Post Traumatic Stress / Trauma
Overview of Post Traumatic Stress / Trauma: Trauma is an event that severely threatens our physical survival or safety or our emotional and psychological integrity and safety. A trauma is an event that frightens or shocks us, endangers our long-term well-being, causes us to fear for our life, safety, or sanity, or causes deep emotional pain, confusion, or fear.
Trauma probably affects most people at some point in our lives – we may have a car accident, suddenly lose a loved-one to death, experience a criminal act (armed robbery, sexual assault, etc) be subject to serious emotional or physical abuse, live or serve in a place where war or terrorism occur, or in some other way be subject to intense fear, either for a moment or for a long period. Some people experience repeated trauma (such as victims of repeated abuse as a child, people who live in war zones, etc). Some psychologists consider birth to be a traumatizing experience.
Many people recover from trauma through the support of family and friends and bouce back with great resiliency. For others, the recovery process is a longer journey and for some, the support, guidance, and assistance of professionals is fundamental to their healing.
The Medical Model and Post Traumatic Stress / Trauma: The best chance of recovering quickly from trauma is to address it in the immediate aftermath. Crisis debriefing, or Critical Incident Stress Debriefing, is a form of very short-term therapy or counseling that helps people make sense of their experience and feelings, plan to cope and stay safe, and connect with resources that can help them. If you experience trauma, talking about it with a professional as soon as possible can help diminish the chances of lasting ill-affects.
However, sometimes trauma does lead to long-term difficulties. The painful or frightening event may be replayed in memories, daydreams, and nightmares. We may avoid situations or people that remind us of the trauma. We may be emotionally numb, depressed, or anxious. Sometimes, people turn to drugs to numb feelings of terror that last for weeks, months, and in some cases, years after a trauma. If you experience such feelings, thoughts, or behaviors after a trauma, know that such experiences are very human and nothing to be ashamed of. Trauma is more and more common in the United States military due to the current military engagements, and many soldiers seek help to deal with thoughts and feelings that result in being injured, watching fellow soldiers be injured or killed, killing opposing soldiers, or simply from experiencing the intense danger of war. Through the assistance of a trained professional, one can heal from the consequences of a trauma even long after the traumatic event. ~ Content edited by Susanne Dillmann
Diagnostic and Statistical Manual of Mental Disorders (DSM): Post Traumatic Stress Disorder is diagnosed in certain cases. The following is the 309.81 DSM-IV Criteria for Posttraumatic Stress Disorder:
A. The person has been exposed to a traumatic event in which both of the following have been present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.
B. The traumatic event is persistently reexperienced in one (or more) of the following ways:
(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
• difficulty falling or staying asleep
• irritability or outbursts of anger
• difficulty concentrating
• hypervigilance
• exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
Case Examples of Post Traumatic Stress:
Ricky, 24, has recently returned from Iraq where he saw combat. He says he was doing fine until last week, when a robbery occurred in a local store while he was there. Suddenly, memories of combat flooded his senses, and he was paralyzed by them. Now he has nightmares about Iraq, but images of home get “mixed up in there.” Not only does Ricky feel overwhelmed and anxious about these flashbacks, he feels guilty for surviving while two of his friends did not, and guilty for not stopping the robbery at home. Talking about his feelings helps somewhat; focusing on ways to stay safe helps as well. Ricky’s guilt is addressed by exploring the choices Ricky has made and their motivations. Ricky’s beliefs about what it means to be a man, and his high expectations of himself are also explored. The therapist helps Ricky make peace with his own mortality, and teaches Ricky relaxation skills. Ricky asks for a psychiatric referral, and takes anti-anxiety medications to sleep a few times a week. He is also referred to a support group. A year after his first visit, he is no longer taking medications, and is feeling more hopeful, though he still struggles at times with intense grief about the war.
Patricia, 39, is a highly anxious person. A full history reveals severe abuse as a child, which Patricia is reluctant to revisit. The therapist allows several sessions to go by before bringing it up again, and when she does, Patricia becomes very upset and angry. Patricia finally agrees that her reaction indicates the abuse is still “dogging” her, and she agrees to a referral for EMDR. The EMDR process helps her being a real recovery from the abuse, and her anxiety diminishes considerably.
Therapy for Post Traumatic Stress / Trauma: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of post traumatic stress and trauma. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Marriage counseling or family therapy may be an important part of therapy if a traumatic experience is negatively impacting relationships. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for trauma or any other issue, it is helpful to familiarize oneself with these elements.
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I,too, specialize in trauma work in my practice. I enjoyed your article, and the question. I agree, containment of overwhelming experiences (feelings, thoughts, images, sounds, and body sensations etc) is such a key part of this work. As you indicated, the wounded parts of self are so often needed to be "approached" and "modulated." For me, the parts of the client that can provide containment are the ones that the client identifies as being the most capable of doing so. I always want to learn the "role" of each part, its function, before doing the trauma work. I then ask that part permission for it do be part of the "team" that will work on the trauma. Once each part has identified its role, and has voiced its opinion on "doing the work" I can then identify who to "go to" to find the client's internal resource. As a result, the client's system, itself, gives me the message about how to contain what is triggering and overwhelming in that moment. I then ask the part that "knows the most about" the trauma being worked on and the part that knows about comfort, to try to work together. Again, everyone's system is different, and every internal system of containing is different. Nevertheless, I find that working with each part's role makes a huge difference, and helps the client find his or her internal resources as well. It also helps me to gain an alliance with the rest of the client's internal system, by us negotiating how we will work together to process and release the trauma. Thanks so much for this question. Very thought provoking!
Have you looked at Principles of Trauma Therapy by Briere & Scott? I found this an excellent book. He presents the concept of Therapeutic Window. This idea is that the therapist must work with the client to have some affect present by revisiting the trauma, but not so much that the person is dysregulated; hence the idea of window with a sill to stay over and a top to stay below. Nice article, thanks.
A chill went up my spine, when the author refered to "Internal Family Systems" While in Graduate School, I joined a "Family Systems Group" led by one of my professors. Being in Practice and working with prople who suffer from Chronic Mental Illness, I have witnessed the damage "well intentioned" people have in trying to get a person to return to the horror of their trauma! I am a PTSD, sexual assault survivor! That part of me does come out at times with a scent in the air. I found it best to get in the moment using my 5 senses. What I feel, What I see, What I hear what ever to change the chanel in my head and let go of the horror that emerged from my unconsciousness! I had back surgery last fall. Would it make sense to reopen the wound on my back? No! I need to know my limitations and learn the skills to "Let Go" and re chanel my focus on the now!
I found this blog to be very helpful. I am struggling right now with a client with this condition. I find myself getting impatient with my own skills and blaming myself for lack of progress. But, I can see that this client hasn't reached the moment when he realizes what he is doing is not producing the desired outcome. He knows that he doesn't like what's happening, but cannot see where he is contributing to the problems in his life. Is there anyway to help someone to the point of realizing change is necessary or is it necessarily a strictly internal process?
I have found that with my clients, until they are ready to make a change, there is nothing I can do but manage problems. Rather than being a healer, I am a manager. It is indeed frustrating. But, when we realize that at that point in time the client needs a manager rather than a healer, we realize that we are doing our jobs. We need to be skilled in realizing when the client is ready for the shift in our job description, however. If we miss the signs that the client is ready for the shift, we risk becoming part of the problem.
Have you ever worked with a client that has never realized what the root of the problems in his or life is? I have been working with someone for the last five years and feel like he is not any closer to that realization than he was when he started. I then get in a moral delimma when I get a letter from the insurance company checking to see if treatment is still necessary. If my client is not going to progress any, is it moral to say that he still needs treatment? Or, what if the next session is that break through session? I'm really not sure what to do here.
I think that your client does still need therapy. Just because he may not have made the progress at the rate you feel is appropriate, it does not mean that he isn't making progress. If you are really that unsure of your effectiveness with this client, maybe you need to recommend another therapist. You could see the lack of progress as an unwillingness to trust as the author referred to. If this is the case, you have had plenty of time to foster trust with the client. It may be time to let this client go and see if another therapist may be a better fit for him.
This seems to be to be a horrible treatment method! I understand hw prolonged exposure to something could desensitze you but it seems that if you have personally experienced a traumatic event that something like this could bring it all back. This is terrible to me that anyone would even consider this as "therapy" for a patient.
I agree that it sounds pretty horrific; the thing is, there are good studies showing that it really helps people, and rather quickly. Hard to know what to think. I myself will stick to EMDR for trauma.
This method makes me think about the ethical considerations of the so-called "re-traumatisation of the client". Personally, as a therapist and a survivor of trauma, I don't think that this method is ethical. It is based on the idea of "catharsis" as discharge, that construes a person like something similar to a steam engine. But is it a "true" description or just one of the possible ones? Does the client have the right to say "no", or s/he has to follow what the "expert" therapist has in store for him/her?
