Post-Traumatic Stress Disorder: Recovery after accident and disaster

By Kevin Gournay

A traumatic event can turn your world upside down - but there is a way out. Once thought to be a rare condition, PTSD is a natural reaction to disaster and trauma in our lives. In addition, up to 25% of people have significant related problems such as anxiety, depression, or substance abuse. Symptoms include flashbacks, emotional numbness, acute anxiety, and physical reactions such as increased heart rate and nausea. This book takes a wide-ranging look at the nature of PTSD after distressing experiences such as war, sexual abuse or rape, natural and man-made disasters, car accidents, or the death of a loved one.

• Language: English
• Publisher: SPCK
• Release date: Feb 19, 2015
• ISBN: 9781847093219

Book preview

Post-Traumatic Stress Disorder

Professor Kevin Gournay CBE is a registered psychologist, chartered scientist and a registered nurse who is an emeritus professor at the Institute of Psychiatry, King’s College, London. Over more than 35 years, he has had extensive clinical experience in the treatment of adult and child victims of post-traumatic stress. He has been responsible for the assessment and treatment of people who have been through a range of traumatic events. These include the Moorgate tube accident (1975), the King’s Cross fire (1987), the sinking of the Herald of Free Enterprise ferry (1987), the Paddington and Potters Bar rail crashes (1995 and 2002), and the terrorist bombings of 2005. He has also treated and assessed people involved in various domestic, industrial and road traffic accidents and other trauma, including war- and crime-related events and medical negligence.

