Sunday, June 17, 2018

Trauma, PTSD, and Panic Disorder Treatment in Malaysia

TSD and panic disorder commonly co-occur. This may not be surprising given that people who have experienced a traumatic event or have PTSD are at a heightened risk to develop a number of other psychiatric disorders, such as depression, substance use disorders, or other anxiety disorders. One anxiety disorder that is commonly found among people with a history of traumatic exposure or PTSD is panic disorder.

What is Panic Disorder?

To have a diagnosis of panic disorder, you need to meet the following criteria as described by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).
First, you need to have experienced a panic attack. Most people know whether or not they have experienced a panic attack. It can be an incredibly frightening experience. The DSM-IV describes a panic attack as the experience of intense fear or discomfort where four or more of the following things are felt:
  • pounding heart or increased heart rate
  • sweating
  • trembling or shaking
  • feeling as though you are being smothered or having difficulties breathing
  • choking
  • chest pain or discomfort
  • nausea or abdominal pains and/or discomfort
  • feeling dizzy, lightheaded, or faint
  • feeling as though things around you are unreal or feeling detached from yourself
  • feeling as though you are going to lose control or go crazy
  • fear of dying
  • numbness or tingling in extremities
  • chills or hot flashes
In addition, to have a diagnosis of panic disorder, you must have experienced recurrent, unexpected panic attacks. These are panic attacks that just pop up "out of the blue." For example, a person may be in their car and all of a sudden they experience a sudden rush of fear and terror (a panic attack).
At least one of the attacks must also be followed by one month or more of one or more of the following experiences:
  • Concern about having additional panic attacks
  • Worry about the consequences or implications of a panic attack. For example, a person may think to themselves during a panic attack that they are having a heart attack and are going to die.
  • A change in behavior because of the attacks. For example, a person may avoid certain places where a panic attack has occurred.
Finally, it is important to mention that someone can experience panic attacks and not have panic disorder. Panic attacks are actually quite common. In fact, as many as 12% of people may experience a panic attack at some point in their lifetime.

Trauma, PTSD, and Panic Disorder

Approximately 5% of people will develop panic disorder at some point in their lifetime. However, these rates may be higher among people who have experienced a traumatic event. A large number of people who have experienced a traumatic event report that they had a panic attack following the event. In addition, approximately 30% of people who have experienced a traumatic event also report experiencing unexpected panic attacks.
In particular, one study found high rates of childhood sexual abuse (41%) and physical abuse (59%) among women with panic disorder.
Another study found high rates of sexual molestation (24% for women and 5% for men) and physical abuse as a child (around 14% for both men and women) among people with panic disorder. Women with panic disorder have also been found to report high rates of rape (23%).
Besides simply traumatic exposure, panic disorder also commonly co-occurs with PTSD. Specifically, around 7% of men and 13% of women with PTSD also have panic disorder.

Treatment

Fortunately, there are effective treatments available for both panic disorder and PTSD.
In addition, there are a number of options available for people seeking treatment for PTSD. Some of the symptoms of PTSD may place a person at risk for panic attacks, especially the hyperarousal symptoms. In addition, the physical health problems and unhealthy behaviors (for example, smoking and substance use) that often associated with PTSD may increase the likelihood that panic attacks are experienced. By treating a person's PTSD, then, the risk for the experience of panic attacks may be lessened.
Clinical issues are highly treatable with our Psychological Hypnosis Method (Psychotherapy & Clinical Hypnosis). We are also one of the few clinical neurofeedback training service providers in Malaysia (Bangsar South). Our mental health care service also offers great advantages as an adjunct to standard medical management. We're happy to relieve your symptoms and improve your quality of life. We are committed to providing quality therapy in a safe, confidential and non-judgmental environment.
Read our testimonial to know more about how we manage to help PTSD, Trauma and Panic Disorder Cases: http://www.newmindcentre.com/search/label/Testimonials

 

Source: https://www.verywellmind.com/trauma-ptsd-and-panic-disorder-2797519

Saturday, June 9, 2018

如果有效沟通?改善人际关系?

一个缺乏 Assertiveness 的人什么样? 

Assertiveness 是现代生活中极其重要的一项技能和特质。缺乏Assertiveness 会在人际交往和生活中造成很多的问题,比方说, 容易心情低落抑郁、焦虑感更强、压力更大:

不够 assertive 的人往往会觉得无力、无助,觉得对自己的生活没有控制力; 容易心生怨念:不够 assertive 的人很容易在各种地方「吃亏」,心有不甘却不知如何应对; 容易灰心沮丧:不够 assertive 的人常会埋怨自己,为什么自己总是不够坚决呢; 容易发无名火:
不够 assertive 的人不会得当地表达自己的愤怒,最后总是被自己积压的怒火所点燃; 难以建立良好的亲密关系:
不够 assertive 的人往往不能明确地告诉对方,自己希望对方做些什么,希望这段关系如何发展。

