Michael J. Salamon, Ph.D.

            The American Psychological Association defines trauma as “an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea.”

This definition of trauma is broad and covers situations that range from what some may consider minor, such as a very slight fender bender car accident to being the recipient of predatory abuse, all the way to a natural calamity such as a flood or tornado, war, or an event such as being in the World Trade Center buildings on 9/11. What is most interesting about this definition is that the only unifying term is the fact that the event is considered “terrible,” as interpreted by the individual. This is an important point, because we all react differently to the traumas we experience. Some of us do not react to a single trauma but rather to a series of events that may seem negligible to an outsider. Some of us are built with a more resilient personality than others. Some of us have a difficult time handling even seemingly minor distress. It is said that children are more resilient than adults, and they are. But here, too, different personalities react in their own unique fashion. Unfortunately, many people misinterpret the distinctiveness of each individual and may be critical of what they perceive to be too strong a reaction to a small trauma.

            Also of note in the APA definition of trauma is the fact that immediate reaction to a trauma is often denial. This denial is a temporary defense mechanism that the body uses to protect itself from immediately experiencing a trauma perceived as overwhelmingly painful. The denial mechanism can last for years, even decades, and only after another event that may also seem minor will the pain of the trauma arise. Only then will the person begin to react to the initial trauma. This is the type of reaction often experienced by individuals who were abused in childhood.

            Because the reaction to the trauma takes place after the traumatic event, the syndrome is called Post Traumatic Stress Disorder or PTSD. A constellation of reactions help define PTSD. Symptoms include recurring and distressing recollections and dreams of the event, which can cause the person to feel as if they are reliving the trauma; strong painful reactions to cues that symbolize the event; and avoidance of any stimuli, including even thoughts, feelings or activities, that may have been associated with the traumatic event.

            People suffering from PTSD often have difficulty recalling important aspects of the traumatic event and may feel detached from others, or dissociate when certain cues of the event are presented to them. They may also experience sleep disorders, can often be angry and irritable, report difficulty concentrating, and have an exaggerated startle response. In some cases, the PTSD sufferer may engage in a variety of self-abusive behaviors, including cutting or developing eating disorders as a ritualized recreation of the original pain. These self-destructive actions paradoxically provide the person with a false sense of relief or, as the sufferer may say, “release” from the pain.

            Treatment of PTSD includes two important components. The first takes into account the physical and structural changes that occur in the brain of the person who has PTSD. Studies have begun to show that individuals with this disorder have changes in their brain structures, most notably the amygdala and the hippocampus. The amygdala is the portion of the brain involved in understanding and processing fear. In people with PTSD, it appears that this structure is always “on,” in what seems like a constant state of hyper-vigilance.

            The hippocampus is involved with memory, and in people with PTSD it seems that this structure is smaller, as if it has lost the volume that allows it to retain memories.  Both hyper-vigilance and memory deficits are common in PTSD. Treatment of the symptoms and brain changes associated with PTSD usually consists of a combination of psychotherapy and medication. These treatments require a well-trained specialist, as each PTSD sufferer has a unique presentation of their symptoms and reaction to their trauma. With the correct treatment, symptoms may be alleviated.

            The other component to treating an individual with PTSD is treating the “mind” of the trauma survivor. Too often, trauma survivors are told to “just get over it” or “it wasn’t so bad” or, worse, “I don’t believe you.” The reactions a person has as a result of a trauma they have experienced cannot be ignored; asking someone to do so, or not validating their feelings, even years after the event, will only make it harder for the survivor to overcome those reactions.

            An understanding and supportive social and family environment is the best treatment to help cure the mind of the trauma survivor. When PTSD sufferers feel they have a validating and comforting environment, they can make good strides toward getting better.

Michael J Salamon, Ph.D. is a psychologist and researcher. His most recent book is Abuse in the Jewish Community: Religious and Communal Factors that Undermine the Apprehension of Offenders and the Treatment of Victims. He is also the author of The Shidduch Crisis: Causes and Cures.  Dr Salamon can be followed @drmjsalamon.