Understanding Anxiety and Trauma

Anxiety refers to the response of the body towards a stressing, unsafe, or unfamiliar circumstance. It describes the sense of distress, nervousness, or fear that one feels before an important event. Being nervous about a job interview or terrified over an upcoming test is healthy and is commonly referred to as “normal anxiety.” Anxiety of this nature encourages people to adequately prepare for situations they are uneasy about and ensures that one stays prepared and attentive. Anxiety can develop to levels that need health or medical attention (Wu, Tang & Leung, 2011). Anxiety Disorder can be devastating. The anxiety that may require treatment is usually overwhelming, absurd, and inconsistent to the situation. People who suffer from it feel like they have no control of their sentiments, and can include severe physical symptoms such as nausea, headaches, or trembling. If normal anxiety develops to be disproportionate and starts to recur and affect one’s daily life, it is referred to as reaching clinical levels and termed a disorder.

 

Trauma refers to an emotional response to a devastating circumstance such as physical or mental abuse, rape, accident, natural disaster, etc. After an event has occurred, denial and shock are common. Unforeseen emotions, flashbacks, stressed relationships and some physical symptoms such as nausea and headaches are some of the long term responses to trauma (Baldwin & Leonard, 2013). Traumatized people have problems moving on with their lives and may sometimes require guidance and intervention help from psychologists and other health care professionals to move on.

 

Some people who experience traumatic events may develop an anxiety-linked disorder referred to as Post-traumatic stress disorder (PTSD).  Individuals who suffer from PTSD encounter a hard time in the aftermath of the traumatic event that continues to impact them even after the event has subsided (Ardino, 2011). Continuous anxiety and difficulty in concentration are some of the prevalent symptoms in people suffering from PTSD.

 

It is important for psychologists and other professionals in the health care field to truly comprehend the relationship between trauma and anxiety (Hughes, Kinder & Cooper, 2012). Clinical Psychologists perhaps have an ethical responsibility to go beyond a mere text book understanding about this relationship if they are to become effect in their treatment approach.  In other words simply knowing what to call something by name does not terminate the treatment process. That may also be why psychology is referred to as a helping field (operative word being help) not just a naming one.    The treatment of both trauma and anxiety entails a detailed assessment and creation of a treatment plan that meets the distinct needs of the sufferer. It is essential for the health practitioners to have an in-depth understanding of both the conditions so as to be better placed to help the people suffering from these conditions. Because of the differences in experience and repercussions of the trauma, the treatment differs and is tailored to the symptoms and requirements of the person (Hyman & Pedrick, 2012). Psychologists must have a good understanding to ensure that their patients are able to lead a more balanced and functional life again. Health practitioners may have a difficult time in differentiating the symptoms of anxiety and trauma. Therefore, health practitioners must become proficient and informed on how to handle people suffering from anxiety and trauma.

 

Possessing sufficient understanding that can assist differentiate between anxiety and trauma will improve the outcomes of some of the interventions applied to assist those affected. In most cases, people suffering from anxiety disorders have previously been affected by a certain traumatic event. Thus, it is possible that these people will exhibit some symptoms that are the same during the phase they suffered from trauma. It is important for the health practitioners to understand the relationship between anxiety and trauma to ensure that they give the correct medications and that the appropriate intervention procedure is used. More importantly, we need to have in-depth knowledge and understanding so as not to re-traumatize those who are entrusted under our care. There is the high probability that many on your caseloads and even those you work around, you will have had traumatic past experiences.  Your approach in caring for these individuals can be a direct reflection of your skills and understanding about the anxiety/trauma relationship. Moral ethical rule number one: Do no (more) harm.

 

References
Ardino, V. (2011). Post-traumatic syndromes in childhood and adolescence: A handbook of research and practice. Chichester, West Sussex, UK: Wiley-Blackwell.

Hughes, R., Kinder, A., & Cooper, C. L. (2012). International handbook of workplace trauma support. Chichester, West Sussex: Wiley-Blackwell.

Hyman, B. M., &Pedrick, C. (2012). Anxiety disorders. Minneapolis: Twenty-First Century Books.

In Baldwin, D. S., & In Leonard, B. E. (2013). Anxiety disorders.

Wu, K. K., Tang, C. S., & Leung, E. Y. (2011). Healing trauma: A professional guide. Hong Kong: Hong Kong University Press.

 

Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern

 

Friday Factoids: Psychology Got Talent! (Or, the art of recognizing and valuing true productivity while promoting self-care in others.)

