word precept;
the way of what pulled through me at 3499 Paradise Drive, Tiburon, California
the way of what was That!!
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Saturday, June 21, 2014
No Wonder Cats Have Nine Lives It Would Take That Long To Figure Being To Lusting
In the Thought of Yesterday I knew that Tomorrow was A Day because last week I remember,
that this time last year there was a calendar on a Month that had a point to the factual remind,
to go to the store in the day of time of a hunger pain in my side which said to work out,
but in the broth of think I forgot that I fat and can't do that because of the conscience tax,
upon the summed equation that if we total our consumption with the in take of bread,
the sour of the dough would be costing to the seed which had to derive from an original lead.
Now while I can't impossible to know the future to know that I would have to drive my car,
to the Park that can't be because it cannot be built for it was a nice idea oh wait that is,
reading the might of a thought at the known that the playground was a place for a swing,
oh wait that's a good time which not one person can have while we are to be busy about,
the processing of the garden of eden and the fruit which needs a name for the Apple.
In the grove of the field of the life that can not be for cannot have been to know that we are,
back to the hungry that is a feat could never complete for the tree would have had to grow,
while our feet did the walk to look to the snake that with the twist of his tongue said oh yea,
no that can't be right for it's split down the middle no thats a girl in the midst of job on,
well back to the Swallow of the original steed or was the deed that said it was creed?
To gain to the future that would than assume no that can't be right for that than would mean,
an Ass was a Tree and the Deed had a Fee in the Fenced off decision of a thought in a need,
no that can't be right so it must be the egg that cracked in the sky called the big bang for the space,
no that can't be right for corrective in action would have just gone explode I'm wild in the sky,
oh wait that means the burst was a candy display to explain that the gum was just oh wait,
the thought that I read your mind on the way home in a split of the second I got the tack.
My cell phone did ring but the bell was the time on the wrist I can't have cause tomorrow is glad,
for I cannot laugh at the joke you did tell for that would mean I presume to the know,
that your body language told me you spoke in a hub called your brain oh please don' you go,
before no that cannot be 'cause the Cavemen did leave these carvings all at the time of the dream,
no that can't turn time 'cause the back of the garden had a Man with a flee in the talk of whom tops,
no that cannot work into the story for that would mean an argument ensued.
Now in the hour of the topping of tower on who was will and would be power oh wait,
no that cannot be 'cause the story predates the need for an eve. of wait it's a knight,
no that doesn't answer the quest for the pause in the been that mud can make Men,
no that doesn't work for in the begin when batter was buttering up to toast sin,
now that one might work in the fit of tomorrow 'cause really it's just observance of lens.
I wonder sometimes what actually can be without that it can't be in the I don't fit scenario.
Monday, June 30, 2014
It's Been A While
I used to think that I was interested in knowing what Love was all about of this I do confess to truth,
the idea of what Humanity continual spoke on speaking the empty piece to the filling of the concept,
told what I already knew on fact that I had not been afforded such experience an opportunity,
while in my youth I did stare and wonder of it's emotion as I saw it towards my siblings Four!!
The aspect was curious as it was a better yearning to have witnessed in my mothers eyes for them,
my mother does love my Step-father as she has that same pull within her being to his nature,
growing-up under this constant made me understand that even if I did not appreciate his prowess,
that I also had no right to dissolve or even suggest the dissolution of their partnership towards one another.
My mother did always make me laugh when she was unaware that I was watching her,
she would call my step-father into the room with the funniest yowl in her vocal chords,
a howl to the Moon so to speak with a swagger of her hips as her body sort of was in a swoon,
just as he would enter into her sight the blush on her Being was extreme he made her a bit queer!!
Not that this was a bad thing for the two of them I believe had I not been in the loop of the left overs,
their life may have enjoyed that innocent attach much more leasting circumstance as the stop.
The result of the investigate of the actual emotion has proven to be a thing that just appears to be pain,
after years of merely asking to meet James Blunt based on a the facts of a common theme,
I just had wanted to converse as to what had been inspired him to have sung such a quantum ballet in grands,
the overwhelming nature of which he invests seemed to be an audible drink of my very own passions.
