What is the nature of PTSD and trauma?
I have conducted hundreds of PTSD evaluations and trauma evaluations of people from in the Tucson area, and nationwide, for over the last 20 years.
Post traumatic stress disorder, often called PTSD, is a disorder that causes a person to suffer after they have experienced, witnessed, or heard about one or more stressful events. These events cause lingering psychological problems. But because PTSD is expressed through your individual personality, each person has their own unique version of PTSD. That is why skilled clinicians will not just diagnose you with trauma or PTSD. Rather, they will help you confidently grasp how your PTSD is being experienced, expressed and coped via your unique personal features.
An essential part of PTSD is trauma. Trauma is definable as a collection of cognitive thoughts, physiological feelings, external behaviors and distressing memories that together cause impairment in daily functioning. One of the best books ever written on PTSD, and chronic PTSD, otherwise known as “complex PTSD”, is called The Body Keeps the Score, by Dr. Bessel Van der Kolk. This book has approximately 78,000 reviews producing a 4.8 out of 5.0 score. This is a great book partly because Van der Kolk does a great job of explaining how trauma so severely affects even your basic physiological functioning. Trauma is as much a body problem as it is a mind problem.
Trauma falls along a spectrum from mild to severely impairing, and PTSD came into greater public awareness when Vietnam Veterans continued to present with similar sets of impairing symptoms. Trauma results in a distracted mind with impairing mental dynamics, as visualized below.
What to know to get the best help
As a PhD psychological expert, I can confidently tell you that PTSD is one of the most overlooked and misunderstood problems in all of behavioral health.
A key reason for this is people who have experienced trauma often don’t want to talk about the traumatizing experience. They often would rather lock it away in their psychological closet. Reasons for this include people often feel ashamed or embarrassed about the traumatizing event. It might be helpful for you to read a blog I wrote about why you should not keep quiet about trauma you have experienced. Individuals often tell me they feel scared that if they start talking about their trauma they will get worse and become more destabilized. The truth is when a person starts talking about their trauma they can feel worse momentarily.
But I want you to understand that there is hope for you. But you won’t be helped by just anyone who wants to do talk therapy with you. You need to work with someone who uses scientifically researched methods. Here is a list of the currently scientifically supported treatments for PTSD and trauma. Because talking about trauma can be destabilizing you need to work with someone who knows how to use the right process so you feel safe, secure and confident as you work through your trauma.
Who can competently evaluate your trauma or PTSD?
You need to make sure that you carefully interview anybody have a health professional you’re considering. Here’s a list of questions you can use to interview a behavioral health professional. And because so many people think all behavioral health professionals have the same level of training and competence, I wrote this website page so you can clearly understand the difference in training between a psychologist and other professionals.
Amidst my 23 years of research, evaluation and treatment of PTSD and trauma, it is clear to me that while most behavioral health professionals are confident they can treat your trauma, only a small minority may utilize the best science when they work with you. And yet, the most complex organism on planet Earth is the human brain, and PTSD can create severe distress. This is why, In my opinion, trauma treatment tends to best be handled by those with the highest level of training in the field of behavioral health.
What problems indicate your need a trauma evaluation?
You feel numb or distant from the people around you
You have repeated, intrusive memories that disrupt your ability to get things done
You feel triggered by things others can handle easily
Your shame about something that happened to you has lowered your self esteem
You use substances to try and block out memories of a bad event
You cannot consistently focus
What does a trauma assessment clarify?
Which events have impacted you the most
What steps you need to take to neutralize previously destabilizing memories
What combinations of evidence-based treatments will help you the most
What type of clinical practitioner will be most cost effective for you
What educational or workplace accommodations are necessary
Which personality strengths can you leverage to minimize the effects of the trauma
What are some hidden realities of PTSD?
As I talk about in my blog entitled “Top 5 psychological misdiagnoses”, PTSD is often missed even by well-trained behavioral health professionals. Why? Because those with trauma hide their trauma, meanwhile they present as if they have ADHD like symptoms. I called trauma the “great disruptor”. It causes you to have problems with focusing, concentration, interacting with others, impulsivity and poor judgment. Those are all common problems for people with ADHD. ADHD is what the front of your psychological house looks like when you have PTSD. meanwhile people tend to keep their trauma experiences locked away in a dark basement. After having evaluated over a thousand people I can honestly say that in a large amount of those cases people were misdiagnosed with ADHD words the root of their focusing issues was actually trauma they had suffered from.
How do I go beyond generic PTSD diagnosis?
Even if you are diagnosed PTSD, this is often not very helpful. The reason is PTSD present in each person in a highly individualized manner. Because PTSD is a combination of anger, anxiety, depression, impulsivity and dissociation, each person can have their own blend of these kinds of issues. Thus, you need a practitioner is not simply diagnose you with PTSD, but they help you understand what specific blend of symptoms are impairing you. Some people with PTSD have massive problems with anger, where as others with PTSD have much more of a problem with dissociation.
To help you save money on treatment, you need the evaluation to provide a specific rudder for the future therapist. I have given numerous talks about trauma, including to attorneys regarding mistakes attorneys often make when their client has trauma. Even for highly skilled attorneys, it can be difficult for them to know how to tell the story of their client. Read my blog entitled “Great psychological assessment goes far beyond diagnosis”.