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, were 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 Disorder 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. This 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

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Drinking a little alcohol can make PTSD worse

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

Nightmare

Nightmares maintain depression and PTSD.
Photo courtesy of Pixabay

The Alcohol and PTSD connection.

Alcohol has some strong effects on people with PTSD and those effects turn out to not be what we expected.

Recently I came across a couple of studies about the interaction of alcohol and PTSD. There may be more studies about this and I will keep looking. But here are some things we think we know.

The way in which memories are stored will depend on the level of alcohol in the bloodstream when the traumatic event occurs. Alcohol consumption is related to trauma; more than one study has indicated that people who perpetrate violence are more likely to be intoxicated.

I know that this does not mean that drinking makes you violent. Millions of people have a drink every day and do not go out and perpetrate violence. But among those who do get violent, a great many are under the influence of drugs or alcohol. It is easy to see that when someone is drunk they have reduced control of their behavior and having lowered inhibitions they are more likely to engage in violent behavior.

What we also find is that victims of violence are frequently under the influence of drugs and alcohol. Being intoxicated reduces your self-protective behavior and you are more likely to put yourself in a dangerous situation, more likely to look like an easy target to someone with a violent intent and intoxicated people are more likely to “not take it anymore” and engage in argumentative and assertive behavior.

So why would drinking by someone who had been the victim of a violent trauma make the PTSD symptoms worse?

A small amount of alcohol in someone’s system may increase PTSD symptoms rather than anesthetize them for several reasons. Maintaining control of thoughts and emotions especially the intrusive memories from PTSD requires sustained effort. Alcohol reduces the ability to ward off those emotions.

Bisby, in his study, found that intrusive memories in PTSD were most likely to be suppressed at the extremes of blood alcohol content. So with no alcohol in the bloodstream, the memories could be shut off by the person’s effort. As the level rose they were less able to control those intrusive, memories until the blood alcohol levels reached the legally drunk point. While this study stopped with a blood-alcohol level of .08, the definition of legally drunk, it is likely that the memories would have continued to decline as the person became progressively more intoxicated (Bisby et al. 2009.)

Now, this study did find that memory for facts, the verbal memory portion, was impaired and the more alcohol in the bloodstream the less accurately the person remembered precisely what had happened.

What they did remember more of when under the influence was the emotional feelings associated with the traumatic experience.

Additionally, I suspect that some of this increased recall of trauma with a low-level of alcohol in the bloodstream is the result of state-dependent learning. The presence of alcohol in the bloodstream opened up the memories that had been stored away and sealed off when sober.

Further, this study concluded that people with small amounts of alcohol were more likely to develop PTSD as a result of a traumatic event. As I mentioned in a previous post the presence of alcohol in the bloodstream increases the storing of the emotions of the event while surprising the factual memories.

Having alcohol in the system during stressful events may not calm your nerves and improve your coping skills. It is more likely to reduce the ability to cope and increase the risk of developing a PTSD response to being the victim of trauma.

So for any number of reasons, consuming a small amount of alcohol is not a good idea for someone who has experienced a trauma. A small amount will increase traumatic memories and it will take highly intoxicating levels of alcohol to shut those memories off.

The result is that people with PTSD who drink any alcohol are at high risk to develop a severe case of alcoholism.

This is one more case where the use of chemicals to avoid pain can, in fact, result in increased pain when the chemicals drop below intoxicating levels.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

When T.V. watching causes trauma – coverage of school shootings

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

Why don’t violent people get mental health treatment?
Photo courtesy of Pixabay.com

Can we be traumatized by watching news coverage of mass tragedies?

Here in America, we have once more to consider an incident in which a shooter took a number of lives and died in the process.

I am gravely saddened by the events in Connecticut. My heart goes out to the families of the victims and those in that community whose lives will forever be altered by these events. I am also saddened by the implications this event has for our future.

There was a time when schools, churches, and hospitals were safe places, places of spiritual and psychical healing. That illusion of safety or even the possibility of safety in this modern world has been shattered.