In the flight of death being life I thought asking to be introduced would settle the gnawing question,
it is difficult these days to do what gives me solace when I speak to people as I need to look eye to eye,
in an ordered conversation they're speech volumes as the body language fills the tempo of the Talk,
as time grew into the future this simple thought became a bigger and bigger pulling to his Hymn!!
Throughout the conversations that mode of sending through the Web I realized that a curious,
no matter the factual process or the reasoning behind such perfective it was still a web of trouble,
everyone reads the posts from you engaging the commerce of belief a Cause in of itself,
with each additional express the tug behaved as glue would in the adherence of an idea.
With all the doubt piled on me from random butt jokes not on topic but for never being able to meet,
the dirty taste in my mouth that was left by those people just made me understand the objections,
not to be based on the belief itself rather the improbability of just meeting a Singer on his way to Stardom,
a sort of strange in the end of thoughts for truth of our not meeting to date is based on the else!!
Regardless the entire Love scenario is the scorching knife ready to stab my already broken life,
to even think on the pain that it may produce should I have met James Blunt and he then walked,
well lets just go with Society keeping us at Bay for fears unknown to the Philosophers in Play,
the World answered my Quest with their Actions of Denial on this Account of Bet by refusal to inquire.
Love looks very dangerous
Friday, June 27, 2014
Speaking Light
Back in the day before I was hey in birth upon this land their advice was to not watch the Screen,
basically Television was a drain on the brain wasting time a way to streaming guise ideas,
the product of many conversations that took place to explain the replacement as paved,
with thoughts that may not plug but be that introduction too the faster rots in a Minds Thought!!
To speak on passing leads that regulated such thinking of such a promotable feed in brooming,
swept by the Nationals in what was popular by the day to the Week of the year in a Series,
as Monday rolled Tuesday to Wednesday Salons in Thursdays believe Friday partied on,
leaving Saturday for Cartoons and Sunday stuck in Booms,
the basis of a life with regards to T.V. guides!!
Now there are no worthy days to brag upon such real fates that destiny dictates the moment place,
why bother to wait for the show when you can download the action as the video blows.
Each Past to Future lathe the shield of advisement has warned of the over use in Watts,
remote controls were frowned upon as now we were to lazy to get up and change the channel,
so this made those words able to dig in a deeper Tell of how inactive the Watch became in the Stares!!
I remember the frustration of my brother standing in front of the said black and white View,
just to annoy the looker to react to the blocker in order to spite a fight in a playful might,
should I have turned the tables which I did not for he was bigger than me so I felt the loss,
this is a common lesson in my life however the gains is the lesson learned in playing gamed!!
Patience dictated the fight to no reaction and the ability to walk away knowing his shows were over,
being capable of reading the guides to channel the turn of the informational switch proved real,
for taking a walk on the far side lead me to the out doors and to Horses the where to go!!
Or, taking consideration of the time to day of week in play than producing the water to make mud,
building wishes that I could aim the dry cakes to the brain waving of striking him with looks,
as a value to addition the reams as a booking of themes that teach the dreamer the value of little talks!!
A cruise into these plays must put the effort to the production of true aim as the plug cannot drain,
in San Francisco there are One-Way Streets for reasons of the traffic that wishes not to be held back,
so the flow is indicative of the mapping out upon the advisement of True North Compassing shores!!
Attentive Lives pay great tribulation to these evaluations as Proper is Prime to the piece of the pie,
therefore reserving the bowl for a greater play on the stage that Venues the Type of undivided,
for that is the being with not of a circulation that would just become draining as a performance,
thereby leaving the Singer to Job a Way to enjoy the Countenance of his Ability to Be the Greatest better!!
Take that weird and hold your hand....Oh Wait...I mean your phone and Call to the base of the bones,
than upon arrival try to remember the wrought that said dialing for attention will cost you in deal,
for speaking conversations is a working to the actual lost in translation.
