Trauma and Post Traumatic Stress Disorder (PTSD)

Dr. Scott Giacomucci, DSW, LCSW, CTTS, CET III, PAT

Trauma exists upon a continuum or a spectrum. There are experiences that we often describe as capital “T” Traumas, and other experiences that we refer to as lower-case “t” traumas. Both can be equally disruptive in one’s life, especially when experienced over and over again. One of every four adults, and one of every two children, that experience a traumatic event will develop PTSD symptoms.

It seems appropriate that PTSD and trauma are often responded to with denial or dissociation – attempts to defend or protect one’s self from the vulnerability and reality of surviving a traumatic event. However, in order to fully recover from trauma and PTSD, one must come to a place of acceptance of their past. Post-Traumatic Stress Disorder (PTSD) is one of the most poorly understood mental health disorders. Interestingly, it is also one of the few diagnoses which asks, “what happened to you?” rather than “what is wrong with you?”.

What Is Trauma?

According to Dr. Peter Levine, an expert on traumatic stress:

“Trauma is a basic rupture – loss of connection to ourselves, our families, and the world.  The loss, although enormous, is difficult to appreciate because it happens gradually. We adjust to these slight changes, sometimes without taking notice of them at all…although the source of tremendous distress and dysfunction, it (trauma) is not an ailment or a disease, but the by-product of an instinctively instigated, altered state of consciousness. We enter this altered state let us call it “survival mode” when we perceive that our lives are being threatened. If we are overwhelmed by the threat and are unable to successfully defend ourselves, we can become stuck in survival mode. This highly aroused state is designed solely to enable short-term defensive actions; but left untreated over time, it begins to form the symptoms of trauma. These symptoms can invade every aspect of our lives.”

One of the most effective ways to evaluate if you have been traumatized is to answer these simple questions about a significant incident: when you remember the incident, is the memory exactly the same every time? Or, is the memory fragmented or difficult to recall?

If an answer is yes, then the memory is likely a traumatic one.  By no means does one traumatic memory constitute a diagnosis of PTSD; however, it does indicate that the traumatic event has been stored in an unprocessed manner and continues to cause you distress or require the defense of dissociation to avoid fully accepting what happened.

What is a PTSD Diagnosis?

The Diagnostic and Statistical Manual of Mental Disorders or DSM5, offers 4 criteria for a PTSD diagnosis.

The first criterion relates to the actual trauma:

Directly experiencing the traumatic event(s)

Witnessing, in person, the event(s) as it occurred to others

Learning that the traumatic event(s) occurred to a close family member or friend

Experiencing repeated or extreme exposure to aversive details of the traumatic event(s); this does not apply to exposure through media such as television, movies, or pictures

The second criterion involves the persistent re-experiencing of the event in 1 of several ways:

Thoughts or perception

Images

Dreams

Illusions or hallucinations

Dissociative flashback episodes

Psychological distress or reactivity to cues that symbolize some aspect of the event

The third criterion involves avoidance of stimuli that are associated with the trauma and numbing of general responsiveness, as determined by the presence of 1 or both of the following:

Avoidance of thoughts, feelings, or conversations associated with the event

Avoidance of people, places, or activities that may trigger recollections of the event

The fourth criterion is 2 or more of the following symptoms of negative alterations in cognition and mood associated with the traumatic event(s):

Inability to remember an important aspect of the event(s)

Persistent and exaggerated negative beliefs about oneself, others, or the world

Persistent, distorted cognitions about the cause or consequences of the event(s)

Persistent negative emotional state

Markedly diminished interest or participation in significant activities

Feelings of detachment or estrangement from others

Persistent inability to experience positive emotions

The fifth criterion is marked alterations in arousal and reactivity, as evidenced by 2 or more of the following:

Irritable behavior and angry outbursts

Reckless or self-destructive behavior

Hypervigilance

Exaggerated startle response

Concentration problems

Sleep disturbance

The duration of symptoms is more than 1 month

The disturbance causes clinically significant distress or impairment in functioning

The disturbance is not attributable to physiological effects of a substance or medical condition

According to Levine,

“The symptoms of trauma may be continually present or they may come and go. They may even surface after being hidden for decades. Usually, symptoms do not occur individually, but in clusters grow increasingly complex over time. Unfortunately, they become less and less connected with the original traumatic experience, making it increasingly difficult to trace the symptoms to their cause, and easier to deny the importance of the traumatic event in one’s life. However, if we pay attention to these symptoms, for what they are – internal wake up calls – we can address and begin to heal our trauma.”

Experiencing trauma and/or PTSD is not rare or uncommon. While many may suggest seeking treatment is a sign of weakness, we would argue that it is a tremendously courageous act. Though it may not feel possible at times, many trauma survivors report that they experienced growth and positive changes after a traumatic experience and/or the treatment of PTSD – this has been termed Post-Traumatic Growth.

