b'PTSD|had a difficult time, I consider myself compar- Social workers, occupational therapists, andatively sane. I am proud of that.recreational therapists are in an ideal position to helpPROMOTING PTSD RECOVERYThe challenge of PTSD recovery, according patients, both on acute inpatient units and in outpatientto van der Kolk, is to reestablish ownership of body, mind, and self and feel free to know facilities, based on mentioned therapeutic suggestions. and feel without becoming overwhelmed, enraged, ashamed, or collapsed.This physician is a strong believer in the concept of mindfulness. In order to heal, one needs to be open to inner experiences. Allow the mind to focus on sensations and out stress hormones to deal with real or imag- with anger and fear of uncontrollable rages. Herespond to changes in body position, breath-ined threats leads to physical problems, suchexpressed confusion. This man eventually wasing, and thinking. Practicing mindfulness as sleep disorders, headaches, unexplainedable to express that his feelings of helpless hor- calms down the sympathetic nervous system, pain, and oversensitivity to touch or sound. Toror began when members of his platoon wereso one does not feel the sensation of fight-or-relieve tension, some may engage in self-harm- killed or wounded in a manner of seconds. Heflight. Mindfulness also has effects on physi-ing activities, such as cutting self. They oftencontinued to hear the screams of these men.cal health, immune response, blood pressure, define themselves as defective and worthless.He experienced shame about what he did orand cortisol levels. Additionally, the practice They often lack trust, making it difficult tofailed to do during the war experiences. of mindfulness seems to activate brain regions form friendships. Traumatized people have a tendency toinvolved in emotional regulation.Van der Kolk has documented that childrensuperimpose their trauma on everythingSupportive relationships are a powerful part and teenagers that were regularly subjectedaround them and have trouble understandingof coping and healing from a traumatic expe-to abuse became neurologically over-arousedwhat is going on around them. Van der Kolkrience. Survivors benefit from the presence of and disorganized, with an inability to develophas documented that traumatized people lookfamiliar, caring people. Victims can recover in inhibitory and excitatory brain systems. Theyat the world in a fundamentally different waythe context of relationships: safe families and expected they would lose control if somethingfrom other people. An example is a rape victimloved ones, as well as AA meetings, veterans upsetting happened. About one half developedwho sees someone innocently approachandorganizations, religious communities, or with diagnosable mental health problems. Childrengoes into a panic.professional trauma therapists. People who and adolescents who receive healthy, consis- Trauma is not just an event that took placehave been abused by caregivers as children tent caregiving become neurologically regu- sometime in the past; it is the imprint left byoften do not feel safe with anyone. They may lated people. In studies of sexually abused girls,that experience on the mind, brain, and body,have a memory of one teacher, neighbor, min-clinicians found cognitive deficits, depression,according to van der Kolk. ister, or coach who cared; this memory may dissociative symptoms, troubled sexual devel- Author Barbara Leaming (2014), researchedhelp promote the ability to recover. However, opment, high rates of obesity, and self-mutila- this apparent imprint experienced by Firstvan der Kolk has helped patients who cannot tion. They also showed abnormalities in stressLady Jacqueline Kennedy. Mrs. Kennedy suf- recall any safe experience. He is an advocate hormone responses. They are often unable tofered from the clinical symptoms of post-trau- for pet-assisted therapy: engaging with horses, trust anyone and lack friends of either gender. matic stress disorder from her experiencedogs, or other animals that will provide an Veterans who have observed the horrorsof the assassination of President Kennedy.unconditional and safe first relationship step.of war are also often unable to tolerate socialMrs. Kennedy expressed flashbacks, insom- This physician has also written of the bene-relationships. Trusting self or others seemsnia, numbness, avoidance, fear, depression,fit of movement, in the context of music, sing-impossible. As a young psychiatrist, van derand anger. Mrs. Kennedys staff and familying, and dancing. A sensory integration clinic Kolk worked with an agitated, alcoholic,reported her guilt (if only she had been able toenvironment, often well-known to pediatric disheveled Vietnam veteran. It was summer- administer effective first aid to her husband).occupational therapists, can provide swings, time, with fireworks, heat, and gatherings ofShe often was unable to sleep, or awoke withtubs with multicolored rubber balls, balance adults and children, all of which remindedscreaming and nightmares. She was known tobeams, and weighted blanketsall of which this man of his time in the service. Noise ofdemonstrate emotional outbursts. Althoughmay help integrate a disorganized nervous sys-any kind caused agitation. He was afraid to beMrs. Kennedy reportedly received therapytem. The experiences may also be in a group around his family for fear of becoming upset.from a renowned psychoanalyst, she seemed tosetting, as when we play together, we tend to At night, he was haunted by nightmares. Hesuffer continually. In 1980, when asked duringexperience a sense of connection and joy.was unable to express any affection toward hisa presentation of her greatest accomplishment,Van der Kolk does recognize the benefits of wife or children, feeling emotionally numb orMrs. Kennedy replied, I think although I haveantidepressants, anti-psychotics, anti-anxiety 12 MENTAL HEALTH|2019| www.elitecme.com'