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Finally, let's look at how mental filters by your client may predispose them to PTSD. These mental filters bring forth some major ethical areas for concern. I use filtering to refer to the mental mechanisms which helps us to individually sort through our world and integrate information. We have found in times of national trauma, due to terrorist attacks, that we can somewhat predict which of our clients will react extremely to the situation based upon what I will call their Filtering Style. Ive divided filtering into six categories. Lets look at the first category of positive versus negative filters.
6 Filtering Style Categories
Filter #1 - Positive
Regardless of how the client tries to change this filtering style, it appears to be extremely resistant to modification. Its been my experience that clients experience more severe PTSD if their filtering mechanism is more negative than positive. What filter do you use?
Filter #2 - Global
Im wondering if you have found, like we have, that PTSD clients who see the world from a more global view are able to more easily put events into perspective. Are you global or a details person?
Filter #3 - Time
Filter #4 - The
My colleagues and I have found PTSD clients appear to focus more on present events similar to past stressors, as opposed to events that differ from the past. What is your focus on, similarities or differences?
Filter #5 - The
Switch Referential Index
Do you notice a pattern with your PTSD clients regarding I feel versus they feel? What is your referential perspective?
Filter #6 - Authority Perspective
The Code of Ethics states that we must show acceptance and be non-judgmental.However, when we experience someone who has the same perspective or filtering system as we do, we have a positive sense of commonality and security in communication. You may experience a feeling of understanding, connecting, and being on the same wavelength with your client. His state of rapport creates an awareness of harmony and unity in the treatment session.
However, when rapport is either
broken or not established (as in a conflict of perspectives or filters), you may
encounter a negative sense of detachment and discomfort in communication in the
session. This negative sense can lead you to consider the client as being wrong.
To increase your self-awareness regarding your filtering or perspective consider
the following three questions:
For example, the therapist may reexperience intrusive images. While for the client, this memory may represent primarily a disruption in her sense of safety; to the therapist what is prominent may be the sense of betrayal, which is related to trust. Once the therapist has identified this theme, it can be connected to other issues, for example related to trust disruptions in the therapists life. This allows the therapist to begin to work with and, over time, to integrate the images; it can then cease to be intrusive for the therapist.
One type of disruption most notably experienced by all taking this home study course is the visualization of the destruction of the Twin Towers. Many of my colleagues reported having visceral reactions when they would see tall buildings on television immediately following the attack.
In summary, we have talked about victims of terrorism experiencing a loss of invulnerability, loss of an orderly world, loss of positive self-image, and loss of trust. We also discussed the role that prior experience and training make in the predisposition to PTSD. The psychodynamics of hostage victims including pathological transference and psychological infantilism were also discussed.
The importance of ventilating feelings and realistic guilt were discussed along with the psychopathology of being held hostage. The factors of feelings of helplessness, existential fear, and sensory input overload were also discussed as they related to psychological anchors and transference regarding the mutual fate bond, six filtering perspectives, and Code of Ethics issues.
is hoped that this portion of the home study course has provided you with a broader
knowledge base regarding the ethical treatment of PTSD resulting from terrorism
and other traumas. This is Tracy Catherine Appleton with the Healthcare Training
Institute. Thank you for selecting us to be a vehicle for you to earn your Continuing
Education credits. I look forward to talking with you in another home study course.
Online Continuing Education QUESTION
9: The Code of Ethics states that we must show acceptance and be non-judgmental.
What are three self-awareness questions? To select and enter your answer go to CE Test.
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