PTSD and the Opioid Dependent Client
description
Transcript of PTSD and the Opioid Dependent Client
Angel Landrum, M. A.
Licensed Professional Counselor
Angel Landrum, MA LPC
◦Angel Landrum, M.A. LPC
◦Worked in substance dependence field for over 6 years
◦Narcotic Treatment Program over 3 years
Angel Landrum, MA LPC
Identify:◦Stress◦Trauma◦PTSD
Dependence as Trauma Techniques to help clients
Angel Landrum, MA LPC
Angel Landrum, MA LPC
Stress is the body’s reaction to an event that excites, frightens, confuses, or endangers the individual
Coping mechanism
Important and essential
Angel Landrum, MA LPC
Trauma is a set of physiological, cognitive, emotional, behavioral and spiritual symptoms that result from events that overwhelm the nervous system’s ability to cope
Angel Landrum, MA LPC
Can happen in any situation due to individual perception of the situation
Any situation can be potentially traumatizing if it is perceived to be: Life threatening Life altering Life diminishing Life deadening
Angel Landrum, MA LPC
The CNS (Central Nervous System) is overwhelmed and becomes dysregulated during a traumatic event
Individuals can lose the capacity to stabilize and regulate themselves
Results in feelings of helplessness, hopelessness and sense of being out of control
Angel Landrum, MA LPC
Where the body holds trauma:
◦Peripheral Nervous System consists of:
◦Autonomic Nervous System Circulatory, respiration, digestion, reproduction
◦Somatic Nervous System (Sensory-Motor) muscles reflexes proprioceptors
Angel Landrum, MA LPC
Loss of Self-Regulation over time is the core of PTSD
Traumatized people have to go from stimulus to a response without being able to assess the cause of the stress
Trauma disorganized the Nervous System
Angel Landrum, MA LPC
Trauma is in the nervous system---It’s NOT the event
Symptoms arise when the residual energy from the experience is not released from the nervous system
Angel Landrum, MA LPC
Posttraumatic stress disorder, or PTSD, can occur after someone goes through, sees, or learns about a traumatic event like:
Traumas
• Combat exposure •Child sexual or
physical abuse • Terrorist attack • Sexual/physical
assault • Serious accident • Natural disaster • Jury Duty• Dependence
traumas
• Job Related Stress
• Relationship Stress
• Fender Bender • Financial Stress
Angel Landrum, MA LPC
About 60% of men and 50% of women experience at least one traumatic event in their lifetime
Of those who do, about 8% of men and 20% of women will develop PTSD
Angel Landrum, MA LPC
Angel Landrum, MA LPC
Person must have both of these elements:
◦Event involved actual or threatened death or serious physical injury to the patient or to others AND the person felt intense fear, horror or helplessness
◦Person repeatedly relives the event in at least one of these ways: Intrusive, distressing recollections Repeated distressing dreams
Angel Landrum, MA LPC
Acute: If duration of symptoms are less than three months
Chronic: If duration of symptoms are three months or more
Specify if: With or without delayed Onset Onset of symptoms at least six months
after the event
Angel Landrum, MA LPC
Fear and Anxiety (Sympathetic Nervous system)
◦Feel tense or afraid
◦Agitated and jumpy
◦Must be on alert
Angel Landrum, MA LPC
Sadness/Depression
◦Sadness after a trauma may come from a sense of loss---of a loved one, of trust in the world, faith, or a previous way of life
◦Crying spells-lost of interest in things they used to enjoy- want to isolate feeling tired, empty, numb
Angel Landrum, MA LPC
Guilt and Shame
◦Clients may feel ashamed because during the trauma they acted in ways that they would not otherwise have done
◦Survivors guilt
Angel Landrum, MA LPC
Anger and Irritability
◦Anger may result from feeling of being unfairly treated (Misconceptions of OST)
◦Behavior changes or repeated attempts to manage opiate Dependence and distance themselves from treatment
Angel Landrum, MA LPC
Reliving the event or re-experiencing the event
Nightmares
Flashbacks
Seeing a person or being in similar place
Angel Landrum, MA LPC
Avoidance Trying to avoid situations or people that
trigger memories of the traumatic event
Resists talking about the event
Angel Landrum, MA LPC
Feeling numb ◦Cannot express what they feel
Feeling keyed-up (hyper-arousal) ◦Always on alert and on the lookout for
danger
Angel Landrum, MA LPC
Lengths to feed their Dependence Seeing a friend/family member overdose
or die Overdosing themselves Judgment from society and family- OTP
Angel Landrum, MA LPC
Withdrawal - not being able to fix during active drug use
Withdrawal - brought on self◦Not able to pay for services◦Not being complaint with rules of program◦Jail (if no services are available for dosing)
Angel Landrum, MA LPC
Withdrawal - In Opiate Treatment Programs, this can be a real event that is played out repeatedly
Withdrawal - In the Legal System with no access to medication when incarcerated
Angel Landrum, MA LPC
Remember - Even if the client doesn’t meet criteria for PTSD…
Traumatic events that remain stuck in the CNS can cause havoc
How can you help?
Angel Landrum, MA LPC
Client starts to disassociate…now what?
Put on your Oxygen Mask and Ground
Angel Landrum, MA LPC
Grounding
Connect
Contain
Calm
Angel Landrum, MA LPC
Grounding
Grounding is a connection between the person/space/thing and the earth
Establishes physical, emotional and spiritual safety
Angel Landrum, MA LPC
Connect
Establishing a connection that creates safety in the present moment
Reminding them to breathe and be in the moment
Angel Landrum, MA LPC
Contain
Containment exercise
Visualization works great
Educate the client
Angel Landrum, MA LPC
Calm
Breathing is back to normal
Can you feel your feet?
Stabilize
Angel Landrum, MA LPC
Important to know when to refer a person to a higher level of care if it is beyond our expertise
Outside Agencies may specialize in this area◦ Safe Place or YWCA◦ www.211.org
Private Clinicians who specialize in Trauma EMDR www.emdria.org
A reaction experienced by counselors who suffer trauma from the event(s) that have traumatized their patients.
Also called “Vicarious Traumatization” and “Secondary Trauma
Angel Landrum, MA LPC
Bystanders GuiltRageGriefDreadAnxietyDifficulty ConcentratingDepression
Numbing- “Have nothing left to give.”Panic AttacksDisturbed Sleep NightmaresChronically Late to WorkCrying Spells
Angel Landrum, MA LPC
Signs and Symptoms
Angel Landrum, MA LPC
Recovery from Fatigue Accept support and non-judgmental listening when offered Avoid negative peopleExercise, get out doorsTake turns with the most stressful tasksStaff Support GroupsGet Support
Angel Landrum, MA LPC
Traumatic events can cause relapse in our clients
Educate on how the body holds these traumatic events and that there is a solution
Anyone has the ability to help ground someone in the here and now
Angel Landrum, MA LPC
?
Angel Landrum, MA LPC
For copy of the presentation, please email me:
www. AngelLandrum.com