Trauma and PTSI Therapy, East Hampton, CT

Post-Traumatic Stress Injury

(Although the DMS and ICD term is PTSD, CORE does not promote the term PTSD because it is not a disorder. Many trauma specialists are working to have the term PTSD officially changed to PTSI.)

PTSI is a natural response to unnatural events and experiences. There is nothing wrong with you for experiencing PTSI. You are not weak for experiencing PTSI. You don't "just get over it". It doesn't matter how long ago it occurred. PTSI is the mind and body's brilliant way of protecting us to survive horrible things. However, after the experience, our mind and body needs help returning to its natural state. Neuro-psychological research shows that during trauma, adrenalin embeds the sensory experience into our brain. The smells, the images, the body sensations, the emotions and the thoughts - become embedded into our awareness. PTSI can impact our quality of life, work, family, and social functioning.

There are many parts to an experience, including an image, a cognition (a thought about the event), an emotion and a physical sensation (headache, chest tightness, stomach pain, etc). With trauma, each of these areas can become over and under active. We might have body pain but emotional numbness. The process of healing is holistic and includes working with all areas that are impacted by the trauma.

Here is a list of very common symptoms of Post-Traumatic Stress Injury:

Flashbacks: we can have spontaneous flashbacks of our experience that feel impossible to control or stop once we are in it. Our body may respond as if it was actually reoccuring in the present. Sometimes flashbacks flood our awareness, catching us off guard, with or without a know trigger, that causes the memory.

Numbing: we can become numb to our experiences, both from the past and in the present. Numbing is an attempt to protect us from feeling. We can numb our emotions and our body physically. We feel flat, detached, empty, disconnected.

Triggers: we can get triggered by any reminder of the trauma, including an image, sound, smell, physical sensation, sight, person, location, name, date, etc. Triggers create a response in our mind, body and emotions that relate to the trauma. We can feel flooded with different emotions and become overwhelmed and we can feel numb, detached, angry, anxious, or confused.

Anxiety and Depression: We can feel one or both of these emotions, which are like two sides of the same coin. The struggles with anxiety can often be followed with depression. Irritability, impatience, distress, restlessness, worry, fear, hopelessness, lack of motivation, boredom, helplessness are common responses to trauma. Feeling suicidal, such as just wanting the pain to go away, wanting it to stop, feeling tired of the struggle, is a frequent response. This may lead to suicidal ideation, which moves from an emotional experience to an actual intent and plan. We may startle and experience hypervigilance.

Sleep: we can have difficulty with insomnia, nightmares, restless sleep, early waking or oversleeping.

Hypervigalence: we can have heightened awareness to our surroundings, to others, to activity, to sounds; always scanning and assessing our environment.

Physical Conditions: we may experience headaches, stomache aches, neck and back pain, insomnia, nightmares, body pain (body memory), weight change, fatigue, chest pain, phantom pain, vision change all due to the stress on our body and mind.

Cognitive and Mental Conditions: we may become preoccupied with the trauma, we may avoid anything associated with the trauma, we may have difficulty concentrating and remembering, depersonalization (like we are watching from outside ourselves), and dissociation (like our awareness is shut off, going away in our mind). We may have amnesia from some parts of the trauma that we have blocked out. We may ruminate (continually replaying the scene) about the trauma. Negative thoughts (blaming, criticizing, minimizing, shaming, etc) can loop through our mind. We may experience survivor guilt for surviving what others did not.

Avoiding and Acting Out: We can turn to methods such as substance abuse, gambling, sex and high risk activities in an effort to distract and avoid the effects of trauma. However, these behaviors sabotage us and add another layer to the suffering we are already experiencing.  

These are all commonly occuring effects of trauma. We are innately wired to protect ourselves through these defenses and responses. We can learn to heal this invisible wound through appropriate treatment.

Here is a simple online assessment tool from the VA: http://www.ptsd.va.gov/public/pages/trauma-symptom-checklist.asp

Treatment

There are various forms of psychotherapy that can help us heal from the impact of trauma.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a proven method that has been highy researched and approved by the Department of Defense for the treatment of combat trauma. The method replicates REM (rapid eye movement) eye movements while processing trauma. To learn about EMDR and to find a therapist near you, go to the resource section or www.emdr.com.

Emotional Freedom Technique is another researched method that helps with trauma. It is based on the concepts of accupuncture and accupressure and involves tapping energy points while processing stressors. To learn more, go to the resource section or www.garythink.com/eft/ for free training videos and instruction.

Psychotherapy: Talk therapy is an effective treatment for PTSI. By learning to understand the impact of trauma and developing strategies to cope, we can heal. It is important to work with a therapist who is trained and experienced in trauma therapy. You can check with your insurance company or search online for a trauma therapist in your area. Having a safe and supportive person to share your experience with is crucial. You can also learn strategies to resolve many of the problem areas described above with an individual focus for a treatment plan.

Specialized Therapy: Seek specific treatment for any issues you are experiencing. Join AA or NA for substance abuse issues or GA for gambling issues. Admit yourself into an inpatient program at a local hospital if you are at risk for suicide or homicide. Your primary physician can also help coordinate appropriate care and services for you. A psychiatrist or APRN nurse can assess any need for medication that may help ease your symptoms. Also, a licensed professional may be able to submit FMLA (Family Medical Leave Act) documents that protect your job while you take medically necessary leave for treatment.

Self-Care: There are many things you can do to promote your own recovery.

Exercising for 30 minutes for three days per week has been shown to be equivalent to taking an anti-depressant.

Writing or journaling about your experiences can be a great release and lead to powerful insights.

Focusing on a hobby or activity can be a release and/or relaxing.

Build a social network of support. Family, friends and social involvement are important. Don't isolate!

Developing coping skills through meditation, prayer, yoga, tai chi are proven strategies for reducing stress.

Laugh-seek out the lighter things in life: go to a comedy club, watch a funny movie, read a joke book. It changes your brain chemistry. (And at the same time, limit your exposure to war and trauma based materials: movies, photos, internet stories, news, etc. They can provoke triggers that remind you of your traumatic experiences.)

Focus on others: love your family and friends, volunteer in a social or community organization.

Give yourself permission to feel: scream into a pillow, cry it out. Find safe ways to feel your emotions.

Yeah, I know, when you're in a dark place, this sounds like bullshit. That's why therapy, especially EMDR, is a vital part of getting out of the darkness. Then we have more energy and motivation for the things listed above. 

Traumatic Brain Injury

PTSI can look like TBI, as many symptoms overlap. If you had any physical injury or any experience involving a head injury or IED's, it is important to be evaluated for TBI and to receive any necessary treatment.