Therapy Blog

PTS(d) and Crisis

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After publishing my post on Talking to Kids about Tragedy, I had a lot of requests to offer more information on Crisis and PTS(d). The ‘d’ (stands for ‘disorder’) is in parentheses because Post Traumatic Stress (PTS) is NOT a disorder in and of itself; unchecked, it can become more intense, but we should not assume that somebody has a ‘disorder’ just because they show signs of trauma.

Trauma and PTS(d)

When tragedy strikes, it is rarely expected or planned for. Usually,
it comes in the form of unexpected trauma ranging from natural disasters
such as tornadoes and hurricanes to the unfathomable tragedies of 9-11
terrorism. As human beings, we are equipped to handle these tragedies,
but we must understand that part of what tells us we need help is
intense, and often shocking, distress that follows. If not addressed,
these symptoms (often referred to as Critical Incident Stress or Post
Traumatic Stress) may linger for months or even years, needlessly complicating
our lives, and worrying our loved ones who may feel helpless when trying
to ease our pain.

When it is expected, we think of impending disasters like going to war, losing a
loved one to a terminal illness, etc. Make no mistake though, PTS can still
arise from even anticipated trauma. Sometimes the anticipation is traumatic.

What to expect from PTS(d)

While we all experience trauma, grief, etc. in our own unique ways,
there are several trends that seem to be rather consistent across traumatic
experiences. Beginning with shock, denial and sometimes even repression
of the experience, the symptoms of traumatic stress will also include
other cognitive, behavioral, physical and emotional symptoms. Appetite
and sleep fluctuation, irritability, depression, fear and recurring
images (flashbacks) are common. More severe symptoms may include chronic
depression, phobic reactions to triggers of memories, job loss, physical
decline and major personality changes. Remember, these unpleasant experiences
can be seen as reminders that something needs to be done . . . since if
we are comfortable we have no motivation to change how we are living–it
is the discomfort itself (of the above symptoms) that motivates change.
It is our own responsibility to ask for help or to heed the suggestions
of our loved ones–even if we feel unmotivated or too tired to pursue
making an appointment with a counselor.

What to do

While some people may be able to effectively manage their traumatic
stress without counseling or traumatic stress management/debriefing,
it is always best to talk to a professional if you have any hesitation
at all–it is worth the time and expense to put your mind at ease; remember,
some of the manifestations of traumatic stress can be subtle as they
stay inside and fester only to show up later as more distressing symptoms.

In order to deal with traumatic stress effectively, it is suggested
that you contact a credentialed Critical Incident Stress Management
professional within the first 24-72 hours to begin the process of bringing structure to the
chaos of tragedy aftermath. Your healing may involve both group debriefings
and individual counseling, as well as ongoing aftercare for a few weeks,
or as long as you feel is necessary (I provide group
debriefings and individual follow-up counseling).

If you know somebody that has been through a crisis or trauma

First, please understand that people who have been through a trauma do not have a “Disorder.” The Post Traumatic Stress (PTS) simply becomes a part of their survival. They can, and will, work through it. You can be a part of their recovery from this “invisible wound” by:

Follow their lead. Be there if they ask for help.

Do NOT ask for details; this can traumatize you (called Secondary Trauma, or Vicarious Trauma) and re-traumatize them by bringing the pain back up for them.

Be reassuring, help them remember what they can do: exercise, be social (careful about alcohol though), play music, read a book, anything that helps them unwind. Even offer to go do this with them.

If they would like to talk about how they feel, or about the situation, be sure that you are clear about your limits. They will be appreciative that they know you will be honest with them. If you do feel upset by anything, be sure you reach out for help as well.

Offer to bring them something they need: a meal, a book, yourself, etc. However, do not treat them as if they are incapable of caring for themselves.

Just love them by being a good friend and/or family member.

Helpful tips if you have been impacted by PTS

Here are some suggestions for things to try after surviving a tragedy (these
may also be used as suggestions for loved ones that are struggling):

Try to remember, it is OK to feel rotten about a rotten situation

As you feel ready, begin to bring normalcy back in your life by doing things
that you used to do before the trauma

Exercise and follow a healthy diet (talk
to your doctor!)

Talk to your friends and family

Talk with a professional counselor (preferably
Critical Incident trained)

Practice meditation, relaxation, gentle, relaxed

Get plenty of rest

Attempt to find something that you can learn from the trauma (i.e., how
to prepare for a tornado, how to perform 1st aid and CPR, learn self-defense)

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