hey gang hey welcome back we have just one more week of classes and then we have a final next week don't forget your autobiography papers do and there will be a final exam it's just gonna cover the last three chapters though like every other exam so it'll cover personality disorders and therapy so we're going to talk about disorders and therapy this week and that's perfect so they go hand in hand so what I'm gonna do is as we go through will give you an outline for this chapter first when I talk about kind of just what disorders are and a way to think about disorders and then we'll talk about different classification of those disorders remember this is just intro psych so this is surface material about these disorders of course you can go and much more depth in much more detail about each classification of disorders and then all the different like sub categories of disorders within that classification but today or for the for our class for the purpose of our class we're just gonna kind of touch on the basics of each of these disorders alright so let's begin so as we go through talking about these disorders I always give this disclaimer there don't you know you'll feel the urge to start to diagnose maybe yourself or to diagnose people around you I just want to remind you that you may seem obvious but you are not qualified to do so even based on the criteria that we go over and in class doesn't mean that you're you know qualified to diagnose people neither am i by the way right my background is not in clinical psychology so you know I just want to say that off the back as you might feel like as we go through the symptoms of some of those disorders you'll go oh my god I have that right and then we'll jump to the next category and you're like I can relate to that I must have that too it's like hold on slow down right slow way down maybe you do maybe you don't you know go see somebody you know a professional if you think that these disorders actually do apply to you right but you know it's it's good that you can relate to some of the symptoms and that's you know what we expect honestly and the best way to understand disorders is that you can identify with some of the symptoms for each of these disorders that we go over right and that's a good way to think about disorders you know we'll talk about that first like what is abnormal Howard I disorders diagnosed classified and then we into the different types we'll talk about anxiety disorders we can talk about you know just associate disorders mood disorders personality and schizophrenia you know as we go through the class of course there are other disorders Willie just can't touch base on all of them so we'll just do like these these big categories which are really good for an intro course right things that you'll find interesting it's kind of a mix of those that are common disorders like the anxiety and mood and then the very like uncommon but still out there but in common like this so said dissociative identity here just this associative and disorders in general very atypical not very common same with like personality and schizophrenia okay but like I was saying it's good that you can relate to some of the symptoms of the disorders and that's a good way to think about it like you can relate to some of them right you've probably felt some of the symptoms of these disorders maybe even deeply but it may have been like short-lived so that'd be an important part of the diagnosis and that means that these orders are on a continuum right like we tend to think about everything you know things is like black and white and a lot of our lives like if I caught in this like you know yes/no very binary right like go stop yes no black-white you have a disorder where you don't have a disorder it's not really a good way to think about disorders that's the way the legal system thinks about you know words like sanity for example like you're saying or you're insane that just doesn't make any sense to a psychologist if you can have disorders and symptoms of disorders that are on a containing and by the way you can still be sane and have a disorder so for like psychologists sane means like you just have you know no awareness that you even have a disorder right and so that doesn't apply to very many of them at all so it's a weird one right and the legal definition of disorders and the psychological don't always match so sometimes you might you see like psychologists you know have to testify in court on behalf of somebody and don't ask them that question like you know is this person sane or insane your psychologist go that doesn't make sense to us as a question so how do i how do I answer this right okay so we do need to talk about like philosophically you know what constitutes a disorder or not so like you know that's called psychopathology which is the study of abnormal psychology right and abnormal is a really old word for disorders like a lot of people will use it but they also use like a typical which means this is not a typical way of behaving or thinking or feeling right it's outside of the norm all right so sex orders it says here it's like any pattern of behavior that causes significant distress causes a person to be a harm to themselves or others so it's distressing them it's dangerous it causes harm to themselves or others and it affects their ability to function in daily life so it's gotta be all of these things I would throw deviant in there too so it's gotta be it's like off the four DS right so for C deviant means most people don't do it it's distressing so it's emotionally distressing for somebody it's dangerous you know for the person or for other people around them and then it's just dysfunctional as it impairs their daily life right it's like the big four DS and I would say you need to have like all four of those really to say this is a disorder it's distressing to me it's not a typical behavior it's potentially harmful for me or for other people around me and then interferes with my day to day functioning and so we have to think okay well what do we mean by you know what is normal you know what's if we're talking abnormal behavior what's normal behavior and that's a fair question is there's like two big ways to think about like what what is normal the first is defined by culture right