Trauma and Traumatic Stress

  • Trauma comes in many forms, and the traumatic stress that follows entails an emotional reaction to the serious crisis or stressful event. These emotional responses may be short or long in duration and may include strong physiological reactivity (e.g., elevated heart rate, perspiration); insomnia; feeling jumpy or startling easily; strong and/or fluctuating emotions.

  • PTSD can develop after a traumatic experience. Symptoms include:

    Re-experiencing the event through such things as flashbacks or nightmares;

    Avoiding places, thoughts and feelings of the event;

    Hyperarousal such as feeling tense, having trouble sleeping, experiencing irritability or startling easily;

    and

    Having difficult feelings or thoughts, for example, negative thoughts about yourself or the world, self-blame, and trouble remembering the trauma.

    PTSD can have a delayed start following the traumatic event and in general, it has a variable course and duration.

  • ASD begins within a month after experiencing a traumatic event. The symptoms are similar to those of PTSD, but, unlike the symptoms of PTSD, they tend to resolve after a month’s time.

    Getting effective treatment for ASD can help to prevent PTSD.

Treatment

  • ASD Treatment

    The first-line treatment for ASD is

    1) Trauma-Focused Cognitive Behavior Therapy (TF-CBT). The goal of this treatment is to decrease symptoms of ASD and prevent the onset of PTSD symptoms. Therapy entails education, exposure and addressing stuck points that develop as a result of the traumatic experience. *

    *ASD Treatment Recommendations

  • PTSD Treatment

    The American Psychological Association (Clinical Practice Guidelines, 2017) strongly recommends the following treatment for PTSD:

    1) Cognitive Behavior Therapy (e.g., TF-CBT), which entails education, exposure and reframing stuck points related to the trauma.

    2) Cognitive Processing Therapy (CPT), which includes writing an impact statement of the trauma, examining pre- versus post-traumatic views of the self and the world, and then restructuring thoughts that can keep you “stuck” in the trauma. For example, you may have thoughts such as “all people are bad” or “I caused this trauma to happen to me” that, when reframed, can result in improved symptoms. This therapy is particularly helpful to those who do not want to process their trauma details in depth. *

    *CPT info

    3) Cognitive Therapy (CT), which involves examining how your evaluations of your past traumatic experience continue to cause you to feel unsafe, and then modifying your thought patterns accordingly;

    4) Prolonged Exposure (PE), which entails the use of exposure to the trauma memories slowly and over a period of time to learn that the memories of the trauma are no longer dangerous and do not need to be avoided;

    The American Psychological Association conditionally recommends

    1) EMDR (see EMDR Institute for more information about this treatment.) The APA currently recognizes EMDR as an effective treatment and is interested in additional research to support a strong recommendation for this form of therapy. *

    *EMDR Recommendations