But isn't this what any good treatment method is all about anyway? Allowing you to face your past and your demons in a safe envirnoment so that you can encounter them and no longer feel threatened and stunted by that which has happened to you in the past?
Of course exposure to something will leave you less sensitive to it but I still do not see how this would treat someone and the problems they were having associated with it. I cannot imagine having to go through this or allowing that treatment for soemone that I love.
Yes, the good old extinction theory...but indeed with virtual reality being so real it does seem like the danger of re-traumatization is strong and could be un-ethical. The training period must be very important for the therapist and they must be very sensitive to the ability each individual has to tolerate how much 'little-by-little'
I guess I can see the pros and the cons of this style of treatment. It does force you to confront your demons but at what cost? Will you simply continue to go through life traumatized? I think there are better therapy solutions than what this presents.
I see no positives to this treatment style at all. I have a relative who experienced a very traumatic event in her own life and I cannot imagine someone asking her to relive this again and again as a part of a treatment session. That is just unheard of. Therapy should be gentle and compassionate, not even more stressful to the patient.
Post Traumatic Stress Disorder or PTSD has been shown to have a genetic and environmental connection. A study conducted by Kerry Ressler, of Emory University in Atlanta, established that an individual may be at an increased risk for developing PTSD if he/she possesses a particular gene variant in combination with a past traumatic experience. The research team examined the effects of a gene called FKBP5 and concluded that the presence of this gene could mean a predisposition to PTSD. Every individual has a different mechanism to deal with stressful situations like violence, accidents, natural calamity and war.
And what about those who cannot deal effectively with this kind of trauma? How will therapy like this in any way help them? To me it seems like this could only set them back rather than advance their treatment.
I totally agree. this sounds like the most backwards "treatment" mthod I have ever heard of. I would never allow a family member of mine be subjected to this.
Margo I totally agree. Anyone who did agree to this really has lost their mind!
I have very conflicted emotions about this treatment method. There are pros and cons to it I suppose just like there is everything in life. I am sure that exposure to certain things over and over again can in some ways allow you to confront and deal with irrational fears. This is not always a bad thing now is it? And surely those who employ this treatment method are trained to know when enough is enough and would remove the trigger from the patient in order to ensure that a healthy mental state is maintained.
I was really eager to know how virtual reality is used to treat patients of post traumatic stress disorders while I found these lines "Virtual reality is also used in the medical community. Therapists use virtual reality to treat phobias and Post Traumatic Stress Disorders. Physical therapists use virtual simulations to help their patients reach treatment goals. But the method you depicted here sounds horrifying.
I honestly don’t know what to think. I would like to see more data into the results of this ‘virtual therapy’. I feel I can be sure that it does not work for everyone and I fear what consequences can arise for the individuals that become even more traumatized by their therapists. Dr. Prout has produced some interesting works into prolonged trauma with the assistance of animals for PTSD suffers. He actually has many insightful works into PSTD treatment that are great for study of PSTD therapy. His full reference of work on PTSD can be found at http://www.mauriceprout.com
Dear Patti, Your article makes some excellent points. The DSM-IV-TR category of PTSD often does not capture the full impact of chronic early maltreatment within a care-giving relationship; which is the basic definition of Complex Trauma or Developmental Trauma Disorder. This chronic early maltreatment within a caregiving relationship causes very pervasive damage across a broad range of domains...PTSD does not capture the full extent to the range of impairments in the domains of 1. Self-regulation 2. Interpersonal relating including the capacity to trust and secure comfort 3. Attachment 4. Biology, resulting in somatization 5. Affect regulation 6. Increased use of defensive mechanisms, such as dissociation 7. Behavioural control 8. Cognitive functions, including the regulation of attention, interests and other executive functions 9. Self-concept. For a full description of this concept see: Cook, A., Blaustein, M., Spinazolla, J. & van der Kolk, B. (2003) Complex Trauma in Children and Adolescents.White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force.National Center for ChildTraumatic Stress, Los Angeles, CA. Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M. et al. (2005) Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398. The pervasiveness of these impairments requires a treatment that addresses these areas. Dyadic Developmental Psychotherapy is an empirically supported evidence-based treatment for children with trauma and attachment disorders. See, for example: Becker-Weidman, A., & Hughes, D., (2008) Dyadic Developmental Psychotherapy: an evidence-based treatment for children with complex trauma and disorders of attachment. Child and Family Social Work, 13, pp. 329-337. For a sort of treatment manual about Dyadic Developmental Psychotherapy see: Hughes, D., (2007) Attachment Focused Family Therapy, Norton, NY Becker-Weidman, A., & Shell, D., Creating Capacity for Attachment, Wood N Barnes, Oklahoma City, OK. Thanks for a very good article that describes a complicated set issues quite clearly. Art
All of this is very fascinating. It is amazing how many things are so interrelated that may have never made sense before but now do all of a sudden. Thanks for the great insight.
Does anyone know the numbers about what percentage of people who go through a depressive episode it boils down to being a result of some trauma they have experienced in their lifetime? This would be interesting data to track.
Many individuals who experience Complex Trauma, which is a clinical formulation and not a DSM-IV diagnosis, or PTSD, which is a psychiatric diagnosis, have depressive symptoms. A significant majority, in fact. However, regarding how many people who meet the DSM criteria for any of the depression diagnosis have Complex Trauma or PTSD, that is a good question and I just don't know the answer to that. regards Art
I have a friend whose father, a war veteran, has had his entire life crippled from the effects of PTSD as has the entire family as a result. I am glad to see that there is progress being made in the research behind this mental illness, but there is still a lot of work to be done to ensure that veterans and really anyone who suffers with this is able to get the treatment and recovery resources that they need as well as deserve. This is something that I have watched firsthand devastate the lives of so many and I am hopeful that this new research will put it back in the forefront so that those with PTSD have to suffer no longer.
Dear Michael, I'd hope your friend's father is receiving treatment as there is good and effective treatment for PTSD, especially when combat related. While the VA may have a very long waiting list for services, if they have private insurance, they may be able to find good treatment quickly. One approach that is quite useful in such instances as you describe is EMDR. regards, Art
Well you stated the big problem. No private health insurance and the VA center in our area is very tough to get in for appointments unless it is deemed a "physical" problem. Seems there is no recognition of mental issues there. Any other suggestions?
Dear Michael, I am so sorry about your plight. No insurance leaves few options. However, sometimes the local Community Mental Health Clinics may be a resource. In NY many of the mental health clinics have specific PTSD treatment programs and they accept health insurance, Medicaid and Medicare, and have reasonable sliding scales. So, I'd suggest contacting the local CMHC to see what they have to offer. In addition, you may qualify for Family Health Plus or another governmental health plan. I hope this is helpful...let me know. regards Art
What a shame that lack of health insurance keeps someone in need from getting the medical treatment that he needs.
Johnson, Yes, it is awful. I would hope that they might qualify for some government insurance such as Child Health Plus or Family Health Plus (New York State programs) or Medicaide or Medicare... Art
In a number of road accidents, I believe people causing them are as traumatised as the victims involved in it. Especially where the victim has died. The cumulative stress in today's life makes a person constantly tired. The physical and mental exhaustion of the day's events causes road rage and careless driving.
Ben, I believe you are right. I've worked with a number of persons convicted of DWI and vehicular homicide, and they, too, often are traumatized by what they have done. Thanks for the comment.
I guess it would all depend on whether or not you had this sense of purpose in life before the traumatic event actually occurred. It seems like it would be harder to develop this sense of purpose after and event like this because it takes so much away from you. If you had that firmly established in your life before the incident it may be easier to look forward and keep moving toward what may have always been a goal for you.
a purpose keeps one occupied and whatever wounds life afflicts on us we get over them by staying with our goals, aims or ambitions.
Shouldn't this study be relevant for all, no matter their race?
I would assume this would be the case regardless of race as well, but for some families there may be other factors. Perhaps certain races have better inter family support than others? Perhaps other races have better access to care than other races? So I can see why this was focusing on African Americans exclusively and cannot necessarily be said that this is the case for everyone across the board. I want everyone to have a purpose in life- this definitely gives you something to live for. This is increased even more when you have a family who supports you and believes in you, which I think is something that may be lacking in many American families today. I hope that my own children have to never experience an event such as this but if they do I know that they have goals and ambition as well as a mother who is there anytime they need her to help them pick up the pieces.
I just happen to think that this may simplify things a little. NO matter how strong one is when he or she experiences a traumatic event there is going to be a residual effect. Perhaps it will take a shorter time for them to heal but it will be there and I do not want that point to become minimized.
You are right Maci. There have been many instances that I have witnessed where people will say things like she should just get over it, she has her whole life ahead of her, etc. These kinds of statements only make the victims of trauma feel marginalized and may in fact negate any previous goals they may have been working toward before whatever happened to them.
