PTSD+in+Sohrab

**__PTSD In Sohrab __ // By: Nichelle Matias, Jamie Phillips // **

** About Post-Traumatic Stree Disorder ** Post-Traumatic Stress Disorder (PTSD) is a condition that follows a terrifying event. In most cases people who suffer from PTSD continually have frightening thoughts throughout the day or/and nightmares of their incident. PSTD was once referred to as shell shock or battle fatigue, which was brought to public attention by war veterans. Because PTSD can occur at literally any age 4% of the population will experience symptoms of PTSD in a given year. However, not every traumatized person experiences PTSD. The disorder is only diagnosed if the person has symptoms longer then a month. People who have been diagnosed with PTSD usually experience symptoms within 3 months of the trauma. Some even recover within 6 months, but others have symptoms that lost much longer. Occasionaly, the illness doesn't occur unitl a year after the incident.



** Common Causes of PTSD in Children **
 * Witnessing a traumatic event
 * Learning about a traumatic event
 * Violent death of sibiling or peer
 * Experience of sexual abuse

**Symptoms of PTSD**
 * Flashbacks
 * Nightmares
 * Feelings of intense stress when reminded of the trauma
 * Intense physical reactions to reminders of the event; pounding heart, fast breathing, muscle tension, sweating.
 * Hesistant responses
 * Loss of memory
 * Poor concentration
 * Hypervigilance (similar paranoia)
 * Anger over small issues with violent outbursts
 * Extreme nervousness and anxiety
 * Muscle aches and pains for no apparent reason
 * Unexplained fear
 * Low self-esteem/lack of confidence
 * <span style="font-family: Arial,Helvetica,sans-serif;">Experience a sudden numb feeling
 * <span style="font-family: Arial,Helvetica,sans-serif;">Avoiding anything that reminds of the traumatic experience



**Treatments for PTSD**
 * **Medication**
 * Although medication is not a cure to the problem, the medicine has been proven to affective for helping people cope with anxiety disorders. In most cases, the doctor will begin the patient on a low dose of medication and gradually increase to the full dose. Every medication is known to have side effects, but within time gradually go away or can be tolerated with. The medication is only to be taken for a couple weeks or a little longer is side effects to become a serious problem.


 * ** Behavioral Therapy **
 * ​ Behavioral Therapy focuses on changing a person's specific actions such as, hyperventilate and lightheadedness. This is very important because patients on experience hyperventilation have the tendancy to take rapid shallow breaths that can trigger rapid heartbeat. The Behavioral Therapy will help the patient enroll is breathing exercise classes involving slow, deep breaths to reduce anxiety.


 * ** Cognitive Therapy **
 * Cognitive Therapy teaches patients to react differently to the situations and bodily sensations that set off panic attacks and other anxiety symptoms. Patients also begin to learn the understanding of their thinking patterns and how they contribute to their symptoms; also how to change their thoughts so the symptoms won't continually occur. The awareness of thinking patterns is combined with exposure therapy to help the patient confront their feared situations. Cognivitve therapy is a common way that children are rehabilitated when dealing with PTSD


 * ** Exposure Therapy **
 * Gradually exposes patients to what frightens them and helps them cope with their fears.


 * ** Eye Movement Desensitization and Reprocessing (EMDR) **
 * EMDR has an eight phase approach to rehabilitate people with PTSD. **Phase one** includes a therapist evaluating the patient's situation and deciding if the patient is ready for EMDR, and the course of treatment. **Phase two** the therapist makes sure that the client is stable enough to handle EMDR, if not, the therapist then attempts to help the patient achieve the level of stability that is necessary. **Phase three, four, five and six** the patient recalls the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. The patient is then told to focus on the memories and beliefs while the therapist moves his/her finger back and forth in front of the patient's field of vision. Then the patient is to report to the therapist whatever comes to mind and the therapist takes an approach based on what is in the report. This is repeated multiple times. **Phase seven** includes making sure the patient has some sort of closure, and walks out of the session feeling better then they did when they walked in. **Phase eight** is to review previous sessions and any progress that has been made.


 * **Group Psychotherapy**
 * A group of people meeting with one or more therapists, usually focusing on interpersonal interactions and relationship problems. Purpose of group therapy is having support.


 * ** Gentling **
 * Approach used on children. Gentling is using calm, caring gestures. Understanding of parents/adults is needed. Even when children have outbursts, the Gentling approach is that a child with stress disorder is not acting out to misbehave and patients is needed because children with stress disorders have different thought processes.

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Losing Interest in Activities** - "//Please! Please, no!" he croaked 'I'm scared of that place. They'll hurt me! I don't want to go". (page 341)// **Trying to Avoid Thinking or Talking About the Traumatic Event** - "//So I left the room and went looking for another hotel, unaware that almost a year would pass before I would hear Sohrab speak another word" (page 356)// - //"Because I don't want them to see me...I'm so dirty." He sucked in his breath and lte it out in a long, wheezing cry. "I'm so dirty and full of sin." (page 319)//
 * Sohrab's Comparison
 * A fter the fight between Assef and Amir, we never see Sohrab use his slingshot again.
 * Sohrab won't fly the kite with Amir
 * Showing More Sudden and Extreme Emotional Reactions **
 * As soon as Amir mentions sending Sohrab back to an orphanage, he reacts by sobbing uncontrollably
 * When he is unhappy about the orphanage, he attempts to kill himself.
 * Having Problems Staying or Falling Asleep **
 * Amir wakes up twice to find Sohrab's bed empty when he has only been asleep for a few hours.
 * Sohrab never mentions waht happened while he was at the orphanage, or while he was with Assef.
 * Difficulty Maintaining Close Relationships **
 * After Sohrab and Amir become close, Sohrab cuts himself off from everyone.
 * Overwhelming Guilt or Shame **
 * Sohrab is glad that his parents aren't around anymore because he believes they would be displeased by him because he thought he was full of sin.