What is Post-Traumatic Stress Disorder PTSD?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Post-Traumatic Stress Disorder PTSD?
Photo courtesy of Pixabay.

Would you know PTSD if you experienced it?

PTSD is something that we hear a lot about, but most people have only a general idea what it involves.  PTSD was first recognized in returning military veterans. It has since been recognized in children who were abused, in cases of domestic violence, as the result of sexual assaults as well as the result of other traumas. While each case of PTSD is unique, they have many features in common.  Many people with PTSD may also have one or more other psychiatric disorders, some of which are likely the result of traumatic incidents. Below is a list of the features that professionals use to identify PTSD.

PTSD involves a specific trauma.

Something has happened or there was a high risk it would happen.  This trauma involved death, possible serious bodily injury, or a sexual assault. This event needs to happen to you or someone close to you, not just be something you saw on the television.  This event was either violent or sudden and unexpected.

Also included in the definition of a trauma below, are the effects which dealing with the incident has on first responders or other emergency personnel.

This traumatic event keeps forcing its way back into your life.

Part of PTSD symptoms are the recurrent memories of the event.  You may have nightmares about what happened or things connected to that event.  Some people with PTSD experience spacing out or dissociation.  You may also experience flashbacks and in these times it can feel like the event is happening again.

These recurrent intrusive memories are easily triggered.  Both internal triggers, thoughts and feelings, and external triggers, people, places, and things, may bring back the memory.

People with PTSD try to avoid reminders.

There are all kinds of ways to avoid being reminded of something that has happened. You may avoid going to certain places or events. People may turn to drugs, alcohol or other distractions.  They may try to avoid having feelings, or other thoughts about the incident.

Sometimes the brain does this job for you.  You may find that there are periods of time for which you have no memory. Some people describe this as having a blackout or amnesia.  They may avoid activities which are in any way connected to these unpleasant memories.

Behavior changes when you experience Post-Traumatic Stress Disorder.

People with this disorder often become irritable and angry.  They may become either self-destructive or reckless.  Part of this condition is having an exaggerated startle response.  In the aftermath of the trauma, people may develop poor concentration and impaired sleep.  Someone with PTSD may stop engaging in activities that used to be fun, they detach from others and may say that they just can’t feel happy.  These behavioral changes are also characteristic of depression, and the two disorders often occur together.

PTSD can cause cognitive changes.

In the aftermath of trauma, it is common for people to blame themselves.  They may tell themselves that if they hadn’t been there, or had been more careful, it would not have happened.  Negative thought patterns may develop.  People begin to feel bad about themselves, other people, and the future.  These cognitive changes can result in developing depression.

PTSD needs to last a while and not be something else.

This condition is expected to last more than a month after the stressor.  As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem we’re likely to think this is something other than PTSD.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

For more on this topic see Trauma- and Stressor-Related Disorders. 

See Recommended Books.     More “What is” posts will be found at “What is.”

What is an Adjustment Like Disorder? (F43.9)

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What is Acute Stress Disorder?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Acute Stress Disorder?
Photo courtesy of Pixabay.

Stress can knock you down and leave you in the mud.

Most people have heard of the granddaddy of all the Trauma- and Stressor-Related Disorders, Posttraumatic Stress Disorder, far fewer people have heard of the smaller member of this family, Acute Stress Disorder.

Acute Stress Disorder is a condition in which something bad happens and it knocks you for a loop but eventually, it goes away. We do not want to make the normal problems of living into a mental disorder so we only begin counting things as possible disorders when the stressor is still affecting your life at least 3 days after the incident.

A great many people experience some stressor which does not end up becoming PTSD. If you are still having symptoms a month after the event we start thinking this may become long-term and then you get the designation of Posttraumatic Stress Disorder.

We want to keep normal life events out of this equation, so expected events like having an elderly person in your family die an expected death do not count as a trauma disorder, either Acute Stress Disorder or Posttraumatic Stress Disorder.

The full text of the DSM-5 includes a detailed description of how to recognize Acute Stress Disorder but here is a short description of the condition.

Four conditions need to be met for this trauma to be Acute Stress Disorder.

