Psychological Self-Help

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62
advocate psychotherapy; if they know you are a strong advocate of
self-reliance, they assume you seldom vote for a Democrat. 
Usually strong trauma, intense pain, or an identity crisis is
associated with major dissociation. Combat may produce "battle
fatigue" or Post-Traumatic Stress Disorder. Awful accidents, near
death experiences, death of loved ones, physical or sexual abuse,
severe humiliation, and unbearable losses can lead to memory losses,
intense emotional reactions as if you were suddenly back in a
traumatic crisis, numbed feelings (e.g. cutting themselves without
feeling it), depersonalization (robot-like, "I know what is happening
but it doesn't seem like me"), two or more "personalities" inside trying
to control the same person, confused or Fugue states, etc. All these
reactions serve as a defense against pain, fear, helplessness, panic,
and other intense feelings or ideas. It is as though, under stress, our
normal stream of consciousness fails to integrate all of our thoughts,
emotions, somatic sensations, sense of identity, and knowledge of
what happened. Thus, one may remember what happened to them but
forget how they felt. Compared to repression, in dissociative reactions
memories are splintered and distorted, not just lost. Indeed, there is
often a repetition compulsion to repeat some part of the traumatic
experience, experiencing it over and over. We have already read about
dissociation in Trauma above and we will read more about it in Suicide
in chapter 6 and in discussions of serious pathological states in chapter
9. 
Denial: refusing to admit or face a threatening situation. Denial
can be unconscious as when a dying person refuses to admit what is
going to happen or when a person with a heart condition denies that
their overeating or smoking is of any consequence. Denial can be
semi-conscious as when a person refuses to see any problem in a
relationship when it is pretty obvious to everyone else. Denial is
probably quite conscious when a post-puberty young man of 13 says,
usually with a grin, "I'm not interested in girls." 
Research (Roth & Cohen, 1986) has shown that there are two
major ways to cope with stress: (a) avoiding, repressing, looking
away, forgetting, escaping and letting someone else be responsible or
(b) approaching, learning more, obsessing, being vigilant, and taking
charge of planning what to do. The first way (denial) reduces stress;
the second way (sensitization) increases our chances to cope. We all
use both ways, although we may tend in general to be avoiders or
approachers, while in specific situations, like facing surgery, we each
have our favorite way of coping. Which is the better way? 
Denial is probably better when the situation is out of your control
(a sudden crisis or in surgery) and approach is probably better when
you can do something about the situation (avoid or lessen a problem).
The disadvantages of each way are: more stress and useless worry for
the approachers, and more failures to act and lack of awareness for
the avoiders. As you can see, ideally we would use both avoiding and
approaching ways of coping with a particular stress over time. This
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