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Living Well, Value-Based Living.

5/1/2014

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One of the first questions a Therapist asks the client in Therapy is "What would you like to accomplish in treatment?" Surprisingly, this is a difficult to answer for many.  Of course, people want to feel better and reduce symptoms of anxiety or depression. However, a deeper question is "If you didn't have anxiety or depression, how would your life be different? What would you do differently with your life?"

Mental Health treatment used to be stuck in a disease-oriented model, focusing excessively on symptoms and ignoring the whole person. Fortunately, the trend has begun to shift in recent years to embrace a positive psychology approach. Rather than focus solely on symptom alleviation, many types of therapy today help people feel better by connecting the individual with their core values that have been neglected or forgotten due to being overwhelmed by mental illness. 


In one type of therapy called "Acceptance and Commitment Therapy," people discover that they are depressed or anxious because they are not engaged in behaviors that are consistent with their values. Values such as integrity, relationships, spirituality, community, work, recreation, and physical health help give our life purpose and meaning. The loss of a "value-based life" makes the road to recovery difficult, especially without a moral compass to guide you through hard times and give you inner strength. 

Fortunately, you never lose your value system (although priorities may change over time). Reconnecting with your core values helps motivate you, and gives you courage and commitment to take small steps to reestablish the things you love.  How has connecting with your values helped you overcome stress and adversity? 

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The Top 50 Most Common PTSD Triggers

3/14/2014

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  1. Sitting at the food court in the mall
  2. Certain smells that remind you about the traumatic event (for example diesel, the cologne of the perpetrator, burning trash)
  3. Seeing people that are the same ethnicity/gender/age as the perpetrator
  4. Hearing Fireworks
  5. Not sitting with your back to the wall
  6. Not scoping out emergency/contingency exits
  7. Not carrying a weapon with you in public
  8. Enclosed spaces such as elevators
  9. The sight of raw meat
  10. Eating beef or cooked meat
  11. Driving in the slow lane on the freeway
  12. Seeing a movie about war/combat
  13. News stories on TV about war/combat
  14. Seeing people in the military/ wearing uniforms
  15. Being near people in authority (Police Officers)
  16. Not checking/rechecking doors/locks/windows multiple times at night
  17. Not wearing multiple layers of clothing to sleep at night
  18. Not bringing prescription medications in case of a panic attack
  19. Going to an unfamiliar places spontaneously without planing
  20. Going to a big box stores (Walmart, Target, Costco) without a clear exit
  21. Introducing yourself to a stranger
  22. Not bringing your cell phone with you in case of an emergency
  23. Sexual intimacy with your partner 
  24. Emotional Intimacy (For example, telling your wife or husband you love him or her)
  25. Physical intimacy (For example giving a friend a hug or letting someone pat you on the back)
  26. Getting a massage
  27. Listening to noises of war/combat on the internet
  28. Hearing a song that reminds you of someone that was killed
  29. Visiting a cemetery or funeral
  30. Going swimming or being in the ocean
  31. Undressing in front of others at the gymnasium's changing room
  32. Seeing a violent play or theater production
  33. Waiting in lines at grocery stores
  34. Sitting in the passenger seat of a car and letting others drive
  35. Wearing clothes that attract attention in public (for example a colorful yellow scarf)
  36. Wearing flip flops or shoes where escape would be difficult
  37. Not going to sleep before others are already asleep
  38. Sleeping near a window
  39. Performing at an open mic night at a coffee shop
  40. Driving on a bumpy road
  41. Going through an automatic car wash
  42. Talking to a loved one about the details of the traumatic event
  43. Opaque shower curtains
  44. Going to a crowded concert venue
  45. Being around children in the playground
  46. Going on a roller coaster
  47. Seeing trash on the side of the road
  48. Going to a big box store on "Black Friday"
  49. Going to a cinema on a movie's opening weekend
  50. Visiting a haunted house on Halloween

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PTSD Resources 

2/28/2014

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Interested in Getting Help? Click Here For a Free Consultation

Education about PTSD
National Center for PTSD  

Coping techniques for PTSD
PTSD Coach App on Google Play (Android)
PTSD Coach App on Apple iTunes (iOS)

Crisis and Suicide
Veterans Suicide Hotline
The National Sexual Assault Hotline (1.800.656.HOPE) and Online Hotline (rainn.org)

Therapies for PTSD
Prolonged Exposure Therapy
PE Coach App on Apple iTunes (iOS)
PE Coach App on Google Play (Android)
Cognitive Processing Therapy
Eye Movement Desensitization Reprocessing (EMDR)

Reducing Stigma
PTSD About Face

Books about PTSD
Achilles in Vietnam: Combat Trauma and the Undoing of Character by Johnathan Shay, M.D.
Odysseus in America: Combat Trauma and the Trials of Homecoming by Johnathan Shay, M.D.

Military and Veteran Organizations
Department of Veterans Affairs
Vet Centers
Wounded Warrior Project

Military Musters
Guardian Angels for Soldier's Pet

Male survivors of sexual abuse
1 in 6 Organization

Refugee and Political Prisoners
International Survivors of Torture

Nonprofit Organizations
Sidran Institute 

Research Organizations
International Society for Traumatic Stress Studies
Trauma Research Institute
Institute on Violence, Abuse, and Trauma

American Psychological Association's Division 56 Trauma Psychology

Resources for Family/Friends of Individuals with PTSD
National Alliance on Mental Illness
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PTSD InfoGraphic

1/27/2014

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Very informative PTSD infographic. Credit goes to the website: www.bestmastersincounseling.com
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Emotional Support Animals and PTSD

1/21/2014

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Having an animal companion may alleviate symptoms of anxiety and depression associated with PTSD. Many people say that having a connection with a pet decreases levels of stress, promotes an active lifestyle and increases engagement in physical activity, and provides a sense of comfort and close companionship. You may also be more likely to increase social interactions with other pet owners at parks or beaches because you share similar interests.