so some things that are normal or one culture are not normal in another and so you need to take that into account when you know if trying to figure out a case this person suffering from some type of diagnoseable you know disorder is what they're doing deviant in their culture and that's got to be a component of it right so it's that cultural definition like if you're thinking like who decides which normal man right but that's a good question is fair part of it is culture right culture dictates some of that and then or a big big part of it but as part of the definition and the other is like statistical so if you think of a bell curve and you go alright well in the middle of that bell curve is like 68% of the population if you're outside of that range from that middle 68% above or below then that's a typical you know statistically speaking so that could be deviant as well so that could be you know potentially disorder territory if it's also dangerous or distressing or impairs your day-to-day functioning so it's dysfunctional right so you got the cultural definition you got kind of like the clinical or almost like mathematical you know the definition of the scientific definition as best as we can do okay but that cultural part is important so I thought I would just you know for a second you would talk about like cultural variations and disorders some examples of that these are called culture bound disorders if you're interested in the diagnosis or abnormal psych and diagnose diagnostic criteria for disorders then you want to look at something called the dsm-5 so that's the diagnostic Statistical Manual and that's used to create a common language for clinical practitioners to to diagnose and so they're all using the same criteria so if like say one patient or client goes from one therapist to the next that says hey I have this disorder you know I was diagnosed by my previous therapist then that new therapist goes like okay they said you have this disorder then like here's what they must have gone through is their checklist just like a medical disorder right you treat it the same way so that's that's consider the medical model of thinking about psyche disorders as a disease or infliction you know that can actually be it can be treated in some ways and we would treat that with some form of therapy okay but some of the culture-bound disorders you will find in the back of that dsm-5 where they have these that are specific to cultures I thought I'd just show you a few like that we don't have in our culture at least not the same prevalence rates so like people from Malaya or the Koro people they had this it's not around so much anymore now that everybody's becoming kind of globalized but this this one traditionally is hard to relate to for us in the US but the men of the Koro had this deep fear that like when they were asleep that somebody would castrate them literally like chop off their pain is so that their penis would retreat back into their abdomen and this was a common anxiety among this among these people arguably with something I read was that it was as prevalent as anxiety is in the u.s. so it would be extremely common but it's a hard for us to relate to that we don't have that same type of disorder right so if someone from this culture came to ours and said I got this anxiety this fear it would seem even bigger to us because we're not used to hearing that right another one would be you know the Windigo the Algonquin Indians so natives rather so these native peoples believed something kind of significant and they've been actually reading about this one extensively that there's the Windigo myth that actually has been kind of like exported into like European cultures within the US and they kind of took that myth in that story and changed it somehow and it actually went back backward to the windigos and changed the myth a bit to be like some form of like literal Bigfoot sasquatch like monster but that's not the original story at all it's like the original story was that the Algonquin native peoples thought you know they had this fear that they will they would wake up and they would have this like insatiable urge to eat human flesh right and that was scary because that would be scary right to wake up with that urge to want to eat people so that's a little different than thinking like there's some other monster out there externally that wants to do these things I think it's much scary to think that that monster is like inside you much more psychological - right we don't really have that to the same extent they're not like that specific type of you know anxiety or fear that was bound by a culture right so you know these are just kind of some examples that were interesting to me we're coming across reading and looking for culture-bound disorders but there are others - like a and if you go to I think it was just so Japan it was so as Japan was becoming more kind of Americanized in forms of it's like pop media like popular media like music and movies and things like that as that became more popular we started to see the disorders change in Japan a bit too so an example that would be the idea of body dysmorphia so that's usually attached to or strongly correlated with eating disorders in the u.s. right so you have this body dysmorphia means that you see your image you see your body in a way that's not actually accurate so a lot of people who have body dysmorphia and like anorexia or anorexia and bulimia you know they look at themselves and they don't see themselves as other people do right to an extent that they're almost obsessed with it so in Japan they had the eating disorders without the dysmorphia they did really have the dysmorphia they're still at eating disorders so anorexia bulimia they didn't have the body dysmorphia really until their media became more Americanized and in a way right became more popular anyway and then the bar dysmorphia started to show up there right and there was this neat kind of study looked at the correlation between American media prevalence and has it increased in body dysmorphia increasing well so you know that's kind of like you get the light and the dark right like you want the American popular media you want that kind of fun part of society the entertainment then there's potential to also get the dark