Shore Therapy

Post-Traumatic Stress Disorder (PTSD)

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post traumatic stress disorderPost-Traumatic Stress Disorder is often characterised as the development of a long-lasting anxiety response following a traumatic event. Usually, those described as having PTSD have witnessed or experienced a traumatic event that threatens death, serious injury, or loss of personal integrity to themselves or another. Sometimes, you can develop PTSD from learning about a traumatic event that has happened to a loved one, this can be known as vicarious trauma.

Traumatic events that can trigger the occurrence of PTSD are; violent assault – such as physical/sexual abuse, mugging, kidnapping, being taken hostage, war, terrorist attacks, severe car accidents, natural disasters – such as hurricane, tsunami, volcano eruption, earthquakes and flooding, man-made disasters – such as explosions, fire, and chemical spills, life-threatening illnesses, or unexpected death or injury of a loved one or another person.

Post-Traumatic Stress Disorder usually develops between three to six months of the traumatic event and can be characterised by the following experiences:

  • Flashbacks of the event – such as dreams, images or reliving the event over and over.
  • Night terrors – really disturbed sleep and horrific nightmares often waking the person in fits of terror can be often.
  • Adversity to any object/place/person/activity that can act as a reminder to the event.
  • Any time the person is in contact with an object/place/person/activity that is a reminder of the event, it is followed or accompanied with an intense anxiety response. Panic attacks can be common.
  • Often people find it really difficult to remember specific fact or aspects of the traumatic situation.
  • Memory and concentration difficulties also become apparent.
  • Regularly, irritability or depressed mood is noticeable.
  • The outside world and people can become a very scary place, so isolation and social withdrawal are also common.
  • Hypervigilance and being startled easily can be an indicator to trauma.

Treatment:

Effective treatment for Post-Traumatic Stress Disorder can involve systematically confronting the experiences, memories and situations that are associated with the traumatic event. It can often be a scary experience, but processing through the thoughts and feelings linked to the event in a healthy way can have an amazing effect on quality of life. PTSD untreated, can be a hugely isolating and debilitating disorder that can affect how you function and experience the world.

As with most therapy, a huge part of the effectiveness of this work is the development of trust and safety between you and your therapist. This kind of work relies on the trust you have with your therapist to help keep you safe while unpacking scary and painful experiences.

If you would like to discuss Post-Traumatic Stress Disorder or require more information, please contact a mental health professional or us here at Shore Therapy.

Relaxation Skills

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Relaxation SkillsIn today’s society we are all so busy being busy, that we often forget to relax and unwind. This can lead to a number of issues down the track – such as anxiety, stress and burnout. Relaxation skills can be a great way to unwind and reduce the risk of these issues.

What are Relaxation Skills?

Relaxation is the intentional letting go of tension. This tension can be physical tension in the muscles or it can be mental or psychological tension. During relaxation, the nerves in the muscles change the types of signals that they send to the brain. These different signals bring about a sense of calmness both physically and emotionally. Muscle relaxation has a huge effect on the nervous system and therefore, can be seen as a treatment of both physical and psychological stress.

Why use Relaxation Skills?

When you have been under extended periods of stress or when you have no break from work or other stressful situations, you seldom allow your high levels of muscle tension to decrease. The tension then ends up staying with you for longer periods. Eventually you become so used to being tense that this becomes your new base-line or ‘normal’ state of being. Often you won’t even realise that you are tense or stressed! But it can begin to affect you day to day life.

When it gets to this stage it can be really difficult to shift this tension without professional help.

Three Key Features of Relaxation Skills?

  1. Recognising Tension
  2. RELAX!!
  3. Practice

Recognising Tension

The following questions may be helpful to initiate your recognition of your tension:

  • Where do you feel tension?
    • Do you notice tension in your face and jaw?
    • Do you clench your fists?
    • Are your neck and shoulders tense?
    • What other parts of your body do you feel tense?
    • Are there parts of your body where tension goes unnoticed until you feel pain?
  • What are the characteristics of the tension?
    • Do your muscles feel stretched and sore?
    • Do you muscles feel hard and contracted?
    • Do you muscles fee fatigued?
    • Does there appear to be effort involved in maintaining normal posture?
  • Which events within yourself lead to increased tension?
    • Anger?
    • Thinking about you difficulties?
    • Changes in breathing or heart rate?
    • Loneliness?
    • Boredom?
    • Impatience?
  • Which external events lead to increased tension?
    • The way people speak to you?
    • Loud noises?
    • Having to wait in ques or traffic?
    • Being watched while working?
    • Your relationship?

RELAX!

If you follow the steps below you may be well on your way to learn how to relax. This exercise should take about 15-20 minutes. However, if you only have 5 minutes to spare, then 5 minutes is better than nothing!

  1. Find a quiet and relaxing space:

Choose a comfortable chair in a place that is free from noise and interruptions (make sure you turn off your phone).

  1. Clear your mind:

Try to clear your mind of all worries or disturbing thoughts. If these worries or thoughts drift back into your mind while you are relaxing, do not worry, and just gently push them out of your mind again. Let your mind be calm and clear.

