All Posts in Category: Trauma

Is Suicide Contagion Behind The Recent Parkland Deaths?

We are only one month past the first anniversary of the shootings at Marjorie Stoneman Douglas High School and this past week we have all been saddened to learn of the suicides of two students who survived the attack. Additionally, the father of a child who was killed in the 2012 Sandy Hook school shootings also died this week – apparently due to suicide. Is it possible that these deaths are the result of suicide contagion?

What Is Suicide Contagion?

When the media reports that someone notable has died by suicide, it often seems that other suicides quickly follow – as if taking one’s life somehow becomes “contagious.” As an example, we saw this phenomenon last summer when Anthony Bourdain took his own life within days of Kate Spade’s death. Now there are concerns that this most recent suicide cluster involving the Parkland students and the Sandy Hook father may have happened partly because of suicide contagion.

Suicide contagion is also known as the Werther Effect – a phrase coined by suicide researcher, David Phillips, in the 1970s. Werther was a character in a 1774 novel by Johann Wolfgang von Goethe. In the book, Werther kills himself after the woman he loves marries another man.

The book was blamed for numerous copycat suicides across Europe after its release. In this early example of suicide contagion, many of the victims died in a similar manner to the Werther character’s death in the novel. Some were even found with copies of the book on or near their bodies.

There is strong evidence to suggest that suicides can occur in groups. Moreover, Phillips’ research into clusters of suicides led him to conclude that copycat suicides rise when there is excessive media coverage of the suicide of notable figures.

The Media’s Connection To Suicide Clusters

Besides Phillips’ research, several other studies agree that suicide rates go up when there is an increase in media coverage about a suicide. And the rates fall when the media coverage stops. Dr. Madelyn Gould, a suicide researcher from Columbia University has said, “The way suicide is reported is a significant factor in media-related suicide contagion, with more dramatic headlines and more prominently placed (i.e., front page) stories associated with greater increases in subsequent suicide rates.”

And, as with Goethe’s book, suicide clusters also tend to happen when a fictional television or movie character dies by their own hand. Dr. Gould says, “Research into the impact of media stories about suicide has demonstrated an increase in suicide rates after both nonfictional and fictional stories about suicide.”

Experts have long debated why suicide contagion occurs. Does the news coverage of a suicide cause other people to take their own lives or do they do so because they were already in a vulnerable state?

Either way, media guidelines for reporting these deaths have been in place in many parts of the world since the end of the twentieth century. The Centers for Disease Controls and Prevention (CDC) and the World Health Organization (WHO) have both issued policies for how news reports should cover notable and celebrity suicides.

Nowadays, however, we have a new concern. In the twenty-first century, we rely less on standard media reporting (like radio, newspapers, or television reports) and depend more on online sources to find out what is happening around us.

In particular, young people get their news from the internet and social media, which can spread a topic far faster than news broadcasts and – unfortunately – can do so with no filtering.

Suicide Risk Factors

In the case of the Parkland tragedy, we know that the first student to take her life was struggling with post-traumatic stress disorder (PTSD). She also suffered with survivor’s guilt, as do many of the teens who were there that day. It can be devastating to know that you’re still alive, but your friends will not reach the milestones that you will. Instead of being happy occasions, events like graduation or the first day of college are often very distressing for a survivor.

For young people between the ages of 10 and 24, suicide is already the second leading cause of death and this is without factoring in the trauma of a massacre like the one in Parkland. Clearly, we need to talk more openly about suicide prevention.

Adults and peers can help prevent a death by watching for youth suicide signs and risk factors and asking direct questions.

Although a risk factor can’t predict if someone will take their own life, having one or more of them makes it more likely the person will consider or attempt suicide. These risk factors are:

  • Mood or mental disorders (particularly anxiety disorders, schizophrenia, and some personality disorders)
  • A personal history of trauma or abuse
  • Feeling hopeless
  • A family history of suicide
  • A previous suicide attempt
  • Isolating themselves or having a lack of social support
  • Stigma against asking for or needing help
  • Alcohol abuse or abuse of other substances
  • Absence of mental health and substance abuse treatment
  • Knowledge of recent suicides of peers or learning about others who have taken their lives via news stories, the internet, or social media
  • Suicide ideation

The chances of suicide can also increase in someone who has recently had a financial loss, been diagnosed with a major physical illness, lost their job, or lost a close relationship.

