Trauma

As a mental health professional who has been in the trenches working with people for more than forty years, I have had extensive experience working with the victims of trauma.  Those clients have primarily fallen into two overlapping categories:  the victims of sexual assault and people who present the symptoms of PTSD (Post-Traumatic Stress Disorder).

In the US, someone experiences a sexual assault every two minutes!  Due to unreliable underreporting sexual assaults in the US number somewhere between 200,000 and 600,000 annually. Two thirds of the victims are assaulted by someone they know, further complicating the decision to report and clinically treat.

As a Vietnam Era therapist, I have had a special interest and involvement with veteran’s issues.  I proudly support and honor veterans but question the missions they have severely devastated them.  Politics aside, twenty-two veterans commit suicide every day (one every 65 minutes!) and of 2.3 million Iraq and Afghanistan veterans, 20% experience PTSD and depression, and 19% experience TBI’s (traumatic brain injuries – severe concussion from proximity to explosions).  Of 8.2 million Vietnam veterans, 30.9% suffer from PTSD.  For all these veterans, 39% present a pattern of alcohol or drug abuse, and 50% never seek treatment.  For those that do, the VA currently reports a backlog of 900,000 disability applications with the VA response time for new applications exceeding one year.  As a country, we are tragically and dramatically letting our servicemen and women down!

In the general population, approximately 7% of the population presents symptoms of PTSD, of which 36% are severe.  Life events that can cause PTSD are:  domestic violence, automobile or other forms of violent accidents, severe illness or medical events, losses, alcohol or drug experiences, sexual assault, financial setbacks / home foreclosure, or legal / criminal cases.  The precipitating event, whatever it is, needs to be severely traumatic in the eyes of the beholder.

A crucial foundation for the treatment of trauma is the development of a therapeutic relationship with a clinician.  My belief is that the therapist must present experience, competence, and caring.  The therapist needs to be perceived as an advocate who can create a safe environment to review and explore a painful, terrifying, and confusing event or series of events.  Gently and cautiously reviewing the trauma allows the therapist access to distorted cognitions (thoughts) that can lead to guilt, shame, and the sense of personal responsibility for the traumatic event(s).  Cognitive reframing allows the client to take control of their life back, to move on, to let go, and to file the event in the rear of the filing cabinet.

The hardest step may be to pick up the phone.