side of that and as you can see that in some other cultures so that's important right to think about culture okay so as far as like diagnosing and classifying disorders goes we could say there's some pros and cons right though the pros by having like a manual and using what's called the medical model of diagnosis the pros to that is that it provides us common language to professionals which i mentioned earlier so if you go to one therapist and you start to see another one they can communicate with knows about your diagnosis and they they know they know shorthand kind of what it means if you have a certain type of disorder it gives them an idea about how to treat that disorder she wouldn't treat them all the same right all right so it establishes those distinct categories diagnosis for treatment and understanding and that's that's kind of the goal right like some of these sorters fall under one category or another partially based on the treatment that works best for them all right now the cons of that you know is it is it overly prejudicial or stigmatizing to say you have a disorder you know tests say like okay I've officially diagnosed as this and now you have to bear the brunt of the prejudice and stigma that you know may may come your way because now you have you know you officially have this disorder but I don't know for some people though I think I better would think about that is like you know I know I've been diagnosed now I know how to plan how to plan so I can be as healthy and as happy as I want to be like what works for people with this disorder it's like it's a bunch of literature on that and your therapist should be aware that and I you know seasoned and practiced on the type of therapy that with most beneficial for you all right so there's no pros and cons for sure there's the psychology student syndrome which I mentioned earlier like don't start diagnosing yourself just because you're in a psychology class like I said you're not qualified I'm not qualified nobody here is qualified to do that right okay so let's get into the different types of disorders now the most common disorder or category that's the most prevalent anyway are anxiety disorders and some of that is because there's such a strong like physiological underpinning in the definition of an anxiety disorder that it often people have multiple disorders at once and anxiety is often a part of that not always right so that's one reason it's the most common is that you can have this plus other disorders right and there's a huge physiological component underlying it like I said and some of those there's something physiologically to understand it yet but this one we understand it better than some of the others so well all of them have in common before we get into the specific types for anxiety disorders is that for all of them there is like excessive apprehension and anxiety so it's not like a typical to never feel anxiety in fact something that can be useful as a tool to motivate you but maybe the part of definition is that it's excessive apprehension so it's like typically happens more often you know you have these these issues things iodine you know more often than not you're feeling it anxious and then probably even at like a heightened level then like the average amount right so it's like more of it and more often so the symptoms and these the symptoms kind of sound kind of strange right cuz they aren't all like based on a specific physical part of your body right but but that is like the underlying like etiology of them right there is something going on biological as well so we have excessive and unrealistic worry and fears and of course there's persistent uncontrollable tenseness and apprehension so they're talking about here there's tenseness and apprehension that's like the physical part and the worries and the fears or it's like the cognitive and emotional you know component of an anxiety disorder and another physical part is the excessive autonomic arousal right so that fight-or-flight you know system of your body fight flight and freeze we should say all three of those become like activated more often than for most people into a larger extent than for most people right so the prevalence of anxiety disorders is about 18 percent of the u.s. population this is for all types combined and 18 percent might sound light might not sound like a lot but that's at 42 and a half million people right that suffer from an anxiety disorder so let's talk about like the first type of anxiety disorder it's called dad sometimes for short or general anxiety disorder this is like it says here a free-floating anxiety it's not specific right it's not like a phobia it's like a fear of one thing you're right and it's generalized with generalized comes from as there's a like a diffuse sense of worry anxiety and the physiological arousal so excessive anxiety worry that occurs more days than not for a period of at least six months and the typical age for onset here is in the early 20s it tends to be gradual for most people and precipitated by stressful life events but generally anxiety disorder can also become chronic in which some periods of time are marked by more anxiety than others but it never really goes away right that's a general anxiety disorder um this makes me think about okay so I have I have a buddy and he has generalized anxiety disorder and he takes medication for that now and he goes to talk therapy but I remember when he even when he first started going to talk therapy you know he I get phone calls from him and he would just talk and talk and talk non-stop and he was so scared of everything and second-guessing everything he did and really like the cognitive part he would be like interpreting something like ambiguous as being worthy of anxiety provoke provoking write worthy of that response were like I don't know what's gonna happen tomorrow it's like well nobody really knows what's gonna happen right in his brain always goes to be worse it's gonna be the worst kind of the worst and as always anxiety about it it's like mm-hmm you know maybe that's true or maybe it could be the best right it probably won't be either of those things the worst of the past probably somewhere in the middle right but you know he's only thinking rationally about this it's like his