“The PTSD Workbook is an outstanding aid to those recovering from exposure to traumatic life events and the symptoms of post-traumatic stress disorder (PTSD). For use while in psychotherapy or by itself, this workbook provides an important guideline and template for moving forward with life. Derived from considerable clinical experience and up-to-date with recent research on recovery, The PTSD Workbook is an invaluable addition to the growing number of clinical tools to improve resiliency and enhance healthy outcomes.” —Terence M. Keane, PhD, associate chief of staff for research and development at the VA Boston Healthcare System, director of the behavioral science division of the National Center for PTSD, and professor of psychiatry and assistant dean of research at the Boston University School of Medicine “This is a treasure trove of a book filled with up-to-date information on trauma, with the best collection of self-help methods in the field. It is easy to understand, and will be a resource for all individuals who are suffering from the effects of traumatic events, as well as for professionals.” —Atle Dyregrov, PhD, clinical and research psychologist, and head of professional issues at the Center for Crisis Psychology in Bergen, Norway; professor of clinical psychology at the University of Bergen, Norway; author of Disaster Psychology, Children in War, Grief in Children, and Supporting Traumatized Children and Teenagers; founding member of the European Society for Traumatic Stress Studies; and chair of the Children and War Foundation “This update of The PTSD Workbook nicely reflects the authors’ sensitive understanding of psychological trauma and resilience. It provides individuals suffering from post-traumatic stress disorder (PTSD) and their professional helpers with an impressive compendium of self-help and therapeutic techniques. Each of its twelve chapters is full of easy-to-use exercises that allow readers to decide which techniques are most suited to their individual situation. Anyone with a personal experience of, or exposure to, traumatic events will learn something useful from an encounter with this excellent work.” —Joseph H. Albeck, MD, clinical associate in the department of psychiatry at McLean Hospital in Belmont, MA; Chairman (Emeritus) for the Intergenerational Transmission of Trauma and Resilience Special Interest Group of the International Society for Traumatic Stress Studies (ISTSS); and cofounder of the New England Holocaust Memorial “This is an extremely helpful book for trauma victims and facilitators, but also for you and me, to own and look into it daily.” —Hédi Fried, psychologist, writer, teacher, Holocaust survivor, author of The Road to Auschwitz, and winner of the 2015 Public Advocacy Award from the International Society for Traumatic Stress Studies (ISTSS) Publisher’s Note This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought. Distributed in Canada by Raincoast Books. Elements from The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment by Babette Rothschild. Copyright © 2000 by Babette Rothschild. Used by permission of W. W. Norton & Company, Inc. “Assessing Your Self-Criticism,” “Using Self-Compassion Phrases,” and “Fostering Self-Compassion” adapted from SELF-COMPASSION: STOP BEATING YOURSELF UP AND LEAVE INSECURITY BEHIND by Kristin Neff, copyright © 2011, published by HarperCollins Publishers. Used by permission of author. Copyright © 2016 by Mary Beth Williams and Soili Poijula New Harbinger Publications, Inc. 5674 Shattuck Avenue Oakland, CA 94609 www.newharbinger.com Cover design by Amy Shoup; Edited by Brady Kahn; Acquired by Catharine Meyers; Text design by Tracy Marie Carlson All Rights Reserved Library of Congress Cataloging-in-Publication Data on file One never knows the curves that life brings. In the second edition, I dedicated this book to my children, never imagining that January 2014 would bring the unexpected death of my son Cary. This revised edition is dedicated to him and his strong will to live. —MBW I would like to dedicate this book to my mother, Maria, a war orphan herself, and the mother of mothers. —SP This book is also dedicated to survivors throughout the world. It is also dedicated to all the helping professionals, members of the military, law enforcement officers, and