The emotional consequences of the kinds of trauma listed below may not look like PTSD. They may manifest as depression, anxiety disorders, or a host of other psychological presentations. But from a treatment perspective, it is valuable to explore these life experiences as traumatic experiences. By looking at this through this lens, treatment can be much more effective.
Post traumatic stress disorder (PTSD) involves the development of certain symptoms following one or more traumatic events. Symptoms can include (but are not limited to) flashbacks, intrusive memories, recurrent distressing dreams, strong emotional reactions to traumatic triggers, avoidance related to trauma, changes in mood, thinking patterns, and behavior, and even having experiences like feeling detached from one’s body or feeling like one’s surroundings aren’t quite real.
While the development of PTSD can occur with having a direct experience of the event, it can also develop by other means. These include witnessing the event as it happens to others, finding out that a traumatic experience occurred to a close family member or close friend, or by experiencing extreme or repeated exposure to aversive details of a traumatic event.
If the symptoms occur between three days to one month of the event it is considered Acute Stress Disorder. After one month it is considered to be Post Traumatic Stress Disorder.
A Broader Understanding of PTSD
One problem with the criteria for PTSD is that the definition of trauma is restricted to obvious events, e.g., those that most people would recognize as traumatic, and the definition doesn’t take into account things that might have occurred while the person was too young to form a declarative or “picture” memory of the event or events. When it comes to a broader definition of trauma, here are some things to consider:
- Trauma is extreme stress that overwhelms a person’s ability to cope
- Trauma is a subjective experience of a threat to life, bodily integrity, or sanity (a situation where survival is the overriding concern)
- Trauma is an ongoing circumstance or adverse circumstances in the past that negatively affects a person in the present
- Trauma can include more subtle, chronic experiences, e.g., a hypercritical or emotionally absent parent or significant other.
- Developmental trauma, or traumatic experiences that occur during brain development, can include experiences such as abuse or neglect.
- If the trauma is intrauterine (in the last trimester babies react to the mother’s stressors) or preverbal (before language acquisition) the “memories” might not be declarative or explicit, but can take the form of emotional or body memories.
- There is also growing evidence that trauma may be intergenerational; that the trauma of parents and/or grandparents could cause changes in genetic expression (epigenetics) that may have consequences for subsequent generations.
View Specialized Therapies to understand how Nancy Goldman approaches therapy for PTSD.