Preventing Suicide

The first step in suicide prevention is awareness that someone is considering suicide. The next step is determining whether intervention is needed immediately.

If you know someone is at risk, you can help them by using the Columbia Protocol suicide risk assessment. The Columbia Protocol was developed jointly by researchers from Columbia University, the University of Pittsburgh, and the University of Pennsylvania, in conjunction with the National Institute of Mental Health (NIMH). In 2011, it was adopted by the CDC and today it is used worldwide to assess at-risk individuals.

The Columbia Protocol is a series of three to six simple, direct questions that you ask the person you are concerned about. The answers they give will provide enough information to know whether they need help and whether urgent action is needed (download the free Columbia Protocol toolkit now).

If your child or someone else you know tells you they are considering suicide, don’t judge them. Instead, show compassion for their feelings. Next, get help from a mental health professional or a suicide crisis hotline. The crisis hotline is especially critical if the person is in immediate danger of attempting suicide.

Never leave someone alone if they are threatening suicide. If you believe they are in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) in the United States. The line is open 24/7.

Let Us Help

If you are worried about yourself or a loved one who may be at risk for suicide, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Contact us or call us today at 561-496-1094.

References

Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine; National Research Council. Contagion of Violence: Workshop Summary. Washington (DC): National Academies Press (US); 2013 Feb 6. II.4, THE CONTAGION OF SUICIDAL BEHAVIOR. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207262/

 

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Abusive Relationships – Are You Involved With A Narcissist?

Abusive Relationships – Are You Involved With A Narcissist?

A narcissist is usually described as someone who believes they are better than others. It’s all about them. They think they know more about everything, are better looking, and have a better personality than those around them. They don’t have much regard for others.

Narcissists feel they deserve special treatment because they are so special. Everything they do stems from their need for approval. Life is good as long as they get their “fix.” But, those in a relationship with a narcissist often find that they unknowingly say or do the wrong thing, which sets off the narcissist’s hostility – even in minor situations.

What Makes A Person A Narcissist?

When you are in a relationship with a narcissist, the beginning stages can be overwhelmingly romantic. Narcissists are often popular people who are charming and engaging. They’ll “sweep you off your feet,” causing you to overlook any red flags.

In a new relationships, narcissists will go out of the way to make you feel special by sending flowers and surprising you with thoughtful gifts. They’ll flatter you and tell you how wonderful you are. They usually want quick intimacy and a commitment from you.

But, they are prone to grand ideas and exaggeration. They often have more than one intimate partner (even if they are in a long-term relationship) because they need more attention and admiration than one person can give them.

When something goes wrong, they lash out and their loved ones are generally their primary target. Narcissists have trouble holding positive feelings toward someone while they are angry at them. Thus, they become cold, withhold their love and attention, and sometimes become violent.

Their bullying and belittling is a way to cover up an underlying fear that they don’t measure up. A narcissist must maintain superiority at all costs, even if it means putting down or insulting their loved one in public or striking them in anger.

Narcissistic Personality Disorder (NPD)

In a 2009 study, Levy et al., noted that, “Narcissistic personality disorder (NPD) is characterized by a pervasive pattern of grandiosity, a sense of privilege or entitlement, an expectation of preferential treatment, an exaggerated sense of self-importance, and arrogant, haughty behaviors or attitudes.”

A 2008 study by Stinson, et al., revealed that 6.2% of the U.S. adult population has NPD. The disorder is most common in males. It is thought to be caused by both genetics and biology, combined with the person’s early home life and life experiences.

Psychology Today reports that narcissistic personality disorder is indicated by five or more of the following symptoms:

  • Exaggerates own importance
  • Is preoccupied with fantasies of success, power, beauty, intelligence or ideal romance
  • Believes he or she is special and can only be understood by other special people or institutions
  • Requires constant attention and admiration from others
  • Has unreasonable expectations of favorable treatment
  • Takes advantage of others to reach his or her own goals
  • Disregards the feelings of others, lacks empathy
  • Is often envious of others or believes other people are envious of him or her
  • Shows arrogant behaviors and attitudes

How Do You Get Away From A Narcissist?

Don’t think that a narcissist will change if only you care about them enough – especially if the person has NPD.

No matter what you do, it will never be enough, last long enough, or be loving enough for them, unless the person can become more self-aware. But, it is a rare narcissist who digs deeply enough into their own shortcomings to change that much.