  1. You get exposed to something that could kill or seriously injure you or someone close to you.
  2. It happens in the real world. Movies, TV or your imagination do not count.
  3. This is unexpected.
  4. You can’t escape the results of this experience. You re-experience the events in more ways than one. Think of people who investigate child abuse or first responders at shootings or those who recover body parts in the war zone in addition to those who were the direct victim.

This experiencing and re-experiencing causes you problems.

The DSM-5 lists 14 symptoms. I will not repeat them all here. For the full text see the DSM-5. These 14 symptoms are clustered in 5 categories. To get the Acute Stress Disorder you need to have at least 9 of the 14 symptoms but they can be from any category.

1.The experience keeps coming back.

You may have nightmares, intrusive thoughts, flashbacks, spacing out and this may be triggered by either internal thoughts or external triggers.

2. This experience bums you out.

Basically, you get into and stay in a really negative mood.

3.The trauma spaces you out.

You may get overwhelmed and just “bounce” mentally. In more clinical language we would call this dissociation.

4.The result of the experience is it keeps you away from things.

You may find yourself avoiding people, places or things that remind you of the trauma. Some people do not like to be alone or they may use drugs and alcohol to knock themselves out rather than just falling asleep.

5.You are on edge and stay that way.

This could come out as poor sleep, being irritable or angry all the time, be losing your ability to concentrate, or being easily triggered by any little thing. People in this condition are always on high alert for something that might go wrong. The door slams down the block and those with Acute Stress Disorder will jump at a sound others will not notice.

As with the other things we are calling a mental illness, this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities, or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is a preference, not a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem this problem needs to be more than your situation would warrant. These other issues need treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Questions and comments – let me get back to you on that

By David Joel Miller, Licensed Therapist, and Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

You have questions – you left comments.

Sorry about not getting to answer all those great questions. You, readers, have sent in a number of comments and questions, some on one site and some on another.  All those comments and questions deserve a decent response. I am finding that this time of year with finals, a three-day training, preparing for the next semester and the general hecticness of the season, there has just not been time to get back to all of you as I had wished.

So I hope you will keep reading the posts as they are scheduled to appear and know that I will get back to your questions and comments as soon as I possibly can.

You should know that most of the posts on counselorssoapbox.com are written ahead of time and then scheduled to appear at a later date.

There have been lots of new developments in therapyland and in recoveryland also. I have been reading some new research and the way we see substance abuse, mental illness and recovery are all about to change.

Over the next year, I want to talk about all of these items and give the questions and comments the replies they deserve.

Here are just some of the things that remain on my to-write-about list.

1.  How treatment and recovery might apply to children and adolescents. Over my time working in the recovery field I have seen a lot of youngsters that need and deserve help. Working with adults I see issues that are clearly the result of childhood mental illness or substance abuse that went untreated.

2. The role of the internet and modern technology in mental health and recovery. I see both harms and help from these new technologies. We should talk about what might be helpful in treating and preventing emotional and substance abuse issues and what internet features may be promoting recovery.

3. The changing role and status of LPCC’s in delivering mental health and substance abuse treatment in California.

4. Affairs: This is not a new topic but it is a large, possibly the largest, reason couples come to see me in private practice. People have strong feelings about this. With more than half of all marriages ending in divorce and more than half of all people reporting they have had affairs we need to look at this issue and how you might recover from an affair – yours or your partners.

5. New developments in brain science. The last year has resulted in some intriguing new knowledge of the brain and how it works. This research has suggested some new ways that mental and emotional illnesses, as well as substance use disorders, can be treated. Not all of this new knowledge points to using more medication to treat problems. Research continues to point to the value of talk therapies in treating emotional issues.  While I am neither a medical doctor nor a researcher, as a counselor, therapist, and writer, I find these developments worth commenting on.

6. The major role of stress, adjustment, and dissociation in emotional problems. PTSD, complex trauma and a host of other problems have received less attention than they require. We need to talk more about how stress affects people, how to manage stress and how to heal from past stressful experiences.

One goal for the counselorssoapbox.com blog this year was to write and post 350 new articles. With those already scheduled to appear before the year-end, it is clear that we will reach this goal. This will bring the total of articles posted on counselorssoapbox.com to over 700 posts.

