ptsd Tag

What Are Intrusive Thoughts? And What Can You Do About Them?

Intrusive thoughts can occur at any time and are just as they sound—intrusive! Intrusive thoughts are thoughts that come out of nowhere, are involuntary, and can be difficult to get rid of. Common examples of intrusive thoughts include wondering if the doors are locked, if the stove or curling iron is turned off, or if people like you.

Everyone experiences intrusive thoughts at some point in their lives. For most people, intrusive thoughts come into their mind and seem to leave almost as quickly as they arrived. They can recognize the presence of the intrusive thought, acknowledge it, and take care of it, whether that’s by cognitively or behaviorally disproving it. They may check to make sure the door is locked and then don’t give the thought any more attention. Or they may simply remind themselves that “of course the door’s locked” and focus their thoughts on other things. For most people, intrusive thoughts are nothing more than a huge annoyance.

For some people, however, intrusive thoughts can be a symptom of a deeper issue. Intrusive thoughts can be characteristic of several mental health conditions such as anxiety, depression, obsessive compulsive disorder (OCD), and post traumatic stress disorder (PTSD). In these cases, the intrusive thoughts are more than just annoying; they may cause severe emotional distress to the person or cause them to behave in erratic ways. For a person with OCD, for example, instead of dispelling the intrusive thought that the door is not locked by checking the door, the intrusive thought persists and can become a compulsion. For these individuals, the intrusive thoughts simply won’t go away.

Intrusive thoughts are different from hallucinations because they occur as thoughts and will typically present the way the person speaks. Hallucinations, on the other hand, sound as if someone else is speaking in your mind. Regardless of if you experience an occasional intrusive thought or experience them frequently as a symptom of a larger mental health issue, there are some things you can do:

• Acknowledge the thought and identify it as intrusive. When people try to ignore the thoughts or push them away, they typically occur more frequently. Has anyone ever told you not to think about something? I remember being told not to think about ice cream once. Suddenly, ice cream was all I could think about!
• Remember that you are “normal” and everyone has intrusive thoughts from time to time.
• Continue with your usual behavior.
• Practice mindfulness and meditation to help practice “refocusing” your thoughts. Many people find “grounding” – a therapeutic approach where you focus on connecting to the earth – helpful. This can be accomplished by simply looking around the environment for things you see, hear, feel, taste, and smell.
• Learn and practice Cognitive Behavior Therapy (CBT) or another approach to reframe distorted thoughts.
• Receive professional treatment if intrusive thoughts persist or become bothersome. During your initial meeting, the clinician will usually ask about the frequency and intensity of the intrusive thoughts. They will also ask other questions to determine if the intrusive thoughts are symptomatic of an undiagnosed mental health condition. Sometimes a clinician will decide that medication may be the most appropriate way to treat intrusive thoughts.

Written by Rayeann Milne, Counseling Intern. If you’d like to schedule an appointment with Rayeann, please call us at 412-322-2129.

Interested in Medication Management for Intrusive Thoughts?

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References: 

Bilodeau, K. (2021). Managing intrusive thoughts. Harvard Health Publishing. 

https://www.health.harvard.edu/mind-and-mood/managing-intrusive-thoughts

Sreenivas, S. (2021). What are intrusive thoughts? WebMD. 

https://www.webmd.com/mental-health/intrusive-thoughts

What is Complicated Grief?

Losing someone close to you can invoke many complex emotions like sadness, pain, loss, and hurt. These feelings are natural and a part of life, but with complicated grief, or complicated bereavement disorder, such feelings don’t fade with time or improve. Their emotions might be so intense that it disrupts their daily life.

Living with complicated grief can bring up dysfunctional behaviors and unconventional thoughts. This chronic form of suffering can make it impossible to return to a healthy state of life. When normal grief does not go away, complicated grief occurs.

Think of complicated grief like being in a heightened state of mourning that prevents you from accepting and moving forward. Often this looks like intense sorrow and pain and constantly thinking about the loss of your loved one. You may find it challenging to think about anything else but your loved one’s death. But also, complicated grief could also arise from separation as well as life transition such as loss of job. 

