Treatment of specific phobia in older adults

Phobia Release Program

The curative methods that are described in the 5-Day Phobia Release Course are psychologically proven and are vouched for by many phobic patients, who no longer feel the fear. Each technique is something that you can perform them on your own. Each technique is easy, described in plain, ordinary English and requires no more than a couple of minutes to do. In all, the course contains 9 exercises, organized into 5 days for your convenience. You also receive some background information about Neuro-Linguistic Programming and references for further reading on Nlp if you are interested in learning more.

Phobia Release Program Summary

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Ptsd And Fast Phobia Relief Self-help Audio Program

This audio home study program was developed by Robert Mantell, the founder and executive director of BrightLife Phobia And Anxiety Release Center. With this audio program, you'll get 3 full-length CDs and more than 180 minutes of revolutionary mental repatterning tools, strategies and techniques. You'll learn the basics about fear and anxiety, how to neutralize past fears and how to condition yourself for success and self-confidence. How to Free Yourself from Trauma, Phobias And Anxiety in 7 Days Or Less! introduces Imagination Creation Accelerated Personal Breakthrough Technology that will lead to quick and easy relief. Free yourself from anxiety, fears, phobias and post-traumatic stress disorder (Ptsd) with the help of How to Free Yourself from Trauma, Phobias And Anxiety in 7 Days Or Less!

Ptsd And Fast Phobia Relief Selfhelp Audio Program Summary

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Dissociative Symptoms As Predictors Of Ptsd

Dissociative symptoms, especially numbing, have been found to be rather strong predictors of later post-traumatic stress disorder (McFarlane, 1986 Solomon, Mikulincer et al. 1989 Koopman et al., 1994, 1996 Classen et al., 1997). McFarlane found that the time course of dissociative symptoms is critical in the prediction of subsequent PTSD (McFarlane, 1997). Automobile accident victims' dissociation scores on the day of the trauma did not predict subsequent PTSD symptoms, their dissociation scores at 10 days did. Thus a failure to readjust quickly after trauma seems to place people at higher risk for later PTSD. Thus, physical trauma seems to elicit dissociation or compartmentalization of experience, and may often become the matrix for later post-traumatic symptomatology, such as dissociative amnesia for the traumatic episode. Indeed, more extreme dissociative disorders, such as Dissociative Identity Disorder, have been conceptualized as chronic Post-traumatic Stress Disorders (Spiegel,...

Brief History Of Ptsd

There has been a tendency to slip into one of two mistaken extremes in regard to PTSD. One is a cynical attitude which implies that most patients are making up their symptoms for secondary gain. An example is a case in which an armored car driver was shot in the chest three times during a robbery. His two colleagues were killed as they were walking out of an elevator. The company he worked for objected to providing treatment for post-traumatic stress disorder. This was not some fantasy of childhood sexual abuse he took three bullets in the chest and saw two of his friends die and yet there was doubt that he had genuine psychiatric symptoms afterwards. One of our professional responsibilities is to have the kind of educated empathy to understand what it is like to go through this and be able to articulate that. Post-traumatic symptoms often involve considerable (and frequently inappropriate) guilt about imagined or real lapses during the traumatic event. This can generalize into a...

Neuropsychological Outcomes

There has also been recent research looking at the prevalence and predictors of post-traumatic stress disorder (PTSD) after mechanical ventilation for ARDS. Schelling and colleagues used a questionnaire called the Post Traumatic Stress Syndrome 10-Questions Inventory (PTSS-10) with 80 survivors of ARDS with a median time since ARDS of 4 years and excluded patients with head trauma or pre-existing neurological or psychiatric diseases 40 . These authors found that 28 of the ARDS survivors had a PTSS-10 score above the cut-off for PTSD, a significantly higher proportion than two control groups patients who had undergone maxillofacial surgery and German United Nations soldiers who had experienced prolonged service in Cambodia 40 . These authors showed that if patients reported memories of traumatic experiences during their ICU stay, including memories of respiratory distress, feelings of anxiety, pain, or nightmares, they were more likely to have symptoms of PTSD. It remains unclear...

