DESCRIBE YOUR PTSD SYMPTOMS

GOALS OF THE EXERCISE

1. Identify and clarify the experience of PTSD symptoms.
2. Identify the most distressing symptoms and the frequency of their occurrence.
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL
• Physical/Emotional Abuse Victim
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
This is a simple and straightforward exercise designed to help the client focus his/her
thinking on the specific PTSD symptoms he/she has experienced. You may want to
review
the list of PTSD symptoms with the client within the session to clarify the meaning
of some of the symptom descriptions. During your review of the completed exercise,
allow
the client to elaborate on any of his/her symptoms and explore how these symptoms
have affected his/her life.
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EXERCISE XXIII.A

DESCRIBE YOUR PTSD SYMPTOMS

After having been exposed to a serious threat or actual physical trauma or abuse,
many
people develop a set of symptoms in reaction to the trauma. The immediate response
of
fear, helplessness, or horror often gives way to lingering effects that can be intense at
times and can affect your life in many ways. This exercise is designed to help you
focus
on and identify those specific symptoms that you have experienced.
1. Review the items in the two columns and put a checkmark in front of the symptoms
that you have experienced since enduring the traumatic event:
Intrusive thoughts/Images
Disturbing dreams
Flashbacks of the trauma
Reminders of trauma bring distress
Shakes, sweats, heart racing
Avoid talking about the trauma
Avoid trauma places/people
Amnesia regarding trauma
Withdrawal from activities
Feel detached from other people
Emotionally numb
Pessimistic regarding future
Sleep pattern abnormal
Irritable
Poor concentration
On edge
Easily startled
Sad or guilty feelings
Alcohol/Drug abuse
Suicidal thoughts
Conflict with others
Verbally/Physically violent
2. Which of the symptoms that you have placed a checkmark next to have caused you
the most distress?
3. How frequently does each of the symptoms that you noted occur?
4. When was the last occurrence of a PTSD symptom and what was that symptom?
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Therapist’s Overview
DESCRIBE THE TRAUMA AND YOUR FEELINGS
GOALS OF THE EXERCISE
1. Describe the traumatic experience(s) in some detail.
2. Identify the ways that the trauma has impacted your life.
3. Communicate the feelings associated with the traumatic event.
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL
• Grief/Loss Unresolved
• Physical/Emotional Abuse Victim
• Sexual Abuse Victim
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
It is always a delicate clinical decision as to when and how to encourage the client to
explore
the details of a severe trauma that he/she has experienced. If there is any question
about the ability of the client to focus on the details of the traumatic event outside of
the
supportive therapeutic relationship, allow the client to answer the first question within
a
therapy session. Allow the client to begin to express his/her feelings associated with
the
trauma, both those that were immediately precipitated by the event and those feelings
that
can be stirred after the event.
220
EXERCISE XXIII.B

DESCRIBE THE TRAUMA AND YOUR FEELINGS

It is not unusual for someone who has experienced a physical and/or emotional trauma
to
want to avoid anything and everything that is associated with that trauma. A common
reaction
is, “I don’t want to talk about it.” However, refusing to deal with a traumatic event
by attempting to bury it will only increase the negative consequences of that trauma
and
prolong its effects. The trauma victim needs to share, when the time is right, as much
detail
about the experience as he/she possibly can. This exercise is designed to help you
share what happened and express how you feel about it.
1. Describe the traumatic incident, giving as many specifics as possible (e.g., your
age,
the place of occurrence, details of what happened, who was present at the time of the
trauma). If necessary, use additional paper to describe your experience.
2. What other events have you experienced in your life that are similar to the
traumatic
event you described?
3. What are the harmful ways that you have attempted to cope with your emotional
reaction to the trauma (e.g., substance abuse, avoid thoughts of the incident, avoid
people/places associated with the incident, social withdrawal, sleeping)?
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EXERCISE XXIII.B
4. How have the trauma and your reaction to it, affected your life (e.g., peer
relationships,
school performance, family relationships, social/recreational activities, spiritual
journey, physical health)?
5. For each of the following emotions, place an X on the continuum to indicate the
strength of your feeling about the traumatic incident as you experience it on a regular
basis.
Anger
|||||
Very strong Strong Somewhat Barely Never
Sadness
|||||
Very strong Strong Somewhat Barely Never
Fear
|||||
Very strong Strong Somewhat Barely Never
Guilt/Shame
|||||
Very strong Strong Somewhat Barely Never
Embarrassment
|||||
Very strong Strong Somewhat Barely Never
Tension/On Edge
|||||
Very strong Strong Somewhat Barely Never
6. What do you think is going to be the most helpful strategy as you try to overcome
this
traumatic experience?
222
Section XXIV
PSYCHOTICISM
Therapist’s Overview
DESCRIBE YOUR HALLUCINATIONS
GOALS OF THE EXERCISE
1. Reduce anxiety associated with the experience of hallucinations.
2. Identify stressors that increase the frequency or intensity of hallucinations.
3. Separate reality from an hallucination.
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL
• Depression
• Mania/Hypomania
• Suicidal Ideation
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
This exercise provides an opportunity for the client to describe the history, nature, and
precipitating circumstances surrounding his/her hallucinations. It may be necessary to
administer this exercise verbally within a therapy session because the client may not
be
capable of staying focused enough to complete this as a writing assignment. The
therapist
should clearly label these hallucination experiences as the result of the client’s illness,
not
a reflection of reality. Suggestions could be made as to coping techniques (distraction,
medication adjustment, sharing with supportive individuals, etc.).
224
EXERCISE XXIV.A

DESCRIBE YOUR HALLUCINATIONS

Hallucinations are those private experiences of hearing voices or sounds, or seeing
visions that others do not experience. You may hear voices that others cannot hear/or
see
people or objects that others cannot see. This can be a very scary experience and it can
seem as if the experience is very real. This exercise is designed to have you describe
these private experiences that are not shared by others. Be as open and honest as you
feel
comfortable with as you answer these questions.
1. Do you hear voices that others do not hear? Yes No
If yes,
A. When did you first hear such voices?
B. What do the voices say to you? (Use additional paper, if necessary.)
C. Does it seem like the voices come from outside or inside your head?
D. Do the voices ever command you to do anything? If so, what do they tell you to
do? Do you do what they tell you?
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EXERCISE XXIV.A
E. What circumstances seem to bring on the hearing of voices? (When you are tired,
afraid, tense, alone, with a crowd?)
F. How does taking your medication affect your hearing of voices?
G. On a separate piece of paper, draw a picture of what you imagine the person
speaking to you looks like.
2. Do you see people or objects that others cannot see? Yes No
If yes,
A. When did you first experience these visions?
B. Please describe what you see that others cannot see.
C. What circumstances seem to bring on the vision?
D. How does taking your medication affect your seeing these people or objects?
E. On a separate piece of paper, draw a picture of what you see that others do not see.