In today’s world, mental illness and distress are common and these account for a significant burden of disability within our community. At the same time, there is a growing interest in understanding and enhancing positive mental health and wellbeing; particularly from developments in the fields of positive psychology and mental health promotion. Positive Psychiatry is a new term (Jeste et al 2016) that describes a dual approach to mental health, where we build strengths, supports and healthy lifestyles as well as treating illness and distress. In this course, we will explore different aspects of good mental health as well as provide an overview of the major kinds of mental disorders, their causes, treatments and how to seek help and support. The course will feature a large number of Australian experts in psychiatry, psychology and mental health research, and we will also hear from “lived experience experts”, people who have lived with mental illness, and share their personal stories of recovery. We take an evidence-based approach to a range of strategies that anyone can use to enhance their own mental health and that of others, from exercise and relaxation techniques through to the role of love, relationships and 'good' types of work. We cover topics from creativity and yoga through to psychiatric medications and psychotherapies.
Trauma
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ES
Aug 22, 2018
Es excelente y lo recomiendo para todos los enfoques de la psicologia, es bueno estar al tanto de la perspectiva humanista dentro de la psiquiatria y salud mental
NY
Mar 27, 2019
Thank you for a wonderful course! it's help me to understand more about mental health and very useful for everyone especially Mental health at workplace.
从本节课中
Module 4 - Mental Illness
In this module, we cover the major categories of mental illness: their symptoms, causes and treatments. This includes the more common conditions such as anxiety, depression and addictions, as well as less common mental illnesses such as psychosis, schizophrenia and bipolar disorder.
教学方
Sonia Kumar
Psychiatry Course Coordinator
Ourselves develop in relationship.
Initially, in attachment relationships in early childhood.
And then later, in the world of social connection.
This development is in every aspect of our being: physical,
psychological, emotional, cultural, spiritual.
This connectedness for development and well-being is
a theme you have been hearing about throughout the MOOC.
When we have flowing and lively sense of self,
we tend to feel well and tend to flourish.
This talk however is about trauma,
and trauma is a difficult subject because it's a difficult experience.
Trauma breaks down our being, our sense of self.
And can break down how we feel about ourselves,
others, and the world.
So, it's an important experience that impacts profoundly on our well-being.
We could think back to Tina's story in the first week of our MOOC,
and the impact of childhood trauma on her sense of self,
and her important and long road to recovery.
For a time, we didn't pay enough attention
to just how common and just how damaging trauma could be.
We didn't realize just how many people seeking or needing help for
their mental health had been impacted on by trauma.
Sometimes, sadly, the experience of
mental illness and its treatment was traumatic in itself.
The good news is that we're in a time where we are realizing the huge impacts of trauma,
and are actively developing our approach to it to help people,
families, and communities recover and return to thriving.
In a phenomenon called post-traumatic growth,
we can actually grow through trauma and eventually become stronger,
more resilient than before.
This was Tina's story and it is the story of many.
We are realizing that repair, recovery, resilience,
require us to foster personal and interpersonal connections,
and over time integrate
traumatic experiences into a new story of our self and a new way of being.
We both repay the old aspects of self and the old connections and we nurture the new.
I often think of this is the way trees heal.
The rings they lay down at their core will always tell the story of a tough year.
But if the tree survives,
it often becomes stronger than before.
We are more than the story of our traumatic times.
We are people that reflect on ourselves and make meaning of our experiences and so,
our recovery can be rich at multi-layered.
So what is trauma?
We certainly all have stress.
And we've heard about
how universalities and ways to manage it are discussed in other MOOC talks.
The trauma is however more than simple stress.
It is a highly stressful life event or actually cumulative amount of
stress that exceeds a person's capacity
to regulate themselves and manage in the face of it.
So the event disturbs their equilibrium or what we call "Homeostasis".
Traumatic events include single events like a serious accident, assault, or disaster.
And also include long term situations like domestic violence,
entrapment, or child abuse.
The stress diathesis model is central to understanding
the distress associated with onset of mental health problems and stress system disorders.
It says that everyone has a level of risk for disorders to which stress adds.
And where there's enough of it,
symptoms and disorders emerge.
A self-regulation involves every level of being.
So when trauma breaks it down,
it can happen at any or all of these parts of our life.
Part of being tuned in to trauma is a challenge to health.
It's to recognize that I might notice the effects on my body,
my mind, my relationships,
my cultural life, or my spiritual life.
And those who know me or work with me might
feel that in those areas where we come into contact and connection.
This recognition of trauma or in its effects is a crucial current issue in health.
Trauma can break down how we connect to others and
tell our story and breakdown our trust in the world.
When trauma happens in childhood and adolescence.
In the very relationships of care in a home or
community that is meant to keep us safe and help us grow,
it can impact on how we develop and regulate ourselves in adulthood.
It can then become a risk factor in mental and physical health.
The big ace study in the USA investigating
these adverse childhood experiences
showed the knock on effects on mental and physical health of childhood trauma.
So, post traumatic stress disorder which can
follow experiencing or witnessing
a single life threatening event is an important disorder.
Features of PTSD include nightmares,
flashbacks, anxiety, and a tendency to avoid reminders of the trauma.
People with PTSD often have insomnia and/or depression,
or use substances to try to deal with the symptoms.
However, we now understand that the most severe dysregulation occurs in people who as
children lack a consistent caregiver or adequate experiences of safety and comfort.
The cumulative effect of this kind of trauma is called
"Complex trauma" and is a big contributor to many mental health disorders.
We need positive connection.
So for example, even daily devaluation in childhood, or neglect,
can lead to an ongoing sense that I'm not
worthwhile and impact my attachment state of mind and how I view myself.
Trauma causes shock, numbness,
and feel and can cause dissociation or disconnection in the individual experiencing it,
and those around them.
Dissociation describes the disconnection or disorganization of parts of
mental and physical life that would normally be connected and healthily organized.
For some people these disconnections,
dissociations or disorganizations are very severe.
For example, those with dissociative identity disorder can be disconnected from
whole parts of themselves that then function at times as another state of self.
This problem with remembering who they are at
different times can be very confusing for them and for those around them.
Strong feelings of confusion, disorientation,
rage, disgust, helplessness, hopelessness, can emerge too.
The strong feelings and associations around trauma probably partly explain why
trauma has often been hard to examine or recognize and can
lie out of direct sight, out of mind.
When trauma happens in secrecy like abuse often does,
then the difficulty in recognizing it and in seeing it is compounded.
These days we're trying to develop trauma-informed care,
ways of caring for others and ourselves that
understand how trauma breaks down consciousness and self.
And then, explores the pathways back to feeling whole and to flourishing.
Now, we often talk about a faith based approach to treatment.
Fundamentally, we first have to establish safety for those experiencing trauma,
and the families and systems of care around them.
You can probably imagine that if I have grown up in an unsafe home or community,
that safety might take a while to set up.
This step requires the listening,
validation, and tuning in of carers and clinicians.
We take time to notice if someone is terrified and
engage them in ways that help them feel safer.
After safety comes stabilization
where we try to help the person find ways to feel supported.
Ways that can help them manage safely,
to minimize the ongoing breakdown effects of trauma.
This helps them move away from
other unsafe strategies like drugs and alcohol or self-harm.
Here some of the skills and strategies discussed in
the MOOC can be crucial in fostering calm and hope,
and settling down our body and mind which might be feeling terrified,
anxious, angry, or frozen.
Here, relaxation, breathing, exercise,
being validated in a caring relationship,
mindfulness and meditation are some ways that help.
Each person needs the strategies to fit well with them.
And practicing them may also take some time.
Then, and only then,
when we feel ready and supported,
can we then think, feel,
and work through what happened to us in a number of ways.
As trauma affects all aspects of being.
Any of these can be an initial window into recovery.
Trauma focused cognitive behavior therapy and Eye Movement
Desensitization are types of psychotherapy used for PTSD.
Body therapies, creative therapies,
other psychotherapies, and neurofeedback can all have a place.
For some spiritual frame is important.
Something like meditation can work in a number of levels
to bring about reconnection and new connections between mind and body.
So, integrative approaches help us counter the disconnections in mind,
body, and soul caused by trauma and help us become whole again.
Those who've been through trauma need support to recover.
But sometimes they need time and evidence to believe that they can trust others again.
Trust the care we offer and even trust themselves.
Yet, we can resolve trauma to recover,
grow from it, and flourish.
And it seems that the best way to do this is to do it together in safe company.
We don't have to do it alone.
