by Robin L Goldstein, EdD Licensed Psychologist

Many people associate this syndrome with the effects of going to war and, in fact, this was where Posttraumatic Stress Disorder (PTSD) was first recognized and defined. In World War I the condition was referred to as Shell Shock. PTSD came in to the public awareness on a larger scale during the Viet Nam war when some returning vets attracted public headlines with their difficulties. Actually, any intensely stressful and frightening experience can trigger PTSD.

What is PTSD? What are the symptoms?

The Diagnostic and Statistical Manual of the American Psychiatric Association gives the following (edited) definition:
The person has been exposed to a traumatic event in which both of the following were present:
• The person experienced, witnessed or was confronted with an events or events that involved actual or threatened death or serious injury or a threat to the physical integrity of self or others.

• The person’s response involved intense fear, helplessness or horror.

The traumatic event is persistently re-experienced in one or more of the following ways:
• Recurrent, intrusive and distressing recollections of the event
• Recurrent distressing dreams of the event
• Acting or feeling as if the traumatic event were recurring
• Intense physiological distress at exposure to cues reminiscent of the event
• Physiological reactions at exposure to cues reminiscent of the event

Persistent Avoidance of Stimuli Associated with the Trauma and Numbing of General Responsiveness Including:

  • • Efforts to avoid thoughts or feelings associated with the trauma
  • • Efforts to avoid activities, places or people that arouse recollections of the trauma
  • • Diminished interest or participation in significant activities
  • • Feelings of detachment or estrangement from others
  • • Restricted range of emotion
  • • Sense of a foreshortened future

Increased Arousal

  • • Difficulty falling or staying asleep
  • • Irritability
  • • Difficulty concentrating
  • • Hyper-vigilance
  • • Exaggerated startle response

If these symptoms occur within a month of the trauma it is referred to as Acute Stress Disorder.
While war brought PTSD to the public’s attention many other traumas can bring this syndrome in to our lives. More common types of trauma that the general public is exposed to are car accidents or any serious accident, death, injury or severe illness of a loved one, especially if unexpected, serious illness in ourselves, physical assault and rape. Lately, with the severe downturn in the economy people have developed PTSD from a sudden unexpected loss of financial safety and security from job loss or loss of assets.

A common reaction to a diagnosis of PTSD is to minimize the impact of the trauma, “it was just a car accident… everyone has to die some time, he or she had a good life…. other people have it worse.” We have a tendency to underestimate the impact of trauma on ourselves or feel inadequate if we have trouble coping. Another common reaction is, “this shouldn’t bother me so much” or “I should be over this by now.” In reality, we never know how trauma will affect us or how long it will take to recover. So many factors go in to the equation. How or if we recover from trauma depends on how many other bad things have happened to us in the past, how good a support system we have, the severity of the trauma, the coping skills we already possess, the impact of the trauma (does it lead to other adverse consequences beyond our control) and, of course, the help we get to recover.

For example, research shows that grief over the loss of a loved one is less if it doesn’t happen suddenly or unexpectedly (giving us time to adjust and prepare for the loss), if the loved one did not suffer terribly or, if an illness, did not go on for an extended length of time. The loss of a child, rare in our society and therefore much less expected is more likely to cause trauma than the death of an elderly parent who has lived a long and fruitful life. Longevity is so much the norm in modern America that many people react to a severe medical diagnosis of any kind with PTSD because it is a shock to be seriously ill before we reach our eighties.

Trauma is very real and has a very real impact. Many people are surprised by the seriousness of their reaction and, feeling guilty or embarrassed about their perceived “weakness” may neglect to get help, thus prolonging and worsening the symptoms.


Both psychotherapy and medication are used to treat PTSD. A skilled psychologist can determine the severity of the symptoms and develop an individualized treatment approach. Since substance abuse is a common secondary effect of PTSD often substance abuse treatment is also necessary. A new treatment for PTSD, EMDR or eye movement desensitization reprocessing has been proven to be effective and more psychologists are becoming trained in this technique.

People can and do recover from trauma but education, support and appropriate treatment are necessary.

I urge you to get help so you can get better, please contact me, or call 561.212.5408 to schedule an appointment.