In their minds, everything that goes wrong is someone else’s fault. In a relationship, they fault their significant other, although their loved one has no idea what they did wrong.

Tiptoeing around their outbursts isn’t going to change them. Letting them rant won’t pacify them. In order for them to change, they have to want to change – and a narcissist won’t even be willing to try unless they can really understand and empathize with your pain.

If you want to leave a narcissist:

  • Block them from your social media, block their phone number, and block the friends you have in common. A narcissist can’t stand to lose, so they’ll have no problem using any of these methods to win you back.
  • Don’t go back, despite their pleas that they made a mistake or that this time will be different. For narcissists, it’s all about winning. They’ll say or do whatever it takes to get you back. But, if you go back, ultimately nothing will change and you’ll go through the cycle of upset, pain, and leaving them again.
  • Concentrate on the future. You deserve to be in a healthy relationship. Don’t worry about the narcissist or try to contact them. Once a narcissist realizes the relationship is truly over, they can move on with very little thought to the pain you are going through.
  • Don’t beat yourself up over the relationship. Narcissists are great manipulators and deceivers. There is even a term – narcissistic trauma bonding – that explains why it can be so difficult to leave a relationship with a narcissist.
  • Learn from the relationship so you don’t repeat the pattern with someone else.

Can Narcissism Be Cured?

Current treatment for NPD is talk therapy and group therapy. These modalities sometimes can help a narcissist learn to relate to others more compassionately. Additionally, mentalization-based therapy may help the person learn to analyze someone’s behavior before misinterpreting it and reacting inappropriately.

The success of any therapy for narcissism relies on the person being able to acknowledge that they have a problem. Given a narcissist’s inflated view of themselves and their general defensiveness, this can be challenging. In fact, to date there have been no randomized clinical trials examining the efficacy of any treatment for the disorder (Levy, et al).

For many people, the best thing they can do for themselves is to break away from the narcissist. If that isn’t possible, seek therapy and get support to rebuild the self-esteem and confidence you have lost because of your abuse.

Seek out a mental health professional who has been specially trained in trauma recovery to aid in healing from narcissistic abuse. A therapist can help you learn to communicate effectively and set boundaries so the narcissist can no longer take advantage of you.

Important: if you are experiencing physical abuse, understand that it will continue or will get worse. Get help immediately by calling the National Domestic Violence Hotline at 1-800-799-7233.

Let Us Help

If you are involved with a narcissist, get help from our specially-trained trauma recovery mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

References

Levy KN, Chauhan P, Clarkin JF, et al.: Narcissistic pathology: empirical approaches. Psychiatr Ann 2009; 39:203–213

Frederick Stinson, Deborah Dawson, Rise Goldstein, S. Patricia Chou, Boji Huang, Sharon Smith, W. June Ruan, Attila Pulay, Tulshi Saha, Roger Pickering and Bridget Grant, “Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions,” Journal of Clinical Psychiatry 69, no. 7 (July 2008):1033–45, 1036.

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PTSD After The Sudden Death Of A Loved One

PTSD After The Sudden Death Of A Loved One

People form countless relationships throughout their lives – with family members, friends, coworkers, and neighbors. We have the deepest connections with the people we love – these relationships help make us who we are. They contribute to our sense of identity and have the power to transform us, for good or bad. Because of this, the death of a loved one can create numerous psychological issues, including PTSD, particularly if the loss was tragic and unexpected.

Posttraumatic Stress Disorder (PTSD) Symptoms

We know that survivors often experience depression or anxiety after the death of someone close. We don’t usually think about them having posttraumatic stress disorder (PTSD), but it can also happen, especially after a catastrophic death.

By definition, PTSD can occur when someone has “experienced, witnessed, or been confronted with a terrible event.” News of an unexpected death already brings up especially strong emotions because it catches us off guard. A tragic death magnifies those feelings.

In fact, a 2014 study¹ by Keyes, et al, noted that, “unexpected death was associated consistently with elevated odds of new onsets of PTSD, panic disorder, and depressive episodes at all stages of the life course.”

The symptoms of PTSD include:

  • Being frequently angry, tense, or jumpy.
  • Physical symptoms like heart palpitations, sweating, or hyperventilating.
  • Flashbacks of the trauma or dwelling on what the person might have gone through in their final moments.
  • Persistent avoidance of things or events that remind us of the person or place where the tragedy occurred.
  • Avoiding the emotions surrounding the death or event.
  • Problems sleeping or nightmares.
  • Changing their personal routine to avoid reminders of the event.
  • Distorted feelings of guilt; blaming themselves for the event.
  • Negative thoughts

Most of the time, people will slowly begin to recover from the initial shock and grief of a death. For those with PTSD, though, the symptoms dramatically affect their day-to-day life and they experience them for at least a month.