I once had goals and dreams but my PTSD has taken all of that away from me. I have been going through therapy for many years and it still makes me sad to realize how much this has taken awaay from me. I am in a good place in my life now but sometimes you still have to wonder what might have been without PTSD interfering.
Trauma is devistaing. Coming out the other side and building an new life is very difficult and when you accomplish that, you are able to move beyond the past and into a new future. regards
It is hard for us to understand how trauma victims feel unless we've been in their situations. I do think we need to help trauma victims as much as possible by either introducing therapy or just being there for them.
As someone who suffers from PTSD, this absolutely makes sense. I work in a field that requires a lot of mathematics, so when I am involved in a task that requires problem solving, spatial reasoning, etc I can definitely see how that would help in preventing the recurrence of symptoms. It only makes sense that when you fire up another part of your brain, another lies more dormant.
I dont know whether it really helps as my dad served in the Vietnam war as a doctor. He has never been able to get back to a successful medical career as whatever he does has memories haunting him. However, lately he has been involved with social work and that seems to be doing him a bit of good.
It's sad to see an individual go thru this. I am happy to hear that there's something out there, even Tetris, than can help.
I have been fortunate enough of not having to go thru this or deal with someone who has PTSD. I can only imagine how it impacts on one's life. I think any kind of activity that keeps the person busy is a good thing in helping them get through this.
This was an interesting article and Lisa Marie has a point. If we can somehow activate another part of our brain, by playing games, socializing, etc... Maybe this will help with PTSD.
I never realized that so many Americans were affected by PTSD. That is a tremendous amount. I am glad to hear there is something out there that can help people who suffer from this.
Amazing that something like tetris could help with something as serious as PTSD. Great article, very interesting. Thanks for posting!
How odd- I never thought of Tetris as enough of a diversion to help someone with PTSD but looking back on the hours that I have spent playing this game and how you become aware of nothing but the game I see how it may could help those with this disorder. It is sad because I have only considered veterans as those who suffer from PTSD but upon reading this I had one of those moments where I realized that this probably affects more people than we even know. Rape and abuse victims, as well as other crime victims are probably subject to developing this and often are turned away for treatment becasue no one takes the time to discover what is really going on with them. I too am glad to hear that there is something fun that could actually help with their treatment and to get them back to the land of the living.
i have heard of this type of treatment being done with children with emotional and behavioral problems but never with adults. What a great idea, and i am glad to know that it is helping so many of those out there who really do need the help the most.
We offer EAP using the EAGALA model in San Diego...EAL for Autistic kiddos...pass the word!
Glad to see that horses are being recognized for their unique calming qualities. I know that groups have been doing pet therapy for years with dogs and cats but there are other animal groups out there that can be just as beneficial to the healing process for so many people. I think that people like the calm and the freedom that the very idea of horses represent for them so I can definitely see how being around these animals could be therapeutic for so many.
My daughters both love to ride horses, and although they have no mental illnesses that I know of I can see how rewarding and energizing it is for them to be around these animals. After going for their lessons they always come home in much better moods and I not only attribute this to them just enjoying their time riding but also from having been around the horses themselves. They could just lose themselves in their time with the animals so I can really see how this could help others living in a dark place.
I feel the same way your daughters do Samantha so I can easily see how horses could be used for therapy.
How do we have horses in New York?? I am a teacher and I would love my students to be able to interract with animals while in school. We cant have big animals at all in our congested cities. That is definitely sad.
@Ron - In NYC? What about the horses/ponies in Central Park? I've seen the cops use them too so why not for others?
Wonderful!!! If you have a moment would you be able to recommend some journal articles that support your findings of behavior therapy with assisted therapy animals and PTSD? I do not want to miss any articles and am trying to create a literature review of the subject. Thanks. Again, keep up the excellent work!:)
Ron, Kensington Stables in Brooklyn has an animal therapy program called 'Gallop' - they work with disabled kids and horses - may want to check into that - Kensington Stables is at the south end of Prospect Park. Good luck! June
I am a therapist who also practices Equine Facilitated Psychotherapy, how can I get on your list of practitioners? rand
Thank you for this informative post. With so many Americans having to deal with trauma at some point in their lives it really helps if they understand at the very root what it is they are facing.
I was a college student in Charleston SC when Hurricane Hugo hit in 1989 and that was one of the worst experiences of my life. We evacuated and got out of the downtown area which took a hard hit but after going through that I had a hard time even going back to school. I felt as if another big storm was going to strike at any time. I now live in the Midwest but am still afraid when I hear about a hurricane nearing the coast.
My brother and his family were victims of the tsunami. The only surviving member has been his 7 year old son. We are his foster parents and everyday that I see this child, I know his fear is so deep that its going to take all his inner strength and our efforts to get over it. He is with a good therapist but even the therapist appraised us that it's going to take a lot of time.
I have an allergy since childhood. The doctors recently told me it is psychosomatic in nature. My mother was a victim of a violent marriage and my siblings and I grew up watching this everyday. We feared for our lives and her's. Today i.e behind us but whenever I have any kind of emotional stress, worry or fear I still break into a rash. I think this has something to do with my childhood trauma
There have been so many people over the globe who have experienced traumatic events in their lives. It is great to see that there are people who are trained to help them through this and to help them hopefully overcome those experiences.
thanks for the great article. There are many who face traumas like you said sometime in their life and one really does not know what they will do until faced with it. It is great that we have people who are willing to help those deal with it.
Thank you for sharing this insightful information.
Sometimes you have no idea of the many ways that a traumatic event will affect you until potentially years later. I have heard stories especially of soldiers coming home from war and thinking everything was just fine and then bam! It finally hits them like a ton of bricks all of the horrible things they have seen and this may not happen until years down the road. It is funny how the brain works that way sometimes. I guess that just goes to show you that you really do always have to be prepared for anything to happen because you just never know when things from the past might just sneak back in and get ya all over again.
My uncle had PTSD until finally it consumed him and he committed suicide. He was never able to get the help that he needed to overcome his issues and ultimately that caused him to take his own life. Traumatic experiences should never be overlooked because like so mnay others have said here you just can never be sure when they may come back to rear their ugly heads.
I think it can be useful to make a distinction between PTSD, which often involves discrete trauma or a discrete traumatic event from Complex Trauma which involves chronic early maltreatment within a caregiving relationship. Complex trauma may often cause impairment in several domains such as attachment, biology, emotional regulation, behavioral regulation, dissociation, cognition, and self-esteem. As such it can be quite damaging to the developing child. One of the factors that can mitigate the effects of trauma and "prevent" PTSD is a broad and deep social network and a secure pattern of attachment. This is not available to the person experiencing Complex Trauma since the trauma is caused by and is occurring within the attachment relationship.
Thanks for that insight, Dr. Arthur. Trauma, I agree, is a terrible thing to have to go thru and I know many people have gone or will go through this. What I consider trauma is when my brother died, although I know it was natural causes, and when my died died of a heart attack. I can remember those so clearly and when my dad died, it took me a long time to get over it.
Dear Lysa, The loss of a loved one is a trauma and the bigger/more significant the loss the larger the trauma experienced. I am sorry for your losses.
I think any kind of writing is great for the soul... It's such a terrible trauma what these individual must have faced and keeping it bottled up inside, cannot be good. I think that's why many people who write in a journal daily gets a little relief from what they are feeling.
I agree with Stella, writing can be very theraputic and I write in my diary almost every day, whether it's the stress i feel at the end of day, if i want to vent, or whatever. I know it's nothing compared to what the people had to go through during the terrorist attacks.
For me writing is a very therapeutic experience and helps me to just get everything out in the open. I know that it can help others in the same way too.
Writing has helped me to deal with so much in my life. If it wasn't for logging down what i felt i think I would have gone crazy... it really helps.
I think being able to express trauma in a positive way doesnt come naturally to everyone. A friend of mine has been an introvert from childhood and a very reserved person. She is having a very hard time despite being in therapy. She survived a bad skiing accident last year and lost her boyfriend in that 1.
Writing is not really my thing but I know that I have found in the past that sometimes putting words to paper is a lot easier for me than saying the words out loud. It gives you the opportunity to get things out in the open without being afraid of what others will say in response. In school I always hated having to keep a journal even when the topics to write about were those that I could pick for myself. But as I have gotten older I do better recognize the value of this process and hope to get into the habit of making it more a part of my own daily life.
Is this something like getting someone to write a diary. Maybe starting from the point of bad memories. As you keep going you tend to sound more positive with the written word. Some of that rubs on into the psyche I guess in the process.