emotions kind of taken over there's too much arousal in his body right so it's heart can you know palpitate faster sweating all this um all the stress hormones that are created during this anxiety is bad for your health it's bad not just for your psychological health but your physical health remember he would call me and when he started therapy and he probably didn't feel like a month if somebody was taking medication and going to talk to somebody for about a month he called me once and he didn't really feel any anxiety and I could tell just from talking to him and for him him going you know I've been telling me how he feels pretty good he's like I feel okay like the relationships I was worried about all right but works all right schools okay you know everything's going on right and then that wasn't typical for him so right away his brain still went to interpret even that things are all right as worthy of anxiety so you'd be like why are things going okay like I don't get it and you know he's like things never go okay for me I should be suspicious or paranoid about that things are going alright and he like talked himself back into this anxious state that's like whoa man you were you were right there at all is cool always get it like you know take a deep breath it's that's kind of general anxiety disorder and we'll talk about you know therapeutic treatments for that and a bit most people will react pretty well to medications for anxiety disorder of course the downside of that is you know just how addictive most things I just orders are right so we'll talk about that treatment when we get to the treatments the therapy chapter all right so drillings I just ordered not tied to any specific type of event can be dangerous it can lead to panic disorder we have full panic attacks and that can lead to difficulty like catching your breath so it has a respiratory you know respiratory issues and you have cardiac issues for panic attacks you know from your heart being affected and some people even do things like pass out right um so yeah so it can lead to panic attacks which can be you know debilitating and very dangerous very bad for your health okay so let's move from generalized anxiety to a phobic disorder these are these are pretty rare really as far as like anxiety goes but still when I say that it still can be upwards of you know 20 million people a phobia is are are unique because there's very specific types of therapy that are that are perfect for addressing phobias which work really well it's not quite the same as other anxiety disorders but we're gonna give them their due I especially want to point it out because a lot of people talk about having a phobia when I'm very suspicious that they don't right so a phobia is and this is key an irrational persistent fear of an object situation or social anxiety right so irrational there's is is is the key so it's irrational its persistent and it's amplified right to the point where it interferes with your life so someone is just like really afraid of spiders they don't really have arachnophobia and less like the thought of interacting with one they have this physical response in their body or they're thinking about these spiders when they should be thinking about doing their homework and stuff like that and it's really intruding causing distress and dysfunction that it might be a phobia but if you're just scared of spiders then you're just scared spiders it's okay and maybe it's not irrational to be scared of spiders argument there right so there's a difference between just being really scared of something and a phobic disorder sending you into like a panic state man there's so many different types of phobia the the strongest theory about phobias here or they come from the etiology is the behavioral theories so there's good and bad news about that you know it means that you learned to have this level of fear and level of panic you probably have to have some genetic predisposition to like achieve like phobic standards so have your biology and play for that but learning can get you there if you already had our predisposed for this type of hormonal and chemical regulation that underlies the anxiety response the fight-or-flight response but if it's learned though the downside is that you can learn to have a phobia for anything right it's like absolutely anything and the upside is that if it's just a learned response then you can practice unlearning it you can t condition yourself to not be afraid anymore so I mean if you just google phobias you'll find like hundreds of examples of different types you know some of the most common are things like claustrophobia people are aware that one you know got the idea of being stuck in a confined space or a small space I really don't like that I don't know if I'm claustrophobic like I can play hide and seek I can I could hide in the closet I'm okay right there's acrophobia which is like fear of heights there's a agoraphobia agoraphobia is different than most people assume and partially because the definition has changed as we learn more about what agoraphobia is it's like agoraphobia most people say oh it's the fear of of going outside or being in you know spaces with people that's where the name comes from agoraphobia from the Greek really means fear of the marketplace like fear of being out in public in the marketplace and that's a pretty good definition but we know a little more about the specifics of agoraphobia now so most people are afraid of it's not like you know being social and being around other people just because they're like in normal normal ways that people have social anxiety like I'm afraid I'll say something stupid or people won't like me like that's that's a part of it but it's more specific for people with agoraphobia they tend to also have a panic disorder so meaning that I have panic attacks and so being on public can kind of like amp up some of that social anxiety and it's enough to send them into a panic attack right so they have a fear of being embarrassed because of having a panic attack in front of other people and so those people have agoraphobia they have had a panic attack you see their behaviors kind of clustered around really staying inside like staying away from other people so they don't embarrass themselves and have a