This coming year looks to be a busy one. I will be teaching more classes than last year, doing more trainings and plan to get back to work on that book or books. Readers have asked questions about, change, recovery, resiliency and how to create a happy life, which needs much longer discussions than a blog post. The books in progress will be a way to offer my views on those topics.

Thanks to all the readers, new and longtime, of counselorssoapbox.com.  Keep those questions and comments coming; it encourages me to keep writing.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is Dissociation?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Confusion.

Confusion.
Photo courtesy of Pixabay.com

Does Dissociation really happen? What causes it?

Personally, I think there is more misunderstanding around this condition than most other mental health issues. First off Dissociation is way more common than most people realize. It comes in varying intensities; much of it is mild and goes unrecognized, denied and undiagnosed.

Dissociation, particularly Dissociative Identity Disorder has so much stigma around it that when we see it in clinical practice, I believe most clinicians call it something else more acceptable, like stress or Posttraumatic Stress Disorder, and let it go at that. This leaves people with more severe cases of dissociation with less than adequate treatment.

My view is that milder forms of dissociation are a normal protective behavior for most vertebrates, humans included. Under stress, the brain stem engages the “F’s” and takes over the functions of the brain to ensure survival.

Dissociation in its milder forms is, as I understand it, a functional survival mechanism. It is a close cousin to daydreaming and alcoholic blackouts.

Some simple examples of Dissociation.

I am driving along, I am thinking about something I need to do tonight. In my mind, I am picturing a set of slides that I want to create for the power point. I realize all of a sudden that I am miles past my freeway exit and I have no memory of driving this way. My mind has blanked out.

At this point, I turn around, drive as fast as I can and reach my destination. Do I tell everyone about my “zoning out?” Not a chance. I make some lame excuse about traffic and getting off work late.

Next example, more severe

A woman who was gang-raped in the past is walking around downtown. She sees some men who are wearing gang colors and look kind of like the men that assaulted her. She becomes frightened and crosses the street, she begins walking fast to get away. A few minutes later she slows down. Her panic is subsiding. She looks around and finds she is walking through a neighborhood and she has no idea where she is or how she got here.

So now we can see a mechanism by which someone who is upset might do actions like run away and be functioning essentially on autopilot. High levels of stress, like high levels of alcohol in blackouts, might shut off the connection between current functioning and memory.

Does that mean this woman has some form of Dissociative Disorder?

Maybe, maybe not. The new DSM-5 lists five major kinds of Dissociative Disorders plus some specifiers and or sub-types.

This woman, now upset because this past problem, memories of the rape, is messing up her life and also a lot worried because she ended up in a strange neighborhood with no memory of how she got there comes to see a therapist.

She begins to talk about her experience. She had an experience that brought back memories of her rape (Intrusive thoughts.) She tried to avoid things, ran away (avoidance, yes.) She has been anxious for several nights since and has lost sleep over this. Maybe even had a nightmare and this has been affecting her home life and her relationship.

At this point she gets assessed, a treatment plan created and treatment begins.

She was embarrassed so she left out the part about walking for a while and having no memory how she got there.

Her diagnosis – it’s likely to be Posttraumatic Stress Disorder.

In clinical settings, the stress-related disorders get diagnosed a lot more than the dissociative disorders. Sometimes it is a judgment call. Which disorder are this woman’s symptoms more like? But I think we professionals may be overlooking a lot of dissociative symptoms. The result may be that in outpatient settings we are under-diagnosing Dissociative Disorder and over-diagnosing PTSD.

In carefully controlled research the prevalence of Dissociative Disorders of all 5 types exceeded 5% of the population. That makes dissociation up to 17 times more common than Schizophrenia.

Dissociative Disorders are the next chapter over in the DSM-5 from stress-related disorders. We see a huge overlap between those two groups. There is also an overlap with Borderline Personality Disorder another misunderstood condition.

If we think of all these conditions as reasonable responses to stress given the person’s biology and experiences we can see how some of the things that occur to a person with dissociation make sense.

Dissociative Disorders are most commonly found in the aftermath of traumatic events. Some of the symptoms of dissociation are embarrassment, confusion and a desire to hide the existence of your symptoms. If you are the victim of trauma and let on how much the trauma affected you, this might put you at risk to be revictimized.

