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Wednesday, February 13, 2008

Post Traumatic Stress Disorder

Post traumatic stress disorder (PTSD) is a pathological anxiety that usually occurs after an individual experiences or witnesses severe trauma that constitutes a threat to the physical integrity or life of the individual or of another person.

The individual initially responds with intense fear, helplessness, or horror. The person later develops a response to the event that is characterized by persistently reexperiencing the event, with resultant symptoms of numbness, avoidance, and hyperarousal. These symptoms result in clinically significant distress or functional impairment. To meet the full criteria for PTSD, these symptoms should be present for a minimum of 1 month following the initial traumatic event.

The events experienced may be natural disasters, violent personal assaults, war, severe automobile accidents, or the diagnosis of a life-threatening condition. For children, a developmentally inappropriate sexual experience may be considered a traumatic event, even though it may not have actually involved violence or physical injury.

PTSD can also be caused by experiencing, witnessing, or being confronted with an event involving serious injury, death, or threat to the physical integrity of an individual, along with a response involving helplessness and/or intense fear or horror. The more severe the trauma and the more intense the acute stress symptoms, the higher the risk for PTSD. When these events involve an individual with a physiologic vulnerability based on genetic (inherited) contributions and other personal characteristics, PTSD results. These personal characteristics include prior exposure to trauma, childhood adversity (eg, separation from parents), and preexisting anxiety or depression.

Researchers have identified factors that interact to influence vulnerability to developing PTSD. These factors include the following:

- Characteristics of the trauma exposure itself - Proximity to, severity of, and duration of exposure to the trauma

- Characteristics of the individual - Prior trauma exposures, family history or prior psychiatric illness, and sex (Women are at greatest risk for many of the most common assertive traumas.)

- Posttrauma factors - Availability of social support, emergence of avoidance or numbing, hyperarousal, and reexperiencing symptoms.

PTSD can be acute (symptoms lasting less than 3 months), chronic (symptoms lasting more than 3 months), or of delayed onset (6 months elapses from event to symptom onset).

When a family member is diagnosed with PTSD, the entire family may be affected. Members may experience shock, fear, anger, and pain because of their concern for the victim. Living with family members who have PTSD does not cause PTSD. Yet, it can cause some similar symptoms, such as feelings of alienation from and anger toward the victim. Other family members may find it difficult to communicate with a person with PTSD. Sleep disturbance and abuse (physical and substance) may occur among family members.

Families should engage in counseling if anger, addiction, or problems in school or work become issues. Stress and anger management and couples' therapy are possibilities. Families should try to maintain their outside relationships and should continue to be involved in pleasurable activities.

- From

Tuesday, February 12, 2008

Not "Just Friends"

Just because infidelity in increasingly common doesn't mean that most people understand it. So much of the advice on television shows and in popular books about how to affair-proof your marriage is misleading. In fact, much of the conventional wisdom about what causes affairs and how to repair relationships is misguided.

Popular thinking about infidelity - the therapy that deals with it - is clouded by myths. The facts, which my research and clinical experience prove, are much more surprising and thought-provoking than unfounded popular and clinical assumptions. Here are a few truths that you will learn from this book:

Assumption: Affairs happen in unhappy or unloving marriages.
Fact: Affairs can happen in good marriages. Affairs are less about love and more about sliding across boundaries.

Assumption: Affairs occur mostly because of sexual attraction.
Fact: The lure of an affair is how the unfaithful partner is mirrored back through the adoring eyes of the new love. Another appeal is that individuals experience new roles and opportunities for growth in new relationships.

Assumption: A cheating partner almost always leaves clues, so a naive spouse must be burying his or head in the sand.
Fact: The majority of affairs are never detected. Some individuals can successfully compartmentalize their lives or are such brilliant liars that their partner never finds out.

Assumption: A persona having an affair shows less interest in sex at home.
Fact: The excitement of an affair can increase passion at home and make sex even more interesting.

Assumption: The person having an affair isn't "getting enough" at home.
Fact: The truth is that the unfaithful partner may not be giving enough. In fact, the spouse who gives too little is at greater risk than the spouse who gives too much because he or she is less invested.

Assumption: A straying partner finds fault with everything you do.
Fact: He or she may in fact become Mr. or Mrs. Wonderful in order to escape detection. Most likely, he or she will be alternately critical and devoted.

- An excerpt from Not "Just Friends" by Shirley P. Glass, Ph.D.