PTSD Awareness Month Expert Interview & Advocacy Guide
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“When we avoid situations after a traumatic event, it’s our body telling us to stay clear so that we don’t put ourselves in a dangerous situation. That’s an incredible gift our body is giving us. But the work in therapy is to figure out which parts of that gift are helpful, and which are not.”
Dr. Charmayne Adams, Assistant Professor at the University of Nebraska at Omaha
Around eight million Americans suffer from post-traumatic stress disorder (PTSD). Once referred to as shell shock and combat fatigue, PTSD is often associated with military veterans, but it also affects survivors of domestic abuse, sexual violence, car accidents, and other forms of trauma. According to the American Psychiatric Association (APA), women are twice as likely as men to have PTSD; Black, Hispanic, and Native Americans have disproportionately higher rates of PTSD than non-Latino whites.
While our understanding of PTSD has matured in recent years, there’s still a lot of work to be done around PTSD education, awareness, and treatment.
June is PTSD Awareness Month. Established in 2010 in honor of Staff Sergeant Joe Biel, a National Guardsman who took his own life after returning home from his second tour in Iraq, PTSD Awareness Month seeks to reduce the stigma associated with PTSD, raise awareness around PTSD-related issues, and help ensure that those suffering from PTSD receive the help they need. It’s also an opportunity to highlight the work of mental health providers in improving the lives of those who have experienced trauma.
To learn more about PTSD and how the mental health community is helping to fight it, read on.
Meet the Expert: Charmayne Adams, PhD, LIMHP
Dr. Charmayne Adams is an assistant professor at the University of Nebraska at Omaha and an independently licensed professional counselor. Her clinical background focuses on working with individuals with a history of trauma or in crisis. She currently serves on the Advancement for Clinical Practice committee for the American Mental Health Counselors Association (AMHCA).
Dr. Adams’ research focuses on teaching about trauma, systemic and emotion-focused clinical interventions, and the application of attachment theory in clinical and academic settings. Both clinically and academically Dr. Adams is focused on social justice counseling and empowering clients to examine barriers and use their strengths to overcome life’s challenges.
Understanding Trauma and Trauma Responses
“Trauma comes in a lot of different forms, and the response to trauma is unique to every individual,” says Charmayne Adams, PhD, LIMHP, assistant professor at the University of Nebraska at Omaha. “Trauma response is our body’s best attempt at keeping us physically and emotionally safe. It is adaptive, creative, and makes sense in the context of the traumatic event. When we start talking about trauma response as our body’s creative attempt to survive horrific events, we start to take out the stigma and view it as the coping skill it is.”
Trauma rewires the mind and the body. At the time of a traumatic event, that rewiring can be extremely useful, even life-saving: a soldier may duck at the sound of an explosion or a sexual abuse victim may dissociate from their surroundings.
But once the traumatic event has passed, the reflexes that it spawned may linger, and not always helpfully: a veteran may fall to the floor when someone knocks on their front door, or a sexual abuse survivor may dissociate from otherwise healthy relationships.
“When we avoid situations after a traumatic event, it’s our body telling us to stay clear so that we don’t put ourselves in a dangerous situation,” Dr. Adams says. “That’s an incredible gift our body is giving us. But the work in therapy is to figure out which parts of that gift are helpful, and which are not.”
Understanding PTSD Demographics
Veterans are one of the hardest hit demographics: up to 20 percent of veterans of Operation Iraqi Freedom and Operation Enduring Freedom experience PTSD in a given year. But while the US Department of Veterans Affairs (VA) is the largest organization systematically studying trauma and PTSD, they only focus on a very specific segment of the population.
Part of the mission of the mental health community today is to broaden that research, and the findings of that research, to include the general public. It remains to be seen whether what works for veterans will work (or work best) for other segments of the population.
“The largest demographics affected by PTSD are women and veterans, but that’s partially because those demographics have been studied the longest, and are the ones we understand the best in presenting symptoms,” Dr. Adams says. “The PTSD diagnosis is extremely limiting in its ability to diagnose other demographics, such as marginalized groups who have experienced entire generations of traumatic experiences but may not present symptoms in the way veterans do, since the diagnosis was built off the experience of veterans.”
Just as each individual has their own unique response to trauma, certain demographics can have distinct responses to trauma that require specific treatment considerations. Consider what Substance Abuse and Mental Health Services Administration (SAMHSA) calls group trauma: trauma experienced by groups like first responders, military service members, doctors, and nurses. Since members of these groups have a shared identity, a shared experience, and are often exposed to repeated traumatic events in the line of duty, they tend to keep themselves insular and only discuss those events with other members of their group. For these groups, peer support and collective resources are crucial, but different groups may have different responses, and thus different needs.
“We have continued to broaden our understanding of what types of events tend to elicit a trauma response, who is most at risk, and how we treat it,” Dr. Adams says. “PTSD is at the extreme end of a clinical continuum that includes a variety of responses to trauma exposure depending on the individual, their available resources to cope with the trauma, and the type of support they receive.”
Understanding PTSD Treatments
“In general, trauma leaves individuals feeling helpless and isolated, and any treatment that includes connection and empowerment will most likely lead to positive treatment outcomes,” Dr. Adams says.
There are two levels of working with someone with a history of trauma: trauma-informed care (TIC) and trauma-specific care.
Trauma-informed care is both a philosophical way of approaching client care and a specific collection of skills used to reduce the chances of re-traumatization while working with clients. Counselors practicing trauma-informed care believe that trauma can pervasively affect an individual’s wellbeing, including physical and mental health. And, since trauma can impact how individuals seek out services, interact with service providers, and respond to treatment, it is imperative that from the first contact providers recognize the impact trauma could be having on their client.
Trauma-specific care focuses on treatment modalities aimed at helping clients specifically work through their trauma experience. These can include: trauma-focused cognitive behavioral therapy, biofeedback, neurofeedback, and eye-movement desensitization and reprocessing (EMDR). So far, the VA has done extensive randomized trials that show efficacy for several of these methods.
“All of these treatment methods have come a very long way in the past 10 to 20 years because our understanding of who is impacted by trauma and what their response will be has grown exponentially,” Dr. Adams says.
But treatments only work if people use them. And, according to the APA, untreated PTSD is unlikely to go away on its own and could contribute to chronic pain, depression, substance use, and other mental health issues. That’s why PTSD Awareness Month seeks to spread awareness, reduce stigma, and educate the public about PTSD.
“The more we talk about trauma, and not just in a casual way, but really share in safe communities, the healthier our society will be,” Dr. Adams says.
Resources for PTSD Awareness Month
PTSD Awareness Month serves as a reminder that no one has to endure this disorder alone. Check out some of the resources below for up-to-date research, education, and treatment options for PTSD.
- American Mental Health Counselors Association (AMHCA): The only organization working exclusively for mental health counselors, AMHCA uses its unified voice to help meet the healthcare needs of those that mental health counselors serve, as well as to advance the profession.
- American Psychiatric Association (APA): The APA brings together psychiatrists to ensure humane care and effective treatment for all people with mental illness. It envisions a society that has available, accessible, quality psychiatric diagnosis and treatment.
- National Center for PTSD: Hosted by the US Department of Veteran Affairs (VA), the National Center for PTSD is the world’s leading research and educational center of excellence on PTSD and traumatic stress. They also offer easy-to-read educational material about PTSD and effective treatment options.
- Substance Abuse and Mental Health Services Administration (SAMHSA): An agency within the US Department of Health and Human Services, SAMHSA leads public health efforts to advance the behavioral health of the nation. They also host resources for patients, providers, and the public, including a PTSD hub.