 

If you would like to become more productive while at the same time having more free time for yourself, you need to etch the ratio 52:17 into your mind. According to an article in the BBC health Column, the ratio 52:17 represents the average time spent working and relaxing for top earning performing employees.  That is, for every fifty-two minutes they spent working on the job, they had seventeen minutes of relaxation, self-care time. The article also outlines that the top ten percent of valuable performers at companies do not necessarily spend more time working than other low performing workers, instead they have periods of deep intensive work followed by short resting periods.

 

After reading this article I thought about work, productivity and more importantly effectiveness.  I realized that there was a significant difference between all three. It felt like an epiphany. Living our lives in an industrialized culture, it is usually ingrained that hard work lasting for long hours was productivity, and the less sleep you got meant you were being a good producer. I have seen many people brag about how many long hours they worked and how little sleep they got. They took pride in their work ethic without paying much attention to the actual results of that work. Who could blame them? If they came in early to work, left late, and looked busy for the ten or twelve hours they were at work, they would most certainly be considered for a promotion, a raise, awards, or perhaps coveted privilege employee of the month parking spots. Not hating the game, just highlighting some players. However, large high volume producing companies like Google, Apple and Starbucks have already aimed to shift that old pods, fully equipped gyms, yoga classes and literally free lunches to staff? A happy worker is a productive worker. Simple deductive reasoning, but not everyone is on board just yet.

 

Unfortunately this specific article, completely contradicts the mindset behind that type of thinking. It said that most managers and supervisors could not even tell the difference between employees who worked 80 hours a week from those who just pretended to. It also cited one study done from the Illinois Institute of Technology which said that scientist who spent 25 hours in the workplace were no more productive than those who were in the workplace for just 5 hours. This showed that there was a clear distinction between work and productivity output. There is not a direct correlation between each of the two.

 

In the field of Psychology shouldn’t the concept of caring for our employees be greater emphasized? After all we are in the ‘taking care of people business’. If we are unable to extend care to ourselves and those around us, how on earth are we to offer those services to others in need? Can you teach others to fish without having a fishing rod (and not using the rod as a whip).

 

“Sometimes the most important thing in a whole day is the rest we take between two deep breaths. ” – Etty Hillesum

 

Reference:

http://www.bbc.com/capitalstory/20170613-why-you-should-manage-your-energy-not-your-time

 

 

Dianne Rapsey-Vanburen, MA
WKPIC Doctoral Intern

 

 

Article Review: Frightening Truths About First Episode Psychosis: Results From a 2011 NAMI Survey

 

 

For many psychologists, greater experience comes at a costly price tag of desensitization. When conducting a routine structured interview, the phrase “Do you often hear or see things that others cannot?” would hardly elicit a noticeable response reaction, from even the most novice clinician. We may unintentionally disregard that the field of Human Services often times involves evaluating very real, sometimes very difficult human experiences.  Treating these experiences with the great humility and reverence they deserve can unfortunately sometimes fade with time.  It is therefore imperative that clinicians be hypervigilent and proactive in submerging themselves into research studies and literature, which aim to connect and help clinicians to understand these distressing experiences. Experiences such as psychosis can be extremely frightening, confusing and deeply personal not only for those experiencing it, but also for those closely related and wanting to help, like friends and family members.

 

The National Alliance on Mental Health conducted an online survey of people who experienced psychosis or witnessed a friend or family member have an episode of psychosis. The 2011 survey followed another NAMI survey that found that, on average, there is a nine-year gap between a person’s first psychotic episode and the time they begin to receive treatment for their diagnosis.

 

The 2011 NAMI survey also focused on finding the possible reasons why people with psychosis go close to a decade before receiving treatment, and possible solutions to solving the problem. First, there was the issue of lack of knowledge about psychosis. According to the survey, approximately 40 percent of the people who had psychosis said they were the first to recognize the problem themselves. These people reported that they realized something was wrong but they did not know what it was, due to lack of understanding about psychosis in general. This problem was compounded by the fact that many people who experience psychosis tend to isolate from others. According to the NAMI survey, around 20 percent of the responders reported that they did not receive help from friends or family when they had their first psychosis episode (NAMI, 2011). Lack of knowledge also proved to be a problem among family and friends. Just like the patients who experience a psychotic episode, family and close friends have a difficult time understanding and recognizing the symptoms of psychosis when they see it, making it difficult to get the help needed for their loved one.

