“I get flashbacks and freeze in certain situations.”
“Because of what happened to me, I avoid things, push people away or self-medicate with alcohol.”
“I get physical symptoms that I think may be a psychological response to a traumatic event.”
“Since my accident, I have had a flare-up of mental health issues I was getting much better at managing.”
Trauma can come in the shape of a one off event or many events over a longer period of time. Not every trauma causes post traumatic stress. Mind and body have wonderful self healing powers. But the recovery process after trauma can easily get interrupted. Often through lack of sleep in the immediate aftermath, or because of other stressors that were present around the event(s).
Post traumatic stress, when it results, comes in many different forms. You may be more jumpy than “before”, or don’t sleep as well. Minor setbacks get to you more than they used to. You may be tearful or tetchy. You may be more prone to feeling dread or despair. Sometimes, you feel ok relatively soon after the trauma – but symptoms start appearing after significant amounts of time.
Some clients say, “I shouldn’t be getting post traumatic stress symptoms still, or after such a relatively minor event. I must be weak.” Not true. Your sense of strength and responsibility might lead you to take on too much, too soon after the trauma, and that could contribute to trauma memories getting “stuck”. But there is simply no certainty about who will get PTSD and who won’t.
Is there no way then of preventing getting post traumatic stress symptoms after a traumatic event? It’s not fully inside your control. But if you can influence the following, it might help: getting enough sleep is a big one. If sleep is elusive, can you exercise more, ideally in fresh air – walking will do – to give yourself a better chance to sleep? Could a magnesium supplement help? A bit of journalling at the end of the day, focusing on what went well, to get in the right frame of mind for rest? Talking of journalling, do write things down about the event. What your thoughts are, your feelings. Your valued actions. It helps with perspective taking and with focusing on your way forward. It’s also a good idea to talk about the traumatic event to friends and family. Or indeed a CBT therapist : )
The National Institute for Health and Care Excellence (NICE) in the UK, a public body sponsored by the UK government, has the following guidelines: offer individual trauma-focused CBT intervention to adults who have acute stress disorder or clinically important symptoms of PTSD and have been exposed to 1 or more traumatic events within the last month; individual trauma-focused CBT intervention to adults with a diagnosis of PTSD or clinically important symptoms of PTSD who have presented more than 1 month after a traumatic event; consider EMDR for adults with a diagnosis of PTSD or clinically important symptoms of PTSD who have presented between 1 and 3 months after a non-combat-related trauma if the person has a preference for EMDR; offer EMDR to adults with a diagnosis of PTSD or clinically important symptoms of PTSD who have presented more than 3 months after a non-combat-related trauma.
The trauma therapy called EMDR (Eye Movement Desensitisation and Reprocessing) would not be used for at least four weeks after a trauma – and can be used many decades after it first happened. It often produces quicker results than trauma focused CBT, though the latter is good, too. There are fewer therapists accredited in EMDR than are accredited in CBT in the UK, even fewer are accredited in both.
In my work, I offer both trauma focused CBT and EMDR. Inevitably, some trauma focused CBT feeds into my EMDR work, but since qualifying in EMDR, I do have a preference for it as it does seem to achieve positive outcomes faster and with less of an effort for the client. Read more about EMDR, or email or text me if you have any questions.
Take your first step: sdittmar.therapy@gmail.com