By Joyce Marter LCPC
Through over 15 years of counseling experience, I have come to realize that
PSTD doesn’t just occur after the typical traumas associated with the disorder,
such as combat, violence, a serious accident or a natural disaster. I have
had clients present with all the PTSD symptoms following other disturbing life
events. For example, one client who had lost a baby during her third trimester
of pregnancy, presented with many trauma symptoms as she neared the third
trimester of her next pregnancy. Another client presented with PTSD symptoms
after nearly being hit by a crosswalk by a car, which triggered dormant trauma
symptoms from years of childhood sexual abuse. Many fail to realize that
meeting the criteria for PTSD has less to do with the nature of the triggering
event that threatens the safety of self or others (the trauma) and more to do with
the person’s psychological response to the event (persistent fear, helplessness
and horror). In fact, different people may experience the same event, such as
an armed robbery, and some will develop PTSD while others will not. In fact,
according to the National Institute of Mental Health, most people who live through
a dangerous event will not develop the disorder. According to psychotherapist
and trauma expert Courtney Armstrong, LPC, “People who are vulnerable to
developing PTSD are those who have experienced prior trauma in their lives,
lack social support or have a genetic predisposition toward anxiety.”
For those at risk, PTSD may be triggered by a wide array of life events that
are experienced to be threatening. In my practice, I have seen serious trauma
responses triggered by events such as complicated childbirth, adverse medical
experiences, complex grief or loss or even an extreme financial crisis such as
bankruptcy or foreclosure.
Armstrong says that when dealing with post-traumatic stress, it’s like the deeper
part of the mind has not gotten the good news that the event is over and that
you survived. She adds that this more primitive part of the mind continues
to scan for potential threat in the environment, firing off the fight-flight-freeze
response in the nervous system any time it detects something similar to the
initial traumatic event. For example, she says, “Combat veterans report that any
sort of loud noise will often trigger them to go into this fight-flight-freeze mode.
This is because the deeper mind learned to turn on automatic survival behaviors
whenever it’s exposed to any sound similar to what was heard in combat.” In
my practice, I have seen a similar phenomenon in clients who experienced less
obvious traumatic experiences, such as infidelity, for example. One woman
experienced debilitating trauma and anxiety symptoms anytime her husband
prepared to travel for business, because he had admitted he cheated during a
prior trip when the couple was disconnected and he was entertaining customers.
Anytime he started to pack his bags, flashbacks and feelings of panic and
insecurity overcame her.
In order for more trauma survivors to be identified and receive effective
treatment, we must broaden and deepen our understanding of the nature of
PTSD, the available therapeutic approaches and other resources.
The effects of trauma are multifaceted. Cognitive effects include loss of
confidence in one’s own judgment, flashbacks, difficulty concentrating and
dysfunctional beliefs (i.e. “I lost my house because I am inadequate.”) Emotional
effects of trauma include nightmares, emotional numbing, irritability, apathy, and
feelings of shame, guilt, fear and hopelessness. Trauma survivors are impacted
socially as they may avoid places, things or people that are perceived as a
threat, may have difficulty connecting with others and experience impairment in
their capacity to love or be vulnerable. Physical symptoms include difficulty
sleeping, hyperarousal or feeling “on edge,” and muscle tension. The
psychological response to trauma may include depression, anxiety, substance
abuse, Dissociative Disorders or PTSD.
PTSD and the effects of trauma can be treated through both medication
(benzodiazepines such as Xanax or Valium, antidepressants such as Zoloft or
Lexipro, and sleep aids such as Ambien) and psychotherapeutic techniques
(traditional counseling and approaches such as EMDR and Rapid Resolution
Therapy. In my experience, I have seen medication as an effective tool in
alleviating acute trauma symptoms so people can better function. However, not
everybody who experiences trauma symptoms needs to take medication. In
my practice, I recommend that my clients who would benefit from psychotropic
medications meet with a psychiatrist for a medication evaluation rather than
getting these medications from their primary care physician. This is because
psychiatrists are experts in mental health disorders and medications and are best
trained to treat anxiety and trauma disorders. I also caution that benzodiazepines
and sleep aids may become habit forming and should only be used as directed.
Furthermore, I recommend that clients participate in psychotherapy along
with pharmacological treatment, as medicines treat the symptoms but not the
Different psychotherapists use different approaches to treat the effects of trauma.
It is most important that the client feel safe and connected with the therapist.
In my experience, I have found EMDR to be an extremely effective therapy to
help clients rapidly work through traumatic experiences and have used this in
combination with more traditional counseling. Armstrong explains, “The goal of
psychotherapy is to teach the client how to calm the nervous system, reorient to
the present moment and realize the event is no longer happening.” Therapy can
help reprocess the traumatic experience so that it feels more manageable and is
no longer debilitating.
If you believe you or somebody you know are experiencing trauma symptoms,
complete this Post-Traumatic Stress Disorder Self-Test. To find a therapist, please visit