Real Stops
Monday, February 15, 2016
Date 02/15/2016 The Time Is Standard List At Talk 910 KKSF Playing A Repeat From Armstrong & Getty At 6:06 PM On Local Eh IM Radio
Complex post-traumatic stress disorder
From Wikipedia, the free encyclopedia
Complex post-traumatic stress disorder (C-PTSD), also known as developmental trauma disorder (DTD)[1] or complex trauma,[2] is a proposed diagnostic term for a set of symptoms resulting from prolonged stress of a social and/or interpersonal nature, especially in the context of interpersonal dependence. Subjects displaying traits associated with C-PTSD include victims of chronic maltreatment by caregivers, as well as hostages, prisoners of war, concentration camp survivors, and survivors of some religious cults.
Situations causing the kind of traumatic stress that can lead to C-PTSD-like symptoms include captivity or entrapment (a situation lacking a viable escape route for the victim), as well as psychological manipulation (gaslighting and/or false accusations), which can result in a prolonged sense of helplessness and deformation of one's identity and sense ofself.[3] C-PTSD is distinct from, but similar to, post-traumatic stress disorder (PTSD), somatization disorder, dissociative identity disorder, and borderline personality disorder.[4]
Though mainstream journals have published papers on C-PTSD, the category is not formally recognized in diagnostic systems such as Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD).[5] C-PTSD was not included in DSM-IV or in DSM-5, published in 2013.[6] However, the DSM includes "disorder of extreme stress, not otherwise specified" and the ICD has the similar code "personality change due to classifications found elsewhere" (31.1), both of whose parameters approximate C-PTSD.[4]
C-PTSD involves complex and reciprocal interactions among multiple biopsychosocial systems. It was first described in 1992 by Judith Herman in her book Trauma & Recoveryand an accompanying article.[4][7] Forms of trauma associated with C-PTSD involve a history of prolonged subjection to totalitarian control[4] including sexual abuse (especiallychild sexual abuse), physical abuse, emotional abuse, domestic violence, torture or psychological torture—all repeated or prolonged traumas in which there is an actual or perceived inability for the victim to escape.[8][9]
Contents
[hide]Symptoms[edit]
Children and adolescents[edit]
The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war.[10] However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver.[11] In many cases, it is the child's caregiver who caused the trauma.[10] The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development.[10] Currently there is no proper diagnosis for this condition, but the term developmental trauma disorder has been suggested.[11] This developmental form of trauma places children at risk for developing psychiatric and medical disorders.[11]
Repeated traumatization during childhood leads to symptoms that differ from those described for PTSD.[12] Cook and others describe symptoms and behavioural characteristics in seven domains:[13][14]
- Attachment - "problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to other's emotional states, and lack of empathy"
- Biology - "sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems"
- Affect or emotional regulation - "poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes"
- Dissociation - "amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events"
- Behavioural control - "problems with impulse control, aggression, pathological self-soothing, and sleep problems"
- Cognition - "difficulty regulating attention, problems with a variety of "executive functions" such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with "cause-effect" thinking, and language developmental problems such as a gap between receptive and expressive communication abilities."
- Self-concept - "fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self".
Adults[edit]
Adults with C-PTSD have sometimes experienced prolonged interpersonal traumatization as children as well as prolonged trauma as adults. This early injury interrupts the development of a robust sense of self and of others. Because physical and emotional pain or neglect was often inflicted by attachment figures such as caregivers or older siblings, these individuals may develop a sense that they are fundamentally flawed and that others cannot be relied upon.[7][15]
This can become a pervasive way of relating to others in adult life described as insecure attachment. The diagnosis of dissociative disorder and PTSD in the current DSM-IV TR(2000) do not include insecure attachment as a symptom. Individuals with Complex PTSD also demonstrate lasting personality disturbances with a significant risk ofrevictimization.[16]
Six clusters of symptoms have been suggested for diagnosis of C-PTSD.[5][17] These are (1) alterations in regulation of affect and impulses; (2) alterations in attention or consciousness; (3) alterations in self-perception; (4) alterations in relations with others; (5) somatization, and (6) alterations in systems of meaning.[17]
- Difficulties regulating emotions, including symptoms such as persistent dysphoria, chronic suicidal preoccupation, self injury, explosive or extremely inhibited anger (may alternate), or compulsive or extremely inhibited sexuality (may alternate).