Treating PTSD After A Sudden Death

There are several effective treatment therapies for PTSD after the sudden or traumatic death of a loved one, including Cognitive Behavior Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Sometimes medications are used in conjunction with these modalities.

Cognitive Behavioral Therapy (CBT)

A tragedy and the resulting trauma can alter your thinking as you try to process what happened. For example, you might feel overwhelming guilt as if you were somehow responsible for the event. Or you may feel detached from the world or from those you love.

These negative thoughts can cause you to avoid the things you normally enjoy or make you worry obsessively that you’ll lose someone else in a similar manner.

Cognitive behavioral therapy (CBT) teaches you to become aware of your beliefs and thoughts about the situation. Once you identify them, it gives you the skills to see whether there are facts to support those thoughts and how to let them go if there aren’t. In short, CBT helps you manage your destructive beliefs so you can replace them with accurate views.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps people process trauma on an emotional level. It has been shown to help PTSD sufferers heal faster than through traditional therapy. In fact, a study funded by the Kaiser Permanente HMO found that 100% of single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after just six 50-minute sessions.

In PTSD, traumatic thoughts and memories work against the brain’s healing process. Flashbacks, nightmares, and disturbing emotions cycle through the brain, keeping the ordeal in the forefront of the person’s mind. Eye Movement Desensitization and Reprocessing therapy can break that cycle.

EMDR uses bilateral (both sides of the body) stimuli to tap into the biological mechanisms the brain uses during Rapid Eye Movement (REM) sleep. The theory is that using REM while recalling the disturbing thoughts or memories of the trauma helps the brain process it naturally, allowing the mind to heal.

The bilateral stimulation a therapist might use can include:

  • Hand tapping or toe tapping
  • Eye movements (following a pattern of lights)
  • Musical tones

Let Us Help

If you or someone you love has been suffering from PTSD following the traumatic death of someone close to you, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida help. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

References

  1. Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. The American journal of psychiatry171(8), 864-71.
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7 Tips for Dealing with the Trauma of School Violence

The nation has been horrified to hear about another mass shooting this week. For many in South Florida, however, the trauma surrounding school violence has hit particularly hard because it happened right in our own backyard. Many people likely know someone or know of a family with a child who attends the Marjory Stoneman Douglas High School in Parkland, FL. Because of this, you might find it challenging to deal with your feelings about the event.

Keep in mind that it is normal to experience strong emotions, such as anger, fear, sadness, grief, and shock – even if you don’t know someone who is personally connected to the shooting. You might also have trouble sleeping or concentrating and you may even feel numb when discussing the incident with others. All of these reactions are typical responses of trauma psychology.

Tips for Overcoming Trauma after School Violence

It will take a while to move past this heartbreaking tragedy, but we have some tips for managing your emotions during this horrific time. Following these guidelines can help you build resilience – the inner strength that you can draw on when you’re exposed to trauma or adversity.

  • Don’t suppress your feelings. Everyone processes a stressful situation in different ways. Give yourself time to mourn the tragedy and remember that working through grief takes a long time. Don’t try to rush it. If you have a more intense reaction than you feel you should, talk to others or to a mental health professional.
  • Take care of yourself. It’s harder to work through strong emotions when you are tired or not eating well. Try to eat a balanced diet and get plenty of rest. Set aside some time during the day to get some physical exercise, which has been proven to reduce stress. Also, try to avoid using alcohol or drugs to deal with your reactions – studies show they intensify negative emotions and can suppress your feelings, making it tougher for you to deal with your emotional pain.
  • Turn off the news coverage of the event. Overexposing yourself to the anxiety and raw emotions of this community violence by watching endless replays on the news or by reading numerous reports on the internet can increase your stress. In particular, images of the school violence can trigger new anxiety or prolong episodes of distress about the event. Try to focus on something positive to help raise your optimism, which will, in turn, help you feel more encouraged.
  • Maintain a routine. Patterns can provide a sense of comfort and security when your world has upended.
  • Talk about it with others. By doing so, you give yourself permission to mourn. Additionally, sharing your shock and distress makes you feel more supported, less alone, and less overwhelmed.
  • Help others. Being of service to someone distracts you from your own problems, plus it boosts serotonin levels, which will help you feel more positive.
  • If you and your family or friends have been directly impacted by this mass shooting, you will experience some form of grief. You may experience survivor’s guilt because you have lived and your loved one did not. You may feel alone and want to avoid others. Grief is unpredictable – it can seem to lessen, then reappear when you least expect it. Milestones, such as birthday or holidays, will often trigger a fresh round of mourning. Understand that this is part of grief and grieving is a long process.

