June Is PTSD Awareness Month – Take the Pledge

https://content.govdelivery.com/landing_pages/10180/9839c2bc4840115d408f04cc183a0400

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after a traumatic event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time.

Who Develops PTSD?

Anyone can develop PTSD at any age. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control. For example, having a very intense or long-lasting traumatic event or getting injured during the event can make it more likely that a person will develop PTSD. PTSD is also more common after certain types of trauma, like combat and sexual assault.

Personal factors, like previous traumatic exposure, age, and gender, can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.

Although there are a core set of PTSD symptoms that are required for the diagnosis, PTSD does not look the same in everyone. In addition symptoms may come and go and may change over time from childhood to later adulthood.

  • Avoidance
    Avoidance is a common reaction to trauma. It is natural to want to avoid thinking about or feeling emotions about a stressful event. But when avoidance is extreme, or when it’s the main way you cope, it can interfere with your emotional recovery and healing.
  • Trauma Reminders: Anniversaries
    On the anniversary of a traumatic event, some survivors have an increase in distress. These “anniversary reactions” can range from feeling mildly upset for a day or two to a more extreme reaction with more severe mental health or medical symptoms.
  • Trauma Reminders: Triggers
    People respond to traumatic events in a number of ways, such as feelings of concern, anger, fear, or helplessness. Research shows that people who have been through trauma, loss, or hardship in the past may be even more likely than others to be affected by new, potentially traumatic events.
  • Aging Veterans and Posttraumatic Stress Symptoms
    For many Veterans, memories of their wartime experiences can still be upsetting long after they served in combat. Even if they served many years ago, military experience can still affect the lives of Veterans today.
  • Very Young Trauma Survivors
    Trauma and abuse can have grave impact on the very young. The attachment or bond between a child and parent matters as a young child grows. This bond can make a difference in how a child responds to trauma.
  • PTSD in Children and Teens
    Trauma affects school-aged children and teenagers differently than adults. If diagnosed with PTSD, the symptoms in children and teens can also look different. For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years if they do not get treatment. There are many treatment options available including talk and play therapy.
  • History of PTSD in Veterans: Civil War to DSM-5
    PTSD became a diagnosis with influence from a number of social movements, such as Veteran, feminist, and Holocaust survivor advocacy groups. Research about Veterans returning from combat was a critical piece to the creation of the diagnosis. So, the history of what is now known as PTSD often references combat history. * Source:

The “R’s” of Trauma-Informed Care

Trauma affects all levels of society, including the home, school, religious institutions, social service organizations, public and private business, the arts and all areas of culture. A major movement has been occurring, throughout the nation, to change our perspective on trauma-informed approaches. The goal of this movement is to increase sensitivity in client care and prevent re-traumatization.

In order to meet this goal, the Substance Abuse and Mental Health Services Administration has created 4 R’s to guide the individual practitioner and society. These R’s include:

1. Realizing the widespread impact of trauma and understand the potential paths of recovery.

2. Recognize the signs and symptoms of trauma in clients, families, staff, and others involved in the system.

3. Respond by fully integrating knowledge about trauma into policies, procedures, and practices.

4. and seeks actively to Resist Re-traumatization.

This guidance has resulted in paradoxical shifts that promote Resiliency and Regulation to promote positive Recovery. These “R’s” are essential to the practice of social work and mental health.

As the ideas and practices spread through society, we have to explore lesser recognized R’s of trauma-informed care, including Respect and Relationship. These two R’s are elements of success in creating a trauma-informed (cultural of) care.

There is a Zen saying:

If there is light in the soul,
There is beauty in the person,
If there is beauty in the person,
There will be harmony in the house,
If there is harmony in the house,
There will be order in the nation,
If there is order in the nation,
There will be peace in the world.

Respect starts with the individual – has to start with the individual – and then slowly moves through-out society. It starts with the parent in the home, the social worker in the field, the rabbi in the synagogue, the teacher in the physical education program, the supervisor in the organization. This light sparks from respecting oneself and then it then gets paid forward to others around them. It brings gratitude for beauty in the person and harmony in the “house”. It sustains families and transforms organizations and the world.

Respect is defined as the admiration of someone’s ability, qualities or achievements. It creates an atmosphere that promotes safety for the trauma survivor.

“Trauma, by definition, is unbearable and intolerable … Nobody wants to remember trauma. In that regard society is no different from the victims themselves. We all want to live in a world that is safe, manageable, and predictable, and victims remind us that this is not always the case. In order to understand trauma, we have to overcome our natural reluctance to confront that reality and cultivate the courage to listen to the testimonies of survivors.”

— Van Der Kolk, 2014
The question most often asked is how to put these “R’s” into daily practice? How do you make them a Reality?
According to SAMHSA’s report on Trauma-Informed Care in Behavioral Services, these R’s involve the…  
  • Recruiting, hiring, and retaining trauma-informed staff.
  • Training behavioral health service providers on the principles of, and evidence-based and emerging best practices relevant to, TIC.
  • Developing and promoting a set of counselor competencies specific to TIC.
  • Delineating the responsibilities of counselors and addressing ethical considerations specifically relevant to promoting TIC.
  • Providing trauma-informed clinical supervision.
  • Committing to prevention and treatment of secondary trauma of behavioral health professionals within the organization.
A lack of safety often looks like mistrust, a common problem for survivors. Trauma impacts the whole person. I manifest in our physical, mental, emotional, and spiritual self. Symptoms of trauma often come with emotional numbness and a desire to isolate from others. It results in a lack of interest in social connections and impairs parenting, marriages, and working relationships. It can also impair clients and patients desire to seek the services they need because they don’t feel safe. 

All of this must be held in the context of a Relationship. The relationship is the healing factor behind it all. Without relationship, there is no family, no organization, no church, no society. In the science of resiliency, the relationship is how we tip the scale from negative to positive outcomes. One healing relationship in a chaos of trauma can provide enough emotional strength for a child or adult to survive.

Reflect on the “R’s” of Trauma-Informed Care:

1. How has your organization utilized the 4 R’s of Recognize, Realize, Respond, and Resist Retraumatization?

2. What can you do to start or improve on any efforts already done using these 4 R’s?

3. Can you define the concepts of Regulation, Resiliency, and Recovery? Write these definitions on an index card and consider them each time you interact with a co-worker, friend, or client.

4. How have the ideas of Respect and Relationship impacted you personally and/or how have you used these two powerful R’s to move others to more positive outcomes?

~> Need training or consultation on how to implement Trauma-Informed Care into your church, school, or business? Let Ron Huxley help you train your staff or community. Email him today at rehuxley@gmail.com or call 805-709-2023.