Most of us take for granted our ability to complete the most basic steps associated with self care and social engagement. We never really consider that brushing one’s teeth, taking a shower, or having even the briefest social interaction with a stranger may be an emotionally strenuous task for some individuals. Naturally, when a person suffering from post traumatic stress disorder (PTSD) tries to explain the difficulty they experience executing daily tasks, it is not uncommon for them to be met with objections or to have their issues dismissed and be told to simply “get over it.” This advice is in no way helpful to the firefighter who is triggered by the sound of their own children crying, after witnessing children dying in a fire while on the job. And this certainly does nothing to assist the war veteran who relives moments on the battlefield everytime they hear the sound of aircraft overhead. From the decades of research on PTSD, one thing is abundantly clear—avoidance is not a viable option. Enter occupational therapy.
What Is Occupational Therapy?
Occupational therapy is a form of treatment for individual suffering from addiction or mental health disorders that interfere with their ability to perform daily tasks associated with living a normal, healthy. Occupational therapy focuses on three main areas:
- Self Care: includes personal hygiene, grooming, and healthy eating
- Productivity: includes maintaining employment or attending school
- Leisure: includes playing sports, team activities, and personal hobbies
Occupational therapists will often try to restore a patient’s self-confidence by breaking down big tasks into smaller, more manageable subtasks for the patient. This approach prevents the patient from feeling overwhelmed and gives them a sense of achievement by proving a series of small wins that bring them incrementally closer to achieving a big goal.
Symptoms of Post-Traumatic Stress Disorder
The biggest commonality among first responders, veterans, and survivors of abuse with post-traumatic stress disorder (PTSD) is that it impairs their abilities to move forward after the traumatic event. PTSD symptoms create severe psychological limitations that promote self-destructive behaviors. Through repetition, these behaviors become habits that an individual will feel unable to control, much less stop. PTSD symptoms are usually grouped into four categories:
- Intrusive memories
- Avoidance of triggering situations and emotions
- Negative changes in thinking and mood
- Changes in physical and emotional reactions
In his book, The Evil Hours: A Biography of Post-Traumatic Stress Disorder, David J. Morris describes the aftermath of trauma as follows:
Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. … In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas.
Understanding Your Emotions Helps Manage Symptoms
Our emotions are an important part of our individual growth and development. They can help us with everything from situational awareness to establishing healthy relationships. Distinguishing between an appropriate emotional response and a dysfunctional one can be a challenge for individuals with post-traumatic stress disorder (PTSD). Our occupational therapists teach patients principles and skills to help them better understand their emotions:
- Your emotions can provide you with useful information or important signals.
- Emotional signals can often be useful, but they should not be treated as facts.
- Your emotions are important, but keep them out of the driver’s seat when it comes to making certain types of decisions.
- Staying connected to your emotions is essential for developing useful coping techniques. However, you must also maintain the capacity for rational analysis of your reactions to situations and be able to evaluate whether or not your reaction is appropriate.
- In some situations, the appropriate action for you to take may be the opposite of what your emotions are telling you to do—this is called “opposite to emotion action.”
The process of working with occupational therapists is both collaborative and goal oriented, making it easy for patients to track their progress.
The Wise Mind: Balancing Emotion and Reason
When we are in our emotional mind, our actions are predominately based on our emotions and how we are feeling. Our response to stress or triggering situations is extremely reactive as we abandon logic, fact, and reason when our emotional mind has taken over. An example of your emotional mind taking over is when you overreact to a situation because it triggers a negative memory of a similar situation; your fear that something similar to your memory may happen again drives your overreaction, even if it is actually extremely unlikely.
We would all like to believe that we operate from our reasonable mind, however this is not always the case. The reasonable mind is the part of us that is based solely on logic and rational information. It gathers and interprets empirical information from our observations and forms beliefs and opinions based on that information. If drives actions that are are cool, controlled, and strategic. The reasonable mind is very useful in crisis situations. Many military personnel and first responders can tell you, being able to access the reasonable mind when you need it can be the difference between life and death. The reasonable mind is excellent for planning and evaluating big life decisions, however, it is possible to overdo it and fail to recognize and consider the significance of our emotional signals. Overuse can create habits such as minimizing our feelings, and compartmentalizing events that could be pivotal to our development by diminishing our emotional connections to them. Such habits could lead to depression, burn out, or feeling numb.
The wise mind is the integration of the reasonable mind and the emotional mind. It is a functional blend of strategic thinking guided by healthy emotional awareness. It is the capacity to consider past experiences, current perceptions, and theoretical knowledge, to arrive at a constructive understanding of one’s present situation. Our occupational therapists teach our patients techniques to make the wise mind more easily accessible and available to help them manage their trauma symptoms.
Problem Solving: Barriers and Strategies
Problem solving can be difficult for the average person on any given day. It requires us to use all aspects of our mental capacity to analyze a particular set of circumstances and available choices, and then produce a solution. An ideal solution would not only satisfy our immediate need, but would also be consistent with our long-term goals. This process can be extremely difficult for individuals suffering from mental health or substance use disorders as they may not trust their own judgement and or accuracy in assessing a situation.
Barriers to Effective Problem Solving
The first step that our occupational therapists take with patients is to help them identify common barriers to solving problems quickly and effectively, including the following:
- Looking for a perfect solution
- Feeling hopeless or helpless; believing that a satisfactory solution does not exist
- Feeling depressed, distressed, or anxious to the point that one cannot focus on problem solving
- Excessive fatigue to the point that impairs cognitive ability
- Underdeveloped problem-solving skill set
Strategies for Effective Problem Solving
Occupational therapist also teach patients a range of effective problem-solving strategies that can be used in different situations, including the following:
- Algorithms: An algorithm is a iterative, step-by-step procedure that produces a better solution with each iteration. While it has a high change of producing a good solution, it can be very time consuming.
- Heuristics: A heuristic is a mental rule of thumb, such as an educated guess, stereotype, or generalization. Many people tend to employ this particular strategy when faced with a series of complex problems to reduce the possibilities to a more manageable number.
- Trial and error: This approach can be effective when the number of potential solutions is small and the cost of failure is low. The idea is to try solutions, learn from the results, and keep trying until a satisfactory solution is discovered.
- Insight: With this strategy, the solution to a problem may appear “all of a sudden.” Many researchers believe that insight occurs when a person recognizes features of a current problem that are similar to a problem that the person has successfully solved in the past.
Subjective Unit of Distress Scale and Coping Strategies
It can be very difficult for those suffering from substance use and mental health disorders to clearly recognized and understand how they are feeling at any given time. Occupational therapists provide patients with tangible metrics to help them the recognize, isolate, and react appropriately to negative stimuli. The Subjective Unit of Distress Scale (SUDS) works as an emotional gauge, and is a crucial part of therapy. The SUDS protects patients from their more destructive emotions by teaching them practical ways to distract themselves from what they are feeling. The objective is to turn this distraction, which may be unusual to the patient in the beginning, into their habitual response to extreme stressors.
Occupational Therapists Help Patients Get Back to Their Lives Faster and Better
Recovery from post-traumatic stress disorder is a difficult process that requires hard work and commitment from the patient. Occupational therapists help facilitate this process and allow patients to return to their normal lives more quickly, with effective coping skills, useful habits, practical knowledge, and effective problem-solving strategies.
Call Us for More Information
If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.