Posts tagged ‘ptsd’

July 24, 2018

Speed Kills

Remember the ad campaign, Speed Kills? I can’t remember if I first heard the term in an anti-drug campaign or an attempt to reduce speed limits. The phrase has been used for both. This week, I’m thinking of Speed Kills in totally different terms.

Last weekend I went to see Won’t You Be My Neighbor. This movie chronicles the career of Fred Rogers, the creator of MISTER ROGERS’ NEIGHBORHOOD. There was nothing speedy about Mister Rogers. His slow pace stands in stark contrast to other children’s entertainers. This was deliberate. It was also significant.

Mister Rogers understood that very important things happen when we’re still and quiet. He included long pauses and silence in his television program. This is considered a no-no in the TV world, but as someone observed in the movie, there were many times when nothing much was going on, but none of the time was wasted.

On some level, parents and children must have sensed the significance of this. They certainly responded. Mister Rogers became hugely successful in spite of doing everything “wrong” for a television audience.

In my home, I observed that when my boys watched MISTER ROGERS’ NEIGHBORHOOD their behavior was markedly different than when they watched He-Man. He-Man led to an afternoon of hitting each other, breaking toys, and generally violent behavior.

MISTER ROGERS’ NEIGHBORHOOD, on the other hand, had a calming effect. After watching, the boys were kinder, gentler, and quieter. They played together instead of fighting. My house was infinitely more peaceful.

At the time, I didn’t take time to analyze why this was true, I just did the practical thing and banned He-Man. If I needed the kids to have screen time so that I could clean up the kitchen or do the laundry, we opted for MISTER ROGERS’ NEIGHBORHOOD or the video disc Free to be You and Me.

Now, with much more experience under my belt including many years of working long hours, never missing an event, frequent travel, work-work-work-play-play-play and rarely saying no, I understand the importance of being still. Being present requires taking pauses to notice what has happened and how it makes us feel.

I know you may read that and say, “duh,” but look at how we live. We rarely pause between activities, much less during them. We fill our waking hours with movement, noise, and electronic distraction.

One of my grandchildren has 4 structured activity classes per week – he’s 9 months old! Will he be able to lie on his back, stare at the clouds smelling fresh-cut grass and feeling the solidness of the ground supporting him when he’s three or will he be lost without constant activity?

It seems we have some level of awareness that we need to increase our sense of well-being. Ways to increase wellness are often featured on morning TV. The number of people practicing yoga in the US has doubled since 2008. The mindfulness movement touts the health benefits of meditation.

In contrast, we see our friends, neighbors, and family members numb themselves with work, gaming, social media, TV, sex, food, alcohol, and drugs on a regular basis. Sometimes we see ourselves doing the same. If we know we need to feel better, and we know that slowing down to reflect and be present in the moment will help, why do we keep speeding forward?
speed
What’s difficult to admit, much less discuss, is what lies underneath a need to speed through life at a level of maximum distraction. If you have lived in an environment of chaos and/or danger to your physical or emotional well-being that you could not escape, it is excruciatingly hard to sit still and be present. It is also necessary if you are to heal the wounds your spirit has suffered.

It is in this context that I now view the phrase – speed kills. Speed kills our connection to our spirit. This removes us from knowing, accepting, and loving ourselves. It removes us from the very best parts of ourselves. At its worst, this disconnect allows us to act out our anger, hurt, and frustration in vindictive, destructive ways.

In the face of a tragic, hostile act, we often wonder – what kind of person would do that? Often the answer is simple: someone who has suffered in ways you cannot see and may not be able to imagine.

Remaining present and emotionally open in the face of violence, humiliation, rejection, neglect, or shunning, is intolerable for most everyone. It is absolutely healthy in those situations to engage in fighting, fleeing, freezing or fawning in order to protect yourself.

