DISSOCIATIVE & POST-TRAUMATIC STRESS DISORDERS
Highlights of a Lecture by Bob Lawton, MSW
Director, Dissociative Disorders & Trauma Center, McLean Hospital
May 12, 1999

Summary

Mr. Lawton drew on a combination of publicized sources and experiential material when discussing this charged subject. He also discussed the work and approach of the Women's Treatment Center at McLean Hospital. In general the presentation focused on the groundbreaking work of Judith Herman and her 1992 book Trauma & Recovery.

Symptoms of PTSD (Post-traumatic Stress Disorder):

1. Hyperarousal: persistent expectation of danger, poor sleep, chronic arousal, reconditioned nervous system.
2. Intrusion: indelible implant of the traumatic moment in the mind, body, etc. Reliving it as if it was continually happening in the present. Vivid memories and sensations.
3. Constriction: The numbing response of surrender. Perceptions may be numbed or distorted. Can be dissociative. These symptoms dominate over time, particularly if the person is exposed to prolonged trauma, while the others may mitigate.

• Repeated trauma forms or deforms personality
• Abnormal internal relationships are fostered around the body, mind, emotion, imagination
• Sexual abuse is detrimental to body image

The Impact of Abuse Relationships

• Difficulty modulating anger
• Oscillate from isolation to clinging
• Childhood abuse leads to confusion about healthy relationships
• Connections, particularly if there were good connectins beforehand, are a good indicator of success

Stages of Recovery

1. Establish safety: accurate diagnosis, etc.
2. Remembrance & mourning: recovering the trauma. Change self-hate and self-blame and clarify that the adults involved were responsible
3. Reconnecting with ordinary life and re-establishing ordinary relationships. Holding perpetrators accountable. Looking at how we sabotage our life

1. SSRIs (Selective Serotonin Re-uptake Inhibitors): Prozac, Zoloft, etc.
2. Trazedone
3. Anti-anxiety meds, but these aren't used so much because people with PTSD can be subject to addiction.
4. New anti-psychotics: Risperodol, Seraquel, Olanzapine. These help with flashbacks, sleep disturbances.

Recommended Reading (Books)

• Bass, Ellen, & Davis, Laura. The Courage To Heal (1988)

• Chu, J.A. Rebuilding Shattered Lives (1998)

• Herman, Judith L. Trauma and Recovery (1992)

• Napier, N. Getting Through The Day (1993)

• Putnam, F. W. Diagnosis & Treatment of Multiple Personality Disorder (1989)

To order an audio tape of this lecture please call 617-855-2795.

For more information on treatment for mood disorders & substance abuse contact McLean Hospital or see our resource directory .