I found I can express myself more in writing then verbally... There are times when I may not want to say something cause it comes out wrong, or if I am hurt, in a bad mood, etc... jotting it down seems so much easier for me...I feel as if I can say anything on paper
Why do we think that young girls have forever been writing in their dear diaries? It is easier to let things out with no fear of being judged or criticized when you write about what is going on on the inside instead of having to say it out loud to other people. We are so afraid of what others may think about us that it becomes nicer to just write it all down instead. I hope this is not an art form that is fading, because do you know how much of history for example would have been lost if we did not have the diaries of those who lived through those times to read and study? Anne Frank is but one example. She could never express or voice her fears to her family but she laid it all on the line in her writing and look at how much so many of us have gotten from that in return. That went off on a tangent a little but it proves the point that writing is helpful to so many in different ways and I can only hope that there are those who continue in the tradition.
This might sound funny but way back in 1975 my teacher in school got me to write about the most traumatic experience I have had. I was in grade3 then. When I was 6 yeard old I remember being locked up by my elder brother in the broom closet when noone was home. It was an experience that kept me away from so many things and claustraphobic places including elevators. I found writing about that incident over and over helped me get over my fear.
It makes me feel so much better when I read back of what I had written when I am stressed or feeling down. Sometimes it was like therapy to see how far I have come. I have a strange fear of drowning and it may have been when I thought I was going to drown when I was a child. I have never written about that but I wonder if it would help me get over deep water and drowning.
My dad has PTSD. Is this what would qualify in this case?
I pretty much relate to this article as my son lost a friend in an accident they both were in. He still blames himself for being unable to get help as he lost consciousness after dragging himself to safety. He is still convalescing and we have been told by doctors that he is reliving the accident in his sleep and we have been unable to get him to think about anything else in his waking hours.
I was the victim of a violent crime several years ago and when I had to go to court to testify my body just started uncontrollably shaking and I thought that I was going to pass out. It was crazy. I mean I pretty much knew ahead of time what all of the questions were going to be and how my time on the stand was going to go but my body just completely took over from my mind and left me with this response that I had never experienced before in my life. My therapist said this was a reactiion to much of the trauma of the day that I had been suppressing out and it was my body's way of helping me to let it all out. Made sense but very uncomfortable at the time.
Knowledge is power in overcoming the feeling of "craziness".
Well put Josh but if you are like me sometimes gaining that knowledge is one more scary step to take. But I know that when I get to that point it will make things better in the end.
I totally agree Cecil cos I felt the same way for years. I was locked up in a closet as a kid and till date I hate to be alone in an elevator. I still get irrational fear on and off when alone in a confined space. Logically it all seems easy but for some of us who have been there it's tough.
I came very close to drowning when I was 10 years old and to this day, even tho I can swim, I have a fear of deep water of which if I can't touch bottom, I freak out. I don't remember thinking of the incident when I was younger, but it sure has took and affect on me today.
It's pretty obvious that a lot of this stems from the past either in childhood or at an earlier age. I often wonder if past life regression could help with a lot of our fears and traumas.
Does rationalising fear psychosis have anything to do with being a little less of an optimistic person? My reasoning is an optimist looks forward, not back even in an incondusive environment.
My son was kidnapped when he was 5. Therapy has helped him a lot when he needed it the most. The trauma of a child gets compounded with shock as they are very innocent and unsuspecting.
Jonathan what a shocking ordeal. Susanne - thanks for such a clear article. I have printed it for the practitioners in our practice. Regards from Down Under (sydney) Joanna
How many years does it take for those in senior appointments to realize that there are those who stand firm behind the soldier. We here in Australia have the same problem albeit not as big. It started off in Vietnam (TV war) and we have been fighting ever since to make those senior persons realize that those at home suffered too and plus the kids that were born later. We are still having Vietnam Family studies 40 plus years later. We (Viet Vets) will all be dead shortly and one hopes that those senior people will NOT let the same thing happen to these soldiers who have and are still serving in Iraq and Afghanistan. It might also help to curb the divorce rate TH
Hopefully the children of military personnel who have to seek mental health care will not be scrutinized and ostracized like their soldier parents could be for seeking the same treatment. Unfortunately I have heard many stories about soldiers coming home from their tours, needing real medical and mental health, but they are deathly afraid of what that could do to their long term military careers. And will they pass up that same care to their kids because they are likeiwse afriad that it will diminish their chance for advancement in the armed services? I would hope this would never be the case but you hear too many things to even think that this could easily be dismissed as rumor.
Schools and teachers have become more and more a haven for our children. Military children are always moving and the new kids in the classroom, which is not always a situation that teachers and schools are able to tend to....the social fabric of the public schools, being what it is. In the end we all hold responsibility for the choices made in this country around war and we get to take into consideration the repercussions these choices have on children...our legacy.
It's just terribly sad to think about how many children in military fams ar suffering as a result of what their parents go through. I'm glad at least that more attention is being paid to this.
I have a niece whose father and stepmother are both in the Army. There is always one of them in Iraq. You can see the strain on the child's face every time news of soldiers being killed comes on TV. It would be a disgrace for the issue not to be addressed as a priority. The least this nation can do for these military families who give so much of themselves, even their lives, is allow them the peace of mind of knowing their children's mental health as well as physical is being cared for properly.
There is a body of evidence that childhood abuse leads nations to aggression and violence; grown up children are reenacting their youthful experiences, endlessly. It might be informative to see how nations with low rates of child abuse (I include spanking and any corporal punishment) behave in the wider world – a couple of generations on. The children of soldiers are victims of our nation's primitive form of relating with others. Dominating others diminishes on the playground – demonstrating how early kids develop past trying to solve everything by way of who can overpower the other. Some may learn to "behave" when in the sight of adults who require them not to fight; this might explain how competitive tendencies across the country seem so nearly universal and entrenched. Do we know what the effect on children is when a parent is simple gone for an extended time? Gone, and maybe hurt? Gone, and injured? Dead, or maybe dead? I think this constitutes trauma, and I wonder whether a strong policy against traumatizing of children would include the exposure to ongoing, profound anxiety.
may be true, but how bad is the problem of people cheating the system. i would hate to give a bad wrap to those who are really suffering from PTSD
It sickens me people do that. The genuine sufferers will fall through the cracks and their diagnosis will be delayed by having to join the queue behind these time wasters. What's needed are professionals capable of assessing PSTD correctly and also outing these fraudsters.
This is fraud! The law should come down hard on perpetrators and make examples of some to make the rest think twice before this becomes an epidemic. A high profile court case, a jail sentence and being liable for the court costs would send a powerful message from the legal system.
In any system with large numbers there will inevitably be some "spillage" or "cheating" or "spoilage." It would be awful to deny services to those who need it. This is especially true for children and youth who may have experienced Complex Trauma (early chronic maltreatment within a caregiving relationship). This can cause significant impairment in several different domains and have very serious long term consequences, but may not specifically meet the criteria for PTSD (a life threatening event)
How does the system tell the "cheats" from the needy? I dont think there is a clear line especially in PTSD.
Like so many other mental health concerns are there any clear cut parameters that can tell you this is definitely what one suffers from or are a lot of the diagnoses just made as educated guesses?
A diagnosis is an educated guess. I've seen vaguer parameters Sandy. This GoodTherapy.org link has the diagnostic criteria. 309.81 DSM-IV Criteria for Posttraumatic Stress Disorder http://www.goodtherapy.org/therapy-for-trauma.html
lots of frauds have happened after the global change in economics. I think health care is being watched more strictly than ever before. It is possible however to overlook a genuine case.
What would be the benefits of getting a wrong PTSD diagnoses for someone in which it does not exist? Attention maybe or meds that the person seeks for various other reasons? This makes no sense to me. I know that the qualified therapists out there are sure to have a good grasp on what PTSD looks like in patients and do their very best to make the correct diagnosis for the patients and their families every time. It does sadden me that there are people in it only for the money though. That is someone whose head and heart are definitely not in the right place.
In some ways this is shocking, but in others it is not surprising. PTSD has terrible symptoms and especially for soldiers that deal with incredibly traumatic events. Through research I have seen many vets from our current wars suffering from PTSD, a lot of which do not get treated. I can only imagine how few from the Vietnam War have been diagnosed and treated. Ginseng, of course you have got it spot on, early treatment has a chance of reducing the symptoms. I have been reading some works by Dr. Prout regarding the treatment of PTSD, I believe his work would be essential for those studying PTSD treatment. For Vietnam War vets this early PTSD treatment has been lost. This must be learnt for our returning troops from Afghanistan and Iraq, around 50% are not treated because of the stigma surrounding PTSD with army veterans. This really does need to stop because of the suffering that vets incur as well as those around them. To read up on PTSD treatment visit Dr. Prout’s website, at www.mauriceprout.com, containing a full reference of his material on PTSD.
I think soldiers go through a lot of stress. It takes a lot of courage to fight a war but in my opinion it takes a lot more to take one's life.
Do you think that there are some cues from earlier in life which may signal which soldiers may be more susceptible to developng PTSD than others are? Maybe higher rates of depression in the past, or family relationships that are not that stable? I know that you could not discriminate against someone for these indicators being present but it could maybe point out those who might need more help in the future and from there you could start with more preventive actions rather than those which are always reaction based to events that have already occured.