Memory Repression And Recovered Memory

Despite the consistency and reliability of this type of finding, laboratory research has been rejected by some as irrelevant to the debate about recovered memory. For instance, Freyd & Gleaves (1996 Kristiansen, Felton & Hovdestad, 1996 van der Kolk, 1994 but see Roediger & McDermott, 1996) argued that laboratory research on memories of benign, artificially constructed stimuli tells us nothing about processes involved in memory for severely traumatic events. However, recognizing that memory is malleable does not mean recovered memories of childhood abuse are necessarily inaccurate it simply means they are not necessarily accurate. Whereas there is clinical observation and personal anecdote that individuals may avoid or be unaware of threatening memories (Martinez-Taboas, 1996), such memories can be influenced by various cognitive and social events (Loftus, 1993). In other words, there is no strong reason or evidence why memory for traumatic events should follow entirely different...

F440 Dissociative amnesia

The main feature is loss of memory, usually of important recent events, that is not due to organic mental disorder, and is too great to be explained by ordinary forgetfulness or fatigue. The amnesia is usually centred on traumatic events, such as accidents or unexpected bereavements, and is usually partial and selective. Complete and generalized amnesia is rare, and is usually part of a fugue (F44.1). If this is the case, the disorder should be classified as such. The diagnosis should not be made in the presence of organic brain disorders, intoxication, or excessive fatigue.

Uncovering Age Regression Approaches Intrapsychic Conflicts

A significant amount of more recent case material also utilizes hypnotic techniques within a psychodynamic framework. Alden (1995) reports the case of a 35-year-old man with long-standing symptoms of anxiety, depression and multiple traumas, involving the use of hypnosis to provide a 'safe, relaxing framework for the client's therapy and regression to traumatic events'. Gravitz (1994) describes a treatment method illustrated by three cases involving the retrieval and restructuring of past memories of traumatic experiences using hypnotic regression and revivification. Leistikow (1990) details the case of a male patient undergoing hypnoanalysis for depression using techniques such as word association, dream suggestion and age regression in conjunction with hypnosis. Griggs (1989) also describes the process of medical hypnoanalysis, using hypnosis in conjunction with dream analysis and age regression. Mendelberg (1990) used an uncovering technique in

The Aftermath Of Trauma

The DSM-IV (APA, 1994) diagnostic criteria for acute and post-traumatic stress disorder (PTSD) involve intrusion, dissociative, avoidance, and hyperarousal symptoms in the aftermath of a traumatic stressor. A taxi driver in Oklahoma City said 'Oklahoma lost its innocence in this attack, the sense of being the heartland, of being safe.' He added 'I used to like driving downtown, but I don't work downtown much any more. It just doesn't have the same feeling that it used to.' A psychiatrist who was head of the disaster committee commented that things seemed so unreal to him that he had trouble recounting the details of what had happened that day afterwards 'Although I was feeling like a fraud because the event and job seemed unreal, I was amazed at the universally receptive response to my calls. There was a feeling of relief, as though each contact was a symbolic bridge between islands' (Poarch, 1995, p. 9). Post-traumatic stress disorder is a disturbingly common problem. For example, in...

Long Term Retention of Preschool Memories

A final study that examined children's long-term retention of early childhood memories focused on children's recall of a natural disaster. Hurricane Andrew was a severe storm that devastated the Florida coast in 1992. Within a few months of the hurricane, we interviewed 3- and 4-year-old children about their experiences (Bahrick, Parker, Merritt & Fivush, 1997). Obviously, this is an event that differs in several important ways from the previous events studied. Most important, it is a highly stressful and emotionally arousing event. Although many of the events asked about in the previous studies were emotionally salient, few were as stressful as the hurricane. Further, children experiencing the worst of the storm also experienced ongoing consequences, including serious damage to house and property requiring extended repairs. A large literature examining relations between stress and memory has documented that in adults, higher arousal leads to better memory (see Christianson, 1992, for...