 一个 assertive 的人什么样?
Assertiveness 的重点在于我们自己,在于提升自己的「底气」,在于更加诚实、有效地告诉他人「我们是谁」,「我们需要被怎样对待」。
 一个 assertive 的人能深刻领悟并明确自己的以及他人的权利,尊重人与人之间的边界 。他可以清晰、坚定、从容地表达自己的观点或者需求。不会刻意地追求他人的认同,不害怕对别人说「不」,同样的,他也不怕被别人拒绝。哪怕他人的想法对他来说难以理解,甚至是不可思议,他也会尊重别人,尊重这种不同。 

如何做到自我坚定?
自我坚定可以通过训练来习得,自我坚定训练(Assertiveness Training, AT) 是由Andrew Salter (1949)首先提出,Joseph Wolpe进一步发展和普及的。

以下是一些非常实操的,练习自我坚定的技巧:
1. 从“我”的角度来陈述(I-statement)
用“我”的句式能够展示出你的主权,表示你在为自己的感觉和想法负责,站在自己的立场上表达观点。当你思考如何用“我”来表达时,你已经完成了对自己的感觉、想法的识别。
而且,比起“你”的句式来,“我”的句式也能减少攻击性,把情绪改成事实。比如,当你不要说“你从来都不知道我的生活是怎么过的,你真自私”,而是改成“我现在精疲力尽,我需要在照顾孩子上得到多一些的帮助”。

2. 从小处着手,试着做那个发起对话的人
试着发起对话,给自己定下一些阶段性的小的任务,比如,每天主动问候不熟悉的人两次,在一周的时间里和同事尝试开展3次对你来说是很艰难的对话,或者,在餐厅要求换一个位置,在一次讨论里尝试做首个发言的人。

3. 具体化
你需要非常具体地描述你所认为的问题,抓住真正的问题所在,而不要陷于泛泛的指责;也需要具体地描述你想要达到的改变。永远不要认为别人就能自动地知道你需要什么,在感觉什么。
而且,你需要表达的是那个真实存在的问题,而不是笼统的抱怨。比如当你实际上是不喜欢Ta抽烟的习惯时,不要说“你总是这么邋遢”,“你这个人不好”。当你觉得对方某件事情做的不好的时候,具体说出让你不满意的是什么方面,以及你希望对方做出怎样的改进,不要只是说“你怎么总这样”。

4. 学会问问题,要求了解更多的信息
同样,你也可以要求他人去具体化他们的评价、请求和陈述。不要泛泛地问“你为什么这样说?”而是说,“你能让我了解(关于某个具体方面的)更多的信息吗?”

5. 练习表达拒绝的方式
调整在表达出反对和拒绝时候的用语。你首先需要学会的是直接使用“不”这个词,其实对方没有我们想象中那么难以接受。你还需要更多地使用“我不会做……”或者“我决定不去做……”,而不是“我不能……”或者“我不应该……”。
但记得在表达拒绝和反对之前,你需要确定这是你真实的想法。还需要明确的是,你的拒绝和反对,都针对的是某一件事情或者某一个请求,而不是这个人本身。

6. 练习一些非语言的技巧
在整体的态度上,你需要表达出公正和尊重,身体语言要和口头语言保持一致:坚定、平静、放松。你还需要练习保持适度的眼神接触,比如试着用2-3秒的时间注视对方,再逐渐延长时间,但不要死死地盯着对方看。
避免用一些攻击性的身体语言,比如用手指指着对方,攥紧拳头,身体僵硬;也不要用被动的身体语言,比如用余光瞟着对方,低着头,过多地点头。
在每一个犹豫不定、害怕冲突、无法拒绝的时刻,你都可以尝试以上这些。当你通过练习,开始逐渐变成一个自我坚定的人时,你就会更少地受到他人的干扰,更少地焦虑,体会到那种追随“本心”的满足感。

很多小伙伴留言告诉我们,自己无法和父母表达自己真正的想法,父母不会理解,甚至不愿意倾听。我们完全了解,在一些家庭中,如果孩子发出了和父母期待不一样的声音,会引发巨大的怒火和激烈的冲突。那种不被尊重、不被理解的感觉会让我们感到很挫败,久而久之就放弃了为自己主张,选择回避和假意顺从。
但其实有些时候,假如你最终还是希望获得一个更符合你的需要的家庭关系,一个痛苦甚至有些激烈的过程是无法回避的。而自我坚定是能够推进这个进程发展不可或缺的要素。你需要示范给你的父母看,什么是自我坚定的沟通方式,你要让他们感受到你倾听和理解他们,但你始终明确地表达你的想法和坚持;在这个过程里,你会教会你的父母你已经长大,你有独立于他们的意志;这个过程可能会持续很多年,但只要你反复去做,就一定会有进展。
逃跑总是比面对容易,好的改变却往往只能伴随着面对发生。




作者:金石明镜

链接:https://www.jianshu.com/p/efc5f5e8a791
來源:简书
著作权归作者所有。商业转载请联系作者获得授权,非商业转载请注明出处。