Alabamians are very familiar with the destruction tornadoes and hurricanes can bring. When severe weather threatens, the whoop of a siren or the alarm of a weather radio can trigger fears and memories of past storms we thought were buried long ago.
“In some ways, traumas become a measuring stick in our lives,” said Ted Embry, director of the northeast Alabama region for Alabama Baptist Children’s Homes & Family Ministries (ABCH). “Trauma is no respecter of person — it impacts Christians and non-Christians alike and cuts across the fabric of a community.”
And traumatic events are not limited to natural disasters. The National Center for Post Traumatic Stress Disorder, or PTSD, classifies traumatic events into three types. Disasters, both natural and man-made terroristic events, comprise one category. Trauma experienced by military personnel and their families is a second category. Violent acts, including rape, child sexual abuse, workplace assaults and school or community violence, as well as accidents like plane and motor vehicle crashes, fall into a third category.
What distinguishes a traumatic event for another stressful situation is the life-threatening nature of the situation, according to Renay Carroll, a counselor with Pathways Professional Counseling (a ministry of ABCH) who serves Cullman and Blount counties.
“A traumatic event is usually defined as an event in which a person’s life was threatened or endangered or when one witnesses another person’s life being threatened or endangered,” Carroll said. “The traumatic response to the event results from the individual’s feelings of intense fear, helplessness and horror.”
As the PTSD categories indicate, many common experiences can bring on a heightened stress response. House fires, for example, can have a threatening component and cause an increased perception of threat. Car accidents can be traumatic for those involved, but first responders or witnesses can be traumatized by the event as well.
Because severe trauma can result from many different events, the American Psychiatric Association (APA) estimates that almost 40 percent of Americans will experience a traumatic event during their lifetimes. While such situations often involve grave physical danger, the threat such incidents pose to mental health can persist long after the physical injuries have healed.
“There are some horrific traumas that we would all recognize as hard to come away from unscathed — wars, tsunamis, Hurricane Katrina (or the April 2011 tornadoes). The difference is the response of the individual and that person’s own perception of what that trauma means to him or her,” Carroll said.
In his work, Embry has seen the effects of trauma on both children and adults. He believes that many factors influence an individual’s response to extreme stress.
“Personality comes into play, as do past experiences and certainly a person’s faith,” he said.
In the aftermath of a traumatic event, Embry said it is important for the victim to get control of the situation, a process he called “normalizing.”
“When an individual experiences a traumatic event, it’s usually bigger than anything they have ever experienced before,” Embry said.
Sometimes a victim might use phrases like “I’m losing control” or “I’m going crazy” as they try to process their feelings, Embry said. Working with a trained counselor can help a victim understand that their response is not unusual.
“The phrase that captures it is this: ‘You are a normal person having a normal reaction to an abnormal event in your life.’ Then they think, ‘maybe I can handle this,’” Embry said.
Fear, guilt and anger are normal emotions, as is anxiety, Carroll said. Sometimes people want to label severe and lasting anxiety as PTSD, but Carroll said that is not usually the case. One of the most important factors that determines the difference is time.
For most people, the stress of a traumatic situation usually diminishes in time, often with the help of counseling and/or medication. However, if the symptoms persist or if the traumatized individual begins to experience flashbacks and other symptoms that interfere with daily life and relationships, Carroll said an evaluation by a qualified physician or mental health professional is necessary.
According to the “Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),” the primary reference for mental health professionals in the United States, PTSD involves a much farther-reaching and longer-lasting response to trauma than its clinical predecessor, Acute Stress Disorder (ASD). The symptoms of ASD occur within a month of a traumatic event, but with treatment, ASD also abates more quickly. If symptoms of ASD are left untreated, worsen or reoccur, PTSD may develop.
Carroll noted that symptoms of PTSD, even years after a traumatic event, should not be ignored. Even unrelated stressful situations can cause excessive anxiety and flashbacks to the trauma, Carroll said. Sometimes it takes years for the experiences that have settled in someone’s memory to emerge. For example, a victim of child sexual abuse might get through childhood with no specific memory of the abuse until something, like seeing a child spanked, reawakens the memory.
The goal of counseling is to help the affected individual learn to restore order and “calm their system down,” Carroll said. The body’s “alarm system” works in much the same way as a home security system. If a homeowner fails to put in the correct code to turn off the alarm upon returning home, the alarm goes off — even if the homeowner is the one in the home.
“Much the same way, the body’s alarm system is activated when the traumatized person’s stress level is high,” Carroll said. “Putting in the behavioral code for treating anxiety and trauma response helps to ‘turn off’ the body’s alarm system.”
Ultimately, Carroll said, it is important to realize that thousands of people are affected by trauma each year, but each of those individuals responds to stress differently. Not all affected by trauma will experience a disorder, she said.
Likewise, there is no “one-size-fits-all” recovery plan, according to Ian Jones, professor of psychology and counseling and Baptist Community Ministries’ Chair of Pastoral Counseling at New Orleans Baptist Theological Seminary.
“Each individual requires different engagement depending on their relationship to themselves, their level of stress, the way the body is reacting and what you have in terms of voluntary control and involuntary response to trauma,” Jones said. “After a trauma, a person’s hormonal and chemical balance can get all topsy-turvy, and with PTSD, actions and thoughts are outside the individual’s physical and cognitive control. In those situations, there is a need for more than someone sitting down and saying everything will be alright.”
Experienced counselors agree that when a trauma occurs, victims need to process the event as soon as they are able. A solid support system — counselors, family members, friends, pastors and others — equips a traumatized individual or community with the tools to navigate through an extremely difficult experience and come out on the other side, Embry said.
In addition to offering counseling services in satellite offices around the state, Pathways counselors are trained in critical incident debriefing and are available to come into communities when a natural disaster or crisis occurs. For more information, contact the statewide administrative office of Pathways Professional Counseling at 1-888-720-8805 or 205-982-1112.
Symptoms of Post-Traumatic Stress Disorder
- Re-experiencing the trauma through flashbacks, nightmares or frightening dreams (sometimes the content of the nightmare will not be obviously related to the traumatic event. A child who was involved in a tornado may have dreams about wolves).
- Difficulty falling asleep or staying asleep.
- Avoiding reminders of the trauma.
- Reenactment play or repetitive traumatic play in children.
- Hypervigilance: A constant state of being on “high alert.”
- Irritability, angry outbursts, aggression.
(Source: Melanie Howard, Pathways Professional Counseling)
Strategies that interfere with giving support
- Rushing to tell someone that he or she will be OK or he or she should just “get over it.”
- Acting as if someone is weak or exaggerating because he or she is not coping as well as others.
- Discussing your own personal experiences without listening to the other person’s story.
- Giving advice without listening to the person’s concerns or asking the person what works for him or her.
- Stopping the person from talking about what is bothering him or her.
- Telling the person he or she was lucky it was not worse.
(Source: Psychological First Aid, Field Operations Guide, 2nd Edition, National Child Traumatic Stress Network, National Center for PTSD — www.ptsd.va.gov)
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