Dissociation And Trauma

There is growing clinical and some empirical evidence that dissociation may occur especially as a defense during trauma, an attempt to maintain mental control just as physical control is lost (Spiegel, 1984 Kluft, 1985 Putnam, 1985 Spiegel, 1988 Bremner, Southwick et al., 1992 Cardena & Spiegel, 1993 Koopman, Classen et al., 1994 Marmar, Weiss et al.,1994 Butler & Spiegel, 1997 Butler, Jasiukaitis, Koopman & Spiegel, 1997). Fifteen studies of immediate psychological reactions within the first month following a major disaster provide evidence of a high prevalence of dissociative symptoms, and some show that such symptoms are strong predictors of the development of post-traumatic stress disorder. These studies examined the experiences of survivors, victims and their families, and rescue workers in a variety of disasters the Coconut Grove fire mentioned earlier (Lindemann, 1944 94 ), the 1972 Buffalo Creek flood disaster caused by the collapse of a dam (Titchener & Kapp, 1976) automobile...

Acute Stress Disorder

Acute Stress Disorder (ASD) as a new diagnosis in the DSM-IV (Spiegel & Cardena, 1991 Liebowitz, Barlow et al., 1994). It is diagnosed when high levels of dissociative, anxiety and other symptoms occur within one month of trauma, and persist for at least 2 days, causing distress and dysfunction. Such individuals must have experienced or witnessed physical trauma, and responded with intense fear, helplessness, or horror. This 'A' criterion of the DSM-IV requirements for ASD is identical to that of PTSD. The individual must have at least three of the following five dissociative symptoms depersonalization, derealization, amnesia, numbing, or stupor. In addition, the trauma victim must have one symptom from each of the three classic PTSD categories intrusion of traumatic memories, including nightmares and flashbacks avoidance and anxiety or hyperarousal. If the symptoms persist beyond a month, the person receives another diagnosis based on symptom patterns. Likely candidates are...

Principles Of Psychotherapy With Hypnosis

It is important to confront the traumatic events directly rather than attribute the symptoms to some long-standing family or personality problem. Confession. It is often necessary to help trauma survivors to confess deeds or emotions that are embarrassing to them and at times repugnant to the therapist. It is important to help these patients distinguish between misplaced guilt and real remorse. They may well be telling the therapist aspects of the traumatic event that they have discussed with no one else.

Dissociative [conversion disorders

The common themes that are shared by dissociative or conversion disorders are a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements. All types of dissociative disorders tend to remit after a few weeks or months, particularly if their onset is associated with a traumatic life event. More chronic disorders, particularly paralyses and anaesthesias, may develop if the onset is associated with insoluble problems or interpersonal difficulties. These disorders have previously been classified as various types of conversion hysteria . They are presumed to be psychogenic in origin, being associated closely in time with traumatic events, insoluble and intolerable problems, or disturbed relationships. The symptoms often represent the patient's concept of how a physical illness would be manifest. Medical examination and investigation do not reveal the presence of any known physical or...

Anonymity and Selfdisclosure

Sarah was a thirty-year-old woman who had been in three-times-weekly psychotherapy with me for four years. Some months after the traumatic events of September 11, 2001, she arrived for her session clearly irritable. Everything I said was rebuffed. She remarked that we were going round in circles and she could not see the point of what I said to her. She complained that she had come into therapy to be able to have a relationship and she was still not succeeding in this. The night before a man she had started to date made it clear that he had no wish to pursue the relationship further. Sarah was very hurt by this rejection and felt despondent about any future relationships.

Psychoanalytic Perspectives On Memory

The question of memory, of what we can, cannot or do not want to remember is of central concern to psychoanalytic practitioners and researchers. In his early formulations on the nature of hysteria, Freud understood the hysteric's problem as one of ''suffering from reminiscences'' (Breuer & Freud, 1895 7). Freud and Breuer (1895) suggested that the source of the hysterical patient's psychic pain was the inability to forget traumatic events that had occurred in childhood but which could not be consciously remembered. The goal of therapy was therefore to bring back to the surface the repressed traumatic events. Although Freud changed his ideas about hysteria later, this early link between disturbances of memory and psychopathology can still be traced in the implicit thinking of some psychoanalytic practitioners who view the excavation of the past as a necessary goal of psychotherapy. As our knowledge of memory has become increasingly more sophisticated, the classical psychoanalytic view...