Wouldn't "using pharmacology to short-circuit the brain’s stress response" be masking the problem instead of helping PTSD? That's not solving the problem. That's ducking the responsibility of why it occurred and aiding recovery. Shame on them. If you put a man under anesthetic and amputate a limb, just because he doesn't feel it doesn't mean it didn't happen.
Prevent the formation of memories? Dr. Frankenstein is alive and well. I hate that idea.
I think it's great that more research is being done to help with traumatic stress issues. With the times as they are, our society has seen many tough times that we will not soon forget.
This is a very good subject to be researched upon.We know that traumatic situations,like seeing a loved one die in an accident,really do affect a person's mental health. Now curing such a person's trauma should be the top priority and not the ethical considerations.This is because a person is not fit if he/she is not fit in either physical or mental ways.Research in such areas must be given a boost in order to help the thousands of people affected by such traumatic memories.
Dopamine is indicated for the correction of hemodynamic imbalances present in trauma and other shocks. More research should be encouraged by all the nations to rid the world of mental health problems like these.
What? Haven't we been working all along to get everyone to coming to terms with their memories instead of masking them? This seems like it would be taking things a very negative step backwards in terms of what so many of us need to do to heal those painful memories. band aids never work in these cases.
It's extremely distasteful and ignorant on the part of NZ to put cost cutting before compassion and respect for the abuse victim. I dare say a man came up with that stupid idea...no woman would be so cold.
Surely that arrangement isn't in the least bit helpful for the therapists either. When the patient elects which one of the three they see fit to continue on with, all the work put into the meetings by the remaining two was wasted time and energy.
This is so degrading to the victims of this type of abuse. Why does the government want to keep them from getting the care that they need, all for the sake of going through all of the red tape motions? It makes me ill to think of the care that innocent people may not receive because of the "proper" steps that have to be taken first. Are their needs no longer a priority?
It is important to comfort the victims of traumatic events and care for them to help them in getting out of their trauma. The mental state of such people is very weak and they will be very scared and submissive. In such a scenario, reports of hinder to such initiatives was totally uncalled for.
It should be kept in mind that people suffering from psychological problems need to be taken care of, and not troubled. I can say from my personal experience as how difficult it is to talk about an event that is the cause of our problem with anybody. Now, doing the same with a new person must be all the more difficult and the least the administration can do is not to make it more difficult.
I see no benefit for the victim in telling the story three times, only more upset. Are they hoping that one of the therapists will decline the help and save the system money? That's diabolical.
In my experience when you are a victim of 30yrs sexual abuse ranging from incest, pedophile, stalkers & rape, the last thing you wont is to tell 3 therapists your history. As like your usual doctor you want to be able to confide in one person, that person you build your trust with. As this has been taken from you. I have had extensive therapy sessions with many Councillors & the main focus should be to educate & compensate the victims with one therapist.
One has to wonder how these soldiers are being approached regarding participation in the program. Something as simple as a lack of tact when broaching the subject could be the problem. The military has to look deeper into why the strong stigma associated with PTSD exists and what is reinforcing that in the ranks.
Well maybe this is a time when the military needs to step in and make programs like these mandatory. I mean, come on, these are guys who are used to taking orders from higher ups on a reglar basis- this is something that they could make them do as a routine part of their military service. I don't think that particiaption in a program like this would hurt anyone, it could only help. So why the hesitation unles they are being told that doing a program like this would reflect poorly on them in future reviews or something like that. And that would seem unfair.
Members of the armed forces are some of the most taken-for-granted people I can think of... Insufficient funding in the programs resulting in sub-standard mental health-care might be one of the reasons towards this response from the members of the armed forces. Or, it may be pure apathy... some people just do not realize they have a problem until and unless they experience something really drastic.
The stigma of the mental health concerns is one of the biggest pointers for such a poor response. Its not easy being labelled as having issues concerning mental health amongst colleagues in any organisation . It's much worse when you are in the army.
Tell me about it!! My neighbour's son is a marine and had been in Afghanistan for a very long time. He nearly shot a stray in our neighbourhood cos he thought the dog was going to pounce at him. The dog was only trying to pee. I think I can understand the intense reflex action that soldiers possess. It never leaves them even off the battlefield.
If staying away from home for months together in the armed forces was not bad enough, with the ongoing wars, members of the armed forces now have to stay in a foreign land with no certainty about their life, thousands of miles away from home... What would this lead to? Mental health problems of course... but,the apathy of our government about ending the war and looking for peaceful solution just shows that it does not really mean it when it says there will be complete troop-pull out from foreign lands. This, I'm afraid, may well lead to a mutiny.
Personally I think that making it mandatory for all soldiers returning from combat situations to undergo some sort of psychological treatment when they return home from overseas would not be a bad idea. Some may not need it but there may be others who do and this would be a great way to catch anything that is going on hopefully before it got out of hand. I know that it would mean spending more federal dollars but in cases such as this I totally think that it would be worth it, especially if this is a soldier who is looking at having to go back and experience even more action soon, it could not only help him or her to get ready for that but to also be prepared for what the down time will be like when they return home for good.
Not everybody who chooses to be a child abuser has had a horrific past. Some people get sadistic along the way. I basically think hauling parents to jail or the police station for a whack when its well deserved is as insane as someone beating a child incessantly. Children are also smart these days and hold parents to ransom courting the law. Taking time over child abuse cases is important. Justice has to be issued in a right manner not necessarily as a knee jerk reaction.
People treat others in the same way they were treated when they ere little and young. Any kind of negative behaviour with a child will almost certainly make him an abuser as well. It is a chain-reaction, and therefore has to be stopped immediately.
this was the most poignant and numbing article I have ever read. We are such a callous lot. Hum-drum becomes an excuse for insensitivity till trouble touches home ground.
Great news :) Using computational models will save a lot of time, money and also make the results more accurate than before . The accuracy of results is a very important thing in health issue and the find of this study must be implemented as soon as possible by health facilities all over.
Fear is one bane of human psychology that none can escape, and there are several mental disorders related to this very thing-fear. Study in this field should be encouraged so as to bring relief to thousands of people that suffer from such disorders.
PTSD is about abnormal traumatic events that happen to normal people. When either a very exciting event or very truamatic event occurs the chemical reaction of adrenalin and other chemicals in the brain permenatley imprints the memory and associated feelings in the amygdala of the brain. Different sensual information brings about the memorie. Just like the smell of cashews brings about a 50 year old memory of a candy store roasting cashews in the store. Yes a person can learn how to cope and become desensitized but as a PTSD survivor myself the memory of that night 37 years ago is alive and well. Even with 9 ect's!
Funny how the brain still can remember things long after we think that those memories are dead and gone.
It is heartening to know that young stud finding new ways of making medication more efficient and affordable... it is good for the people suffering from mental health problems that new research can be conducted more efficiently and hence newer and more affordable treatments can be developed.
This shows how a war can never provide solutions to any problem. The government should consider the complete pull-out of our armed forces from unnecessary wars as soon as possible.
Just day-to-day events take a toll on our mental health and if we see an accident,most of us would remember that for many days, and have little problems. It is hard to imagine what the armed forces personnel go through in war-time. It must be extremely disturbing to see people die around you, and yourself live with a million threats around you every single day.
These are the people who put their lives on the line for the sake of our nation...for us. They deserve the best support available to overcome problems that they may encounter, and no money should be considered too big for such a purpose.
There are still too many higher ups in the military telling our men and women to suck it up and not bring these things home with them. As we are beginning to see this is not as easy to do as it sounds like it would be. PTSD is a serious disorder that is affecting more and more of them every day and instead of telling soldiers to deal with it we need to be willing to give them ways in which they CAN deal with it, and not just deal with it to get by, but give them ways to understand what is going on and get through it unscathed.
Wow! 35%? That is a very big number of soldiers who are having to deal with PTSD when they come home and the thing that worries me the most is that they will not get the care that they need for this disorder which can very much disrupt their everyday lives. I think that this is something that vet affairs has wanted to hide under the rug for too long and now they are faced with these kinds of numbers coming home and not only are they not going to know how to deal with this on a profesisonal level but I am worried that there may not be enough well trained staff to help the troops work through this. And I know that an even greater fear for families who will be affected are what will happen to them if the govt decides that it can't afford to pay for treatment for them. Where will that leave these soldiers then?
This is very unfortunate and is definitely not going to encourage youngsters to pursue their dream of joining the armed forces. Immediate measures need to be undertaken to bring this under control.
The purpose of my story was to do exactly what was expressed in the above comments. Keeping that stuff a deep secret was like a cancerous growth that wsa becomming larger every day. I am 60 and want to send a message that it is ok to treat the scars and the wound that fuels Post traumatic stress syndrone! A friend of mine who I grew up with once said "It isn't the book learnin that will help, it is what you have beeen through that will help the most". And! I agree that when I appropraitely disclose a part of me to a client the therapeutic relationship intensifies. Then the healing can begin! Thank you for your comments. I really think this is a story that needs to be shared!
John, I feel humbled that you would share your story with us. You're an inspiration to us all. Thank you for shining your light. I just know it will give hope to many.
Your strength and honesty is very impressive, John. You overcame so much! Your patients are extremely lucky to have your unique perspective. This is a gift you've shared by opening yourself up like this. Thank you so much for having the courage to do so and enriching us with your story.
I must say, you have a lot of courage to have come out of the closet with all your experiences and problems and face the world. Not many people have such courage to come out with truth. Your story should and will surely inspire others with problems to come out of the closet too.
Peter you are right on the money! PTSD is a reactive disorder. Using core mondfullness actually trains the brain to be responsive rather than reactive.
Great article. I would like to pick up on the application of mindfulness and mindfulness meditation. These can be very helpful for managing the recurrent habitual reactivity that accompanies PTSD and panic disorder. The particular form of mindfulness practice that can be practiced throughout the day is called Sensory Awareness. The idea here is to train yourself to notice every sense impression that comes through the sense doors - sights, sounds, tastes, smells, and bodily sensations, and really take a moment to acknowledge and fully experience each - mindfully. In this way, you begin to train the mind to be responsive, rather than reactive. You respond to each sensation by choosing to be fully present with it; to observe it; to know it directly. In this process of responsiveness, you begin to shift your primary identity away from being reactive, to being the knowing of sense experience. This primary shift is immensely liberating and lays the foundations for helping you work with mental reactions - the emotions, beliefs and negative thoughts that spontaneously arise out of our conditioning and that proliferate anxiety. You learn to relate and respond to mental reactions in the same way that you respond to physical sensations - both are simply observed as objects that arise and pass away by themselves. The skill is in recognizing sense objects or mental objects as fast as possible and then responding by being mindful and opening a non-reactive space around the object experienced. Peter Strong, PhD is a specialist in Mindfulness Psychotherapy for anxiety and PTSD.
Thank you John for sharing your incredible story.
My cousin had a similar problem after the death of his mother, my aunt Fiona... she passed away while on a trip to to Hawaii and whenever he saw or heard about Hawaii, it would make him stunned and he would sweat profusely. This went on for more than 6 months and finally his family took him to a psychotherapist and he is all fine now, by God's grace.
Thanks a lot for this very informative article. I never thought about what the near and dear ones of the deceased go through, probably because I'm too young and have not been in such a situation. As if losing your close one was not enough, the other family members of the deceased also have to go through the pain of seeing one from their family suffering... ahh...this is too sad even to imagine... peace.
I always think that it is a wonderful thing when new techniques are discovered and used to help people cope with whatever anguish and stress they may be going through. I have never lost a close family relative but I imagine that it would be so difficult to process. It makes me feel good to know that there are those out there who develop their life's work all to benefit the greater good, and to those people I do not think that there is enough gratitude in the world to thank them for all of the hard work that they do.
It is not just a professional achievement to have found this new technique but also an achievement for the human spirit. Every new technique found is bound to help numerous individuals tide over problems in their life and make it more lively and liveable. Kudos :)
Living life that way must be so hard... and it must be hard for the family members of such people too... hard to imagine, but I feel really sad for such people and am delighted to know about this new way to deal with such cases...
Thanks for your comment, Luke. I don't believe that anyone really just "moves on" after the death of a loved one. Grief that is not complicated by trauma involves transforming one's relationship to the deceased so that they remain a presence in the bereaved's life. When the death itself was traumatic, or where the relationship was a complex or ambivalent one, then other work is necessary to heal from grief. Grief is not something to "get over", but to "go through" to grow and heal.
both are above mentioned cases are very sad and it is very sad that some people just cannot move on after a tragedy has struck them... i think it has to do with the level of involvement the sufferer had with the deceased person and also the personality of the sufferer, because not everybody will be affected to such a level, it has to do with the personality too...
Thank you all for your comments regarding my article. They are very appreciated. What I love about EMDR is that it is more than a "technique" - it is truly a whole body approach. I find my work with the bereaved incredibly inspiring, and what inspires me most is people's resilience and their abilities to find their reservoirs of strength in the face of tragedy. I would be happy to talk to any of you further. Sincerely, Beth Patterson, MA, LPC
It is hard to imagine what people in such a situation go through but it sure is a tough and very traumatic period in their lives. Love and care and from the family and family bonding is sure to help.
Yes, Giles, I agree that family support is so important after a death, especially when it is traumatic. Sometimes, though, families can fracture in the face of this kind of stress, and professional support can become necessary. Beth Patterson, MA, LPC
This tragic event highlights the impact of primary and secondary trauma on caregivers and the need for preventive interventions for those working in the help professions. Dr Pat Cane's multicultural popular educational workshop model "Capacitar" is one such intervention, integrating mind/body/spirit in self-care. Her vision is healing ourselves before we heal others. We in Soutn Africa (and many other countries in the rest of the continent) are using her practices and approach to great effect in the battle against HIV/Aids and compassion fatigue. Dr Cane is working in 35 countries around the world, including the USA, where she is based in California. Despite the complexities of this tragedy, the military would do well to adopt her approach.
i saw this report on tv and it sent chills down my spine!imagine the plight of the victims to see their own colleague pulling the trigger on them!that would be shocking enough to put most people in a condition wherein they cannot react as quickly and swiftly as they would if the attacker was an outsider...it is a sad day indeed for the nation to have lost army personnel to the bullets of another...
The incident was shocking indeed, but what was more shocking is that the person in question was a psychiatrist himself! Most people, as you have mentioned, would agree that a person dealing with and helping others with mental illnesses would know better, but as the incident has proved, all of us are human and are prone to committing mistakes... I think the government should, instead of putting the person in question through the usual course of investigation, first try to find out why all this has happened, and do a thorough investigation regarding the cause, and with the results, work in a way so as to prevent any such future incidents. It need not be a person of a particular religion or immigrant parents doing it the next time, it could be anyone under stress or any similar problem as faced by this person.
although this news is as shocking to me as any other american, i just wonder what this is going to do to people's minds... first of all, it will create a prejudice towards even legal migrants, and also in the armed forces, such people are bound to suffer a prejudice... I read that the person who did the act himself was subjected to such prejudice and ridicule in the past, during his service to the armed forces. But this has to change...people need to think in a matured manner...that generalization is not good at all and gives no idea about a person.
This is so tragic! Words can not describe the impact of this event on the families and the people who knew them. And thanks to the constant media coverage, others could be effected by this traumatic senseless act as well. I do related with the message that those of us in the field need to get help as needed. I've been part of a Psychiatric team in an inpatient/outpatient setting for the last 13 years. I have seen staff suicides! Working in the field can be very emotionally draining and we too need a place to go! The message is a real wake up call for me! I need to continue to take care of my self so I can continue to help others. When I become too angry, lonely, tired and emotionally drained, I need to take care of me! I hope other's in the field get this message as well! We do break down! Some more extreme than others! We again have to take care of ourselves! Especially, if we have trauma in our past!
Establishing safety can be problematic in impoverished situations. I work in a schools context where there sometimes is just no safe place for a child to go. Creating that inner safe space, regardless of circumstances, is a key to recovery.
It is not an easy task to just integrate into the real world for a person just out of such a traumatic situation...it takes a lot of time and if there is emotional support, that would be the best possible help for a person.
Before I reached out for help, I could have been in the safest place in the world! I did not understand what this stuff in my head was about or why I was so afraid. I new one thing Alcohol made it seem better! Today there are answers! Unfortunatly, there is still a lot of resistance and stigma in getting help! Becomming willing to get help is really the first step.
When you experience any kind of trauma it makes such an imprint that it can be very difficult to overcome without therapy and time. Some think that these are emotions and feelings that they can deal with on their own, but they have no realization just how deeply these kinds of things can stand to effect them even years after the trauma occurs. When in doubt the best idea is to always find someone that you can talk with and who can help you work through things. It might just even be a good friend or even your minister but there is nothing wrong with seeking help to work through these things and that is guaranteed to leave you healthier in the long run.
Its not like we can just hit the delete key and we forget things... everything that we go through in life is extremely difficult to forget and it is all the more difficult if the event has had a major effect on our lives...
It's about time that vet affairs started looking at this seriously! If anyone deserves quality health care than it is the men and the women who have fought so hard for our country.
Army personnel deserve the best care possible and there should be nothing holding back in this regard. All that they do for the country deserves nothing but the best and to let them have any kind of health issues is just criminal.
the recent incident has shocked one and all and the citizens have all the rights to know what measures are being taken to prevent a similar incident from occuring again in the future. Something substantial needs to be done, and fast.
