Counseling for Trauma

Counseling for Trauma

PTSD is caused when someone experiences an event that threatens their life or safety. PTSD can also develop after learning that a loved one’s life or safety was seriously threatened. After experiencing a traumatic event, most people experience trauma symptoms because PTSD is basically just our natural fight or flight response to danger. Symptoms include:

  • Flashbacks, nightmares, can’t stop thinking about the traumatic event (Intrusive)

  • Difficulties sleeping, easily startled, on-edge, irritability/anger, difficulties concentrating (Arousal)

  • Guilt, anger, blame (Negative Cognitions and Mood)

  • Avoiding thoughts, feelings, and situations that are reminders of the trauma; drug/alcohol use; staying as busy as possible (Avoidance)

After the threat has gone away, some people naturally recover from the fight or flight response while others do not. When these symptoms occur for more than 30 days, a mental health professional would diagnose PTSD. This 30 day time period is important because it recognizes that the above symptoms are a normal response to traumatic events.

Recovery vs. Non-Recovery from PTSD

In order to best understand why some people recover from traumatic events and others do not, we will have to talk about the brain (hang in there with me!).

Dan Siegel, MD is a psychiatrist at UCLA. He developed a way to describe the brain’s reaction to trauma called The Hand Model of the Brain (see picture below).

When you look at the Hand Model of the Brain, you will see that the wrist (spine) is attached to the brain stem (palm), which controls all our basic functions like breathing and heart rate. The thumb represents the limbic system, which controls our emotions and is involved in making memories. The fingers, when curled over the thumb, form the cortex, and the front of the fingers (where the nails are) make the prefrontal cortex. The cortex and prefrontal cortex are very special and help to differentiate humans from the rest of the animal kingdom. The prefrontal cortex in particular is where all of our high level human thinking occurs – this is where we make plans, organize details, and follow through with those plans.

When we experience a traumatic event, we “flip our lid” and our cortex goes “offline.” This is very protective in the moment and a totally normal response because it allows our brain stem and limbic system to react with incredible speed. This leaves the thinking part of our brain out of the equation because it’s just too slow in times of stress. Once the threat is gone, ideally the cortex comes back online and the whole system can communicate to understand what happened, how we reacted and why we reacted in that way. The cortex coming back online also helps to determine whether or not we are safe now. When the process of integration is interrupted, we are more likely to develop PTSD.

Avoidance and PTSD

When the integration process is interrupted, the normal reactions to trauma (see above) may not go away, leading to PTSD. A common symptom of PTSD is avoidance because, understandably, we don’t want to feel terrible and be constantly reminded of the trauma. Unfortunately, our efforts to avoid can actually make PTSD symptoms worse because that avoidance is confirmation to our brain that we are constantly in danger.

Because avoidance leads to worse symptoms of PTSD, evidence based treatmentshave been designed to help survivors approach their traumatic memories, thoughts, and feelings in a safe and supportive environment with a trained professional.


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