fire, rescue, and EMT personnel who serve in spite of the challenges, danger of compassion fatigue, and certainty of impact of the work on their own lives, including potential loss of life. —MBW and SP Contents Introduction —Mary Beth Williams 1: A LOOK AT TRAUMA Trauma Stories Defining Trauma Reacting to Trauma Pre-event Factors Event Factors Post-event Factors Acute Stress Disorder Post-traumatic Stress Disorder Symptoms of PTSD Are There Different Types of PTSD? Remembering Trauma Psychoeducation Why Remember? Who Are You? Feeling Safe 2: BEFORE DOING THE WORK: SAFETY, SECURITY, AND INTENTION Safety Staying Grounded Types of Safety Creating a Safe Place Keeping Your Safe Space Safe Getting to Your Safe Place Through Visualization Checking In with Yourself Relaxation and Breathing Techniques Progressive Relaxation Another Relaxation Technique Trying Meditation for Relaxation Using Mindfulness to Help You Relax and Feel Safe When to Take a Break from Doing Work in This Workbook 3: IDENTIFYING AND WRITING ABOUT WHAT HAS HAPPENED TO YOU Creating Your Own SUDS More About Memory and Remembering Constructing a Trauma Inventory Creating a Trauma Time Line Healing by Writing: Creating Your Own Trauma Story Time to Heal 4: HELPING YOURSELF WHEN YOU REEXPERIENCE A TRAUMA Building Dual Awareness The Rewind Technique Containment and Traumatic Memories Dealing with Traumatic Dreams Dealing with Your Flashbacks as Dissociation What Is Dissociation? What Does It Mean to Have a Flashback? The DVD Technique Getting Outside Your Head Other Ways to Deal with Flashbacks Using Dual Awareness to Treat Flashbacks Changing Negative Thoughts to Positive Triggers: Reminders of Trauma Across the Senses Managing Trigger Events The Trigger Mapping Ladder Using Activities and Anchors to Reduce Triggers Exposing Yourself Safely to Your Past Traumas The Flower Diagram Avoiding Avoidance 5: COPING WITH TRAUMA WITH LESS AVOIDANCE Using Avoidance to Cope The Practical Function of Avoidance Dissociation as an Avoidance Mechanism What Can You Do About Dissociating? Consequences of Dissociation Reducing Dissociation as Avoidance Working to Reduce Other Types of Avoidance Keeping Safe as You Try to Lessen Avoidance Tolerating Your Fears Other Ways to Reduce Avoidance 6: DEALING WITH CATEGORY D SYMPTOMS: PART I Dissociative Amnesia Negative Beliefs About Self, Others, and the World Where Beliefs About the Self Come From Challenging Core Beliefs Challenging Beliefs About Trust and Betrayal Challenging Beliefs About Self-Esteem Ways to Raise Your Self-Esteem Challenging Beliefs About Intimacy Blaming Yourself or Others for the Trauma Looking at Blame Self-Compassion Self-Kindness Common Humanity Mindfulness What About Forgiveness? Self-Forgiveness Challenging and Modifying Your Beliefs Through Affirmations 7: DEALING WITH CATEGORY D SYMPTOMS: PART 2 Long-Lasting Negative Emotions Emotions as Messengers of Information Looking at Emotions That May Persist Negatively Fear Anger and Rage Expressing Anger Anger as a Warning Depression Guilt Survivor Guilt Healing from Survivor Guilt Making Amends Shame Helplessness Sadness Grief and Loss Using Feelings Appropriately Expressing Emotion Being Afraid to Have Feelings Finding Joy and Happiness What Is Your Worldview? Dealing with Worry Substituting Happiness for Sadness Loss of Interest in Doing Things Feelings of Detachment or Estrangement from Others Setting Good Boundaries Communication Techniques Active Listening Asking Questions Describing Feelings Describing Behavior Using Humor Using I-Messages Communication Styles Small Talk Control Talk Search Talk Straight Talk Final Thoughts on Communication 8: LESSENING AROUSAL: WHAT TO DO IF YOU CAN’T SLEEP, CAN’T RELAX, OR ARE ANGRY AND IRRITABLE Techniques to Improve Sleep Another Sleep Routine Good Sleep Hygiene Anger: A Signal Emotion Resolving Anger Coping with Irritability Relaxing to Control Anger and Irritability Anger and Self-Care Using Mindfulness to Lessen Anger and Irritability Reducing Anger by Setting Boundaries Physical Boundaries Emotional Boundaries Distractibility and Trouble Paying Attention Hypervigilance, Heightened Awareness of Danger, and Startling Easily Reckless, Risk-Taking, or Self-Destructive Behaviors Self-Harm Self-Injury as a Type of Self-Harm Beliefs Leading to Self-Injury
Description: