Ten Steps to Healing From Trauma

http://www.martinvcohen.com/trauma1.html

By Martin V. Cohen, Ph.D.


Whether you have been a crime victim, involved in an accident or natural disaster, or were the victim of childhood abuse, the resulting trauma is similar. Pervasive fear and feelings of helplessness are natural reactions to events you probably had little or no control over. “I was totally traumatized,” and “I thought I was going to die,” are among the most often used phrases used to describe such occurrences. Unfortunately, trauma and the stress that follows, is on the rise at the turn of the new millenium in America.


Fortunately, there are ways to overcome the “aftershocks” of traumatic incidents. A cluster of symptoms consisting of 
(1) PersistentlyREEXPERIENCING the event (e.g., flashbacks, nightmares, etc.), 
(2)AVOIDANCE (e.g., avoiding people, places or activities that trigger memories of what happened) and 
(3) HYPERAROUSAL (e.g., jumpiness, feeling on edge, irritability, etc.) can be treated effectively with the following steps toward healing this condition. 


In 22 years of practicing psychotherapy, specializing in treating trauma victims, I’ve seen them work.



1.-- Recognize that your symptoms are normal reactions to abnormal circumstances. Although you may feel like you are out of control or “going crazy,” in reality, you are experiencing what are called post-traumatic stress symptoms.



2.-- Talk about your thoughts, feeling and reactions to the events with people you trust. Then, talk about it some more. Keep talking about it until you have no need to talk about it anymore.



3.--Do whatever it takes to create a feeling of safety and tranquility in your immediate environment. Do you need to sleep with a night light on for awhile? Can you develop a discipline of meditation or listening to soothing music?



4.-- As much and as quickly as possible, resume your normal activities and routines. Traumatic events can throw your life into a state of chaos. The sooner you resume these activities and routines, the more normal your life will feel. Structure can provide feelings of security as you etch your way back to stability.



5.-- You are in a recovery process. Give yourself the proper rest, nutrition and exercise. If you were recovering from the flu you would not forget these health tips. Do the same for yourself as you recover from traumatic stress.



6.-- Take an affirmative action on your behalf. For example, if you were a victim of crime, prosecuting the perpetrator may be an empowering experience. If this is not an option for you, write in your journal. Strike out at the perpetrator with words. Take some action on your behalf.



7.-- Become aware of your emotional triggers and learn to cope with them creatively. You may have a flashback to your trauma by engaging in a similar activity, going to a similar place, seeing, hearing, smelling, tasting or feeling something that reminds you of the original trauma. One way to cope with this is to recognize that you are experiencing an emotional trigger and engage in positive self-talk (e.g., “This is frightening but I am safe now.”)



8.--Try to find some deeper meaning in what happened to you. True, you were victimized but you can become a survivor. Survivors often find that changes in their outlook on life are possible, even preferable. What have you learned from your traumatic experience? Record these insights in a journal or voice them in a support group that is sympathetic to your situation.



9.-- Seek therapy. Psychotherapy, particularly with a certified EMDR practitioner who specializes in trauma, is often very effective in helping people overcome the aftermath of trauma. If you can’t stop thinking about what happened; if you are always feeling anxious and on guard; if you find yourself avoiding your normal routines or if you are experiencing some of the other symptoms of post-traumatic stress, you can probably benefit from professional help. The EMDR International Association can give you a referral to a certified EMDR practitioner in your area (www.emdria.org), telephone (512) 451-5200. If you were a crime victim, most states offer victims assistance to pay for psychotherapy. For more information call the National Organization for Victim Assistance at (202) 232-6682. In California, call the Victims of Crime Program at (800) -VICTIMS (842-8467).



10.-- Be patient with yourself. Healing takes time. Your recovery will have it’s ups and downs. Follow the guidelines in this article and know that you are in a recovery process that will take time.



Remember, you may have been victimized but you do not have to continue being a victim. In this unfortunate case you were rendered helpless but to continue in that status is very limiting. By following the steps outlined above, you will emerge as a survivor. Your traumatic experience can make you a stronger and wiser person. The potential is there for you to learn and grow in ways you may not have considered had the trauma never occurred.
© 2000 Martin V. Cohen, Ph.D.

Keeping Bones Strong for Life

http://www.thejakartaglobe.com/health/keeping-bones-strong-for-life/459764


Sylviana Hamdani | 
August 17, 2011


Accountant George Sembiring had always been a kind and dutiful husband and an attentive father to his five children. But a minor accident in 2005 changed all that. 

“He didn’t see a hole in the road one rainy night and fell off his motorbike,” said Paulus, his youngest son. 

After that night, George never walked again. He fractured his hips at five different points. His doctors discovered that the 55-year-old’s bones had been weakened over the course of years by osteoporosis. Yet with no pain or any other symptoms, George had never realized it. 

Osteoporosis is a disease that robs bones of their density, leaving them porous, brittle, thin and prone to breaking. 

George underwent a number of costly hip reconstruction operations, burning through his family’s savings. After the third unsuccessful operation, the family took him out of the hospital and decided to care for him at home. 


“My father changed. He became a bitter and angry person because of his disability,” Paulus said. 

Paulus had to quit university and get a job at a computer shop to pay for his father’s medical bills. George remained bedridden until he died a couple of years ago. 

In Indonesia, osteoporosis has become a serious health problem. According to the Indonesian Osteoporosis Association (Perosi), in 2006, the most recent year for which figures are available, 29 percent of men and 32 percent of Indonesian women suffered from the disease. 

“That’s why osteoporosis is nicknamed the ‘Silent Thief,’ ” said Fiastuti Wicaksono, a nutritionist and lecturer at the University of Indonesia’s medical school. “The disease silently eats away your bones and robs you of your active life.” 

Contrary to what many people believe, bones are alive and continue to die and regrow within your body throughout your life. In a healthy person’s body, it takes about three months for an old bone to degenerate and be replaced by a new one. 

For people with osteoporosis, bone loss outpaces growth, causing bones to thin and become frail. 

“But the good news is that the disease can be prevented,” Fiastuti said. “With a well-balanced diet and healthy lifestyle, we can maintain our bone mass.”

Preventive measures should be taken at the earliest opportunity. Bones start to grow while we are still in the womb. If an expectant mother eats a healthy diet high in calcium, it can help to ensure her baby is born with strong bones. 

“Pregnant women also need a diet that is high in calcium to protect their own bones,” Fiastuti said. “Babies derive the calcium they need from their mothers. If a baby doesn’t get it from the mother’s food intake, then it will take it from her bones, leaving her prone to osteoporosis.” 

Children who do not get enough calcium when they are babies can still catch up. 

Toddlers aged between 1 and 3 need 500 milligrams of calcium per day, which can be obtained from drinking two glasses of milk. Children aged between 4 and 8 need about 800 milligrams of calcium daily, or about three glasses of milk. Those between 9 and 18 need about 1,300 milligrams of calcium, or about four glasses of milk. 

“It’s like a savings account at the bank,” Fiastuti said. “We should all start saving calcium in our bones to prepare for future losses.” 

Adults need to about 1,200 milligrams of calcium per day. Human bone mass reaches its peak between the ages of 30 and 35. 

“After bone mass reaches its peak, it will start to lose more than it builds,” Fiastuti said. 

Besides age, other risk factors that nothing can be done about include gender and race. 


“Research has revealed that women are more likely to suffer from osteoporosis than men,” Fiastuti said. “It’s largely because women give away the calcium in their bones during pregnancy and breast-feeding.” 

Women can also suffer from osteoporosis post-menopause. 

Asians and Caucasians, as well as people with smaller physiques, are more likely to suffer from osteoporosis. 

According to Fiastuti, milk is one of the best sources of calcium. 

“Milk contains lactose, which enhances calcium absorption by our bones,” she said. 

However, for lactose-intolerant people, there are other food sources that are high in calcium such as tempeh, tofu, dark green vegetables and anchovies. 

“You can also eat milk-derived products, such as yogurt and cheese, or dishes that contain milk, such as, lasagna,” she said. “When the milk is processed, it doesn’t usually trigger any bad reactions in the body.” 

You should also watch your diet. Junk foods, which are high in fat, salt and seasoning, will impair calcium absorption. You should also stay away from alcohol and cigarettes to protect your bones. 

“Nicotine has a direct toxic effect on the body,” Fiastuti said. “It hampers the body’s ability to utilize growth hormones, calcium and vitamin D to build new bones.” 

Alcohol, coffee and carbonated drinks also deplete calcium and hamper bone growth. 

Besides calcium, you also need vitamin D to fortify your bones. People between the ages of 20 and 50 need 400 international units of vitamin D. Those older than 50, need between 600 and 800. Food sources with vitamin D include salmon, liver, cod liver oil and egg yolks. 

“But, actually the skin can produce vitamin D for the body when it’s exposed to sunlight,” Fiastuti said. 

Between 10 and 15 minutes of sunlight three times a week will help to satisfy the body’s need for vitamin D.

Protein is a major building block for the body. Thus, to repair bone structure, you will need a steady stream. The suggested amount is 55 grams per day for women and 65 grams per day for men. Good sources of protein include eggs, fish, poultry, soy products and milk. 