Overcoming Common Problems Series

Selected titles

A full list of titles is available from Sheldon Press,

36 Causton Street, London SW1P 4ST and on our website at

www.sheldonpress.co.uk

101 Questions to Ask Your Doctor

Dr Tom Smith

Asperger Syndrome in Adults

Dr Ruth Searle

Assertiveness: Step by step

Dr Windy Dryden and Daniel Constantinou

Birth Over 35

Sheila Kitzinger

Body Language: What you need to know

David Cohen

Breast Cancer: Your treatment choices

Dr Terry Priestman

Bulimia, Binge-eating and their Treatment

Professor J. Hubert Lacey, Dr Bryony Bamford and Amy Brown

The Cancer Survivor’s Handbook

Dr Terry Priestman

Chronic Fatigue Syndrome: What you need to know about CFS/ME

Dr Megan A. Arroll

The Chronic Pain Diet Book

Neville Shone

Cider Vinegar

Margaret Hills

Coeliac Disease: What you need to know

Alex Gazzola

Coping Successfully with Chronic Illness: Your healing plan

Neville Shone

Coping Successfully with Hiatus Hernia

Dr Tom Smith

Coping Successfully with Pain

Neville Shone

Coping Successfully with Prostate Cancer

Dr Tom Smith

Coping Successfully with Shyness

Margaret Oakes, Professor Robert Bor and Dr Carina Eriksen

Coping Successfully with Ulcerative Colitis

Peter Cartwright

Coping Successfully with Varicose Veins

Christine Craggs-Hinton

Coping When Your Child Has Cerebral Palsy

Jill Eckersley

Coping with Anaemia

Dr Tom Smith

Coping with Asthma in Adults

Mark Greener

Coping with Birth Trauma and Postnatal Depression

Lucy Jolin

Coping with Bronchitis and Emphysema

Dr Tom Smith

Coping with Candida

Shirley Trickett

Coping with Chemotherapy

Dr Terry Priestman

Coping with Chronic Fatigue

Trudie Chalder

Coping with Difficult Families

Dr Jane McGregor and Tim McGregor

Coping with Diverticulitis

Peter Cartwright

Coping with Dyspraxia

Jill Eckersley

Coping with Early-onset Dementia

Jill Eckersley

Coping with Epilepsy

Dr Pamela Crawford and Fiona Marshall

Coping with Gout

Christine Craggs-Hinton

Coping with Guilt

Dr Windy Dryden

Coping with Headaches and Migraine

Alison Frith

Coping with Heartburn and Reflux

Dr Tom Smith

Coping with Life after Stroke

Dr Mareeni Raymond

Coping with Life’s Challenges: Moving on from adversity

Dr Windy Dryden

Coping with Liver Disease

Mark Greener

Coping with Manipulation: When others blame you for their feelings

Dr Windy Dryden

Coping with Memory Problems

Dr Sallie Baxendale

Coping with Obsessive Compulsive Disorder

Professor Kevin Gournay, Rachel Piper and Professor Paul Rogers

Coping with Phobias and Panic

Professor Kevin Gournay

Coping with Polycystic Ovary Syndrome

Christine Craggs-Hinton

Coping with the Psychological Effects of Cancer

Professor Robert Bor, Dr Carina Eriksen and Ceilidh Stapelkamp

Coping with the Psychological Effects of Illness

Dr Fran Smith, Dr Carina Eriksen and Professor Robert Bor

Coping with Radiotherapy

Dr Terry Priestman

Coping with Schizophrenia

Professor Kevin Gournay and Debbie Robson

Coping with Snoring and Sleep Apnoea

Jill Eckersley

Coping with Stomach Ulcers

Dr Tom Smith

Coping with Suicide

Maggie Helen

Coping with Thyroid Disease

Mark Greener

Coping with Type 2 Diabetes

Susan Elliot-Wright

Depressive Illness: The curse of the strong

Dr Tim Cantopher

The Diabetes Healing Diet

Mark Greener and Christine Craggs-Hinton

Dying for a Drink

Dr Tim Cantopher

The Empathy Trap: Understanding antisocial personalities

Dr Jane McGregor and Tim McGregor

Epilepsy: Complementary and alternative treatments

Dr Sallie Baxendale

The Fibromyalgia Healing Diet

Christine Craggs-Hinton

Fibromyalgia: Your treatment guide

Christine Craggs-Hinton

A Guide to Anger Management

Mary Hartley

Hay Fever: How to beat it

Dr Paul Carson

The Heart Attack Survival Guide

Mark Greener

Helping Children Cope with Grief

Rosemary Wells

Helping Elderly Relatives

Jill Eckersley

The Holistic Health Handbook

Mark Greener

How to Beat Worry and Stress

Dr David Delvin

How to Develop Inner Strength

Dr Windy Dryden

How to Eat Well When You Have Cancer

Jane Freeman

How to Live with a Control Freak

Barbara Baker

How to Lower Your Blood Pressure: And keep it down

Christine Craggs-Hinton

How to Manage Chronic Fatigue

Christine Craggs-Hinton

How to Stop Worrying

Dr Frank Tallis

The IBS Healing Plan

Theresa Cheung

Invisible Illness: Coping with misunderstood conditions

Dr Megan A. Arroll and Professor Christine P. Dancey

The Irritable Bowel Diet Book

Rosemary Nicol

Living with Angina

Dr Tom Smith

Living with Autism

Fiona Marshall

Living with Bipolar Disorder

Dr Neel Burton

Living with Complicated Grief

Professor Craig A. White

Living with Crohn’s Disease

Dr Joan Gomez

Living with Eczema

Jill Eckersley

Living with Fibromyalgia

Christine Craggs-Hinton

Living with Gluten Intolerance

Jane Feinmann

Living with Hearing Loss

Dr Don McFerran, Lucy Handscomb and Dr Cherilee Rutherford

Living with IBS

Nuno Ferreira and David T. Gillanders

Living with Loss and Grief

Julia Tugendhat

Living with Osteoporosis

Dr Joan Gomez

Living with a Stoma

Professor Craig A. White

Living with Tinnitus and Hyperacusis

Dr Laurence McKenna, Dr David Baguley and Dr Don McFerran

Losing a Parent

Fiona Marshall

Making Sense of Trauma: How to tell your story

Dr Nigel C. Hunt and Dr Sue McHale

Menopause in Perspective

Philippa Pigache

Motor Neurone Disease: A family affair

Dr David Oliver

The Multiple Sclerosis Diet Book

Tessa Buckley

Natural Treatments for Arthritis

Christine Craggs-Hinton

Overcome Your Fear of Flying

Professor Robert Bor, Dr Carina Eriksen and Margaret Oakes

Overcoming Anorexia

Professor J. Hubert Lacey, Christine Craggs-Hinton and Kate Robinson

Overcoming Emotional Abuse

Susan Elliot-Wright

Overcoming Fear: With mindfulness

Deborah Ward

Overcoming Gambling: A guide for problem and compulsive gamblers

Philip Mawer

Overcoming Hurt

Dr Windy Dryden

Overcoming Jealousy

Dr Windy Dryden

Overcoming Loneliness

Alice Muir

Overcoming Panic and Related Anxiety Disorders

Margaret Hawkins

Overcoming Procrastination

Dr Windy Dryden