Complicated grief can arise from any type of loss

Losing someone close to you is a distressing and natural event that everyone faces at one point or another throughout their lives. It is entirely normal to go through a period of sadness, numbness, regret, guilt, or even anger. However, these feelings eventually fade and are replaced with acceptance and the ability to get on with life.

For most people, the grieving experience follows a natural sequence and timing of events:

• Acceptance of loss
• Experiencing the pain and grief of your loss
• Adjusting to a new reality without your loved one
• Having new relationships

Complicated grief does not allow you to move through these stages in a healthy time frame.

Examples and Signs of Complicated Grief

Complicated grief can look like normal grief, except that symptoms usually fade over time with normal grief.

Examples of complicated grief may include:

• Avoiding thinking of their loss
• Obsessively thinking of their loved one
• Intense longing for their loved one
• Feeling a loss of purpose in life
• Constantly reminding themselves of their loved one
• Suicidal thoughts
• Unable to accept their loss that occurred at least six months ago
• Feelings of loneliness
• Insomnia
• Lack of interest in taking care of one’s self
• Reckless and self-destructive behavior
• Inability to resume their regular routine
• Avoiding activities or places that remind them of their lost one
• Loss of appetite
• Stress and anxiety

If these symptoms persist for more than a month and significantly impair your life, then it may be time to seek help.

Please contact the National Suicide Prevention Lifeline at 1-800-273-8255 if you have suicidal thoughts to receive support and assistance from a compassionate, trained professional.

Healthy Ways to Cope

The best way to cope with complicated grief is by seeking out professional counseling and therapy. Treatment can help you focus on your condition and begin the process of healing.

The most common treatment option is called bereavement therapy. A bereavement counselor will show you ways to monitor your grief and stabilize your emotions. You can also join a bereavement support group to talk about your feelings of sorrow, pain, and loss. It’s important to know that you are not alone and that other people experience the same emotions.

Other forms of therapy can help you cope with your situation, such as traumatic grief therapy. Help is always available, and you can find ways to find happiness and peace again.

If you are suffering from grief know that you’re not alone, and it’s okay to ask for help if you feel your grief is overwhelming. You can contact us at 412-322-2129 to set up an appointment with one of our Grief Counselors or email us at info@counselingwellnesspgh.com to get started. Or contact us here.

PTSD in the Black Community

Recent events have some people scared. This makes sense. People are clamoring for change, and tensions are high. Not to mention, the nation is still in the middle of a worldwide pandemic that has left millions unemployed and our economy teetering on the edge of a cliff. All of these disasters and injustices have disproportionately affected minorities. Some people will be traumatized by the happenings of today. So in light of that fact, I decided to examine Post Traumatic Stress Disorder (PTSD), as it relates to the black community.

Let’s start by describing this mental health disorder. Post Traumatic Stress Disorder, or PTSD as defined by the American Psychological Association is a mental illness and specifically an anxiety disorder where an individual struggles with recovery from witnessing or experiencing a terrifying event. Unlike the commonly held belief, PTSD is not limited to wartime veterans, and it can manifest due to several different ordeals such as domestic abuse, sexual assault, or even natural disasters. The disorder can last several months to several years, when a person sees, hears, or remembers something that they relate to that event, they are ‘triggered,’ this can happen often and be debilitating for a person who holds or qualifies for the diagnosis of PTSD as triggers can come up often within everyday life leaving them struggling with a feeling that they are back in that  traumatizing event. Remember, a trigger is a memories that evokes an extremely intense emotional and physical reaction. 

Other symptoms of PTSD often include nightmares and unwanted memories, flashbacks, heightened reactions to otherwise non -threatening stimuli, avoidance of triggering situations, PTSD can even lead to anxiety, depression, and make a person more vulnerable to developing substance abuse. Treatment for PTSD is available in the form of different types of trauma-focused therapy models. Some of these models might include the use of medication to relieve symptoms of PTSD as they allow individuals to work toward a better quality of life.

