The PTSD Workbook, Third Edition: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms

403 Pages·2016·1.88 MB·English

by  Williams

“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