  1. Practice the slow breathing method:

Breathe in for 3 seconds and breathe out for 3 seconds, thinking the word ‘relax’ every time you breathe out. Let your breathing flow smoothly. Imagine the tension flowing out of your body each time you breathe out.

  1. Relax your muscles:

For each of the muscle groups in your body, tense the muscle for 7-10 seconds then relax for 10 seconds. Relax you muscles in the following order.

  1. Hands – curl hands into fists, then relax.
  2. Lower Arms – bend you hand down at the wrist, as though you were trying to touch the underside of your arm, then relax.
  3. Upper Arms – tighten your biceps by bending your arm at the elbow, then relax.
  4. Shoulders – lift your shoulders up as if trying to cover your ears with them, then relax.
  5. Neck – stretch your neck gently to the left, then forward, then to the right, then to the back in a slow rolling motion, then relax.
  6. Forehead and Scalp – raise your eyebrows, then relax.
  7. Eyes – screw up your eyes, then relax.
  8. Jaw – clench your teeth (just tighten the muscles), then relax.
  9. Tongue – press your tongue against the roof of your mouth, then relax.
  10. Chest – breathe in deeply to inflate your lungs, then breathe out, then relax.
  11. Stomach – push your tummy out to tighten the muscle, then relax.
  12. Upper Back – pull your shoulders forward with your arms at your side, then relax.
  13. Lower Back – while sitting, lean you head and upper back forward, rolling your back into a smooth arc, thus tensing your lower back, then relax.
  14. Buttocks – tighten your buttocks, then relax.
  15. Thighs – while sitting, push your feet firmly into the floor, then relax.
  16. Calves – lift your toes off the ground towards your shins, then relax.
  17. Feet – gently curl your toes down so that they are pressing into the floor, then relax.
  18. Enjoy the feeling of relaxation

Take some slow breaths while you sit still for a few minutes enjoying the feeling of relaxation.

 

Practice

Practice once or twice every day for at least 8 weeks. The more you practice the easier this will become.

However, if the above amount feels too much perhaps, during the day, try relaxing specific muscles whenever you notice that they are tense.

Hunt, C.J., Andrews, G. & Sumich, H.J. (1995).

What is a panic attack

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What is a Panic Attack?
Panic Attacks
When we are exposed to a physical threat our bodies have an automatic response to help defend ourselves and escape a threatening situation. This response is known as the fight/flight/freeze response, which activates our central nervous system and our bodies become more attuned to our environment. Often we become more alert, our heart rate speeds up, muscles become tense and ready for action, sweating increases to cool the body and our breathing rate increases so that we can get oxygen into our bodies faster. With all of these changes happening at once, we are able to run very quickly from our attackers (flight), fight our ‘enemies’ (fight) or remain hidden so as not to be seen (freeze).

How Does a Panic Attack Cause Problems?

In today’s society we are rarely exposed to any real physical threat. Instead, most of the threats we do experience are psychological or mental. It does not help to fight physically or run away when dealing with these situations. Unfortunately though, the fight/flight/freeze response still gets turned on. We may have the increased breathing rate which serves no real purpose and actually causes problems for some people. This tends to lead to hyperventilation or over-breathing, this can cause dizziness, breathlessness and chest pains.

It is important to realise that these feelings are all part of a physical response to threat and are not a sign that you have some physical disease. These symptoms do not mean that you will die, go crazy, or lose control.

What Do I Do Next?

It is very likely that you will be more able to manage your panic attacks in the future if:

  • You learn how to relax and manage your stress effectively
  • You try to notice your anxiety or stress before a panic attack occurs, increase your awareness of your warning signs
  • You remember to use breathing exercises when you become anxious.

Hunt, C.J., Andrews, G. & Sumich, H.J. (1995).

If you would like more information regarding panic attacks or would like to book in an appointment with a team member at Shore Therapy please click here.

 

Insomnia – Do You Have It?

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Insomnia – Do You Have It?

Insomnia Therapy New Zealand
The most common sleep disorders are sleep-onset insomnia and sleep apnoea

The term insomnia covers a wide variety of sleep issues, each has different causes and each needs different solutions. Insomnia costs New Zealand tens of millions of dollars per year in lost producitivty. The good news is there are steps you can take to improve your sleep.

The first step towards improving your sleep is to work out what type of insomnia you have. The first thing to think about is how long the insomnia has been an issue? And the second, and possibly more important, is to figure out what pattern of sleep problems you have.

Below is a few of the common sleep issues that may be affecting you:

Transient Insomnia

This is insomnia that lasts for a few nights, about a week at most. Most people suffer from this from time to time, particularly when dealing with stressful situations. Transient Insomnia is also common while experiencing a change in time-zone, and is a symptom of jet-lag. Some people also have difficulty adjusting to sleeping in a different place or environment.

For this type of insomnia, often, no treatment is necessary – just the awareness that under some situations having difficulty sleeping for a short amount of time is normal.

