“Do as I say, not as I do.”
How often have we given advice…wonderful, wise advice…to our patients and never once considered its relevance to ourselves? The answer to this is, of course, often, very, very often.
Clinicians routinely talk to patients about the need for balance between work and personal life, the importance of good sleep hygiene, exercise, socialization and eating well. What prevents many of us from acting on this advice?
Some time ago I was in a family’s living room talking to a group who had come to the US as war refugees. Many had been tortured before fleeing their homeland, before finding safe haven in the US. I had been invited there to talk about PTSD and effective treatment. Many in the room likely suffered with the disorder, but if so, called it “nervousness” and referred to themselves or those with the problem as, “he’s crazy now…too bad.”
The horrors of war, the deaths, imprisonment and torture leave an indelible mark on the human psyche. PTSD, however, a psychiatric diagnosis, does not have to be part of the lingering legacy of war. That was the main point of my talk…and to share resources for help.
As I work with clinicians who are trained in evidence-based treatments for PTSD, one query is raised repeatedly…Should I use Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) to treat patient X?
PTSD is one of the signature disorders of the OIF/OEF conflict. PTSD is characterized by symptoms of re-experiencing, avoidance/numbing and hyperarousal. As many as 20% of the US service members returning from Iraq or Afghanistan since 2001 may have PTSD (www.iom.edu/militaryptsd). We may safely assume that a significant number of veterans from the current conflict and other eras will need effective treatment to alleviate PTSD symptoms. Let’s review…
Dissociation is not unusual during psychological traumatization, and dissociative symptoms commonly occur with PTSD. Its manifestation both peri-trauma and during trauma recall is disturbing to both patients and therapists. Some trauma experts believe dissociation plays a unique role in management of trauma-related distress. A dissociative subtype of PTSD is being considered for DSM-V.
Smart phones, they’re everywhere. In fact, currently there are approximately 91.4 million smartphones in the United States alone. Whether or not you have one and no matter your views on how good, bad or ugly smartphones are for society, statistically speaking the probability that your clients wear one like an extra appendage is very high. In fact, approximately 3 out of 5 clients aged 25 – 34 own a smartphone, which is more than any other age group.