Although more scientific research is needed to evaluate the benefit of emotional support animals on PTSD, many people report a decrease in stress from having a furry companion. Some researchers worry that individuals who have an emotional support animal may be inhibited from seeking professional help. However, having a therapeutic animal can serve as a bridge to getting help and becoming engaged in their recovery.

In some states, the designation of an emotional support animal allows the handler to bring a dog or cat to places in which they would be otherwise excluded. For example, some housing or apartment complexes may allow the tenant to own a pet if it is recommended by a doctor. The dog owner may also be able to fly on a plane if permitted by the airline. To get special consideration, the dog owner needs to show a letter of recommendation and qualifications from the mental health provider.

Taking care of a pet is a huge responsibility and for some people it is recommended to wait until their symptoms improve to own a pet. Additionally, it is strongly recommended for the safety and well-being of the public that the pet receive formal training and certification to become a therapy dog. 

For more information about emotional support companions and PTSD, check back for additional updates.

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Top Six Myths That Prevent People from Seeking Treatment for PTSD

1/7/2014

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An estimated seven percent of people will suffer from PTSD at some point in their lifetime, yet there continues to exist major barriers to receiving care for PTSD and other mental disorders. What are the obstacles for people seeking treatment for PTSD? Here are the top myths that get in the way of asking for help.

Myth: "No one can help me."

Response: Some people believe that PTSD is "just something I have to always live with." They are unaware that there are very effective psychotherapies that can reduce or eliminate symptoms entirely. Thinking that things can't get better is often a sign of hopelessness. That too, can get better with treatment. Most people report that their ability to cope with painful memories and emotions do improve with treatment. PTSD is a recoverable condition! 

The most successful therapies are cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing. Medications have been shown to be helpful too. Some names of medications are paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine. A medication called prazosin has also been shown to be helpful for reducing the frequency of nightmares. 

Myth: "I should be able to cope with my emotions."

Response: Coping with emotions after a trauma is difficult for almost everyone. It is normal to need additional support from friends, family, or mental health professionals. Good psychotherapy aims to enhance your existing strengths and encourage an atmosphere that fosters growth and creativity. Regular sessions with a qualified mental health professional can give you an opportunity to find new ways to cope with your emotions in a warm, supportive environment.  


Myth: "It's not necessary to contact a doctor."

Response: PTSD is a serious mental health illness that can have a significant impact on physical health, quality of life, and relationships. PTSD is associated with higher risk of relationship dissatisfaction and marital conflict. The long-term effects of stress and anxiety have been shown to affect productivity at work and result in additional sick days. Why wait when you can address the problem now and begin enjoying your life?


Myth: "The problem will get better on its own."

Response: For some people, PTSD symptoms can get better over time by itself. However, for most people, PTSD symptoms do not go away by itself. In fact, there are studies of World War II Veterans and Holocaust survivors with symptoms lasting longer than 50 years! A problem ignored usually just gets worse over time. 


Myth: "I'm too embarrassed to discuss the problem with anyone."

Response: PTSD is NOT something to feel ashamed about. It is often referred to as a normal reaction to an abnormal event. Biologically, we are hard-wired to respond to life and death situations with the "fight-or-flight" mechanism. This universal and adaptive reaction to threat is alsowhat triggers PTSD! Education about these normal reactions is an important step in recovery. 

It does take courage to admit there is a problem and willingness to seek treatment. Thankfully, there are more role models coming forward who can normalize symptoms of PTSD. Recently, the recipient of the medal of honor acknowledged his struggle with PTSD and the support he received from mental health professionals. 


Myth: "If I seek help there will be consequences (for example, I would be hospitalized)."


Response: Mental health professionals value your trust and go to great lengths to respect your privacy and rights as an individual. There are health laws that protect your confidentiality and individual freedoms. Involuntary hospitalization only occurs under extreme circumstances to prevent imminent harm to yourself or others. Most people receive treatment on an outpatient basis and come to weekly therapy sessions to see benefit. 

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Posttraumatic Stress Disorder: News, Research, and Resources.

12/31/2013

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Welcome to my first blog post! This website is dedicated to providing current news, research, and resources for posttraumatic stress disorder or PTSD. Many people are unaware of the symptoms of PTSD, and even fewer people know that there are effective treatments for the disorder. It is my hope that this website and blog will provide a place for both the public and professionals to access a compendium of resources to help those suffering from the condition. Check back soon for additional topics such as: reducing stigma in PTSD, service animals and other alternative treatments, and support for family and loved ones of individuals with PTSD.
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    Dr. Sage Schuitevoerder is a Licensed Clinical Psychologist in San Diego who offers Psychological Assessments & Individual Counseling. For more information, click here.

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  • About Dr. Sage
  • Services
    • Online / Live Video Sessions
    • Trauma & PTSD
    • Prolonged Exposure Therapy
    • Cognitive Processing Therapy
    • Eye Movement Desensitization Reprocessing (EMDR)
  • Resources
  • Fees
  • Contact