So how does this relate to the black community? It’s easy to see that the black experience in the United States is rife with traumatic events. From the desperation that arises through the effects of poverty, to the overt systematic racism that permeates our justice system. Minorities are repeatedly traumatized by the witnessing of the murders of innocent men and women. Trauma is experienced when we read about the number of black men in the prison system (many for nonviolent offences). We become anxious every time we see a video of a woman threatening to call the police on citizens minding their own business. But the worst part about it, is that we have been exposed to it over, and over, and over again, allowing the traumatic cycle to continue.

As a member of the black community, I want to emphasize that this trauma is real, and that it’s impact has lasting consequences. If this resonates with you, you’re not alone, and this does not mean you’re weak. This is the result of our community collectively experiencing PTSD. As mentioned earlier, there are resources to help individuals make sense of it all. I want to encourage you to take the steps necessary to take care of yourself, even as we all work to make these sources of trauma a thing of the past. Reach out to your local therapist at Counseling and Wellness Center of Pittsburgh, as well as to your support groups. Be aware of your triggers and learn positive ways to cope with them. Remember, your voice is your ally, do not stop talking about this! 

By: Henry Ternier, MSCP, LPC 

Hands off-Please Do Not Touch My Body, Yoga and Consent.

Consent, Please Do Not Touch My Body

Hands off-Please Do Not Touch My Body.

Closeness is sacred and powerful, and we should share it however we would like with a partner or partners with whom we have provided consent. Personally, I am a ‘toucher’, meaning I am a person who enjoys touch with my partner, someone who hugs family and friends and genuinely savors safe closeness. As we all know, touch can feasibly happen in many contexts. A recent trip to a local yoga studio has spurned some inspiration for considering consent and what exactly that means within the context of yoga. Consent is one of the topics of the century, the importance of asking for it, and heeding to it are championed issues with personal, psychological, and legal context. When we are on our yoga mat, we are presumably in a safe zone, we practice yoga to be well, to relax, to be inside of our bodies, to give life and expression to what our physical selves need in the moment to create our highest expression of safety, openness, and comfort. We rely upon the professionalism, understanding, and care of our yoga instructors while we are on the mat. When others take liberties with our bodies, reactions can range from uncomfortable to traumatic, yet we shouldn’t need to rely upon trauma informed yoga instructors to be the only providers who can offer a style of instruction which provides opportunity to say “No thank you, please do not touch my body.’ From chaturanga to shavasana, we find our bodies configuration of the posture as the yoga instructor cues. Without making space for hands off adjustments, one well-intentioned yoga instructor can inadvertently have a negative impact upon his or her student’s practice, day, overall wellness by taking liberties with his or her student’s bodies.

Consent means that one has asked for permission to approach another person in any way, whether that be to touch, to enter an intimate encounter, or even to provide unsolicited verbal feedback, we should always ask before encroaching upon others. After asking for consent, we wait and pause for that person to respond with their response of approach or avoid. A key component of consent is that the other person is truly able to say ‘no,’ if we are in a position of power, or if we are asking a person who is intoxicated, a minor, or incapacitated in any way, then the other can not provide for their own consent. Under normal circumstances, then, if and after we have been given permission to ‘approach’ we take it a step further to check in to be completely sure that non-verbal permission has been granted to continue or deepen the exchange. Physical space, proximity, and closeness are very special, they are exchanges which can lead to bliss, warmth, bonding, relaxation and even orgasm in the right time. When touch is used subversively, to coerce, to control, to harm, physical connection can become shrouded in horror, it also has the potential to instill anxiety, fear, terror, panic, and pain.