panic attack in front of them right so those are the agoraphobia that have not had panic attacks much easier to treat with practice tougher with people that do have panic attacks but you know can still be undone can still be unlearned for sure right okay so let's look at oh I got this the stamp collection I don't know you guys think about this but you know like I said you could have a phobia for just about anything since it's a learned response and then we have all these different animals here that you can have a phobia for right it's such a prevalent idea in our culture that there's even a stamp collection about it but you could have you know tons of different phobias I worked with I worked with a guy when I was in college and I learned that he had a phobia the hard way so he he was our boss where I worked I worked in a Student Union at the college where I went to college and we would fill for everybody's birthday we'd go like overboard because we had access to all like the student life materials so we would do things like get like balloons for each other for our birthdays for the employees and stuff like tax we had access to that or like big posters and colorful paints and markers and all that was all our disposable so his first birthday rolled around and we never liked him he was a good boss and they were like College let's go overboard for his birthday let's show him like how we do things around here be fun and so we filled up his office with balloons right and nobody knew because why would it ever come up in conversation like oh by the way I have something called a global phobia which is a fear of balloons so I remember everybody's like watching him when he comes into work that day his office is full of balloons we're just waiting for him to open the door to see what happens right and he opens the door and he sees all the balloons and he just falls to his knees and he starts shaking and trembling and crying and sweating and he can't breathe and you know he's having a full little panic attack there was going oh didn't see that coming and he was a brave guy because he you know he calmed down and he told all of us right away so as you can see you know I have this irrational fear of this phobia of balloons you know please don't fill my office with balloons again you know the kind of thing but the key there is that you know he's aware of that you know with phobic disorders people who have phobias are aware that they're irrational it's not like they're you know psychopathic and then you're not aware that their fear is irrational they're aware they're perfectly aware of that right okay let's move on ooh obsessive-compulsive disorder oh by the way I have some videos that I'll put up on canvas you can look at some of these disorders if you want to see videos about them okay so OCD for short stands for obsessive-compulsive disorders and those two things are related and necessary for the definition of obsessive compulsive disorder the two things being obsessions and compulsions right so the obsessions are kind of the thoughts right that was really where the anxiety comes from that they kind of relive these thoughts over and over again these thoughts are intrusive you know really like like invasive intrusive thoughts as they're trying to go through day to day functioning and these thoughts kind of get away slow things down you know create self-doubt or sometimes can be even like debilitating as a motivating force for the compulsive behavior which is really a way of like self soothing and trying to control these obsessive thoughts so the Fox come in and they create this anxiety and the person has learned okay if I behave this way after the anxiety creeps in then I can kind of regulate my anxiety levels and bring it down and then eventually what happens is the person says oh I predict that I will have these obsessions now I'm going to be compulsive to kind of beat them to the punch so they don't even intrude it as much right and so they're just making the whole cycle stronger because what happens the thoughts become stronger than the behavior becomes more repetitive right more ritualized and the VAS becomes stronger more ritualized and they're kind of feeding themselves creating this loop or the cycle so this is a little old in 2009 but it hasn't changed a whole lot here are some typical obsessions things like you know being concerned with dirt with dirt germs toxins right something terrible happening that's another big one like a fire a death or an illness other people it's more like a new aesthetic where they're really become concerned with like exactness and order and symmetry and if any of these kind of obsessive thoughts that just kind of can't stop thinking about them you know how do they get them to go away then they behave in a certain compulsive way like with excessive hand-washing or or bathing or you know tooth brushing grooming or they become ritualistic you know I have to like you know become like checkers where they have to check something over and over again you know a certain number of times I've gotta go in out of a door certain number times check my appliances check the car brakes you would ever it might be checking social media for some people but these are all very very common ways to kind of create some kind of control regulation of that anxiety well if these people are like making it worse by doing that right because they're just feeding into the cycle making it stronger and stronger and perpetuating it further and further used to be this not I'll tell you about that one later like if you look at the if you look at the brain you see what a picture of that coming up next not yet if you look at the brain of somebody with OCD and right when they're like in the middle of having obsessive thoughts and not being able to act compulsively to regulate them like what you'll typically see is their brain looks like the same way would look if you're trying to make like a major decision in your life like as emotion attached physicality attached like all these activation centers in your brain are activated as well but it looks like a decision that's like really difficult for you to make it's kind of what the looks their brain looks like if you look at like an fMRI like they're stuck in the middle of this big decision and they can't