Who Needs Trauma Treatment?
Annette Nay, Ph.D.
Copyright © 2008

If you find yourself in one or more of the following situations get psychological help. I highly suggest getting help from a Etiotropic Trauma Management - Trauma Resolution Therapy (ETM-TRT) Counselor. ETM-TRT attacks the root of the problem and reverses the symptomology of trauma (Posttraumatic Syndrome Disorder-PTSD). Other therapies attack the symptomology leaving the problem untouched. If a person will do the ETM-TRT homework, I can guarantee that he or she will get well. There is no other therapy that can say that. That's why I am a ETM-TRT Counselor! If you would like to see how ETM-TRT works and how the therapy is done, click here: http://etiotropic.com/1patient.html/.

Who needs treatment for trauma? Those who find themselves in one or more situations listed below:

Divorce: Loss of home, monetary backing, and death of a relationship with significant others Potential for: loss of children, isolation, and depression, loss of time with children, due to need for several jobs for basic needs.

Drug & Alcohol Abuse by you or significant others: Potential for: loss of health, physical and/or sexual assault, loss of personal property, and death of significant others, loss of safety and trust, fear for life, torture, dismemberment and disability, isolation, depression, and Posttraumatic Stress Disorder (PTSD) or Acute Stress Disorder (ASD).

• Death of significant other(s) - Loss of significant relationships; Potential for: isolation, depression and, PTSD or ASD.
• Physical or Spousal Assault - Loss of safety and trust, fear for life, possible: torture, dismemberment and disability; Potential for: isolation, depression and, PTSD or ASD.
• Sexual Assault (rape, sodomy, forced oral sex and/or martial rape) - Loss of safety and trust fear for life, possible: torture, dismemberment and disability; Potential for: isolation, depression and, PTSD or ASD.
• Incest - Loss of safety, trust in family member; Potential for: isolation, depression and, PTSD or ASD.
• Auto/Plane/Train Accidents: death of significant other(s), dismemberment, disablement; Potential for: isolation, depression and, PTSD or ASD.
• Fire: Loss of property, home, and death of significant others; Potential for: dismemberment, disablement, isolation, depression and, PTSD or ASD.
• Natural Disasters: Loss of property, home, and death of significant others; Potential for: dismemberment, disablement, isolation, depression, and PTSD or ASD.
• Torture - Loss of safety and trust, fear for life, isolation, and depression; Potential for: dismemberment and disability, and PTSD or ASD.
• War- Loss of safety and trust, fear for life; Potential for: torture, dismemberment and disability, loss of freedom, death of significant others, loss of countrymen,  loss of country, loss of personal property, home, and land, and PTSD or ASD.
• Refuge's Issues: Loss of safety and trust, fear for life, possible: torture, dismemberment and disability, loss of freedom, death of significant others, loss of countrymen,  loss of country, loss of personal property, home, and land, isolation, depression, and PTSD or ASD.
• Long Term Illness, Pain, and/or Disbility: continued loss of capabilities and health, isolation, helplessness, worthlessness, depression, and potential for death or ASD.
• Multiple Personalities - Possible: physical assault, sexual assault, incest, torture, war, refuge's issues, fire, and/or natural disasters, Loss of safety and trust, fear for life, possible: torture, dismemberment and disability,  isolation, depression, and PTSD or ASD

Diagnostic criteria for 309.81 Posttraumatic Stress Disorder (PTSD)

DSM-IV & DSM-IV-TR

When an individual who has been exposed to a traumatic event develops anxiety symptoms, reexperiencing of the event, and avoidance of stimuli related to the event lasting more than four weeks, they may be suffering from this Anxiety Disorder.

1. The person has been exposed to a traumatic event in which both of the following were present:
   1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
   2. the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.
   3. The traumatic event is persistently re-experienced in one (or more) of the following ways:
      1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
      2. recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
      3. acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
      4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
      5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
      6. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
         1. efforts to avoid thoughts, feelings, or conversations associated with the trauma.
         2. efforts to avoid activities, places, or people that arouse recollections of the trauma.
         3. inability to recall an important aspect of the trauma.
         4. markedly diminished interest or participation in significant activities
         5. feeling of detachment or estrangement from others.
         6. restricted range of affect (e.g., unable to have loving feelings).
         7. sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span).
         8. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
            1. difficulty falling or staying asleep.
            2. irritability or outbursts of anger.
            3. difficulty concentrating.
            4. hypervigilance.
            5. exaggerated startle response.
            6. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
            7. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

            Specify if:

            • Acute: if duration of symptoms is less than 3 months.
            • Chronic: if duration of symptoms is 3 months or more.

            Specify if:

            • With Delayed Onset: if onset of symptoms is at least 6 months after the stressor.

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         9. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:
            1. a subjective sense of numbing, detachment, or absence of emotional responsiveness
            2. a reduction in awareness of his or her surroundings (e.g., "being in a daze")
            3. derealization
            4. depersonalization
            5. dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
         10. The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of relivinglved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
         11. the person's response involved intense fear, helplessness, or horror
      7. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:
         1. a subjective sense of numbing, detachment, or absence of emotional responsiveness
         2. a reduction in awareness of his or her surroundings (e.g., "being in a daze")
         3. derealization
         4. depersonalization
         5. dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
      8. The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.
      9. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people).
      10. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).
      11. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual's ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
      12. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event.
      13. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition, is not better accounted for by Brief Psychotic Disorder, and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.

      Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Copyright 2000 American Psychiatric Association