Before you can start working on the memories in therapy, you have to be able to manage the PTSD episodes so that they are less disruptive, and you can carry on everyday life. Working on them in depth prematurely can lead to weeks of inner disorganization, and inability to function.
So the first piece of advice is to use a mantra- "I'm xx years old". This keeps you in current reality, serves as a lifeline to your adult personality.
Second, is to learn to recognize the onset of an episode. If you can catch it early, it can be aborted by using the "cooling breath"- rolling your tongue and breathing through it like a straw. If you can't do it (it's a genetic thing) you can purse your lips instead. This yogic breathing technique can stop panic attacks, rages, and PTSD episodes.
I also give people a beta blocker called propranolol, to use as needed. It cuts off the adrenaline rush. Beta blockers can trigger asthma, so anyone with that tendency can't use them. Otherwise, they are benign and non-addictive.
Third, start keeping a PTSD journal. This consists of making a brief note about each episode, covering 4 items:
1) what triggered it;
2) how long did it last;
3) content- just the headline- age at time of memory and a few words- try to stay out of the memory itself when making the journal entry;
4) exit- how did you get the episode to end- could be a nap, a walk, talking to someone, watching TV, working.
The diary serves several purposes.
1) It objectifies the episodes, the first step toward gaining control of them.
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