When Trauma Leads to Posttraumatic Stress Disorder (PTSD)

If the trauma was extremely serious or life threatening (either your life, or that of another), or involved child sexual/physical abuse, a person may develop posttraumatic stress disorder (PTSD). People can also develop some of the characteristics of PTSD, but not all. This is called posttraumatic stress syndrome (PTSS). PTSS causes just as much impairment as PTSD, so it is important to treat both.

Some of the symptoms of PTSD and PTSS include:

Hypervigilance / hyperarousal

• Feeling jumpy, on alert, easily startled
• Always being on guard, (e.g., never sitting with your back to the door)
• Irritability which can lead to angry outbursts because you are using so much energy to be hypervigilant

Intrusive thoughts / nightmares

• Intrusive thoughts of the trauma when you do not want them
• Recurring nightmares

Avoidance / numbing

• Avoiding any people, places or things that remind you of the traumatic event
• Emotional numbness, as if you do not have a full range of emotions
• Dissociative feelings as if you are not in your body, or are watching life as an outsider
  • Depersonalization – it feels like nothing is real, and you are observing your life from outside yourself
  • Derealization – everything around you feels unreal, including people

A negative world view

• Negative thoughts about everything, that the worst will always happen and you can’t trust anyone

The good news is that PTSD and PTSS respond extremely well to treatment. There is no need to continue suffering. Stanford Cue-Centered Treatment is one of the latest trauma treatments and works extremely well. So do eye movement desensitization and reprocessing (EMDR) therapy and brainspotting. Dr. Strom offers all of these treatments for trauma and PTSD. Treatment takes less time than you might think! 

Here’s a 4-question test to see if you might have PTSD. PTSD Screen 2019-10-01

This is a government handout which covers PTSD symptoms and treatments called “UnderstandingPTSD“. 

You don’t have to suffer with posttraumatic symptoms life long. There is help. Please call to discuss your situation, or schedule a consultation to learn more. You can feel better – soon. 

Posttraumatic stress disorder symptoms

In 2013, the American Psychiatric Association revised the PTSD diagnostic criteria in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). One of the changes from previous editions was to move this disorder out of the “Anxiety Disorders” section into its own “Trauma and Stressor-Related Disorders”. Diagnostic criteria for young children are similar, but differ slightly.

Criterion A: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows:

1. Direct exposure
2. Witnessing, in person
3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental.
4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies or pictures

Criterion B: Intrusion (1/5 symptoms needed)

1. Recurrent, involuntary and intrusive recollections *
   * children may express this symptom in repetitive play
2. Traumatic nightmares *
   * children may have disturbing dreams without content related to trauma
3. Dissociative reactions (e.g. flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness**
   **children may reenact the event in play
4. Intense or prolonged distress after exposure to traumatic reminders
5. Marked physiological reactivity after exposure to trauma-related stimuli

Criterion C: Persistent effortful avoidance of distressing trauma-related stimuli after the event (1/2 symptoms needed):

1. Trauma-related thoughts or feelings
2. Trauma-related external reminders (e.g. people, places, conversations, activities, objects or situations)

Criterion D: Negative alterations in cognitions and mood that began or worsened after the traumatic event (2/7 symptoms needed)

1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol or drugs) (C3 in DSM-IV)
2. Persistent (& often distorted) negative beliefs and expectations about one’s self or the world (e.g. “I am bad”, “the world is completely dangerous”) (C7 in DSM-IV)
3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences (new)
4. Persistent negative trauma-related emotions (e.g. fear, horror, anger, guilt, or shame) (new)
5. Markedly diminished interest in (pre-traumatic) significant activities (C4 in DSM-IV)
6. Feeling alienated from others (e.g. detachment or estrangement) (C5 in DSM-IV)
7. Constricted affect: persistent inability to experience positive emotions (C6 in DSM-IV)

Criterion E.Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event (2/6 symptoms needed)

1. Irritable or aggressive behavior (revised D2 in DSM-IV)
2. Self-destructive or reckless behavior (new)
3. Hypervigilance (D4 in DSM-IV)
4. Exaggerated startle response (D5 in DSM-IV)
5. Problems in concentration (D3 in DSM-IV)
6. Sleep disturbance(D1 in DSM-IV)

Criterion F: Persistence of symptoms (in Criteria B, C, D and E) for more than one month

Criterion G: Significant symptom-related distress or functional impairment

Criterion H: Not due to medication, substance or illness

References: American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders (Revised 5th ed.). Washington, DC: Author.

Transformational Sandplay can help resolve pre-verbal trauma in adults and children. Be the person you were meant to be.