© Copyright Gary Johnston 2011 Dealing with Trauma in a Traumatised World 'Tis in my head; 'tis in my heart; 'tis everywhere; it rages like madness, and

Dealing with TraumaDealing with Traumain a Traumatised Worldin a Traumatised World

'Tis in my head;'tis in my heart;'tis everywhere;

it rages like madness,and I most wonder how my reason

holds.

Trauma - PTSD – The TriggersTrauma - PTSD – The Triggers

Instance of exposure to death, Instance of exposure to death, violence, rape violence, rape

– War, accident, assault, rape, natural War, accident, assault, rape, natural disaster, witnessing such event.disaster, witnessing such event.

– Maybe single or multiple occurrenceMaybe single or multiple occurrence

Trauma – Most Common VictimsTrauma – Most Common Victims

War veterans and war survivorsWar veterans and war survivorsie: refugees from war zones etc.ie: refugees from war zones etc.

Natural disasters - civilians Natural disasters - civilians Emergency services – police, fire, Emergency services – police, fire,

ambulance, SESambulance, SES Victims of violent crime, rape etcVictims of violent crime, rape etc Victims of accidentsVictims of accidents

PTSD - SymptomsPTSD - Symptoms

Intrusive thoughts / Flashbacks Intrusive thoughts / Flashbacks / nightmares/ nightmares

Withdrawal and avoidanceWithdrawal and avoidance Hyper-arousalHyper-arousal Panic attacks /Panic disorderPanic attacks /Panic disorder Depression / hopelessnessDepression / hopelessness PhobiasPhobias Survivor GuiltSurvivor Guilt Anger / violenceAnger / violence

PTSD – The Facts (1)PTSD – The Facts (1)

685 out of 1000 people who are exposed 685 out of 1000 people who are exposed to a traumatic event will suffer symptoms to a traumatic event will suffer symptoms of PTSD in the days and weeks following of PTSD in the days and weeks following the event, but these recede for 65% over the event, but these recede for 65% over the following 90-120 days. the following 90-120 days.

Estimated 30% of victims of PTSD will Estimated 30% of victims of PTSD will have lifetime chronic symptoms unless have lifetime chronic symptoms unless properly treated. (= about 19% of total properly treated. (= about 19% of total trauma victims)trauma victims)


61% of men and 51% of women are 61% of men and 51% of women are exposed to at least one traumatic exposed to at least one traumatic event over the course of their lives. event over the course of their lives. An estimated 7.8% will experience An estimated 7.8% will experience PTSD at some point in their lives (as PTSD at some point in their lives (as defined by DSM IV)defined by DSM IV)


64% of female psychiatric inpatients 64% of female psychiatric inpatients suffer PTSD. suffer PTSD. 44% of male psychiatric inpatients 44% of male psychiatric inpatients were victims of physical abuse and were victims of physical abuse and develop PTSD. develop PTSD.

80% of PTSD patients have at least 80% of PTSD patients have at least one co-morbid disorder (anxiety/panic, one co-morbid disorder (anxiety/panic, depression, suicide).depression, suicide).


Over 250,000 Australians suffer PTSD Over 250,000 Australians suffer PTSD annuallyannually

High instance of alcohol and drug abuse High instance of alcohol and drug abuse AApproximately 50% of men and 25% of women with chronic pproximately 50% of men and 25% of women with chronic PTSD have drug and alcohol issues PTSD have drug and alcohol issues (Australian Centre for Post Traumatic Mental Health - 1999) (Australian Centre for Post Traumatic Mental Health - 1999)

Children of PTSD suffers suicide at 3 times Children of PTSD suffers suicide at 3 times the national averagethe national average


Women are twice as likely to suffer Women are twice as likely to suffer chronic PTSD than men (wider range of chronic PTSD than men (wider range of trigger events, rape etc)trigger events, rape etc)

80% of women in war zones develop 80% of women in war zones develop PSTD. Current figure for men is 68.5%PSTD. Current figure for men is 68.5%


In USA 58,000 died in Vietnam. 150,000 In USA 58,000 died in Vietnam. 150,000 have died by suicide since the war. have died by suicide since the war. (Nam (Nam

Vet: Dean 1990).Vet: Dean 1990). Official number is 58,000. Official number is 58,000. 30 years after Vietnam 10% of veterans 30 years after Vietnam 10% of veterans

suffer chronic PTSD (200,000 in US)suffer chronic PTSD (200,000 in US)(Keonen et al. 2008)(Keonen et al. 2008)

Current report 18 die per day, 1000/mth Current report 18 die per day, 1000/mth try to die try to die (VA)(VA)


Post major fires 24% of population show Post major fires 24% of population show PTSD PTSD (Marshall et al. 2007(Marshall et al. 2007). Firefighters same ). Firefighters same statistics as war veteransstatistics as war veterans

The overall prevalences of PTSD, The overall prevalences of PTSD, anxiety, and depression symptoms were anxiety, and depression symptoms were 7.0 percent, 32.6 percent, and 22.2 7.0 percent, 32.6 percent, and 22.2 percent, respectively in displaced percent, respectively in displaced refugees (refugees (JAMA 2011JAMA 2011) . ) .