The problem is many, not just some, MANY of us have lived in an environment in which violence, humiliation, rejection, neglect, or shunning were the norm. Living in persistent, unrelenting physical and/or emotional danger creates wounds that are both physical and emotional and result in disconnection from ourselves. Constantly being in a state of fighting, fleeing, freezing or fawning creates long-term barriers to calm, peace, connection and joy.

When we have the strength and courage to sit still and be present, it opens the door for all the emotions we have been avoiding to come rushing in. This is a great opportunity to release those emotions and the hold they have over us. That’s easy to say, but terrifying and hard for many of us to do even if it is worth it in the long run.

I’ve spent years unraveling the knots in my stomach and my spirit. I know that I did not choose the environment that created them. I was born into it. Accepting this hasn’t eliminated the seemingly bottomless well of sadness I feel in my solar plexus. It hasn’t removed every trigger that can send me into an emotional flashback that I simply can’t outthink. (I know this isn’t some particular defect in me. Signals from the amygdala can override executive function, but it still feels terrifying and out of control.)

Mindfulness has helped me rewire my brain away from anxiety toward noticing small ways in which I feel good. I feel less braced for the (as I learned to view the world) next inevitable attack. My new level of awareness lets me deliberately shift my focus in order to feel better in a given moment.

I am painfully aware how difficult it can be to find support for a healing path. Even places we expect to provide a cushion for processing trauma, grief, depression, anxiety, and somatic symptoms – the therapist’s office, doctor’s office, church, or support groups, may not provide the type of support we need. Feeling unseen, unheard, dismissed, targeted, or misunderstood can leave us feeling even more alone and, sometimes, revictimized.

Healing can bring immediate improvement, but I do not know of a straight or swift path to wholeness. That journey is a process unique to each of us. The best support along the way is to be seen and accepted just as we are at any given moment.

Perhaps this is why I so appreciate Mister Rogers simple affirmation that he likes us just as we are. But I cannot fully receive that message unless I am sitting still.

http://www.doitnow.org/pages/psas.html

http://focusfeatures.com/wont-you-be-my-neighbor/

https://www.fredrogers.org/

https://en.wikipedia.org/wiki/Free_to_Be…_You_and_Me

https://tricycle.org/trikedaily/untold-story-america-mindfulness-movement/

http://childhood-developmental-disorders.imedpub.com/systematic-review-of-mindfulness-induced-neuroplasticity-in-adults-potential-areas-of-interest-for-the-maturing-adolescent-brain.php?aid=8553

https://seattleyoganews.com/yoga-in-america-2016-statistics/

https://www.speakcdn.com/assets/2497/domestic_violence2.pdf

http://besselvanderkolk.net/the-body-keeps-the-score.html

http://www.traumasensitiveyoga.com/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518443/

http://www.cooking2thrive.com/blog/yoga-perfect-home-workout/

http://www.cooking2thrive.com/blog/sometimes-stop-order-start/

http://www.cooking2thrive.com/blog/travel-tip-17-stay-home/

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

July 16, 2018

Here’s an Idea for an App

brainHere’s an idea for an app: Wouldn’t it be great if there were a smartphone app that could scan my tummy & tell me why it’s hurting? Is it a stomach virus, gluten exposure, FODMAP related, lactose intolerance, corn intolerance, salmonella, too much guar gum or carrageenan, natamycin, not enough fiber, too much fiber, the frequency of meals, or the fact that my sister is coming to visit? I’m willing to do whatever it takes to make it stop hurting. The problem is, it’s often difficult to determine what that is.

I was recently part of a team that reviewed a pilot research grant for a study of the effectiveness of an app vs traditional treatment. While we ultimately chose not to fund that particular grant, I see great possibilities in the future of apps to assist healthcare professionals with diagnosis and treatment of disease and chronic conditions, the physical manifestations of trauma, and mental health issues in general.