People under stress will have gaps in their memory. People with dissociation may also not know they have those gaps until someone asks about something they can’t remember. This is referred to in the literature as “amnesia about the amnesia.”

Dissociative Disorders, all 5 of them according to the DSM-5, include both positive and negative symptoms. In the past the only other disorder that I remember being described that way was Schizophrenia, but as I think about them other disorders have both also.

Positive and negative symptoms do not mean they are good and bad. What this means is that people with a disorder lose the ability to do some things others can do. This loss is called negative symptoms.

They also develop symptoms that others do not have. These added symptoms are called positive symptoms.

Since I believe people can and do recover I think that these areas of altered functioning can vary in intensity and can get better or worse depending on time, traumas, conditions, and treatment. More on negative and positive symptoms in future posts.

Another area of concern in talking about dissociation is something called state or trait theory. Trait would imply that once you got it you always got it. So if you dissociate then you are a goner and who wants to believe that. But if dissociation is a state then you can move into and out of it.

One other cause of Dissociative symptoms are efforts to reprogram or expose someone to “thought reform.” This mental reprogramming, like brainwashing, results in a brain that at some level believes two contradictory things. Can you see how that brain could pop in and out of contact with others?

Last, despite all the press about extreme cases of dissociation and the recurrent belief that this is something that only happens to women, the research tells me it is, in fact, more common among men than women. I have some theories about why that might be but that like the rest of this needs to wait till another post.

Dissociative disorders vary from person to person and time to time. Nothing I can say will fit everyone and there is a lot to be said for listening to the “lived experience” of those who have these disorders. More to come on this topic, but in the meantime what do all of you think about this?

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Support Groups for people with PTSD or Complex Trauma.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Group.
Photo courtesy of Pixabay.com

Anyone know of support groups for people with PTSD?

This question came in from a reader. They were specifically asking about local support groups here in Fresno. I did not come up with much and so I thought I would offer a few suggestions and then ask those of you out there if anyone else knows of any other resources.

Unfortunately, most of my suggestions may not help the person who asked the question, the resources are limited.

1. Try on-line groups.

I am familiar with some groups or communities on the internet. More and more the specialized groups are becoming self-help or peer-run groups on the internet.

One, in particular, is Trauma and Dissociation which is a Google+ community. You have to have a google+ account to access this but opening an account is easy and free.

You can also try the WordPress Blog: http://traumaanddissociation.wordpress.com/

2. Larger insurance providers may have something to offer if you have private insurance. Kaiser for one has offered some groups. Can anyone add to that list?

3. Your insurance provider may be able to refer you to a private therapist and some few of them specialize in PTSD an even smaller number may offer group formats.

4. If you are in substance abuse recovery some A.A. and N. A. groups, while not specifically devoted to people with PTSD can be supportive places for people in substance use recovery who have PTSD or another mental health issues also. Check out the group and make sure you feel comfortable with them before divulging the details of things other than the official topic.

5. VA has some groups and more likely to come in the future as so many veterans are returning from multiple deployments with PTSD and the related MST (Military Sexual Trauma.)

6. Those people who are receiving services through their local Community Mental Health Department should check with them for available groups. In Fresno County, if you have no insurance there are county-run programs for those on Medi-Cal and those with no or very low-income.

It remains to be seen if these groups will be expanded. Personally, I think specialty groups for people with specific issues can be especially powerful. I anticipate that as more people become eligible for services in the government-run systems we will increase the number of groups run by both peers and professionals.

Any other suggestions?

Complex Trauma, Stress and PTSD

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Words about PTSD

PTSD.
Photo courtesy of Pixabay.com

What is Complex Trauma and how is it connected to other emotional problems?

Most therapists recognize the existence of a “thing” that might be called Complex Trauma. We are pretty sure it exists. We see clients with it all the time.  Only it looks different in different people. Sometimes it looks like a stress disorder, sometimes it looks more like Post Traumatic Stress Disorder (PTSD) other times it looks a lot like depression or anxiety.

We, professionals, are just not sure what to call this thing and worse yet we are not all sure how to treat it.

This confusion is aggravated by the problem that there is was no diagnosis for this thing, this complex trauma monster, in the DSM-4. Worse yet, even with the increased attention to stress caused disorders in the new DSM-5 Complex trauma did not make the new book either.

