Complexity of Adaptation

Once people develop PTSD, the recurrent unbidden reliving of the trauma in visual images, emotional states, or in nightmares produces a recurrent reliving of states of terror. In contrast to the actual trauma, which had a beginning, middle, and end, the symptoms of PTSD take on a timeless character. The traumatic intrusions themselves are horrifying: They interfere with "getting over" the past, while distracting the individual from attending to the present. The unpredictable exposure to unbidden feelings, physical experiences, images, or other imprints of the traumatic event leads to a variety of (usually maladaptive) avoidance maneuvers, ranging from avoidance of people or actions that serve as reminders to drug and alcohol abuse and emotional withdrawal from friends or activities that used to be potential sources of solace. Problems with attention and concentration keep them from being engaged with their surroundings with zest and energy. Uncomplicated activities like reading, conversing, and watching television require extra effort. The loss of ability to focus, in turn, often leads to problems with taking one thing at a time and interferes with readjusting their lives in response to the trauma (van der Kolk et al., 1996a).

Trauma early in the life cycle, particularly when it is recurrent and when it occurs in the context of an inadequate caregiving system, has pervasive effects on cognition, socialization, and the capacity for affect regulation (Cicchetti and Beeghly, 1996; Putnam and Trickett, 1993; van der Kolk and Fisler, 1995). Children exposed to abuse and neglect are at increased risk to develop depression and anxiety disorders. They have a high incidence of aggression against self and others, are vulnerable to develop disturbances in food intake, as in anorexia and bulimia, and suffer from a high incidence of drug and alcohol addiction (van der Kolk et al., 1996b; Felitti et al., 1998). It is thought that early and persistent sensitization of CNS circuits involved in the regulation of stress and emotion produces an increased vulnerability to subsequent stress by means of persistent hyper(re)activity of neurotransmitter systems, including corticotropin-releasing factor (CRF) (Heim and Nemeroff, 2001). Promising animal models for such chronic brain and behavior changes exist and provide opportunities for working out some of the essential neurological details (Adamec, 1997; Panksepp, 2001).

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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