If you find you can’t move past this school violence or another traumatic event that has happened in your life, it may be beneficial to seek out a support group or turn to a qualified, licensed mental health professional in order to move forward. It is especially important to do so if you are unable to carry out the daily tasks of living, such as sleeping, eating, and other functions.

Our Trauma Professionals Can Help

The Center for Anxiety and Mood Disorder’s Trauma Center has specially trained clinicians on staff to help those who are grieving or who have gone through traumatic situations. For more information, contact us or call us today at 561-496-1094.

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Dissociative Identity Disorder

When a person goes through an overwhelmingly traumatic experience, it is common to dissociate from it if it is too distressing to remember. For example, physical or sexual abuse might trigger detachment, the same way that going through an event such as the recent mass shooting at the Las Vegas concert may cause a survivor to “blank out” the memory that is causing emotional pain. For some individuals, however, their distress is so severe they may not be able to connect with their memories, feelings or even to their own sense of identity. These people likely have Dissociative Identity Disorder.

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Resilience and Optimism Can Predict Trauma Response

Resilience and Optimism Can Predict Trauma Response

How much of a part does resilience play when it comes to dealing with emotional or psychological trauma? As it turns out, quite a lot. Resilience is the inner strength that allows you to adapt when you’ve been exposed to trauma or adversity. This characteristic is strengthened by optimism, which is the extent to which people feel positive and encouraged about their future. Studies have shown that those who are resilient and optimistic feel a higher degree of psychological well-being and are able to recover more quickly from disturbing events. These individuals are able to process stressful situations without becoming overwhelmed and can move through them without turning to unhealthy coping mechanisms, such as substance abuse.

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Narcissistic Abuse – Healing and Recovery

Are you in a relationship with a person who thinks they are far superior to you and to everyone around them? Or maybe your parent ran your life, expecting nothing less than excellence from you and being envious of your achievements – so much so that they found a way to make your triumphs all about them. Perhaps you are married to someone who is “difficult” – they demand all your attention, have an inflated ego, and are frequently critical of you because things are always “your fault.” If you have a difficult, selfish, and unemotionally available loved one and feel like you have less self-confidence, have less independence, or have given up your family, friends, hobbies, or a career for this person, you may be dealing with narcissistic abuse.

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Post-Traumatic Growth

Emotional trauma or psychological trauma is a reaction to an experience or event that is deeply distressing or disturbing to the individual. Trauma can be the result of things such as going through a natural disaster, being involved in a car accident, living through a major event, such as war or abuse, or having been the victim of a crime. A trauma response will be similar no matter what caused it.

When people experience a psychological trauma, it often shakes them to their core, especially if they felt they had little to no control over the event. They are left feeling helpless and they may experience flashbacks or have a persistent fear that something bad will happen to them again.

Even though these emotional responses are part of a normal reaction, trauma changes patterns in your brain, causing you to carry the burden of distress long after the events have passed. However, by working with a mental health professional who specializes in trauma, you can experience trauma recovery and learn to feel safe again.

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What is Trauma?

What is Trauma

In general, trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. When loosely applied, this trauma definition can refer to something upsetting, such as being involved in an accident, having an illness or injury, losing a loved one, or going through a divorce. However, it can also encompass the far extreme and include experiences that are severely damaging, such as rape or torture.

Because events are viewed subjectively, this broad trauma definition is more of a guideline. Everyone processes a traumatic event differently because we all face them through the lens of prior experiences in our lives. For example: one person might be upset and fearful after going through a hurricane, but someone else might have lost family and barely escaped from a flooded home during Hurricane Katrina. In this case, a minor Category One hurricane may bring up traumatic flashbacks of their terrifying experience.

Because trauma reactions fall across a wide spectrum, psychologists have developed categories as a way to differentiate between types of trauma. Among them are complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder.

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