For me, that allusion perished when I heard about the bombings of churches in the south and the shooting of students at Kent State. From this vantage point, those now seem like the first few waves of a hurricane. We now witness one violent incident after another each more horrific than the last.

We know that violence is growing. What we don’t yet know is how to respond. We also know that the window of opportunity to make some sense of this tragedy is small.

What is the effect of watching the extended coverage in the aftermath of these tragedies? We know that the events of September 11, 2001, have been highly studied. We found that watching extended television coverage of the event had the potential to traumatize people who were at some distance from the event. This form of trauma is understood as “secondary or vicarious traumatization.”

Young children who watched the repeated coverage of the planes flying into the towers began to believe that thousands of planes were hitting towers all around us and that soon one would be coming to their town. The more you see an event covered the more “normal” and expected that event becomes.

This is my worry, that so many of these events have been covered in such detail that troubled youths are coming to believe that this is “normal” or “typical” behavior. The question has stopped being if another school shooting will happen but rather when.

Most of us witness a tragedy and over time the event fades from our memory. The closer you are to the event, the more it personally affects you, and the longer you will hold it in your memory. If you lost a child or knew someone who did you will remember the rest of your life. But the rest of us, those of us at a distance will forget quickly. Those who will consider repeating this event, they will not forget.

In the aftermath of a tragedy, the news coverage stops in a day or two. The magnitude of our collective memory is dependent on the “news cycle” and the occurrence of the next great tragedy. The typical person is stressed for thirty to fourth five days and then their stress response returns to normal. Six weeks after 911 most schools in America had returned to close to normal.

Not everyone gets over the event. More media watching was not just harmful to children. Hours of T. V watching after 911 were connected to more stress in adults as well (Schlenger, 2002.)

Who is most likely to be affected by secondary trauma? Those who had a previous mental health issue!!

What effects will we expect to see in children who experience secondary traumatization in the aftermath of a tragedy?  They are likely to become anxious. Those students are likely to be noticed. They will become fearful, anxious, may refuse to attend school, and they may wet the bed. They are likely to receive treatment. But the others?

Some will become depressed. They will isolate. They are likely to go unnoticed. In our society we often “make treatment available”: but we are reluctant to seek out those children who desperately need help but fail to ask for it.

We may also see some children, a small number, who as a result of watching the events unfold, in person or in the media, will experience episodes of dissociation and psychosis. They may just shut down and fail to respond when spoken to. They may think they are seeing and hearing killers at every turn. Early treatment can help these children.

There is one last way in which children can respond to trauma. This response is a high risk to society’s response. These are the youth who are most at risk to become the next wave of schoolyard shooters and the least likely to receive any help.

Some people, children or adults, respond to trauma with what we professionals call “conduct problems.”  They get angry, refuse to comply with requests, swear, or throw things. They protect themselves from our intrusion by trying to drive us away. Most of the time this works for a while.

These are the students who are expelled from school, the ones who believe they are failures at life. By removing them from schools, by getting them on homestudy we create the illusion that we are keeping our schools and our society safe. We continue to sweep our damaged people under the rug rather than offer them the reparative services that might prevent future tragedies. Our jails and prisons are full of those who were rejected by society and who turned to violence. Some of them could have been saved, the course of their lives, and ours altered if we had been willing to provide the kind of help they needed in the early part of their life.

We will argue over the next few months over the role of guns in this and other tragedies. The politicians and others will offer solutions to make our schools safer. More metal detectors, more police dogs, and more training for teachers and first responders on what to do after the tragedy.

Within six weeks most of these initiatives will have been forgotten.

Beyond the great tragedy that just occurred a greater tragedy looms. We will fail to address the root causes of violence among young people. We will pursue the illusion that we can be safe by excluding the violent when in fact they are the wounded among us.

We will spend for more security measures, but I have my doubts we have the will to spend on prevention and treatment of those who will be our next generation of perpetrators.

For more on what we know about the causes of violence by youth and the ways to prevent that violence, you might want to look at the materials at the Melissa Institute for Violence Prevention and Treatment.  

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel