Healing Trauma, Loss and PTSD
by Darlene Treese, Ph.D. and Cynthia M. Lindner, M.S.

Purpose
The American Psychotherapy and Medical Hypnosis Association offer the following information as a public service. This white paper is intended to provide general information only. Individual personal issues may vary from these general guidelines. Therefore, it is our recommendation that individuals who think they are having symptoms address there issues within a therapeutic setting with a licensed professional who is familiar with the problem and it’s treatment.

Coping With Trauma
Most of us conduct our lives around the belief that we will be relatively safe. For many people that belief was shaken as catastrophic events unfolded on the gulf coast of the United States of America. Hurricanes Katrina and Rita unleashed powerful winds, and high storm surges powerful enough to wash away homes and buildings and have left the landscape nearly unrecognizable. These natural disasters have destroyed property, taken hundreds of lives, altered the lives of millions, and for many people across the nation, undermined feelings of safety.

Events such as this are outside the realm of people’s ordinary experience. Catastrophic experiences are not limited to war and natural disasters (tsunamis, earthquakes, hurricanes, tornados, flooding, etc.) but also include rape, physical or sexual abuse, fires, auto accidents, school shootings, plane crashes, hostage situations, and exposure to other violence such as car-jacking, mugging, and military combat. It is not only the victims of these events, but also witnesses, families of victims and the helping professionals such as police and rescue workers who can develop severe symptoms of stress, which can potentially become long-lasting.

The anxiety experienced during or immediately after a catastrophic event is identified as traumatic stress. When symptoms endure several months after the incident, it is classified as post-traumatic stress. Post-Traumatic Stress Disorder (PTSD) is the term used by mental health professionals to characterize people who have endured highly stressful and frightening experiences and who are having severe distress caused by memories of that event. There are three main clusters of PTSD symptoms which must be present to confirm a diagnosis of PTSD:

Intrusive Symptoms are comprised of intrusive and repetitive memories which trigger the very distressing feelings experienced during the trauma. These symptoms can include flashbacks, nightmares, and uncomfortable traumatic memories that come up in an interfering way.

Arousal Symptoms are comprised of physiological reactions. These can include unwarranted angry outbursts, being easily startled and feeling jumpy, difficulties in concentration sleep problems, and hyper vigilance.

Avoidance Symptoms are a pattern of behaviors with the intention of escaping the memories and stressful feelings of arousal. These behaviors can include avoiding situations, places or people which are reminders of the trauma, avoiding thoughts and feelings associated with the trauma and feeling numb emotionally and detached from other people including loved ones. There may also be feelings of hopelessness, and a decreased interest in pleasurable activities.

 

Getting Help for PTSD
It is important to remember that traumatic stress is a normal reaction to very abnormal circumstances, and PTSD is an extension of that reaction. There is no shame in experiencing symptoms, nor is having symptoms viewed as a sign of weakness.

PTSD is very treatable, especially when it is caught early. The idea behind the treatment is to process the traumatic event, as well as manage the symptoms. A qualified Therapist can help the person with PTSD to find the words to talk about the incident and to understand the feelings that accompany the experience, rather than to avoid things associated with the trauma. Whatever a person resists persists at the sub-conscious level and ultimately controls their thoughts, feelings and actions and interferes with their daily life. Though it might seem natural to want to avoid painful memories, it is important to acknowledge the memories, feel the emotions and work at processing them. When this happens, the trauma no longer controls the person. The person is now in control of the memory of the trauma to the extent that she or he can approach it with flexibility and objectivity.

Hypnotherapy in the Treatment of PTSD A Licensed Clinician skilled in the therapeutic use of hypnosis can facilitate the processing of the traumatic memories, and facilitate alternate perspectives and consequently different responses to the memories of trauma. Hypnosis as a management tool can be used to develop skills in relaxation, and teaching individuals to use self-hypnosis as a self-help tool can have an empowering effect for the individual who uses it to manage their symptoms.

 

Statistics about PTSD
· A majority of people who are exposed to extreme stress are able to process their way through their reactions and never develop PTSD although they will experience a “grieving process” as they regain their normal level of functioning.

· An estimated 70 percent of people will be exposed to a traumatic event in their lifetime.

· Of those people, 20 percent will go on to develop PTSD.

· Women are about twice as likely to develop PTSD as men, because women are more likely to experience interpersonal violence, including rape and physical beatings.

· Rape is a leading cause of PTSD.

· Victims of domestic violence and childhood abuse are at high risk for PTSD.

· Approximately 8 percent of the population will develop PTSD during their lifetime.

 

Self-Help Strategies for Dealing with Loss
People who have experienced a traumatic event usually also experience a sense of loss. In the case of hurricane Katrina, some of the losses are painfully obvious, but let’s not forget that some losses are intangible. The loss of dignity, innocence, or personal safety must also be grieved.

The goal of the person dealing with loss is to move through the stages of the loss process, to acknowledge the impact of the loss, learn from it, and to eventually reach closure so that in the future life can be experienced more fully. Many people will seek the help of a qualified mental health professional who may be better prepared than most to empathize and guide the process in a productive way.

If you are suffering:
· Acknowledge the loss in order to get though it. Accept the loss as an important and necessary part of your life experience.

· Realize that intense feelings are normal and expected. Expect losses to uncover intense feelings, this is especially true if a person has not achieved closure on past losses. When a person can process the loss productively, these feelings, over time will pass.

· Take care of your health. While adjusting to losses, people are more prone to letting themselves go, opening the door to other health problems and even accidents. Be sure to get enough sleep, exercise, and maintain a nutritious diet. Avoid alcohol and drugs during time of adjusting to loss. They may provide temporary relief, but can become another problem, and abusing substances will stall the loss process and make the recovery period longer.

Burnout
Often in extreme situations, those who are taking care of others suffer greatly because of the requirement to temporarily put aside their own needs. Those who are first responders and caretakers need to know that they have support available and have been victims as well. Those in the helping professions must remember that it is being strong to ask for help when it is needed. Unless one is taking care of these personal needs and processing the trauma experienced, there will be nothing left within them to offer others and consequences of the memories of these experiences may linger for months or years to come. A licensed professional is bound by their Code of Ethics to client privacy and confidentiality and can offer objective, nonjudgmental support.

 

Conclusion
Knowing that at some time in life there will be losses allows a person to mentally prepare for it. No one is protected or immune from trauma and loss. It is a part of life that all will experience in some way either as an individual, a family, a community or a nation and it will usually come at an unexpected time and in an unexpected way. Some losses are small and easily forgotten; others change the course of life. A loss may destroy a person or make that person stronger. Following the steps that are outlined allows one to take charge of grief, to choose to live again, to make decisions that make a difference and to complete this journey back to wholeness.

Darlene Treese, Ph.D., and Cynthia Lindner, M.S. are both Past-Presidents of American Psychotherapy and Medical Hypnosis Association.

 

To get a local reference for treatment, check the member listing at http://APMHA.com/memberlisting.htm

 

Bibliography
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Alman, B & Lambrou, P. (1992). Self-hypnosis: The complete manual for health and self-change. New York: Brunner/Mazel

Grove D. & Panzer, B.(1989) Resolving traumatic memories: Metaphors and symbols in psychotherapy. New York: Irvington Publishers, Inc

Yapko, M. (1995). Essentials of hypnosis. New York: Brunner/Mazel

 
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