- Variations in consciousness, including forgetting traumatic events (i.e., psychogenic amnesia), reliving experiences (either in the form of intrusive PTSD symptoms or in ruminative preoccupation), or having episodes of dissociation.
- Changes in self-perception, such as a chronic and pervasive sense of helplessness, paralysis of initiative, shame, guilt, self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings
- Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator (caution: victim's assessment of power realities may be more realistic than clinician's), becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge, idealization or paradoxical gratitude, a sense of a special relationship with the perpetrator or acceptance of the perpetrator's belief system or rationalizations.
- Alterations in relations with others, including isolation and withdrawal, persistent distrust, a repeated search for a rescuer, disruption in intimate relationships and repeated failures of self-protection.
- Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair.
Diagnostics[edit]
Main article: Posttraumatic stress disorder
C-PTSD was under consideration for inclusion in the DSM-IV but was not included when the DSM-IV was published in 1994.[4] It was neither included in DSM-5. PTSD will continue to be listed as a disorder.[6]
Differential diagnosis[edit]
Post-traumatic stress disorder[edit]
Main article: Posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) was included in the DSM-III (1980), mainly due to the relatively large numbers of American combat veterans of the Vietnam War who were seeking treatment for the lingering effects of combat stress. In the 1980s, various researchers and clinicians suggested that PTSD might also accurately describe the sequelae of such traumas as child sexual abuse and domestic abuse.[20] However, it was soon suggested that PTSD failed to account for the cluster of symptoms that were often observed in cases of prolonged abuse, particularly that which was perpetrated against children by caregivers during multiple childhood and adolescent developmental stages. Such patients were often extremely difficult to treat with established methods.[20]
PTSD descriptions fail to capture some of the core characteristics of C-PTSD. These elements include captivity, psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized. Most importantly, there is a loss of a coherent sense of self: it is this loss, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.[18]
C-PTSD is also characterized by attachment disorder, particularly the pervasive insecure, or disorganized-type attachment.[21] DSM-IV (1994) dissociative disorders and PTSD do not include insecure attachment in their criteria. As a consequence of this aspect of C-PTSD, when some adults with C-PTSD become parents and confront their own children'sattachment needs, they may have particular difficulty in responding sensitively especially to their infants' and young children's routine distress—such as during routine separations, despite these parents' best intentions and efforts.[22] Although the great majority of survivors do not abuse others,[23] this difficulty in parenting may have adverse repercussions for their children's social and emotional development if parents with this condition and their children do not receive appropriate treatment.[24][25]
Thus, a differentiation between the diagnostic category of C-PTSD and that of PTSD has been suggested. C-PTSD better describes the pervasive negative impact of chronic repetitive trauma than does PTSD alone.[19][26]
C-PTSD also differs from continuous post traumatic stress disorder (CTSD), which was introduced into the trauma literature by Gill Straker (1987).[27] It was originally used by South African clinicians to describe the effects of exposure to frequent, high levels of violence usually associated with civil conflict and political repression. The term is also applicable to the effects of exposure to contexts in which gang violence and crime are endemic as well as to the effects of ongoing exposure to life threats in high-risk occupationssuch as police, fire and emergency services.
Traumatic grief[edit]
Main articles: Grief and Grief counseling
Traumatic grief[28][29][30][31] or complicated mourning[32] are conditions[33] where both trauma and grief coincide. There are conceptual links between trauma and bereavement since loss of a loved one is inherently traumatic.[34] If a traumatic event was life-threatening, but did not result in death, then it is more likely that the survivor will experience post-traumatic stress symptoms. If a person dies, and the survivor was close to the person who died, then it is more likely that symptoms of grief will also develop. When the death is of a loved one, and was sudden or violent, then both symptoms often coincide. This is likely in children exposed to community violence.[35][36]
For C-PTSD to manifest, the violence would occur under conditions of captivity, loss of control and disempowerment, coinciding with the death of a friend or loved one in life-threatening circumstances. This again is most likely for children and stepchildren who experience prolonged domestic or chronic community violence that ultimately results in the death of friends and loved ones. The phenomenon of the increased risk of violence and death of stepchildren is referred to as the Cinderella effect.