I wonder when I read about experiments that involve unpleasant experiences for the volunteers. Aren't they too risking doing themselves damage by subjecting themselves to them? I can understand wanting to participate in the more pleasant ones, not something like this.
Everything we say and do is because of our mind and everything we CAN do is because of our mind. No matter whether we have to accomplish a seemingly impossible chance, I really do think its all in the state of mind and if the mind strongly believes so, it will surely make it work!
When I came back from my tour in Desert Storm it took me years to get past the things that I saw and did over there. It is one thing to tell yourself that it is over, that you are not there experiencing that anymore. But it is a far different thing to get your brain to catch up and realize that that is the truth. I had dreams and nightmares that were so vivid that I literally felt like I was in the desert all over again, and there wasn't hardly anything that could shake me awake and bring me back to reality. A great family and a great therapist has helped me start to get my life back on track but it has been hard work. I pray for the soldiers who are still going through this daily.
In some ways this is shocking, but in others it is not surprising. PTSD has terrible symptoms and especially for soldiers that deal with incredibly traumatic events. Through research I have seen many vets from our current wars suffering from PTSD, a lot of which do not get treated. I can only imagine how few from the Vietnam War have been diagnosed and treated. Ginseng, of course you have got it spot on, early treatment has a chance of reducing the symptoms. I have been reading some works by Dr. Prout regarding the treatment of PTSD, I believe his work would be essential for those studying PTSD treatment. For Vietnam War vets this early PTSD treatment has been lost. This must be learnt for our returning troops from Afghanistan and Iraq, around 50% are not treated because of the stigma surrounding PTSD with army veterans. This really does need to stop because of the suffering that vets incur as well as those around them.
Best thing i've heard in quite a while concerning Afghanistan. A friend of mine in the war is going through a messy divorce and it is sad as some people dont have the tenacity for war. I am sure this is a welcome measure for soldiers needing help dealing with trauma and making sense of it.
We feel weird and abnormal for days if we happen to see a freak accident that claims a life. Imagine seeing death all around you all day, everyday... it must be taking a big toll on their mental health and there needs to be a good reddressal system so that they don't happen to succumb to the chaos.
It would be better if mental health services, that are being offered to veterans returning from these wars are extended to the personnel currently there too... maybe they can have a session every week when it is their time off the duty...?
We can only imagine what these personnel go through seeing so much violence and being involved in all the chaos... and all that in a foreign land... staying away from their families for months together! It is not everybody's cup of coffee and those who are able to do all this for the country deserve the best possible support.
Well I think regular session are an essential part of supplies given to personnel in war-time because after all the physical pain that they go through, they even carry the mental baggage around and there needs to be an outlet to offload this baggage of theirs and mental health services serve as a good offloading destination.
This is a welcome move because a lot of personnel in the armed forces are very stressed due to the physically and mentally challenging nature of work. I just hope the plans are implemented in the most effective manner.
While long stretched warfare in a foreign land is bound to take its toll on armed personnel both physically and mentally, it is laudable that measures are being taken to try and prevent psychological problems before they actually set in. Truly, prevention is better than cure.
Ummm isn't this kind of thing called profiling and generally seen as a negative thing to do? I am very wary of predicting what others might do before the situation even presents itself and I should think that the military should have some of the same sorts of concerns. And as a soldier I would be MIGHTY hesitant about supporting a program like this which may unfairly find you labeled as somehting which may in the future be detrimental for your career.
It seems like an easy task to get over an event for any person, but for the one that actually underwent the trauma, it is nothing short of an uphill task... People who are going through trauma require all the care and affection and this should continue to flow to them even after they recover... only then will the recovery be complete and a slipping back into the trauma can be averted.
Good post on a topic dear to my heart. Thanks.
When do you surrender the ridiculous ideas you generated to explain it all? Do we not begin with meaning and the process is remaking it? I cannot imagine it not being the defining moment of my life or learning to mark time in a way that is associated with before and after. Yet I work at it still...after all these years. Thanks for the post...I am always eager to learn.
A person who has just overcome a traumatic situation is extremely vulnerable in my opinion. This, I think, is because he/she has spend a considerable amount of energy in tiding over the problem and even if a small new problem or situation crops up, it is going to be extremely difficult for the person to cope with it.
I am very cautious in the treatment of PTSD. I have seen many who have gone to therapists who do not specialize in PTSD and who were encouraged to detail the trauma and had very negative consequences. I know one case that the re experience actually precipitated a dissociation! I know of others who committed suicide! The effects of Trauma are related to a person's flight fight response. If a person is terrified of going to the event, teach the person how to cope and handle the symptoms. I have also seen people who never want to see a therapist again due to a well intentioned therapist probing into a truamatic event before a person is ready. Treatment and Recovering from PTSD is like chipping at a brick wall that is protecting the memory. It is also like peeling an onion. PTSD Treatment and Recovery takes time and the first step is building a strong, trusting relationship with the therapist! One of the best treatments I have found in treating PTSD over the last 20 years is using guided imagery, hypnosis, and teaching people how to reduce hypervigilence and hyperarrousal. I am sensitive to this subject as I am not only a psychotherapist I am also a PTSD sexual assault survivor. The intent of my comment is not meant to have any negative impact on the writer. The intent is simply to be cautious in guiding a person through this frightening journey John Lee LMHC www.altbehave.com
I think if someone is too cautious about socializing, he/she should start with being a part of small gatherings and numbers can be increased as the healing process is taking further, and there is no better time to do this than the holiday season.
You are right! Recovery begins wih small steps. With PTSD there are any memories that can be triggered and feeling safe with the small group is paramont! Plus haveing a plan B
i firmly believe that building good relationships with people around us and involving oneself in an interesting activity or hobby can really take our mind off the trauma that we struggled to come out of in the first place.it is very easy to slip back into trauma and hence utmost care must be taken by the people around such a person to make sure that a relapse does not occur and social bonding is encouraged.
Sometimes moving out of the darkness of the past is so intimidating that it is difficult to see the light of the future. For me it has felt like the most difficult journey that I have ever experienced because for me the dark has become my normal, and the light at the end of the proverbial tunnel just scares me because I do not know what awaits me there. I experienced a very traumatic experience as a teen af few years ago and I still have nightmares. I have a great family and a very strong support system but somehow I am still not able to get through many days without tears and anxiety. I know that this is all a big part of the healing process but it is just so hard that I have wondered before if I will ever be able to get through. it. Somewhere out there is there going to be some type of closure for me? I am still looking but it just does not feel like I am going to be able to find that.
Coming out of trauma is a very difficult phase in any person's life, and it would do him/her a world of good if there is someone to guide him/her through this very difficult path...Professional help should be sought after.
Honestly I have read this article a few times and I still can't get past the opinion that this is reaching for a solution that is not there, or that's what it seems like to me anyway. How are you ever going to prove that these soldiers were going to develop PTSD in the first place? I mean there are some who never do, so who's to say it is the morphine shot that is warding this off? Maybe they were not predisposed to be affected by it in the first place.
What strikes me is the question, how many soldiers have to wait beyond that hour to get the morphine? That's ridiculous. Administration of painkillers should be as immediate as possible, especially in cases where the severity demands morphine.
“We are not sure if the effect is from pain reduction or from an effect morphine has on memory consolidation in the brain immediately after a traumatic event. Or it may be both working together,” Troy Lisa Holbrook of the Naval Health Research Center in San Diego said in a telephone interview. “We need more research to tease those out and find out which one it is,” she said. Who cares? It works! Give them all it instead of using them as guinea pigs.
It is a well know fact that any injury that recieves late attention or worse no attention at all stays for longer. Now what I want to say is if an injury is not attended to immediately, it develops more than it would and also the longer healing time and other things make the patient go through a lot of grief and trauma...this may be why it is observed that quick attention prevents PTSD.
Anytime there is a new treatment to fight these things I say go for it- hopefuly only good things will come ofthe research.
Are there any fears that this may increase any drug dependency in the soldiers afterwards? It's great that it could help to offset PTSD, but then it may bring on another host of problems. Is the military prepared to deal with that too?
It is welcoming to know that soldiers who recieved immediate attention are somewhat immune to stress and mental disorders. This goes on to prove the eefectiveness of an on-time cure to any problem, and the practice should be followed to make sure as many soldiers as possible benefit from this.
How about just the fact that they are immediately receiving treatment- that may actually be the cause for holding off the severity of post traumatic stress instead of the morphine. This seems so far fetched to me, like I can't wrap my mind around how morphine could in any way keep them from having symptoms other than just numbing the pain a bit for a while.
I don't see a reason to fuss over military wives. They know what they signed up for when they married into the military and get plenty of perks because of their family's status that average families don't. You can get an idea of what those perks are here if you don't believe me. http://www.military.com/NewContent/1,13190,Spouse,00.html Wives have waved husbands off to war for centuries. Naturally they get depressed, can't sleep and show anxiety. They wouldn't be much of a wife if they didn't.