Exercise is also necessary to maintain bone mass. So, get off the couch and start exercising regularly, at least three times a week for about 30 minutes each time. Brisk walking, jogging, light aerobics and moderate weight-lifting are all good for your bones. 

“The stamping movements when you walk or jog will help to solidify your bones, while weight-training helps maintain strong muscles to keep up your balance and coordination, which prevents you from falling and getting fractured bones,” Fiastuti said. 

As for Paulus, the 24-year-old drinks milk every day with his breakfast. He also walks to the store where he works, which takes about 30 minutes, rather than riding his motorbike. 

“The accident [with my father] has taught me a lot,” he said. “I want to have a long, meaningful life for my family and myself. And maintaining a healthy lifestyle is just a small investment for the future.”

Teliti Gangguan Seksual Para Perempuan Pengantin Baru, Kayika Raih Gelar Doktor

http://www.jpnn.com/read/2011/07/13/97901/Teliti-Gangguan-Seksual-Para-Perempuan-Pengantin-Baru,-Kayika-Raih-Gelar-Doktor-


FEATURES
M. HILMI SETIAWAN, Jakarta

Rabu, 13 Juli 2011 , 08:08:00

Mencari Data di Delapan KUA, Rayu Responden lewat Seminar

dr I Putu Gede Kayika SpOG. Foto : M Hilmi Setiawan/Jawa Pos

Perempuan yang baru saja menikah alias pengantin baru, ternyata, rawan terkena disfungsi seksual (gangguan seksual). Hal itu terungkap dari penelitian dr I Putu Gede Kayika SpOG. Berkat penelitian tersebut, Kayika kemarin resmi memperoleh gelar doktor.

KAYIKA bernapas lega. Dia pun tersenyum bahagia. Itu terjadi ketika namanya dinyatakan lulus oleh Prof Pratiwi Puji Lestari Sudarmono SpMK dan berhak menyandang gelar doktor.

Pengumuman kelulusan tersebut seakan menjadi gong dalam acara ujian terbuka program doktoral di Fakultas Kedokteran Universitas Indonesia (FK UI) kemarin. Siang itu, sekitar pukul 11.30, Ruang Sena Pratisa Sutomo Tjokronegoro di departemen patologi anatomi menjadi saksi lahirnya seorang doktor baru, I Putu Gede Kayika.

Sesudah ujian terbuka, Kayika mendapat ucapan selamat dari sekitar 20-an undangan yang hadir. Dia didampingi istrinya, Made Sudarmini, serta tiga anaknya, Ni Putu Galuh Wibhutisari, Ni Made Uning Elingasari, dan I Nyoman Karmani Kaynanda. "Terima kasih, terima kasih." Kata-kata itu selalu diucapkan oleh Kayika setiap kali disalami teman-temannya.
   
Saat ditemui Jawa Pos, spesialis kandungan dan kebidanan dari Denpasar tersebut menjelaskan secara panjang lebar penelitiannya. "Penelitian itu berawal dari ketertarikan saya terhadap perilaku para perempuan yang menghadapi masa-masa pranikah," tutur pria 47 tahun itu.

Menurut dia, para perempuan tersebut cenderung menyepelekan berbagai persiapan yang seharusnya sudah dimatangkan sebelum hari H pernikahan. Kalaupun ada bantuan jasa layanan pranikah, menurut Kayika, itu sebatas menata dari sisi spiritual si perempuan dan pasangannya.

"Padahal, orang menikah itu bukan hanya urusan spiritual, tapi juga mental dan kesehatan," tutur dokter yang mengawali karirnya sebagai dokter puskesmas di Kalimantan Selatan tersebut.

Salah satu yang menjadi konsentrasi Kayika adalah urusan seksual. Dia menjelaskan, masa-masa pengantin baru merupakan waktu yang cukup penting bagi perempuan. Masa yang cukup penting itu bisa rusak gara-gara persiapan pranikah yang tidak matang.

Kayika menambahkan, budaya yang berkembang di masyarakat kita masih memandang tabu kegiatan mengonsultasikan persoalan disfungsi seksual. "Terutama bagi perempuan," ujar dia. "Karena itu, penelitian saya tersebut lebih berfokus pada disfungsi seksual pada perempuan pengantin baru," ungkap dia.

Dalam penelitian itu, Kayika menggunakan 94 perempuan yang akan menikah sebagai responden. Bagaimana cara dia mengumpulkan puluhan perempuan itu" Kayika menyatakan menggali data dari delapan KUA (kantor urusan agama) di Jakarta Utara dan Jakarta Pusat. Demi penelitian itu, Kayika mendampingi seluruh repondennya hingga tiga bulan setelah menikah.

Kala menggali data dari para responden, Kayika juga menemukan hambatan. "Mereka cenderung tertutup. Tapi, itu sudah dipertimbangkan," terang dia.

