In Western culture we are schooled for achievement, ranking, and competition as a path to success. The American Dream articulates the idea entertained by millions of immigrants and working class people that hard work and opportunity for all will lead to happiness in the form of life, liberty, and a house with a yard and white picket fence. Of course, American literature is full of critiques of this dream, too. For instance, in The Great Gatsby, Jay Gatsby achieves great wealth in pursuit of winning Daisy, the symbol of the class barrier he is unable to cross. The narrator, Nick Carraway, who witnesses Gatsby’s rise and fall, revises his own story as a result of what he’s witnessed. Recognizing one’s own underlying story is the first step in becoming aware of how such stories can unconsciously influence virtually every choice one makes.
“The world is dangerous”
- Calculating probabilities of specific events.
- Listing advantages/disadvantages of current worldview.
- Cost–benefit analysis of specific vigilance and avoidance behaviors.
- Identifying reasonable precautions.
“Events are unpredictable and uncontrollable.”
- Listing advantages/disadvantages of belief.
- Listing areas of life over which one has some control, and rating the degree of control for each.
- Doing a cost–benefit analysis of specific efforts at prediction/control.
- Keeping a daily log of behaviours that produce predicted outcomes.
- Engaging in behaviours with high probability of predictable outcome.
- Accepting that some events are unpredictable.
“I am incompetent.”
- Examining evidence for competence in daily life.
- Examining unreasonable expectation of competence in extreme an (unusual circumstances.
- Keeping a daily log of competent coping.
- Using graded task assignment.
“Other people cannot be trusted.”
- Listing known persons who are trustworthy, and listing specific ways in which each can be trusted.
- Rating people on a continuum of trustworthiness.
- Examining one’s history of relationship choices and if better alternatives are available?
- Conducting behavioral experiments involving trusting others in small ways.
- Keeping a daily log of people who honour commitments.
“Life is meaningless.”
- Listing activities that formerly were rewarding.
- Scheduling pleasurable/rewarding activities.
- Recognizing feelings of loss as a way of confirming meaning.
- Examining which goals and activities are longer useful/adaptive.
- Working toward an acceptance of death.
- Finding meaning in each day.
Tuning into your breath can be the first step to understanding how your physiological state affects your thoughts and feelings. In our hectic world with its multiple electronic communications systems, it is easy to live in the mind and get caught up with thoughts, pressures, and a sensation of being rushed. Simply taking a few minutes to be present with your breathing can do much to help you regain a sense of calm. At first, just notice, without judging, where you naturally inhale and exhale. Does your breath mostly reside in your upper chest, or do you tend to breath with your belly? As you pay attention to the breath, allow it to expand and take up more room in your body. Then, slowly exhale. You might try counting to three or four on the in-breath, then pause for a moment, and count to three or four on the out-breath, followed by a pause. Such even breathing, with slight rests between inhale and exhale, can help to reset your body’s sense of equilibrium and calm your mood.
A high percentage of traumatized individuals suffering from posttraumatic stress regularly engage in substance use and/or abuse (e.g. alcohol, drugs) in an attempt to numb themselves to their painful trauma-related thoughts/feelings and thereby to avoid the re-experiencing of trauma-related material (e.g. flashbacks, intrusions). These avoidance behaviors frequently pose a serious obstacle to, and interfere with, trauma treatment and serve to further reinforce their traumagenic beliefs that they are unable to cope. With these substance abuse clients a “stabilization phase” is generally an essential first-step of treatment, the primary purpose of which is for clients to learn to more adaptively manage/regulate their trauma-related emotions and dysfunctional coping strategies. If trauma-processing treatment interventions are attempted before a client has stabilized vis-à-vis his/her use of drugs or alcohol as a “coping” strategy, the trauma treatment will likely fail.
This randomized clinical outcome unpublished study examined the efficacy of two different trauma treatments for chronic posttraumatic stress disorder (PTSD) related to female adult survivors of childhood sexual abuse in an outpatient setting. Twelve adult females (mean age 35 years), who had been victims of severe childhood sexual abuse perpetrated by a male family, were randomly assigned to one of two treatment groups: (1) imagery rescripting, which combines visual reliving and rescripting of the traumatic imagery or (2) prolonged exposure plus stress inoculation training. At pre-treatment, all patients met DSM criteria for chronic PTSD. Each treatment consisted of an extensive pre-treatment evaluation session plus eight therapy sessions (1.5 to 2.0 hours each) with regular between-session homework. At post-treatment and 6-months follow-up, none of the patients in either treatment group met criteria for PTSD. In addition, all patients in both treatment groups showed significant reductions in PTSD-related symptoms, although the overall reduction of PTSD symptoms for patients in the imagery rescripting treatment group were noticeably greater than those in the prolonged exposure – stress inoculation group.