 

A second challenge that prevents psychosis sufferers from receiving treatment is the stigma attached to mental illness. Again, this problem stems from lack of knowledge about psychosis. Respondents to the NAMI survey said that the issues they found the most challenging were confronting the stigma of mental illness, telling others about their psychosis, and worrying about no longer being taken seriously by others.

 

All these issues lead to a similar problem, which is, mental health professionals do not become a part of the treatment of patients who have psychosis, until many years down the line after their first episode. This is a significant obstacle to the treatment of psychosis because many of the respondents to the survey suggested that finding the “right” doctor, keeping appointments, and taking medication were very helpful in their treatment.

 

Observing the results of the NAMI survey, this writer believes that a comprehensive approach is necessary to solve the problem of delayed diagnosis of psychosis. According to the survey, many of the respondents said that they first received information about psychosis online. As such, putting relevant information online would be a good first step in educating the public about psychosis. Also, having an educational blitz in schools, workplaces and other institutions about psychosis would go a long way in both destigmatizing mental illness, and providing relevant information for people to get help for themselves and their family members.

 

Finally, understanding that psychosis can be a frightening, confusing, and very personal experience for any individual. The human exchange of simply gaining information and marking a check symbol in some box cannot (hopefully) be a comforting solution for any clinician, when uncovering someone’s experiences with psychosis.  In fact, if the tables were turned, what kind of qualities would you require from the person sitting across from you, before you felt comfortable enough to open up about such a deeply profound experience?

 

“The psychological equivalent to air, is to feel understood” – Stephen R. Covey

 

Reference: https://www.nami.org/psychosis/report

 

 

Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Differentiating Subgroups of ADHD

Penn State University (2016) researchers recently found that young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate subtle physiological signs that may help provide a more accurate diagnosis and possible identification of types of ADHD.  Their findings indicated that while engaged in a continuous motor task, individuals with ADHD had greater difficulty inhibiting motor responses and produced more force during the task compared to controls.  This research allowed for a more precise measure of motor responses compared to previous assessments based on key-press response.  Additionally, the amount of force was related to the self-report of ADHD symptoms of inattention, hyperactivity, and impulsivity.

 

The goal of this research was reportedly to help differentiate subgroups of those diagnosed with ADHD, which aims to inform treatment and offer diagnostic specificity.  The use of continuous performance tests (CPT) in ADHD assessments has yielded variable reviews, although the use of CPT in research has provided valuable information specific to ADHD (Bjorn, Uebel-von Sandersleben, Wiedmann, & Rothenberger, 2015).  Regardless, research indicates that CPT provides information specific to sustained attention and impulsivity, and can be utilized as a tool to aid diagnosis and per Penn State researchers, possibly identify more subtle signs that could directly inform treatment and interventions.

 

References

Albrecht, B., Uebel-von Sanderslebem, H., Wiedmann, K., & Rothenberger, A. (2015). ADHD history of the concept: the case of the continuous performance test. Current Developmental Disorders Reports, 2(1), p. 10-22.

 

Penn State. (2016). Inhibitory motor control problems may be unique identifier in adults with ADHD. Retrieved from https://www.sciencedaily.com/releases/2016/11/161116103443.htm

 

Dannie Harris, MA
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Impact of Trauma on Later Mental Illness

Palmier-Claus, Berry, Bucci, Mansell, and Varese (2016) found childhood adversity, described as neglect, bullying, and emotional, physical, or sexual abuse, was 2.63 times more likely to have occurred with individuals with bipolar disorder.

 

They note the effect of emotional abuse was particularly robust, with emotional abuse being 4 times more likely to have occurred with individuals with bipolar disorder.  Given the severity, course, and deleterious impact of this disorder on the individual and their family, highlights a need to identify risk factors that can inform treatment.  Similar findings have shown a link between childhood adversity and other mental disorders.  Specifically, Matheson, Shepherd, Pinchbeck, Laurens, and Carr (2013) found medium to large effect size of childhood adversity with individuals with schizophrenia.

 

Thus, for both bipolar disorder and schizophrenia, research suggests childhood adversity as a possible risk factor for development of these disorders.

 

References

Matheson, S. L., Shepherd, A. M., Pinchbeck, R. M., Laurens, K. R., & Carr, V. J. (2013). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 43(2), 225-238.

 

Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), 454-459.

 

Dannie Harris, MA
WKPIC Doctoral Intern