The result is that we have a disorder that we all see in our clients but it looks different in different light and we give it different names depending on who has this issue.

This problem, this idea that multiple, complex trauma is different from single trauma and that the results of multiple traumas are not a case of two plus two equaling four is not new. With complex trauma two plus two maybe six or even seven.

We know this from reading books and articles on zoology. Humans are not the only creatures who suffer more from repeated traumatization. Other creatures can recover from a single large trauma but when subjected to repeated traumas they lose the ability to adjust.

Let me attempt to explain this problem by using a far-fetched analogy.

Complex Trauma is kind of like a hurricane or monsoon.

Most of us know what a hurricane is, sort of. The wind blows really hard. It damages things and knocks things down. A tree may blow over and smash your roof or the wind may break some windows and blow over some things breaking them. But that is not all.

With the wind comes a lot of rain. The rain fills up creeks and small rivers and then they overflow. Your house may get flooded.

That tree may miss your house when it falls and hit a power pole. That pole may start a fire and your house could burn down. If you live near the coast the tide from the ocean may become a tide surge and sweep your home away.

All of these things are the consequences of the hurricane, but the effect on you and the way your insurance company sees things may be very different depending on whether your house is damaged by a falling tree, flooded, swept away by the tide or burns due to a falling power line.

Complex trauma is a lot like that. Different people are affected differently. Some get depressed, some get anxious, some people dissociate and others think of harming themselves or others. All of these possibilities and more are the result of the stress or trauma but each person experiences them slightly differently and they all may get different diagnoses.

A different diagnosis may result in different treatment which means some people are way more responsive to a particular treatment.

We used to think that there were a discrete number of mental illnesses, two, neurosis or psychoses. Then a hundred or so and in the DSM-4 about 400. Now we are thinking that if we keep splitting up these problems of living we are going to end up with one diagnosis per person. So we are trying to think more in terms of a continuum. Some people are only a tiny bit depressed occasionally and others are major depressed all the time.

This variation in features is also impacting the way professionals see and respond to stress-related problems.

Over the next few weeks as time and space permits, I want to talk more about complex trauma, how it develops and why it is sort of like PTSD, anxiety and other named disorders and why it is enough different from those other disorders that clinicians are developing specialized treatments for this issue.

People can and do recover from complex trauma so stay tuned and we will talk about the steps to recovery from this misunderstood disorder.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is secondary trauma?

Injury

Trauma.
Photo courtesy of Pixabay.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Can you be traumatized by something that did not happen to you?

Secondary trauma.

Secondary trauma is the traumatic result of watching someone else be injured or their life threatened.  It is just as real as if the incident happened to you and can last long after the incident is over.

One place where we saw a lot of secondary trauma, this might also go by the name of vicarious trauma, was the incidents of September 11th. Children who watched the planes fly into the towers over and over on Television became frightened even though the events were thousands of miles away. They believed, because of the repeated showings, that thousands of planes were hitting thousands of buildings and that any moment the planes might hit buildings in their neighborhood.

This points out that events do not need to happen to you to be traumatic.  Watching a close family member be injured or killed can be as traumatic as if it happened to you. One reason there seems to be more Post-traumatic Stress Disorders among military veterans is the number of horrific incidents they witness during a tour of duty.

Watching others you are close to being killed or injured has a traumatic effect on you even if you are far enough away to escape injury.

Humans are endowed with very vivid imaginations. Which raises the question can people be traumatized by fictional things, things that never happened?

As we grow older our ability to distinguish reality from fiction should improve. Young children are not always able to tell the difference. Plenty of children develop fears, night terrors or long-term phobias because adults watch horror or other graphic entertainment. They allow the kids to watch along with them since the adults are not overly frightened they expect the child to be able to understand the difference.

Unfortunately many young children these days are not able to tell the real from the imaginary especially in video format where great effort has been expended to make the horror as realistic as possible.

So whether the trauma was real or imagined, whether it happened to you or someone you know and care about, those traumas can and do traumatize people. We call this trauma, secondary traumatization because the victim of the physical attack may not be the person who suffers the most or the longest.

If you have been traumatized by watching someone else be harmed, there is help available. If your child develops fears or phobias after watching a video, talk with them about reality and fiction. If the problems continue, get professional help.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.