Trauma and PTSD

Exposure to tragic and devastating experiences—such as physical or sexual assault, car accidents or natural disasters, robbery or war—can cause extreme feelings of helplessness, horror and fear.

- Victims of complex trauma could have been directly affected as survivors, rescue workers or firsthand witnesses; or indirectly affected as friends and relatives of victims or via the media.
- International surveys show that traumatic experiences are common across the world. While many people recover within a short period of time, there are those who endure lasting symptoms, which can disrupt their lives.

Recent research has advanced understanding of post-traumatic factors that lead people either to cope well or to be at increased risk for physical or mental health problems. Fortunately, for most people, responses to trauma are normal and expected, and they can return to normal life in about a month—their fear, anxiety and painful memories gradually decreasing over time.

For others, however, treatment is necessary to overcome intense responses shock and denial that can persist and can be followed by longer term reactions of unpredictable emotions, flashbacks, strained relationships and physical symptoms.

Those more likely to develop severe symptoms may:

- Have an existing mental health condition
- Face ongoing stress
- Have had traumatic experiences in the past
- Lack support from family and friends

Responses can be immediate or delayed, brief or prolonged, and include:

- Feeling anxious, sad, angry
- Trouble concentrating and sleeping
- Continually thinking about what happened

Types of Trauma treated at CFI

Based on severity, age of onset and recurrence of the event or its memory, subtypes of trauma include:

Complex trauma: The long-term effects on a child exposed to multiple, traumatic events—often severe and pervasive, such as abuse or profound neglect—can disrupt a child’s development and interfere with forming secure attachments with caregivers.

Childhood or developmental trauma: Emotionally painful or distressful events experienced or witnessed by a child often result in lasting mental and physical effects.

Acute stress disorder (ASD): A small percentage of people have intense emotional or physical distress, usually in the first month following a catastrophic event.

Post-traumatic stress disorder (PTSD): Some people do not naturally recover after experiencing a traumatic event, even when not in danger.

Somatic symptom disorder: Excessive thoughts, feelings and behaviors relating to physical symptoms—pain, weakness, shortness of breath—resulting in major distress or problems functioning.

Early Intervention & Assessment

If symptoms persist, get worse or interfere with daily life, individuals who have experienced trauma or related disorders should seek professional help for a diagnosis and effective treatment. Without help, they can be caught in a negative cycle of recurring memories and thoughts, causing spikes in anxiety and fear—and retreat from such disturbing thoughts.

Traumatic events can also affect the brain and nervous system, as well as lead to:

- Increased health-risk behaviors—smoking eating disorders, substance use, high-risk activities—may relieve symptoms temporarily, but can lead to new problems and delay recovery
- Long-term health problems (diabetes, heart disease) or premature death
- Increased use of health and mental health services or child welfare and juvenile justice systems
- Difficulty in finding fulfilling relationships or holding onto jobs

Serious signs can include:

- Feeling intense anxiety or depressive symptom, crying often, feeling angry, resentful, irritable
- Having trouble thinking clearly, having frightening thoughts or flashbacks, reliving the experience
- Having nightmares or difficulty sleeping and/or other behavioral changes
- Avoiding places or people associated with disturbing memories and responses, becoming isolated from family and friends
- Physical responses (headaches, stomach pain and digestive issues, feeling tired, racing heart and sweating, being jumpy and easily startled)

To analyze how cognitive and behavior therapies can start the healing process, a clinician conducts a comprehensive assessment of the individual, family members, and one’s day-to-day environment

Clinicians also assess how treatment supports family members to aid the individual’s recovery and help with emotional regulation in future stressful situations. This analysis includes:

- Signs and symptoms described by the individual and parents/caregivers, spouses or other loved ones
- Consideration of treatment methods and outcomes
- Causes or types of trauma
- Family involvement

Treatment & Coping Skills

Trauma treatments offered at CFI:

Dyadic development psychotherapy (DDP)—for children who have experienced childhood or developmental trauma.

Trauma-focused cognitive behavior therapy (TF-CBT)—for victims of acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) and other traumas

Trauma systems therapy (TST)—for children still living in stressful environments

Cognitive processing therapy—shown to be effective in reducing PTSD symptoms related to traumatic events

Therapists reintegrate trauma survivors in their daily life by decreasing anxiety or hyperarousal and by fostering social or work connections. Clients can gradually process their memory to make symptoms tolerable and more understandable through such techniques as:

- Using deep relaxation, hypnosis or mindfulness to manage fear and anxiety and stimulate inner security
- Exploring thoughts and guiding understanding of when such thoughts are contrary to reality
- Teaching skills (how to grieve, manage anger and rage) or socialize again (making eye contact, reaching out, moving towards people, receiving support)

Coping strategies for post-traumatic adjustment

- Practicing skills and techniques learned in therapy at home
- Seeking emotional support from family and friends by talking about the experience
- Lowering stress by staying active and engaging in relaxing activity (naps, walks, quiet time, meditation)
- Avoiding alcohol and drugs
- Maintaining normal routines for meals, exercise and sleep

CONNECT TO CARE

References

Association for Behavioral and Cognitive Therapies

Bethel University study on childhood trauma

Centers for Disease Control and Kaiser Permanente in the mid-1990s

CDC and Kaiser ACE studies in 2002

Cleveland Clinic

Dyadic Development Psychotherapy Network

The National Child Traumatic Stress Network

National Institute for the Clinical Application of Behavioral Medicine (NICABM)

National Institute of Mental Health

Psychiatry.org

U.S. Department of Veterans Affairs: National Center for PTSD