The Evidence For Unconscious Processing

Such is now the evidential basis for unconscious perception and processing that no therapeutic approach can dispute the existence of an unconscious, at least in the descriptive sense. However, even though there is evidence for unconscious processing, that is, for learning and perception that occurs without conscious awareness, the notion of a dynamic unconscious is more problematic. In Freud's original formulations, the dynamic unconscious was depicted as a constant source of motivation that makes things happen. In this sense, what is stored in the unconscious was said not only to be inaccessible but Freud also suggested that its contents were the result of repression. Repression was a means of protecting consciousness from ideas and feelings that were threatening and hence the source of anxiety. At first, Freud, along with Breuer, suggested that repression operated on memories of traumatic events excluding them from consciousness. Later, he suggested that repression operated...

Future Directions Multiple Systems across the Lifespan

Working Memory Lifespan

Autobiographical memory requires the use of the integrative memory system, at least one modality-specific imagery system (usually visual imagery), spatial imagery, to varying degrees imagery in the other senses, language, narrative reasoning, and emotions. For different memories within an individual and for different clinical populations, the degree to which each system contributes varies. Thus, for instance, flashbulb memories are more likely to have considerable visual and spatial imagery, and people who are depressed or who have posttraumatic-stress disorder are likely to have voluntary memories that lack sensory details and narrative coherence. In contrast, the intrusive memories of people with posttraumatic-stress disorder are likely to have considerable sensory detail and, compared to other memories, sensory details in the olfactory and gustatory system. There is considerable support for this view from behavior (Rubin, Greenberg & Schrauf, 2000) and neuropsychology (Rubin &...

Classification Of Dental Fears

The anxiety disorders include panic disorder with or without agoraphobia, agoraphobia without panic disorder, specific phobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorder, acute stress disorder, generalized anxiety disorders and anxiety disorders due to a medical condition.

What Is The Trauma History

An increasingly popular practice among clinicians is the inclusion of questions about historical traumas (Linden, 1995). The relevance of traumas in the client's clinical history is the culmination of several factors that coalesced in the field of mental health. These were the Women's Movement of the 1970s and sociopolitical concerns about victimization of women, attention to the scope of child physical and sexual abuse and sociopolitical concerns about the victimization of children, the addition of the diagnostic category of PTSD to the 1980 DSM II nomenclature (Yehuda & McFarlane, 1995) and the rapid expansion of research in the area of dissociation during the decade of the 1970s (Lynn & Rhue, 1994) which grew out of the similarities between the trance behaviours of abused persons and hypnotic phenomena (Lynn Hilgard, 1986 Spiegel, 1986 Braun, 1986). Added to this, was the appreciation that little was understood about the nature of trauma in children, and that most knowledge came...

Recovered Memories

Repression and dissociation are key processes in some theories and particular approaches to therapy. According to these theories, memories of traumatic events may be blocked out unconsciously and this leads to a person having no memory of the events. However, memories of traumatic events may become accessible at some later time. It is important to recognize that the scientific evidence does not allow precise statements to be made about a definite relationship between trauma and memory (McConkey & Sheehan, 1995). The evidence tells us more that memories reported spontaneously or following the use of special procedures in therapy may be accurate, inaccurate, fabricated, or a mixture of these. Belief can often be strong but it is not the yardstick of veracity and neither is the level of detail diagnostic of the truth of the recollections. distant events, and particularly memories of early childhood, appear to be very susceptible to distortion and error. Further, it is the case that many...