Attachment theory, BPD and C-PTSD[edit]
Main articles: Attachment theory and Borderline personality disorder
C-PTSD may share some symptoms with both PTSD and borderline personality disorder.[26] Judith Herman has suggested that C-PTSD be used in place of BPD.[37][38][39]
It may help to understand the intersection of attachment theory with C-PTSD and BPD if one reads the following opinion of Bessel A. van der Kolk together with an understanding drawn from a description of BPD:
Seeking increased attachment to people, especially to care-givers who inflict pain, confuses love and pain and increases the likelihood of a captivity like that of betrayal bonding,[41] (similar to Stockholm syndrome) and of disempowerment and lack of control. If the situation is perceived as life-threatening then traumatic stress responses will likely arise and C-PTSD more likely diagnosed in a situation of insecure attachment than PTSD.[citation needed]
However, 25% of those diagnosed with BPD have no known history of childhood neglect or abuse and individuals are six times as likely to develop BPD if they have a relative who was so diagnosed[citation needed] compared to those who do not. One conclusion is that there is a genetic predisposition to BPD unrelated to trauma. Researchers conducting a longitudinal investigation of identical twins found that "genetic factors play a major role in individual differences of borderline personality disorder features in Western society."[42]
In Trauma and Recovery, Herman expresses the additional concern that patients who suffer from C-PTSD frequently risk being misunderstood as inherently 'dependent', 'masochistic', or 'self-defeating', comparing this attitude to the historical misdiagnosis of female hysteria.[4]
Treatment[edit]
Children[edit]
The utility of PTSD derived psychotherapies for assisting children with C-PTSD is uncertain. This area of diagnosis and treatment calls for caution in use of the category C-PTSD. Ford and van der Kolk have suggested that C-PTSD may not be as useful a category for diagnosis and treatment of children as a proposed category of developmental trauma disorder (DTD).[43] For DTD to be diagnosed it requires a
Since C-PTSD or DTD in children is often caused by chronic maltreatment, neglect or abuse in a care-giving relationship the first element of the biopsychosocial system to address is that relationship. This invariably involves some sort of child protection agency. This both widens the range of support that can be given to the child but also the complexity of the situation, since the agency's statutory legal obligations may then need to be enforced.
A number of practical, therapeutic and ethical principles for assessment and intervention have been developed and explored in the field:[45]
- Identifying and addressing threats to the child's or family's safety and stability are the first priority.
- A relational bridge must be developed to engage, retain and maximize the benefit for the child and caregiver.
- Diagnosis, treatment planning and outcome monitoring are always relational (and) strengths based.
- All phases of treatment should aim to enhance self-regulation competencies.
- Determining with whom, when and how to address traumatic memories.
- Preventing and managing relational discontinuities and psychosocial crises.
Adults[edit]
Herman believes recovery from C-PTSD occurs in three stages. These are: establishing safety, remembrance and mourning for what was lost, and reconnecting with community and more broadly, society. Herman believes recovery can only occur within a healing relationship and only if the survivor is empowered by that relationship. This healing relationship need not be romantic or sexual in the colloquial sense of "relationship", however, and can also include relationships with friends, co-workers, one's relatives or children, and the therapeutic relationship.[4]
Complex trauma means complex reactions and this leads to complex treatments. Hence, treatment for C-PTSD requires a multi-modal approach.[14] It has been suggested that treatment for C-PTSD should differ from treatment for PTSD by focusing on problems that cause more functional impairment than the PTSD symptoms. These problems include emotional dysregulation, dissociation, and interpersonal problems.[21] Six suggested core components of complex trauma treatment include:[14]
- Safety
- Self-regulation
- Self-reflective information processing
- Traumatic experiences integration
- Relational engagement
- Positive affect enhancement
Multiple treatments have been suggested for C-PTSD. Among these treatments are experiential and emotion focused therapy, internal family systems therapy, sensorimotor psychotherapy, eye movement desensitization and reprocessing therapy (EMDR), dialectical behavior therapy (DBT), cognitive behavioral therapy, psychodynamic therapy,family systems therapy and group therapy.[46]
See also[edit]
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