Trauma, including PTSD
(single and multiple incidents)
Post-Traumatic Stress Disorder is a common reaction to an event that a person witnessed or experienced that involves actual or threatened death or serious injury. The event could be a natural disaster, combat, a car accident, or a violent personal assault such as rape. While most people recover, some will remain anxious and depressed for months or even years after the event. People with post-traumatic stress disorder will have many of the following symptoms.
1. Re-experiencing the trauma through intrusive distressing recollection of the event with flashbacks and nightmares. In children this can be expressed in repetitive play where themes of the trauma are expressed. This can include:
· Feeling or acting as if the event were reoccurring, including a sense of reliving the experience.
· Intense distress when exposed to the cues that symbolize or resemble an aspect of the traumatic event, for example smelling smoke if the traumatic event was a fire, or driving if it was an automobile accident
2. Emotional numbness and avoidance of people, places and activities that are reminders of the trauma including:
· An effort to avoid thoughts, feelings and conversations associated with the trauma.
· Inability to recall important aspects of the trauma.
· Less interest and participation in significant activities.
· Feeling detached or estranged from others.
· Decreases range of emotions, for example difficulty having loving feelings.
· Difficulty imagining the future, for example having a career, marriage, children or living to old age.
3. Increased arousal such as:
· Difficulty falling or staying asleep.
· Irritability or outbursts of anger.
· Difficulty concentrating.
· Exaggerated startle response.
To meet criteria for post-traumatic stress disorder, the person must have symptoms that continue 4 weeks after the event, but sometimes symptoms will not appear for months or years after the event. Acute distress disorder has the same symptoms listed above, but only lasts from 2 days to 4 weeks after the event.
Trauma Focused Cognitive Behavioral Therapy (for children), and Cognitive Processing Therapy (for adults) are evidence-based treatments that can help clients heal from their wounds by developing healthier coping mechanisms to deal with painful memories. The goal of treatment is to help the client to store their traumatic memories in a way that is both more accurate, and more helpful so that they experience less intense and frequent negative symptoms.
SPR (Psychological Skills for Recovery) is a bried treatment model (about 5 sessions) that is helpful for those who have experienced a traumatic event (such as a natural disaster), and has also shown to be highly effective in working with first responders and veterans.