Suggestibility

The third component of hypnosis is suggestibility, a tendency to respond readily and uncritically to social cues. The hyperarousal states in PTSD are analogous to that. On the other hand, during trauma many people find themselves in a 'state of shock', responding in an automaton-like fashion. In a traumatic situation, as people narrow the focus of attention they tend to act without thinking about consequences. The police, for example, frequently do not believe a rape victim's story because she doesn't fit their image of what rape victims should look like. A supposedly classic

Treatment

Three types of psychotherapy have been applied to PTSD psychodynamic, cognitive-behavioral (CBT), and hypnotic-restructuring. In each of these approaches, telling and retelling the story of the trauma is an essential element, albeit with different methods and goals clarification of unconscious themes and transference distortions in psychodynamic treatment, correction of cognitive distortions in CBT, and abreaction and the restructuring of traumatic memories with the help of hypnosis. Since the hypnotizability of Vietnam veterans with PTSD has been found to be higher than that of other populations (Stutman & Bliss, 1985 Spiegel, Hunt et al., 1988), it makes sense that techniques employing hypnosis should be useful. Especially if traumatized individuals with PTSD are in a spontaneous dissociative state during and immediately after the trauma, hypnosis is likely to be helpful in tapping traumatic memories by recreating a similar type of mental state. The literature on state-dependent...

The Role of Emotions

In addition to depression, posttraumatic-stress disorder differentially affects autobiographical memory across the lifespan. Vietnam War veterans with posttraumatic-stress disorder had more memories from the time of the Vietnam War than did veterans without posttraumatic-stress disorder (McNally, Lasko, Macklin & Pitman, 1995). In addition, veterans with posttraumatic-stress disorder, like patients with depression (Williams, 1996), had difficulty recalling specific autobiographical memories and had more difficulty producing specific memories when the cue words were positive traits as opposed to negative traits. The differences in the distribution of autobiographical memories and in the specificity of those memories were greatest for those veterans with posttraumatic-stress disorder who wore Vietnam War regalia to the testing sessions. These veterans did not differ from the other veterans with posttraumatic-stress disorder in terms of depression, anxiety, and combat experience,

Conversion Disorder

Described may crudely mimic epileptic seizures and have some resemblance to certain frontal lobe epileptic seizures but often have prominent sexual and aggressive components. They are usually recognized readily by observation and particularly by videotape observation and do not include alteration in background EEG. Some are predominantly swoons a more or less graceful collapse without injury often into a recovery position, in some rhythmic jerking of the head, one or more limbs or trunk or pelvis predominates. In some cases incest, child sexual abuse, or other cause of posttraumatic stress disorder (PTSD) may be the etiology (84,85).

Hyperarousal

Numb, detached and avoidant and at the same time have intrusive flashbacks and nightmares The crucial issue is that the cluster of PTSD symptoms is a combination of intrusion and avoidance. These sometimes come in sequence, sometimes with more intrusion, sometimes more avoidance. But the normal homeostatic equilibrium, the control of one's inner life, is very much disrupted by traumatic stressors. The worse the intrusions are, the more desperate are the efforts to avoid them. Indeed, the flashbacks and hyperarousal come to symbolically represent the traumatic circumstance itself, repetitively imposing distress just as the assailant, accident, or natural disaster did.

Training In Hypnosis

To complete the anxiety-depression spectrum, Spiegel's lucid and comprehensive presentation of PTSD symptoms and treatment approaches in Chapter 10 begins with an account of the vicissitudes undergone in developing the concept of post-traumatic stress disorder. It provides a cautionary tale that however confident we feel in the accuracy of our knowledge we can never know all the answers, and therefore should retain an open mind for opposing views. Dr Spiegel notes the growing interest in the overlap between hypnotic and dissociative states and post-traumatic stress disorder, in particular a clear analogy between the three main components of hypnosis absorption, dissociation, and suggestibility (Spiegel, 1994), and the categories of PTSD symptoms. Like PTSD, conversion disorders are particularly suited for treatment using hypnosis. In 1986 Trillat made the hasty conclusion that hysteria was an illness that would no longer be seen, but conversion disorders still present neurologists,...