The EffectThe Effect

Net effect is that chronic PTSD causes Net effect is that chronic PTSD causes extremes of anxiety, panic, depression, extremes of anxiety, panic, depression, withdrawal and isolation.withdrawal and isolation.

A key factor in isolation is the A key factor in isolation is the awareness of the stigma attached to awareness of the stigma attached to “mental disease”“mental disease”

Avoidance Symptoms - 1Avoidance Symptoms - 1

Trying to avoid thinking or talking about Trying to avoid thinking or talking about the trauma, as well as any feelings the trauma, as well as any feelings associated with the trauma. associated with the trauma. AApproximately 50% of men and 25% of women with chronic pproximately 50% of men and 25% of women with chronic PTSD have drug and alcohol issues PTSD have drug and alcohol issues (Australian Centre for Post Traumatic Mental Health - 1999) (Australian Centre for Post Traumatic Mental Health - 1999)

Avoiding people, places and activities Avoiding people, places and activities that trigger memories of the traumatic that trigger memories of the traumatic event. event.

Not remembering an important part of the Not remembering an important part of the traumatic event traumatic event

Avoidance Symptoms - 2Avoidance Symptoms - 2

Losing interest in, and enjoyment of leisure Losing interest in, and enjoyment of leisure activities, study, work or stop participating in activities, study, work or stop participating in such activities altogether. such activities altogether.

Feeling detached from other people Feeling detached from other people Being unable to feel joy or have loving Being unable to feel joy or have loving

feelings feelings Not be able to see a future for themselves, Not be able to see a future for themselves,

they don't expect to get married, have a they don't expect to get married, have a family, live a long time family, live a long time

(Hawthorne 2010)

(Hawthorne 2010)

More StatisticsMore Statistics

Excess Burden of health in Australia Excess Burden of health in Australia from PTSD early 2000’s $348 million from PTSD early 2000’s $348 million for Vietnam Vets alone for Vietnam Vets alone (Hawthorne 2010)(Hawthorne 2010)

14.4% of Australians live with severe 14.4% of Australians live with severe isolating anxiety illnesses every year isolating anxiety illnesses every year – that is 3 million people – that is 3 million people (ABS).(ABS).

Social IsolationSocial Isolation

Isolation stems from avoidance Isolation stems from avoidance symptomssymptoms

plusplus

Stigma associated with PTSD and Stigma associated with PTSD and mental illness in generalmental illness in general

(Only 10% of war veterans sought help)(Only 10% of war veterans sought help)(Nam Vet: Dean 1990)(Nam Vet: Dean 1990)

Actions RequiredActions Required

Encourage government, military Encourage government, military and emergency services and emergency services organisations to accept organisations to accept responsibility and properly fund responsibility and properly fund research, education and research, education and intervention programs.intervention programs.


De-stigmatising effects of trauma De-stigmatising effects of trauma through through educationeducation of public, of public, government, medical, government, medical, psychologists, schoolspsychologists, schools

Educate the educators!!Educate the educators!! Include ethnic education for minority Include ethnic education for minority

groups from war and natural groups from war and natural disaster refugeesdisaster refugees


We must normalise anxiety, We must normalise anxiety, especially PTSD, so they are viewed especially PTSD, so they are viewed as common as the cold – reducing as common as the cold – reducing social isolation and encouraging social isolation and encouraging treatment – public awareness.treatment – public awareness.

De-isolating improvements in De-isolating improvements in quality of life and reduction in quality of life and reduction in depression, anxiety and anger.depression, anxiety and anger.


Encourage adoption of new Encourage adoption of new evidence based methods to deal evidence based methods to deal with both the physical and with both the physical and emotional basis of PTSDemotional basis of PTSD

Current research points to Current research points to biochemical and emotional biochemical and emotional memory contributors to trauma memory contributors to trauma anxiety and memory /time anxiety and memory /time distortions.distortions.

Contact detailsContact details

Gary JohnstonGary JohnstonGrad. Dip. CH, MTLTPGrad. Dip. CH, MTLTP

Member International Society for Trauma Stress Studies (MISTSS)Member International Society for Trauma Stress Studies (MISTSS)Australian Association of Clinical Hypnotherapists and PsychotherapistsAustralian Association of Clinical Hypnotherapists and Psychotherapists

Director of the Australian National Hypnotherapy Register (ANHR)Director of the Australian National Hypnotherapy Register (ANHR)Senior Faculty of Goulding InstituteSenior Faculty of Goulding Institute

Web: http://www.gmfint.comWeb: http://www.gmfint.comhttp://www.ptsdresearch.orghttp://www.ptsdresearch.orgEmail: [email protected]: [email protected]

Tel: 03 8682 8772Tel: 03 8682 8772Mob: 0407 070234Mob: 0407 070234

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© Copyright Gary Johnston 2011 Dealing with Trauma in a Traumatised World 'Tis in my head; 'tis in my heart; 'tis everywhere; it rages like madness, and