Table Of Content“The PTSD Workbook is an outstanding aid to those
recovering from exposure to traumatic life events and the
symptoms of post-traumatic stress disorder (PTSD). For use
while in psychotherapy or by itself, this workbook provides
an important guideline and template for moving forward
with life. Derived from considerable clinical experience and
up-to-date with recent research on recovery, The PTSD
Workbook is an invaluable addition to the growing number
of clinical tools to improve resiliency and enhance healthy
outcomes.”
—Terence M. Keane, PhD , associate chief of staff for
research and development at the VA Boston Healthcare
System, director of the behavioral science division of the
National Center for PTSD, and professor of psychiatry and
assistant dean of research at the Boston University School
of Medicine
“This is a treasure trove of a book filled with up-to-date
information on trauma, with the best collection of self-help
methods in the field. It is easy to understand, and will be a
resource for all individuals who are suffering from the
effects of traumatic events, as well as for professionals.”
—Atle Dyregrov, PhD , clinical and research
psychologist, and head of professional issues at the Center
for Crisis Psychology in Bergen, Norway; professor of clinical
psychology at the University of Bergen, Norway; author of
Disaster Psychology , Children in War , Grief in Children, and
Supporting Traumatized Children and Teenagers ; founding
member of the European Society for Traumatic Stress
Studies; and chair of the Children and War Foundation
“This update of The PTSD Workbook nicely reflects the
authors’ sensitive understanding of psychological trauma
and resilience. It provides individuals suffering from post-
traumatic stress disorder (PTSD) and their professional
helpers with an impressive compendium of self-help and
therapeutic techniques. Each of its twelve chapters is full of
easy-to-use exercises that allow readers to decide which
techniques are most suited to their individual situation.
Anyone with a personal experience of, or exposure to,
traumatic events will learn something useful from an
encounter with this excellent work.”
—Joseph H. Albeck, MD , clinical associate in the
department of psychiatry at McLean Hospital in Belmont,
MA; Chairman (Emeritus) for the Intergenerational
Transmission of Trauma and Resilience Special Interest
Group of the International Society for Traumatic Stress
Studies (ISTSS); and cofounder of the New England
Holocaust Memorial
“This is an extremely helpful book for trauma victims and
facilitators, but also for you and me, to own and look into it
daily.”
—Hédi Fried , psychologist, writer, teacher, Holocaust
survivor, author of The Road to Auschwitz , and winner of
the 2015 Public Advocacy Award from the International
Society for Traumatic Stress Studies (ISTSS)
Publisher’s Note
This publication is designed to provide accurate and
authoritative information in regard to the subject matter
covered. It is sold with the understanding that the publisher
is not engaged in rendering psychological, financial, legal, or
other professional services. If expert assistance or
counseling is needed, the services of a competent
professional should be sought.
Distributed in Canada by Raincoast Books.
Elements from The Body Remembers: The
Psychophysiology of Trauma and Trauma Treatment by
Babette Rothschild. Copyright © 2000 by Babette
Rothschild. Used by permission of W. W. Norton & Company,
Inc.
“Assessing Your Self-Criticism,” “Using Self-Compassion
Phrases,” and “Fostering Self-Compassion” adapted from
SELF-COMPASSION: STOP BEATING YOURSELF UP AND LEAVE
INSECURITY BEHIND by Kristin Neff, copyright © 2011,
published by HarperCollins Publishers. Used by permission
of author.
Copyright © 2016 by Mary Beth Williams and Soili Poijula
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup; Edited by Brady Kahn;
Acquired by Catharine Meyers; Text design by Tracy Marie
Carlson
All Rights Reserved
Library of Congress Cataloging-in-Publication Data on file
One never knows the curves that life brings. In the second edition, I
dedicated this book to my children, never imagining that January 2014 would
bring the unexpected death of my son Cary. This revised edition is dedicated to
him and his strong will to live.