Overcoming Shyness and Social Anxiety

Dr Ruth Searle

Overcoming Stress

Professor Robert Bor, Dr Carina Eriksen and Dr Sara Chaudry

Overcoming Worry and Anxiety

Dr Jerry Kennard

The Pain Management Handbook: Your personal guide

Neville Shone

The Panic Workbook

Dr Carina Eriksen, Professor Robert Bor and Margaret Oakes

Physical Intelligence: How to take charge of your weight

Dr Tom Smith

Reducing Your Risk of Dementia

Dr Tom Smith

Self-discipline: How to get it and how to keep it

Dr Windy Dryden

The Self-Esteem Journal

Alison Waines

Sinusitis: Steps to healing

Dr Paul Carson

Stammering: Advice for all ages

Renée Byrne and Louise Wright

Stress-related Illness

Dr Tim Cantopher

The Stroke Survival Guide

Mark Greener

Ten Steps to Positive Living

Dr Windy Dryden

Therapy for Beginners: How to get the best out of counselling

Professor Robert Bor, Sheila Gill and Anne Stokes

Think Your Way to Happiness

Dr Windy Dryden and Jack Gordon

Tranquillizers and Antidepressants: When to take them, how to stop

Professor Malcolm Lader

Transforming Eight Deadly Emotions into Healthy Ones

Dr Windy Dryden

The Traveller’s Good Health Guide

Dr Ted Lankester

Treating Arthritis Diet Book

Margaret Hills

Treating Arthritis: The drug-free way

Margaret Hills and Christine Horner

Treating Arthritis: More ways to a drug-free life

Margaret Hills

Treating Arthritis: The supplements guide

Julia Davies

Understanding Obsessions and Compulsions

Dr Frank Tallis

Understanding Traumatic Stress

Dr Nigel Hunt and Dr Sue McHale

Understanding Yourself and Others: Practical ideas from the world of coaching

Bob Thomson

When Someone You Love Has Dementia

Susan Elliot-Wright

When Someone You Love Has Depression: A handbook for family and friends

Barbara Baker

Overcoming Common Problems

Post-Traumatic Stress Disorder

Recovery after accident and disaster

PROFESSOR KEVIN GOURNAY

First published in Great Britain in 2015

Sheldon Press

36 Causton Street

London SW1P 4ST

www.sheldonpress.co.uk

Copyright © Professor Kevin Gournay 2015

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.

The author and publisher have made every effort to ensure that the external website and email addresses included in this book are correct and up to date at the time of going to press. The author and publisher are not responsible for the content, quality or continuing accessibility of the sites.

British Library Cataloguing-in-Publication Data

A catalogue record for this book is available from the British Library

ISBN 978–1–84709–321–9

eBook by Fakenham Prepress Solutions, Fakenham, Norfolk NR21 8NN

For my dad Joe (1917–2010),

an unsung hero – of the Second World War and other things,

but most of all a hero to his children,

Kevin, Bernard (1948–2013) and Imelda

Contents

Acknowledgements

A note of caution

Introduction

Part 1: About post-traumatic stress disorder

1 The history and nature of PTSD

2 Types of trauma

3 Defining PTSD

4 Professional treatment

5 Older people and complex cases

Part 2: How to cope with symptoms

6 Learning and talking about PTSD

7 Coping with avoidance and other problem behaviours

8 Coping with panic and anxiety

9 Coping with anger, guilt and depression

10 Relationships

11 Mindfulness, relaxation and exercise

Conclusion

Useful addresses

References

Further reading

Search terms

Acknowledgements

My professional life, spanning more than four decades, has been blessed by contact with so many wonderful people – professionals, clinicians and academics – who have taught me so much, not just about the subject of this book but about psychiatry and psychology in general. I was also privileged to have spent a great deal of my working life at what is arguably the best psychiatric research institution in the world, the Institute of Psychiatry at the Maudsley Hospital, at King’s College, London. Therefore there are simply too many individuals to thank and name, and if I attempted to do so I am sure I would leave someone out. However, I wish to mention some people who have provided me with particular inspiration, encouragement and education.

First and foremost I thank Isaac Marks, now an Emeritus Professor who, through the groundbreaking training programme in Behavioural Psychotherapy – now rebranded as cognitive behavioural therapy (CBT) – gave me the skills and knowledge that I have used to pursue my career, not only as a clinician but also as a researcher, teacher and policy adviser. Isaac inculcated in me the recognition that one needs to be aware of the background evidence for any treatment approach. He also taught me the value of dealing with each individual in a pragmatic way and to use hunches and intuition when designing treatment.

Professor Kevin Howells supervised my own MPhil and PhD, which had a primary focus on the evaluation of exposure therapy – one of the central interventions for post-traumatic stress disorder (PTSD). As with so many things, it is now, more than 30 years on, that I recognize the way his quiet encouragement provided me with the opportunity to begin to develop my skills as a researcher. I will be forever grateful to him for his supervision of not one but two theses.

Later on in my development I was fortunate to have Professor Sir David Goldberg as my boss at the Institute of Psychiatry – a role taken over by Professor Graham Thornicroft in the second part of my professorial tenure. Sir David enthused me not only through his massive intellect and reservoir of knowledge but by his great sense of humour and, at times, his gross political incorrectness! David is certainly one of those individuals who can make one think of the world in a different way. Following David’s retirement, Graham Thornicroft also served as a source of inspiration. Of very different character from David, Graham’s careful, systematic approach to psychiatric research also served to make me see things differently.

I also want to mention my current sources of stimulation and inspiration. Two of my clinical colleagues, Dr David Veale and Dr Mike Beary (both psychiatrists), have also, in their