Terrorfied By Bomb Attacks

Victims of terrorists attack may suffer from post-traumatic stress disorder, living in terror of a further attack. Treatment needs to change to help victims deal with their state of ‘terrified surprise’ [ Scott (In submission) PTSD – An Alternative Paradigm and Scott (2013) CBT for Common Trauma Responses London; Sage Publications]. Clients should be encouraged to swap the glasses gifted by the extreme trauma and through which today is seen as a ‘war zone’, for the glasses they wore the day before the trauma. Below is a handout to help terrorist attack victims gauge the actual personal threat level:

If you have been the victim of a terrorist attack and have PTSD as a consequence, you likely feel ‘there could be another attack anytime’. Life is spent avoiding anywhere remotely like the scene of the attack.  You probably also take flight at the sight of anyone or any object that reminds you of the attack.  Life is lived in a state of ‘terrified surprise’, jumping out of your skin at unexpected noises or sudden movements, perhaps getting angry when this happens. You repeatedly check for signs of danger, seek to minimise risk by for example keeping the exit in sight in enclosed spaces. This all comes to feel normal and that the only safe place is home, but home has actually become a ‘bunker’ and you get cross with others not staying in a ‘bunker’, relationships become strained and there’s an increasing sense of isolation.

  Numbers Murdered In Attack   Odds of Being Killed 1 in…   Numbers Injured  Odds   of being injured 1 in….
2016   97.3 million     19   3.5 million
2017     37   1.8 million   300   220,000
2018    0   infinite   3   23 million

The above odds should be contrasted with the far greater odds of being killed in a car crash at some point in your life, of 1 in 103  or as a pedestrian 1 in 556.

The chances of exposure to an extreme trauma at a public gathering are about 1 in 11,000. [ 6000 had people brought tickets for the Manchester Arena Concert in which 22 people died as a result of the bombing]. Would you bet on a horse in the Grand National at these sort of odds?

The real risk of danger from a terrorist attack is nothing like the PTSD sufferer imagines, the vividness of the memory sounds, smells, feelings of helplessness give a very distorted impression of the likelihood of being a victim. Life is then about daring to live as if you are not in this ‘hall of mirrors’/ ‘war zone’.

Dr Mike Scott

A New First Line Approach To PTSD

On March 4th 2020  I gave a One Day Workshop  Getting Back To Me Post Trauma   detailing the practical implications of my recently published paper ptsd an alternative paradigm. Hope you enjoy the Powerpoint presentation and find the paper interesting. There is a video commentary on the day at cbtwatch.com, please feel free to make your comments and observations there or e-mail me on michaeljscott1@virginmedia.com.

I have just been preparing for a Workshop, I am delivering to the Merseyside Branch of BABCP, on October 4th 2018, titled ‘CBT for PTSD and Beyond’. At this Workshop I shall  unveil my KISS Model of PTSD. KISS for the uninitiated stands for Keep It Simple Stupid. Unlike trauma focussed models of CBT and EMDR, it does not assume a flawed traumatic memory or arrested information processing.

 

 

As part of the presentation I will be saying that therapists should beware of questionnaires as they will overidentify symptoms because:

a) they don’t tease out whether a particular symptom is making a ‘Real World’ Difference e.g a respondent might indicate upsetting dreams, but if they are not woken by the dream and distressed this is not significant functional impairment and so would not count as a symptom that is ‘present’

b) in completing a questionnaire client’s are often not clear about the time frame under consideration, endorsing flashbacks/nightmares when they did have them initially but they are past, and also endorsing symptoms currently present such as poor sleep. For a diagnosis of disorder symptoms have to be simultaneously present and each must make a ‘real world’ difference. Only in an interview can you tease out both and request concrete examples of the extent to which a symptom is impairing functioning

Dr Mike Scott