Cara mengatasinya, Kayika mengumpulkan seluruh reponden dalam sebuah seminar. Di acara tersebut, dia meyakinkan para responden itu bahwa informasi yang mereka berikan bisa mengatasi persoalan seksual orang lain. "Akhirnya, mereka bersedia," kata dia. Para responden itu akhirnya bersedia menjawab pertanyaan-pertanyaan Kayika tentang urusan hubungan ranjang setelah mereka menikah.

Melalui penelitian yang menggunakan alat ukur female sexual function index (FSFI) dan memperhitungkan distress (jenis stres negatif) pribadi, Kayika menengarai 19,1 persen atau sekitar 17 perempuan di antara 94 responden pada masa pengantin baru mengalami disfungsi seksual.

Celakanya, dari jumlah tersebut, hanya seperempatnya yang mempersepsikan diri mengalami disfungsi seksual. "Persepsi yang rendah itu bisa disebabkan munculnya anggapan bahwa disfungsi seksual bukanlah suatu gangguan yang mengancam jiwa," jelas dokter yang sekarang bertugas sebagai kepala Klinik Utan Kayu di FK UI tersebut.

Kayika menuturkan, rendahnya persepsi tersebut mengakibatkan disfungsi atau gangguan seksual pada perempuan tidak dianggap sebagai penyakit. Lantas, bagaimana bentuk-bentuk disfungsi seksual pada perempuan yang barstatus pengantin baru? Kayika membeberkan, disfungsi seksual tersebut bisa digolongkan menjadi empat macam.

Pertama, gangguan dorongan seksual atau desire. "Banyak orang mengistilahkan libido," katanya. Pada kondisi tersebut, perempuan ogah atau sulit "bangun" untuk memulai hubungan intim dengan pasangan. Perempuan menunggu "diganggu" pasangannya dulu.

Kedua, disfungsi seksual yang dia sebut sebagai gangguan kebangkitan seksual atau aruasal. Secara sederhana, dia menjelaskan bahwa perempuan yang mengalami disfungsi seksual jenis itu tidak mudah terangsang. "Sudah lama dirangsang, tetapi tidak basah-basah (tidak terjadi lubrikasi atau perlendiran vagina, Red)," terang dia.

Ketiga, disfungsi seksual yang berwujud gangguan orgasme. Perempuan dengan disfungsi seksual jenis itu saat melakukan sanggama atau coitus tidak bisa menikmati puncak hubungan intim.

Keempat, disfungsi seksual berupa nyeri seksual. Kayika menuturkan, perempuan yang mengalami nyeri seksual itu tidak bakal bisa mencapai orgasme. "Selama berhubungan intim, perempuan hanya merasakan kesakitan," papar dia.

Dari empat bentuk disfungsi seksual tersebut, Kayika menetapkan dua biang keladi yang dominan. Pertama, perempuan itu sebelum menikah pernah mengalami trauma seksual. Kedua, perempuan tersebut mengalami depresi. "Mengalami salah satu saja di antara dua faktor itu berisiko disfungsi seksual," ucap dia.

Berbekal hasil penelitian tersebut, Kayika mengharapkan perempuan lebih giat lagi berkonsultasi tentang seks sebelum menikah. Konsultasi itu dilakukan untuk menggali apakah perempuan yang bersangkutan pernah mengalami trauma seksual atau depresi. Sebab, jelas Kayika, faktor tersebut bisa diselesaikan dengan bantuan psikolog atau psikiater.

Berapa lama? Kayika tidak bisa menentukan lamanya. "Waktu penyembuhan relatif. Bergantung seberapa besar trauma atau depresi yang pernah dialami," tegas dia.
Kayika mengingatkan, semakin cepat diketahui, faktor-faktor yang bisa memicu disfungsi seksual tersebut bisa segera ditangani. Kayika juga mengharapkan perempuan bisa menyelesaikan persoalan itu sebelum menikah. Dengan begitu, peluang munculnya disfungsi seksual setelah menikah bisa ditekan. Dia berpandangan bahwa hubungan seks dalam rumah tangga merupakan unsur penting untuk meningkatkan hubungan dan kualitas hidup.
   
Kayika juga berpesan supaya pemerintah lebih gencar mengampanyekan kesadaran masyarakat untuk menata kesehatan seksual sebelum menikah. Pemerintah, menurut dia, masih memegang peran penting dalam persoalan itu. Sebab, layanan konsultasi pranikah sampai saat ini masih tersebar di kota-kota besar. Ke depan, setiap petugas KUA diharapkan memegang brosur tentang cara mengatasi disfungsi seksual, terutama pada perempuan. (c11/kum)