Consensual sexual intimacy is the gold standard, we should always be sure that we are well within the green zone of any boundaries of any person who we are touching and to also always note that we are creating safety for others as we strive for mutual enjoyment and pleasure. There are many contexts or situations where touch happens from fitness instruction, personal training, yoga instruction, little league coaching, physical therapy, massage, and medical settings. While there are many of the medical and physical instructors listed above who do check in and ask, ‘is it ok for me to adjust you.’ The best ones who follow this question by ‘does this feel ok for you’ and to them I applaud their insight and wisdom to always, in all settings, to ask first and wait for an enthusiastic ‘yes’ or a clear non-verbal head nod which unambiguously encouraging procession. For other yoga and fitness instructors, it may be less obvious that they should ask for consent before breaking the touch barrier with students. Let us examine consent from a trauma informed perspective and look at some ways that we can be sure we are always providing supportive and caring touch.

Regardless of the setting or context, we do not have permission to touch another person until we have asked for it and they have given it. For a trauma survivor it can be very triggering and alarming to feel a person, even a coach or instructor grabbing at them, or tapping on their body, for another person to move ones legs or touch ones hands. Feeling safe and giving permission for these things to happen is vital and walking into a yoga studio to practice does not provide consent for one’s physical boundaries to be violated. Just as walking into a bar or nightclub in a low-cut blouse is not the same as providing consent for someone to touch our breasts. Being a woman out late having drinks is not an invitation to have sex, we need a society which is built upon making space for ‘Yes’, or ‘No’ by always ask first. Yoga and fitness instructors, we are here, we want to participate in a fun and fulfilling way but ask before touching please. Additionally, for some instructors who may have a style of delivering their teaching that is very directive and assertive, it may feel punitive to some students.

Recently, in an all levels class, the instructor was someone I had never practiced with before. The class was much less than an all level class, it was more of an intro in my experience, we were cued to move into postures without much attention to how we flow through the sequencing. In any event, after 15 minutes or so warming up, we were cued to do some Sun A’s. When forward folding the instructor told everyone to grab a two blocks in anticipation of their hands not hitting the ground. I have long arms, and have been doing forward folds for many, many, years, it does not tax my body to fold forward and I find it delicious and restorative. The teacher stomped back to me and said ‘No! get your blocks, do not go into your deepest fold!’ In knowing my body, and knowing that I did not need the blocks I started to reach for them to appease her as she began grabbing my leg and tapping rapidly and harshly onto the front of my quad with her pointed finger tips and squinted eyes, ‘Move! Move! Move!’ she commanded. What started as a day of wellness, mindfulness, and an attempt to let myself feel peace, quickly became a source of discomfort and anxiety.

Being a yoga instructor is a big responsibility, it is a pathway to open ones consciousness, those blissed out happy vibes and chakras can really open up and make others aware of themselves, their feelings as well as anything happening with the instructor. We should encourage yoga instructors to have a higher level of insight into their style of relating to others so that the instructor is not unconsciously projecting their own unmet needs or style onto all of those who they come into contact with. The yoga instructor should be very aware of how of tone and content of speech particularly as adjustments are being made. If an instructor is simultaneously speaking in a critical or cold tone ‘move!’ ‘faster!’ ‘in, in, in;’ in a style that feels like they are spitting commands to the students, if the instructors speak this way while grabbing at a students body, it may become even more likely that they are making others feel tense, uncomfortable for anyone, and furthermore this kind of tone and motion can even be panic inducing for some trauma survivors.

More than ever, we must seek to create safety, to speak with love, to be sure that we are providing physical touch which is tender, and warm, and supportive or not tender and warm, if that is the kind of touch which is consensual and agreed upon by those who can legally and actually provide consent. Speak and act with awareness and care for other people’s feelings, doing fitness, pilates, doing a forward fold or downward facing dog, or even having a suspicious mole removed from our bodies are things that must happen peacefully and respectfully, and always with particular attention to any person’s ability to state, ‘No thank you- please do not touch my body’.

Be well,

Stephanie Wijkstrom, MS, LPC, NBCC

Counseling and Wellness Center of Pittsburgh

830 Western Avenue Pittsburgh Pa

and

Counseling and Wellness Center of Pittsburgh – In Monroeville 

2539 Monroeville Blvd Monroeville Pa 15146

For more reading on the ethics of touch in yoga;

https://www.yogajournal.com/teach/the-ethics-a