Post-Traumatic Growth is not a new idea, it exists within all legends, myths, and holy books throughout time. The phenomenon of growing after hardship is quite common – nevertheless still remarkable. There are five common domains of post traumatic growth which include a new sense of personal strength, new possibilities, new appreciation of life, stronger emphasis on relationships, and spiritual/religious/existential changes. Even more hopeful, is the fact that around 2/3rds of trauma survivors report experiencing post-traumatic growth, making it more likely statistically than PTSD. After experiencing trauma, you are actually more likely to growth from it than to develop PTSD!

The Innate Capacity to Heal

Trauma interrupts our natural rhythms (biologically, psychologically, socially, and spiritually). Our responses to trauma can create barriers to accessing our natural ability to heal.

The mission of the Phoenix Center revolves around helping individuals and groups access their autonomous healing centers and grow after trauma.

Post Traumatic Growth

Post Traumatic Growth in one of these 5 domains is actually statistically more likely to occur after a traumatic event than Post Traumatic Stress Disorder (PTSD)!

1/4th adults that experience a trauma will develop PTSD (or every other child) while around 2/3rds report post traumatic growth in at least one of these five domains!

Top 100 Healthcare Leader

Phoenix Center’s Director/Founder, Dr. Scott Giacomucci, was recognized as a Top 100 Healthcare Leader this year by the International Forum on Advancements in Healthcare!

Check out our website to see how our approach to treatment and therapy is different than traditional talk therapy- www.PhoenixTraumaCenter.com

Experiential Therapy Supervised Practice

Another workshop in experiential therapy focused on supervised practice for trainees working towards certifications through the International Society of Experiential Professionals (www.ExperientialProfessionals.com)

In the photo below, see ‘the Sociometry of Sociometry’, a floor check warming up participants to facilitate experiential processes!

Staff Training in New Jersey

“Working Experientially with Defenses in Addiction and Trauma Treatment” presentation today at Pinelands Recovery Center of Medford by Dr. Scott Giacomucci.

Today’s workshop, the fourth of a training series, focused on defense mechanisms. We used Sociometry & Psychodrama to explore the psychological functions of defenses and how they are used in active addiction, in relation to trauma, and in treatment or recovery.

In the photo you can see our warm-up of using “soul cards” to represent and concretize the part of self called the Manager of Defenses in TSM psychodrama. This internal role gives us the capacity to recognize our defenses, consciously choose when they are needed, and contain them when they are unnecessary or maladaptive.

For more information about bringing Scott to your agency for training, email him here – Scott@PhoenixTraumaCenter.com

Phoenix Center at National Psychodrama Conference in New Hampshire


Phoenix Center is proud to be exhibiting at the American Society of Group Psychotherapy and Psychodrama-ASGPP conference and selling the newly published Autobiography of a Jacob L. Moreno – the founder of psychodrama!

New Publications by Phoenix Center Team

Check out the most recent publications by Phoenix Center for Experiential Trauma Therapy staff:

“Experiential Addiction Treatment: Creating Positive Connection through Sociometry and Therapeutic Spiral Model Safety Structures”  by Mirmont Staff Scott Giacomucci, Sharon Gera, Darrell Briggs, and Kim Bass. This article is open access to the public in the journal of Addiction and Addictive Disorders: Access the Article Here.

“Being in two places at once: renegotiating traumatic experience through the surplus reality of psychodrama” by Scott Giacomucci & Amy Stone in the Journal of Social Work with Groups: Access the Article Here.

Amy Joins Giacomucci & Walker!

I am proud to announce that Amy Stone, MSS, LSW has accepted a position with Giacomucci & Walker, LLC. There are very few people that I would trust to maintain the quality and integrity of my business. Amy is an incredibly talented psychotherapist who finds deep joy and purpose in her work.

Amy has been helping people recover from addiction for over 20 years. She earned her Masters is Social Services with a clinical concentration from Bryn Mawr College. Additionally, she completed her EMDR basic training and has accrued over 500 hours of training in experiential trauma therapy, psychodrama, and the Therapeutic Spiral Model.

She is accepting new clients and specializes in experiential trauma work, sexual trauma, substance abuse, and relationships.

“Asking for help demonstrates bravery and is an action step toward a new experience in life. I have been helping individuals recover from addiction for over twenty years. Now, I assist clients to grow and heal from abuse, neglect, traumas and move through rough patches in life. I recognize the importance of this work, but believe curiosity and laughter can be part of the therapeutic process as well as tears, grief and anger. I use a variety of methods that can go beyond traditional talk-therapy. I’m trained in the experiential methods of EMDR and psychodrama, and both are effective treatments for trauma and PTSD. Transformation and change are often possible and I am honored to witness this daily.”

See her page for contact information.

Neumann University Alumni-in-Action

This past week Scott was featured in Neumann University’s Alumni-in-Action segment of the University alumni newsletter.

See full details here: Scott’s Alumni-in-Action Page

 

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