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Contents Important Note 6 Contents 7 Acknowledgments 11 Introduction: Global Uncertainty and the New Age of Anxiety 12 Times of Uncertainty 13 Living in the New Age of Anxiety 13 To Fight or Fly 13 Personal Crisis Against the Backdrop of Fear 14 Tools for Hope 14 What I Bring to This Journey 16 Part I: Life's Storms 17 Chapter 1: Blown Off Course 18 Normal Reactions to Extreme Events 19 What Can We Learn? 21 Getting Back on Track 22 In Their Own Words: J.T.'s Story 24 Chapter 2: Events That Are Bigger than You or Me 27 Some Helpful Terms 27 The Nature of Traumatic Incidents 28 Immediate and Delayed Responses to the Event 29 Normal Emergency Reactions to Crisis 30 A Chemical Cascade 32 When Things Fall Apart: Acute Stress Reaction 32 Chapter 3: Your Brain under Stress 36 Consider the Brain 36 The Plastic Brain: Use It or Lose It! 37 The Chemistry of Survival 37 Other Brain Centers Affected by Trauma 42 From Brain Structure to Diagnosis 43 Chronic, Low-Level Fear 43 Chapter 4: Mapping the Territory 45 Building a Worldview 45 The "World" as Internal Construction 46 You Are What You Remember 46 Crisis, Memory, and Survival 47 Flashbulbs in the Dark 49 Cerebral "Indigestion" and Hidden Memories 50 What It All Means 51 Chapter 5: When Postcrisis Reactions Take on a Life of Their Own: PTSD, Delayed Reactions, and Complex Reactions 52 Posttraumatic Stress Disorder 52 Delayed and Complex Reactions 58 A Related Issue: The Recovered-Memory Controversy 65 In Their Own Words: Jim's Story 67 Part II: Tools for Hope 71 Chapter 6: Staying on Course when the Weather Gets Rough 72 Losing It 73 The Range of Response to Crisis 74 When the Damage Is Done: Acute Stress Reaction 76 Calming Troubled Waters: Intervening in Cases of ASR 78 In Their Own Words: Alexandra's Story 83 Chapter 7: Stabilizing Our Children and Families 87 Austere Triage for Family Arguments 88 First Aid for Family Chaos 88 What about the Kids? 90 The Parental Shield 90 Talking with Children about the Unthinkable 90 What to Do when Emergency Strikes 92 What We've Learned about Kids and Crisis 93 Identifying Acute Stress Response in Children 95 What If You Suspect Abuse or Trauma? 96 How to Talk to Distressed Children Following Crisis 99 What Not to Do 103 Stabilizing the Home Front 104 Chapter 8: Letting Go of Fear, Anger, and Loss 105 A Quick Review of the What and Why of Arousal 105 Going to Extremes 106 Reviewing the Basics 106 What Can We Do? 106 Special Case: When Resentment Keeps Exploding into Rage 108 Special Case: When Fear Boxes Us In 111 Special Case: When Sadness Becomes Acute 113 Opening to Peace 116 Chapter 9: Dealing with Withdrawal and Numbing 117 Calling in Air Strikes on Our Own Position 117 Brain Fade 118 Where Has Life Gone? 119 What Can We Do? 120 Serious Forms of Dissociation and Depression 121 Surfacing: The Larger Journey Back 124 Hidden Agendas: Uncovering Our Attachments to the Past 124 Opening to Joy 127 Chapter 10: Getting Professional Help 129 Frequently Asked Questions about Therapy 129 From My Side of the Room 131 Getting to Peace: Trauma Therapy 132 Different Ways to Go 133 Shop Around 136 A Few Words about Medication 136 Choosing for Fit 137 Chapter 11: Coming Home: Reconnecting with Loved Ones in the Aftermath of Trauma 138 Outside Looking In 139 In Disguise 139 Buying Recovery Time 140 Rebuilding Bridges 142 When Partners Are Part of the Problem 144 Parenting Through the Storm 145 Ulysses and the Road Home 148 Part III: Resetting the Compass 150 Chapter 12: From Memories to Meaning: Putting Trauma into Words 151 Storytelling Is Good for You 151 But First, a Word of Caution. 152 Storying Your Experience 152 Step I: Set the Stage 152 Step II: What Happened? 154 Step III: And Then What Happened? 155 Step IV: Do a Review 155 Chapter 13: Telling the Inside Story 157 The Personal Side of Context 157 Whose Story Is This? 158 The Inside Passage 159 Revision from Within 160 Revisiting the Aftershocks 160 Reflections on Meaning 162 In Their Own Words: Norma's Story 164 Chapter 14: Reconstructing the Inside Story 167 What Is Your Issue? 167 Getting to the Heart of Things. 168 .And Getting to the Things of the Heart 168 A Memoir Worth Writing 169 The Laying on of Judgment 170 Opening Up Our Stories to More Satisfying Outcomes 171 Rotten Fruit and Hidden Gems 174 Heart Lines 175 Epilogue: The Compass Within 177 Tragedy 177 The Fundamental War Within 178 Keeping Hope Alive 178 Gather Around the Fires 179 Resources 180 Emergency 180 Disaster Preparedness 181 Mental Health 181 Children 181 Index 183
Library of Congress Subject Headings for this publication: Stress management, Psychic trauma, Post-traumatic stress disorder