While the human element offers insight that may be missed by technology, it also brings inherent bias and inconsistency. In the 1960s, the Oregon Research Institute set out to study how experts rendered judgments. Lew Goldberg, a psychologist, developed a case study in which researchers gathered a group of radiologists and asked them how they determined from a stomach X-ray whether a patient had cancer.

The doctors indicated that there were seven major cues that they looked for. In an effort to create an algorithm that would mimic the decision making of doctors, the researchers created a simple algorithm in which the likelihood of malignancy depended on the seven cues the doctors had mentioned, all equally weighted.

Researchers then presented the doctors with X-rays from 96 different individual stomach ulcers and asked them to rate each one on a seven-point scale from definitely malignant to definitely benign. Without disclosing what they were doing, the researchers showed the doctors each ulcer twice with the duplicates mixed in randomly so that the radiologists wouldn’t notice the duplication.

All data were transferred to punch cards and sent to UCLA for computer analysis. When UCLA sent back the analyzed data, it became clear that this simple computer model was surprisingly good at predicting the doctors’ diagnoses. Even more surprising, the data showed that the diagnoses were all over the place. In spite of the fact that they were trained experts, the radiologists didn’t agree with each other. In fact, they often didn’t agree with themselves. Every single doctor had sometimes contradicted his own diagnosis when given a duplicate X-ray.

The researchers also found that clinical psychologists and psychiatrists deciding whether it was safe to release a patient from a psychiatric hospital wildly differed from each other in their determinations. Further, those with the least training were just as accurate in their judgments as those with more training.

The Oregon researchers then tested the hypothesis that the simple computer model they had designed might be better than doctors at diagnosing cancer. Turns out, the algorithm outperformed even the single best doctor in the group of doctors being studied.

What Goldberg came to realize was that doctors had a good theory of the cues to look for in diagnosing cancer, but in practice they did not stick to their own ideas of how to best diagnose. They tended to weigh things differently. As a result, they were less accurate than a computer model.

Given our current reliance on experts to diagnose, this research isn’t particularly reassuring; however, it does bode well for the inclusion of artificial intelligence in diagnostic procedures. That’s right, just the sort of technology that could be deployed by an app on my handheld device.
floating apps
Here’s an idea for an app

A decade ago, I attended the Game Developers Conference in Austin, Texas. There were sessions on massively multiplayer online (MMO) games, animation for video games, avatar development, and artificial intelligence in video games. I remember thinking as I sat through one of the sessions – the highest and best use of characters in a game who can learn from conflict would be to develop “games” or tools for families to learn to resolve conflict and improve communication.

If I create an avatar that behaves like me at first, but learns better ways to navigate specific situations, I can learn to improve my game, i.e., my life. With the distance of “playing” myself, I gain perspective. I still think there’s great potential for emotional and social growth applications.

Here’s an idea for an app

A couple of months ago, I spoke to the Trauma Institute & Child Trauma Institute in Northampton, MA about a new progressive counting method used to treat PTSD and the effects of childhood trauma. Essentially, the patient verbalizes their first chronological memory of trauma while the therapist counts. This process continues until the distress associated with that memory is resolved. Then the patient moves on to the next distressing memory and repeats the process.

I’m sure it’s a little more complicated than that, but my first thought was – I wonder if you can make a phone count out loud? If so, it seems like a lot of this could be done with a smartphone. Maybe you’d do a couple of sessions with a practitioner at the beginning and periodically thereafter, but the rest could be done in the safety and comfort of your own home. We need an app for that.

Well researched and well designed apps have the potential to propel us forward. Whether or not they include my ideas, I’m excited about their incorporation into medical and mental health practices.

http://www.ori.org/scientists/lewis_goldberg

http://www.ori.org/

http://psycnet.apa.org/record/1970-12828-001

http://michaellewiswrites.com/#top

http://www.childtrauma.com/

http://www.gdconf.com/

http://www.cooking2thrive.com/blog/make-it-easier-to-stick-to-your-eating-plan/