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Trauma and Abuse

Trauma & Abuse

Post-Traumatic Stress Disorder (PTSD) is a condition that can develop after experience or witness of a devastating traumatic event or series of events.  Many victims of childhood abuse, domestic violence, or other violent crimes can develop PTSD, as well as soldiers returning from war.  Early childhood abuse results in “Developmental Trauma,” which impacts every area of our psychological and relational functioning.

Developmental Trauma: Children of emotional abuse, physical abuse, and/or sexual abuse often experience lifelong problems that place them at risk for additional trauma and setbacks in life such as addiction, medical illness, relationship problems, work-related problems, and legal involvement. These problems may extend from childhood through adolescence and into adulthood.

 Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a severe condition that may develop after a person is exposed to one or more traumatic events, such as sexual assault, serious injury or the threat of death. The diagnosis may be given when a group of symptoms such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal (high levels of anxiety) continue for more than a month after the traumatic event.  Typically the individual with PTSD persistently avoids all thoughts, emotions and discussion of the stressor event and may experience amnesia for it. However, the event is commonly relived by the individual through intrusive, recurrent recollections, flashbacks and nightmares.

Women, men, and children are all susceptible to developing PTSD. Women experience the greatest rate of PTSD due to domestic violence. Men are at risk for the disorder often due to combat exposure. However, the rate of PTSD in adults who were in foster care for one year as a teen is higher than that of combat veterans.

Alcohol and drug abuse commonly co-occur with PTSD. Recovery from PTSD may be hindered, or the condition worsened, by substance abuse; resolving these problems can bring about a marked improvement in an individual’s mental health status and anxiety levels.

Several forms of psychotherapy have been advocated for trauma-related problems such as PTSD.  Cognitive-Behavioral Therapy (CBT) has been proven to be an effective treatment for PTSD and is currently considered the standard of care for PTSD.  Exposure therapy is a type of CBT that involves assisting trauma survivors to re-experience distressing trauma-related memories and reminders in order to facilitate habituation and successful emotional processing of the trauma memory. Most exposure therapy programs include both imaginal confrontation with the traumatic memories and real-life exposure to trauma reminders; this therapy modality is well supported by clinical evidence.

DSM-IV TR Diagnostic Criteria for PTSD

A: Exposure to a traumatic event. This must have involved both (a) loss of “physical integrity”, or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror, or helplessness (or in children, the response must involve disorganized or agitated behavior).

B: Persistent re-experiencing of one or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective reminder of the traumatic event(s).

C: Persistent avoidance and emotional numbing. This involves a sufficient level of: avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s);

avoidance of behaviors, places, or people that might lead to distressing memories as well as the disturbing memories, dreams, flashbacks, and intense psychological or physiological distress; inability to recall major parts of the trauma(s), or decreased involvement in significant life activities; decreased capacity (down to complete inability) to feel certain feelings; an expectation that one’s future will be somehow constrained in ways not normal to other people.

D: Persistent symptoms of increased arousal not present before These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hypervigilance. Additional symptoms include irritability, angry outbursts, increased startle response, and concentration or sleep problems.

E: Duration of symptoms for more than 1 month If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder.

F: Significant impairment. The symptoms reported must lead to “clinically significant distress or impairment” of major domains of life activity, such as social relations, occupational activities, or other “important areas of functioning”.

Developmental Trauma

Adult Survivors of Child Emotional, Physical, and Sexual Abuse

Developmental Trauma stems from early childhood emotional, physical, and/or sexual abuse.  Early abuse can affect every area of our lives.  The chart below lists seven areas of functioning that are negatively impacted by early abuse: –

1) Relationships, 2) Physical Health, 3) Emotional Health, 4) Awareness, 5) Behavioral Functioning, 6) Thinking Patterns, 7) Self-Image.

If you were exposed to childhood abuse and you experience several or all of these symptoms, consider seeking counseling from a qualified mental health counselor.  Treatment requires a strong investment, but you can regain your life in return.  All of our providers are qualified to treat Developmental Trauma.