PTSD: You Don’t Get Over It. You Get Through It.
Veteran PTSD

  Ms. Dorothy T.W. Smith received her Masters of Clinical Social Work degree from Tulane University in 1978. She has provided evidence based play therapy with children and psychotherapy with adolescents and adults having various disorders. Ms Smith has dedicated most of her career to helping those with Post Traumatic Stress Disorder(PTSD). 

  What is PTSD? It is Post Traumatic Stress Disorder. It is psychological wounding that can occur after events that are so powerful, so extreme, so severe, so long in duration or proximity, so harmful and/or life threatening that they demand extraordinary coping efforts that alter the individual’s sense of self, others and the world.

Can someone catch it from another person who has PTSD? Not unless the person with PTSD causes enough trauma to the other. Even so, not everyone who experiences the same traumas will necessarily get PTSD. What are the symptoms? Some symptoms occur right at the beginning of the trauma. Others may take months or years to develop. Typical symptoms are what we call re-experiencing symptoms. These are nightmares, flashbacks, intrusive thoughts, anxiety, panic attacks, concentration problems, emotional numbness, impaired memory, irritability, even anger or rage, sleep problems, startled reactions from unexpected or sudden noises, movements, smells, severe mood swings, always on alert for something that may be of danger, avoidance of events/people/places that may trigger the PTSD person’s memory of traumatic events. Avoidance can lead to isolation, shutting down of emotions, and could lead to one not even coming out of the house. Some can become depressed to the point they do not eat or bathe. Any of these symptoms can be mild, moderate or severe.

What types of things could cause PTSD? Any kind of abuse such as physical, sexual, emotional. Such things as witnessing others who are in danger, being threatened by another to harm the person or to harm a loved one. Some harm could be severe abandonment, being deprived of food, water, the basic necessities such as utilities, a comfortable place to sleep, privacy. Some causes can be difficult to assess such as a boss who is making sexual comments, a spouse who is negatively name calling or putting the other spouse down, humiliation. Common events to most would be a terrorist attack, combat exposure, serious accident, and natural disasters like fire, tornado, hurricane, flood, or earthquake. Certainly one could be in great fear from other causes, such as a tornado being close by or a tree falling on their house. One could expect that the longer, the more severe the event(s) are, the more likely the person would get PTSD

What types of people are likely to get PTSD vs. those not as likely? Those who are less resilient are more likely to get PTSD. Resiliency is often defined as the ability to bounce back. People who can get back to their best normal selves are usually more resilient than those who can’t. In what ways does one need to be resilient? Physically, emotionally, spiritually, interpersonally, biologically, financially, cognitively, behaviorally, psychologically.

What other problems could exist with those having PTSD? They may have feelings of hopelessness, shame or despair, depression, anxiety, drinking or drugging, physical symptoms such as chronic pain, relationship problems, family problems or violence, divorce, job problems. Some have what we call “stuck points.” Some stuck points are, “I am responsible for what happened. It is my fault. I am a bad person. No-one is to be trusted. I can never be the same. I’ve lost my family forever. I can no longer work. I need to be punished. I don’t deserve good things. There is danger everywhere. I am not safe anywhere. I must be on guard at all times. I am worthless.”

Is there a cure for PTSD? What treatments can help? There is no known cure but there are those who no longer qualify for the diagnosis after treatment and some of them say they are cured. Some of the most effective treatments are the following: supportive psychotherapy, prolonged exposure, Eye Movement and Desensitization Reprocessing Therapy, Cognitive Behavioral Therapy, Cognitive Processing Therap, and at times medications. Cognitive Behavioral Therapy (CBT) is the most effective therapy in which one learns skills to understand how trauma has changed one’s thoughts and feelings which often leads to behavior changes. In Prolonged Exposure (PE) the patient talks about the traumas and may go or do some behaviors that come close to relating to the traumas until the patient learns from experience they can decrease being upset. Eye Movement Desensitization and Reprocessing Therapy (EMDR) involves focusing on sights, sounds, hand movements or touch while doing various techniques in talking about the trauma.

Why do you work with those having PTSD? Because almost everyone gets better. If one applies oneself to the work involved almost anyone could benefit, not just those with PTSD. Some patients have shared things with me they have never shared with anyone before, not even a long time trusted loved one. This is indeed an honor. They have to have established enough trust and safety to do that. It’s all worth it when a family member says, “Thank you for giving me back my husband I had when we first married” or the patient says, “You saved my life.”