Modern day military wives are well compensated for their tears. If they didn’t want that stress, they could have married a civilian. You didn’t hear wives complaining during WWII. They just got on with raising the kids and keeping a nice home for the soldiers to return to.
I disagree. They deserve every perk they get. The most I have to worry about is if my husband will remember to pick up milk on the way home. I can't imagine how military spouses feel, always wondering if your husband or wife will be the next to come home in a coffin.
Although war is not good, having no war is ideal and not really possible in the world we are in now.The least we can do is to look after the individuals who are prepared to lay down their lives for the nation... give them all that we can so that they suffer the least possible...
I would be very wrong to say they should just get on with their lives...it is hard enough to stay away from one's partner.And to know that he is in a battlefield is going to be very very difficult... You don't see whether the person you like and want to get married is a civialian or is in the armed forces, do you...?
Sorry but I am a nurse and don't see that anything good can come from this type of treatment over time
Care to elaborate on why, Shannon? I'm curious as to what your opinion is based upon.
I wonder how long the soldiers were studied, post-injury, for this research? A year, maybe two? Just because they don't have PTSD now isn't a guarantee they won't be suffering it in ten years time. I'd like to see a follow-up on this further down the line.
Good point Sugarlove. I'd also be interested in knowing if the morphine dosage was a single one or if the soldiers that didn't develop PTSD had continued to be on morphine for an extended period. Perhaps that differentiation could be important.
If there is the remotest chance that a dose of morphine will prevent PTSD, it should be standard practice to administer that. One shot or pill that could prevent a lifetime of suffering from PTSD? I'd take it.
I hate to see anybody fighting, girls especially.I realized after I saw two girls squaring up to each other why they call it a cat fight. They are vicious — scratching, biting, ripping hair. It’s a horrible thing to see.
Sorry, wrong thread. Please disregard that comment above and I'll post it in the right one.
It’s okay to say there’s no conclusive proof that the soldier would have developed PTSD anyway. Imagine if it were your child or partner injured on that battlefield. Would you want to wait until the military were 100% sure about why it worked and figured out who was/wasn’t susceptible to developing PTSD then developed a sliding scale on who gets it? Or would you want them, as I would, to give your loved morphine not just for the pain but because it might prevent PTSD? PTSD doesn’t affect only the sufferer. They have families too that have to live with the consequences of that affliction as well.
How would you feel if your spouse didn't get the morphine and you discovered later that if they had, it could have stopped them from going through PTSD? I would be furious. Give them all morphine. Do the additional research, fine! However, don't delay handing out the morphine while you're carrying that out.
Don't think that anything or any type of help can be discounted if it looks like it might help with prevention
it is indeed a very difficult time for those affected by the recent earthquake or just any disaster in general. bonding with near and dear ones would be a good idea in such times as you will be in a much better position to pour out whatever is in your heart and not let it keep troubling you from the inside.
Thanks you for the comment. Yes! Bonding with loved ones is very important during such disasters
It should be ensured that the people affected by the recent massive earthquake are not left to fend for themselves, not only in the matter of food, but also mentally they should not be left alone. Facilities could be set up where they can go and share what is there in their mind.
You are right! The problem is many fear talking about what is going on emotionally. The standard comment is "I'm ok" or "I can handle it" This is what really motivated me to writer about "Normal Reactions to Trauma" That it is ok to talk about it! Unfortunately, there is still too much "Stigma" on reaching out for Emotional Help. Please! It is ok to talk about it!
was veterans undergo a lot of trauma due to the things experienced no doubt but to experience the same at a young age increases the damage substantially... it takes a toll on their mental health to be doing something completely different and experiencing very different things at an age when others are doing something that lets them stay with their family and not undergo so much stress.
You know it is interesting to me that soldiers and veterans of past wars have not had as difficult of a time traditionally of dealing with the combat blues as soldiers in the recent past. Why is that? I really don't necessarily think that the men of yesterday were tougher about the things that they saw. Maybe it was that they were never taught to show emotion? And who knows what kind of things they felt compelled to always keep hidden on the inside. Another thing that I have thought about is that maybe modern warfare is just so much worse than what our fathers and grandfathers had to face. Either way it is interesting to think about. What I am really happy about though is that there is now the recogniition that soldiers do need help when they come home to process all that they have seen and been through and that they are not necessarily simply expected to be hunky dory just because they are back home. We all deal with stress in different ways- I just want to know that they know that and that the military knows that when offering treatment and services.
If you take a new recruit and directly send him into the frontline in war,he is bound to have problems.what is required to be done is that a job other than active battle must be given to all the young and new recruits and only after then should they be exposed to the real thing.
I find this surprising actually...that is because youngsters are more enthusiastic and also have no family,except parents, to be worrying about... they are more chilled out about going to and working in new places...
Preparing the troops for what they are going to encounter should go a long way toward helping alleviate the pain they might feel when they come home.
Youngsters are not too well equipped mentally to cope with all the stress that combat throws up onto them and it would require special training methods to better equip them in this regard.
It is pretty obvious that youngsters who have no prior experience in the battlefield will find it difficult at first.But what the finding of this report also shows is that life is not always a bed of roses that most youngsters think of... there is a lot of hardship out there and lack of preparation may lead to you being affected by many troublesome things.
youngsters should be more adaptable and flexible to changes, even if they are negative...they need to be trained to be able to take the problems in their stride and still note ahead.
These are kids we are talking about here who may not have the capabilities to deal with these issues like adults can. maybe there should not be so much emphasis on the young guys after all. . . maybe some of the older generations might do better in many of these situations.
Every time I see stories on the news about this natural disaster it brings me to tears and I have no family or ties to Haiti. I can only imagine what the grief must be like for those who have lost friends and loved ones there and who may have no idea of their eventual fate. That must be so devastating not to mention the loss of hoes and other material goods that families had to work so hard for to begin with. It makes you wonder why things like this happen- and then you realize that is when there are no answers for why, only more questions. And what a horrible feeling to have to live with everyday. My prayers are certainly with this country as they strive to recover from this tragedy.
The on-ground situation and pictures that we see of all the destruction is only a small fraction of the damage that has been done...the major part of the damage is in the minds and lives of the people there...having lost family members and everything that was their own is going to be very traumatic to say the least...there is going to be people committing suicides, slipping into depression and what not...
It is hard to live in situations where we know we have no control over many events, but such is life. I hope that this is a nation that will be able to recover but I know that it will certainly take time for the healing process to be completed.
^^ Take time it will, Pauline. But what the donor nations can do is to ensure the setting up of counseling centres and other help centres that can actually guide people who have been affected by this fury of nature...
There are so many ways that I feel compelled to help but I don't know where to begin. Send money now or later? Try to donate my own time and services right now or wait until those who are there burn out and leave and there is a lack of care once again? No matter what decision you make it is a tough one and you are never really sure that you are making the right one. Right now I am trying to coordinate with my local Red Cross chapter to determine what is most needed and when would be the best time to give that will make the most impact. It is not necessarily the best solution but I think that is everyone were more responsible with their giving then the impact in a positive way of that giving could be felt and benefitted from for years to come.
Just giving what you can when you can will go a long way toward helping heal this ravaged nation. And certainly prayers are always welcomed.
This is exactly why it becomes all the more important for government agencies to be extra cautious while dealing with health issues and also being prompt regarding announcement of any warnings or news...
yes,I do believe that this matters because when there is a difficult situation in front of you,it all comes down to your reaction and response to the difficult situation...if you respond in a good way,you could well be able to trim down the damage...
In general I think that women tend to be way more trusting than men so it is natural that this is the case in situations like this as well. But I think that the govt is doing the right thing in that it is trying to prevent the spread of disease and outbreaks from spreading and why people would not think that this is a good idea baffles me. I know that there are those who do not necessarily feel that the government needs a hand in everything but this looks to be a wise step to me.
Warnings, cautions and guidelines issues by civic and other government agencies are very important and the ones that are issued should be done with utmost care and caution, so as not to let people panic but get the message out at the same time...it would help if they had experts to decide even the kind of language used in the various messages...
There are always going to be trust issues when it comes to the relationships between the people and the government. Many see that the government is just out to corrupt and bring them down, take them for everything they are worth. I do not feel that way but I know that there are those out there who do. I think that many governments have to do a better job at earning the trust back, and do what they can to make people feel good about the services that they have available to them. That willsure make life a whole lot easier for everyone when things like this do come up. Better to earn the trust now because you never know when you are going to need the full faith of the population behind you.
Protocols and policies are extremely important but what is more important is for the people who frame these guidelines to have people's welfare as the top priority and to keep political power away from these quarters...it will help in delievering good healthcare to the population, thereby increasing the popularity of the political individuals or parties...