get out of it they have like no relief from the decision good or bad until they perform this compulsive behavior then it goes away right so I command if you could like being stuck in the middle of like a huge life-changing decision for you and just never getting resolution for it until you perform this ritualistic behavior and it goes away but then it just comes back later a little bit stronger and so you perform again get you away create this cycle okay I think we talked about and in the category of anxieties is is PTSD or post-traumatic stress disorder so for this one you know here's some of the etiology the the symptoms associated with acute stress disorders like PTSD you know like it says here they they last for more than one month you know and they can develop and by the way they don't always develop right away like right after the event you know sometimes it can be half a year sometimes it could be years later you know when it should when they start to show up these symptoms of PTSD and so here's some basic symptoms like anxiety that's a common one of course so a physiological arousal in your body dissociation is another one's like dissociation means like you feel like you're kind of detached from yourself like you're outside of yourself sometimes even watching yourself um I can tell you more about that later you may manifest is recurring nightmares you know sleep disturbances for sure problems and concentration for sure a very common for PTSD and moments in which people will seem to like relive the event and dreams and flashbacks you see that too we really don't know the prevalence rate of PTSD in the u.s. whatever rate people put out you know most psychologists say it's got to be higher because for a long time it was thought you know oh this is only for like soldiers but that of course of course there's a huge rate proportionally disproportionately of you know people who have seen combat or even not seen combat but soldiers who have PTSD but it can include and you're like you know police officers as well it's pretty subjective like what what is a traumatic event those who who were survivors of abuse right often have PTSD like symptoms or PTSD so they'll be common that way this is one and it's like equal opportunity across the sexes at least as far as diagnosed these go for a lot of these you see them more often in women but but for this one and that's probably just because women are more likely to go seek treatment of this one you see for when women and men right pretty much at equal levels now I know it says women at higher risk at the bottom but I don't think it's no longer think that's true now that more men are comfortable going in seeking treatment for specific types of disorders like PTSD so this one is like intruding memories often like visual images you know of something that was or is somehow related to or a symbolic representative of the event that was traumatic for the person initially okay and the problem is that I get in intrudes at times where of course you don't want it to because you have to live your daily life right but it keeps intruding you know it's a little it's kind of obsessive right you can't stop you know then it makes you think about it then you think like I don't want to think about it now I'm thinking about not thinking about it right it kind of it becomes a little obsessive that way and can distract you from you know dealing with your daily life and of course it can be emotionally distressing as well so I was gonna tell you my story because I actually went to therapy for PTSD I'm not a veteran I never have a surf country in that way it was not from war just just if you're wondering if that's not it for me you mean to get personal with you it's because I saw two of my children dead and they died during childbirth and both times I saw him in the hospital I never I never did seem alive right but both times I remember the nursing staff asked do you want to see them you know there asked me I ate it because it was farther you know could have been part of my grieving process and I just I thought about it and I may have given a different answer now but back then I said no I said no I don't I don't want to write but I like to think by accident I did see both of both of the bodies as they were left in the room with me and of course that was heartbreaking right just devastating in the moment you know to see that and I did things I thought would be helpful for me to kind of grieve and recover but then maybe a year later you know I'm driving on panorama to get to the BC campus and I see this roadkill on you know in the middle of the road and it was bloody and it was gross very gory and and just like all these like it felt like someone was playing a movie for me just for me from me to me of like this traumatic scene in the hospital seeing my kids dead right and I kind of as hard as I tried to block it out man it was just intrusive for like the rest of that day actually called in sick I was like I can do this today in fact I'm gonna go look up a therapist cuz I pretty sure this is PTSD you know it surprised me of course it was emotionally devastating but but also just surprised me out of nowhere I was like oh I wasn't thinking about that at all then like there it is like oh you know a psychoanalyst would say I still had to deal with that trauma and so I did write I went to therapy and it was helpful so you can get PTSD from many types of events who's to say what's traumatic for you but there's usually some you know heightened sense of emotion and definitely physiological arousal isms at some form of event in the event you know usually something very horrific or you have or you behaved in a way that was horrific or you were the victim of something horrific right either way can cause PTSD okay so we'll talk about therapies for these it's like I'm leaving you hanging like we'll get to therapy soon I promise alright so the etiology of anxiety disorders like where they come from there are more types of things eye disorders but these are the big ones so there's the psychodynamic explanations right think like Freud's psychoanalytic I would say like repressed urges and desires are trying to surface from your unconscious you know into your conscious life that kind of feels like what I was describing for myself