Short-term Insomnia

If you have experience insomnia for a few weeks then you may fall into this category. Like those with Transient Insomnia, this type of abnormal sleep may have begun with a stressful life event. Often these disruptions are long-term and have a larger impact on your life, such as death, divorce, unemployment or immigration.

Most people find that as they resolve the issues evoked by the life event their sleep improves as-well. However, in some cases people who identify with Short-term Insomnia develop poor sleep habits and anxiety around their sleep patterns. This can lead to long-term or even Chronic Insomnia.

In terms of treatment, relaxation therapy combined with counselling can help resolve the issues associated with the stressful life event and in turn encourage healthier sleeping patterns. Sleeping tablets, either herbal or medicated may also be of use. However, it is important to speak with a doctor before taking or trying this route, as some medications can interact with sleeping tablets and cause serious harm.

Chronic Insomnia

If your insomnia has lasted for at least three months, then you may be associated with the Chronic Insomnia category. Some people who identify with this group have had is for many years, and often have graduated from short-term insomnia. Often these people have long since resolved the underlying issues that initially caused their unhealthy sleep patterns, but the insomnia has remained. This is why creating health sleep patterns early on can be so important (Bearpark, H, 1994).

Patterns of Insomnia

Insomnia usually has a pattern, recognising that pattern can be very useful to indentify the cause of the problem. Below are a few of the common patterns of insomnia.

Sleep Initiation Insomnia

This is ususally when you have trouble falling asleep, and may be a sign of chronic insomnia. If you have trouble getting to sleep during the night and difficulty waking in the mornings it may be important to speak to a specialist about any other conditions that may be affecting your ability to sleep, such as breathing disorders, restless leg syndrome or delayed sleep phase syndrome.

Sleep Maintainance Insomnia

This is when you have no trouble falling asleep, but often have difficulty remaining asleep, usually waking up often throughout the night. Some common biological causes for this pattern are, sleep apnea and periodic limb movements. However, there are other factors that can influence this pattern, such as alcohol, caffine and nicotine consumption, as well as medication and sleeping tablets.

Environmental factors such as noise, light and temparature can also have a huge influence on your sleep patterns. It is important for you to make sure the environment you sleep in is calm, dark and comfortable so that you have the best opportunity to create healthy sleep patterns.

Early Morning Awakening Insomnia

This is when you have no problem falling asleep or remaining asleep, but that you awaken too early in the morning. This is often associated with shift work or a disturbance with your body clock and often becomes habitual (Bearpark, H, 1994).

Seeking Help

If you feel as though your insomnia is impacting your quality of life and your ability to function, please seek professional help – either contact your GP or another registered health professional.

If you are in Auckland or indeed any part of New Zealand you can talk to the team at Shore Therapy to discuss insomnia or related issues. If you would like to talk more about some techniques to encourage healthy sleep patterns, Click Here to contact us or to make an appointment or booking

Recognising Anxiety

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Recognising Anxiety

Experiencing some anxiety in stressful situations is normal and healthy. Anxiety triggers the physiological and psychological mechanisms that Anxiety and Stressprepare our mind and body to respond to threat or danger. Our attention becomes focused on figuring out the fastest possible escape route, while the rush of adrenaline into the blood stream enables us to run (or react) faster. In other words, we try to escape the threat both mentally and physically, which is helpful in a dangerous or life threatening situation.

These mechanisms become less helpful however when we experience anxiety in situations that are not normally threatening or dangerous. When the feelings of anxiety are excessive they interfere with our normal functioning.

Since everyone experiences anxiety to some degree it is not always easy to recognize if or when it becomes problematic. Further, symptoms can be quite varied since we all have individual differences. Listed below are some commonly recognized symptoms. This list is only a guide and not designed to provide diagnosis. Anxiety symptoms can show up as physical sensations or effects, thoughts or behaviours. These include:

  • Chest pain or tightening of the chest
  • Racing or pounding heart
  • Shortness of breath
  • Dizziness, shaking, trembling
  • Nausea, stomach pain and/or diarrhea
  • Repetitive or obsessive thoughts
  • Catastrophizing, i.e. snowballing thoughts or thoughts that escalate
  • Withdrawing from or avoiding situations that may trigger stress, for e.g. avoiding social situations or public places

Experiencing these symptoms on a regular basis can not only be scary but it can impair our functioning significantly. Recognizing when anxiety has become a problem is the first step to getting the help you need. Seeking help from your GP initially is a good idea, so you can rule out any medical causes. If you find yourself worrying excessively, or feel your anxiety may be preventing you from functioning in a healthy way don’t be embarrassed or ashamed to talk about it. Share your concerns with friends and family. You’ll often find that there are others who can relate to what you are going through.

However, if you would like to speak with a professional, you can contact one of the registered Psychotherapists at Shore Therapy.

 

Reference:

Rau, S. (2013)

Foreman, E; Elliot, C & Smith, L. (2011)

Image courtesy of “jesadaphorn”