—MBW
I would like to dedicate this book to my mother, Maria, a war orphan herself,
and the mother of mothers.
—SP
This book is also dedicated to survivors throughout the world. It is also
dedicated to all the helping professionals, members of the military, law
enforcement officers, and fire, rescue, and EMT personnel who serve in spite of
the challenges, danger of compassion fatigue, and certainty of impact of the
work on their own lives, including potential loss of life.
—MBW and SP
Contents
Introduction
—Mary Beth Williams
1: A LOOK AT TRAUMA
Trauma Stories
Defining Trauma
Reacting to Trauma
Pre-event Factors
Event Factors
Post-event Factors
Acute Stress Disorder
Post-traumatic Stress Disorder
Symptoms of PTSD
Are There Different Types of PTSD?
Remembering Trauma
Psychoeducation
Why Remember?
Who Are You?
Feeling Safe
2: BEFORE DOING THE WORK: SAFETY, SECURITY, AND
INTENTION
Safety
Staying Grounded
Types of Safety
Creating a Safe Place
Keeping Your Safe Space Safe
Getting to Your Safe Place Through Visualization
Checking In with Yourself
Relaxation and Breathing Techniques
Progressive Relaxation
Another Relaxation Technique
Trying Meditation for Relaxation
Using Mindfulness to Help You Relax and Feel Safe
When to Take a Break from Doing Work in This Workbook
3: IDENTIFYING AND WRITING ABOUT WHAT HAS
HAPPENED TO YOU
Creating Your Own SUDS
More About Memory and Remembering
Constructing a Trauma Inventory
Creating a Trauma Time Line
Healing by Writing: Creating Your Own Trauma Story
Time to Heal
4: HELPING YOURSELF WHEN YOU REEXPERIENCE A
TRAUMA
Building Dual Awareness
The Rewind Technique
Containment and Traumatic Memories
Dealing with Traumatic Dreams
Dealing with Your Flashbacks as Dissociation
What Is Dissociation?
What Does It Mean to Have a Flashback?
The DVD Technique
Getting Outside Your Head
Other Ways to Deal with Flashbacks
Using Dual Awareness to Treat Flashbacks
Changing Negative Thoughts to Positive
Triggers: Reminders of Trauma Across the Senses
Managing Trigger Events
The Trigger Mapping Ladder
Using Activities and Anchors to Reduce Triggers
Exposing Yourself Safely to Your Past Traumas
The Flower Diagram
Avoiding Avoidance
5: COPING WITH TRAUMA WITH LESS AVOIDANCE
Using Avoidance to Cope
The Practical Function of Avoidance
Dissociation as an Avoidance Mechanism
What Can You Do About Dissociating?
Consequences of Dissociation
Reducing Dissociation as Avoidance
Working to Reduce Other Types of Avoidance
Keeping Safe as You Try to Lessen Avoidance
Tolerating Your Fears
Other Ways to Reduce Avoidance
6: DEALING WITH CATEGORY D SYMPTOMS: PART I
Dissociative Amnesia
Negative Beliefs About Self, Others, and the World
Where Beliefs About the Self Come From
Challenging Core Beliefs
Challenging Beliefs About Trust and Betrayal
Challenging Beliefs About Self-Esteem
Ways to Raise Your Self-Esteem
Challenging Beliefs About Intimacy
Blaming Yourself or Others for the Trauma
Looking at Blame
Self-Compassion
Self-Kindness
Common Humanity
Mindfulness
What About Forgiveness?
Self-Forgiveness
Challenging and Modifying Your Beliefs Through Affirmations
7: DEALING WITH CATEGORY D SYMPTOMS: PART 2
Long-Lasting Negative Emotions
Emotions as Messengers of Information
Looking at Emotions That May Persist Negatively
Fear
Anger and Rage
Expressing Anger
Anger as a Warning
Depression
Guilt
Survivor Guilt
Healing from Survivor Guilt
Making Amends
Shame
Helplessness
Sadness
