Welcome to my blog! I’ll be talking about trauma and many ways to approach treating it. I’ll spend the first few entries answering questions that I’ve received from people inquiring about how to handle various trauma-related situations.

The main reason for creating this blog is to spread the word to professionals and first responders who work with people who have experienced trauma that healing is possible.

A traumatic incident or series of traumas does not necessarily doom a person to a life of pain and suffering. Many people, including me, who have a history of trauma have been able to heal from the aftermath of that trauma. While we will never be the same as if we had not had these experiences, our lives can be rich and rewarding.

The Chinese character for the term “crisis” combines the notions of danger and opportunity.

When people have experienced trauma, they have been in a crisis and can be helped to find the opportunities for growth within the traumatic situations.

I hope that you will find this blog helpful and will leave comments as well as questions and concerns you would like to see addressed.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

While psychoanalysis is not often thought of as the treatment of choice for PTSD, it may be helpful.

It would rarely be used by itself for the treatment of trauma. It might be used, however, in conjunction with other modalities, such as cognitive behavioral therapy or EMDR (Eye Movement Desensitization and Reprocessing).

Psychoanalysis, or some form of psychodynamic treatment, would be most helpful for those who have had extensive trauma, particularly trauma that occurred in childhood.

When children are traumatized, they often become frozen in time developmentally. While they mature physically, there may be some emotional and social areas in which they have difficulty.

Psychodynamic treatment can aid in healing those early wounds and help the individual make up for what was lost.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

A reader asked how to start over after a large trauma? She had two major surgeries this year and lost just about everyone whom she thought were her friends. She wanted to know how to get back into the world after being isolated, having physical therapy, seeing doctors, etc.

My answer to her follows:

It certainly sounds as though you've had a very difficult year. I hope you have fully recovered physically from your surgeries. I'm sorry you have lost people you thought were friends. Did they leave during/after your surgeries?

Sometimes people have a tough time seeing those they care about be in pain; it makes them feel helpless. That's not to absolve them of the responsibility to find ways to deal with their own feelings so they could be there for you; it's a way to perhaps understand what might be some of the reasons for their behaviors.

I think it would be important to allow yourself time to grieve over the loss of your friends as well as whatever losses are connected to the surgeries you've had.

Certainly you lost your usual way of functioning and feeling over this past year. Don't be surprised if you suddenly feel overwhelmed with sadness that seems to come out of the blue. It may be your mind's way of reminding you to honor your losses.

If you are starting again to look for friends, I'd recommend doing things that bring you joy, or at least satisfaction.

Take a course at an adult school, join an exercise group, take up a hobby.

Something many people find extremely helpful is to do some volunteer work. It's a way to take you out of yourself and helps you feel good about yourself as you give to others.

I don't know what your surgeries were for, but there are likely to be some support groups around whatever that illness or difficulty might have been.

Some people find a short course of therapy to be helpful in dealing with multiple losses. Most communities have a resource directory that might aid you in finding someone familiar with the areas with which you are dealing.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

Why do people involved in a natural disaster act out in aggressive ways?

There can be many reasons why people may act out aggressively following a natural disaster.

Sometimes they may be people who are angry a lot of the time and just see another opportunity to be aggressive.

Others may feel that so much of their normal lives have been disrupted they don't believe they need to follow the rules of society during this time.

Some may believe the only way they will get their needs met is to take what they need from others.

And still other people, who feel they have been hurt by others throughout their lives, can see the disaster as an opportunity to get back at society.

After the crisis is over, those for whom the aggressive behavior is out of character may have difficulty reconciling what they did with their image of themselves. They may feel guilty and ashamed, particularly if anyone else knows what they did.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

People who volunteer their time and talents to work with those who have experienced pain and loss may develop a traumatic response to what they have seen and heard.

Called “vicarious traumatization” or “compassion fatigue,” the constellation of symptoms can include intrusive images and thoughts, hypervigilance, fear, numbing, difficulty sleeping, irritability, and depression.

Some of the very qualities that motivate people to become volunteers may be the qualities that make it difficult for them to pace themselves or even allow themselves to recognize that they are becoming traumatized.

A desire to help others can lead people to ignore physical fatigue or emotional exhaustion. Observing and hearing about the atrocities that exist in the world can lead to a spiritual crisis, a questioning of the world view that one had prior to becoming aware first-hand of the tragedies that some people experience.

Some people may try to deal with these symptoms in unhealthy ways, such as excessive drinking, using illicit drugs, and over- or under-eating. They may also experience difficulty relating to friends and family members and begin isolating themselves.

My next blog entry will address some ways to prevent vicarious traumatization.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

The primary treatment for those volunteers who are experiencing vicarious traumatization is to temporarily have them refrain from the volunteer activities that precipitated the condition. It may be very difficult to help volunteers acknowledge that they are experiencing vicarious traumatization, but it’s essential that their supervisor and/or colleagues help them recognize what’s going on.

If they continue to volunteer, their effectiveness will likely be compromised as will their future ability to help. Burnout is the inevitable outcome of unrelieved vicarious traumatization. Once volunteers have reached that point, they will be unable to be helpful and they greatly increase the risk to themselves of physical and/or emotional disorders.

If vicarious traumatization is caught early, a brief break involving rest and recreation may be all that’s needed. If it has been allowed to progress, a longer period of recovery will likely be needed. During that time it will be important for the volunteers to address any of the unhealthy coping mechanisms they may have been utilizing. Treatment for substance abuse may be necessary.

A complete physical examination might well be called for to catch any physiological consequences of vicarious traumatization. Medication for anxiety and/or depression might be called for. Learning to spend time each day in activities geared toward physical, emotional, mental, and spiritual renewal can be helpful.

Eating and sleeping should be regulated before returning to volunteer activities. It might be possible to begin slowly, perhaps in areas not directly involved with people who are currently experiencing pain and distress. This can give the volunteers a sense of being helpful without compromising their well-being.

Being a volunteer can be an immensely rewarding endeavor. It’s essential that it not become a dangerous one as well.

Hope Makes Healing Possible!

Patricia Sherman, Ph.D., LCSW

I just finished reading the book, In An Instant, by Bob and Lee Woodruff.

Bob was an embedded reporter who suffered a severe head wound while in Iraq. The book alternates between Bob and Lee’s experiences throughout the recovery process.

While Bob’s wounds were physical, Lee’s were emotional. Watching her husband lie in a coma for over a month while arranging for the care of their four children was an incredibly stressful experience for her. Even as he began the miraculous healing process, Lee was torn between needing to be with him and needing to be with her children.

It’s important to remember that your clients’ reactions to a trauma can be short, or it can be long-lived. Regardless of their reaction time, it’s important to remember most of them will react.

Keep in mind how your clients respond to trauma depends on a few things:

• How severe was the trauma?

• How long did the trauma last?

• How strong (physically and/or emotionally) were they before the traumatic event?

Your clients’ answers to these questions will help you determine how they will respond to a traumatic event.

Remember, your clients can have both physical and emotional reactions to trauma. Some of the more common emotional reactions clients tend to exhibit include: