most informed decision possible.</p>
<p>As we consider how we trust people, it is helpful to be clear about what trust is, the role it has played in our lives, and how our sense of trust has been impacted by our trauma. We need to realize that what we have learned through our experiences colors how we think about and make decisions about trust. Being more open minded about people is crucial to having successful relationships. It is helpful to realize that trust is based on knowledge. Paying attention to the need to collect as much knowledge as we can, will help us in all our relationships.</p>
<p>Exercise: Examining your own life experience, consider the following: What happened to your sense of trust as you were growing up? If you had trauma, how did it impact your sense of trust? Who in your life have you trusted the most and who the least? Did your sense of trust for these people change and if so what changed it? Who and how do you trust today? Would a new concept of trust help you to deal better in your relationships?</p>
<p>For a downloadable version of this article, click here: <a href="http://johncflanaganlcsw.com/wp-content/uploads/2009/04/trust-copyright-2009.pdf">Trust</a></p>
]]></content:encoded>
			<wfw:commentRss>http://johncflanaganlcsw.com/trust/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
	</channel>
</rss>

