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Post Traumatic Stress Disorder and Treatment

Posted by Margaret Donohue on June 9, 2013 at 8:55 AM

I heard about the shooting at Santa Monica College from my psychological assistant, Catherine, in a text message.  "I'm home at the moment.  Shooting at SMC in library.  Campus on lockdown and supposed to give an exam at 3:30.  Sad news and adrenaline in my system."  Some of her students fled the library where they were studying for the exam or were sheltered in a locked room by library staff while the gunman shot through the drywall.


Some of these students will have some simple stress as a result of being on campus, seeing the woman that was shot or escaping out of the library.  A percentage will be quite distressed for the next month or so with something called Acute Stress Disorder.  A small percentage will go on to develop something called Post-Traumatic Stress Disorder.  


Acute stress disorder

This occurs within the first month after a traumatic event.  Sleep disturbance and vivid recollections of the event recur.  The recollections are often intrusive.  People start to avoid things that bring up thoughts and feelings related to the traumatic event.  There are a couple of things you can do to help.

  1. Play Tetris.  http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0013706  The authors of this study found that playing Tetris, the old computer game with the falling blocks prevented memories from consolidating and theorize it may serve as a vaccine against developing Post Traumatic Stress Disorder.
  2. Run the movie playing in your head backwards.  This is a neurolinguistic programming technique again designed to interfere with how we record and store memories associated with events.  We think of trauma as visual and as in forward order only.  Running the visual images backwards shows the person safe at the start anchoring that image and disrupting the cycle of being scared all the time.
  3. Stop avoiding the thoughts and feelings associated with the event.   By talking with people or not avoiding places or feelings the places and feelings get over-laid with new information.  

Post-Traumatic Stress Disorder

This diagnosis isn't given within the first month following a traumatic event.  If a traumatic event has occurred and after a month someone is still having nightmares, reliving the event (flashbacks), or avoiding thoughts and feelings associated with the event, and has a sence of feeling numb to other positive events or having a sense that their life has been cut short, they would meet criteria for post-traumatic stress disorder.  There are several things that can help:

Three specific types of psychotherapy help:

  1. Cognitive Behavior Therapy--this type of therapy has depression or anxiety rated on a rating form evey week or so.  The therapist works with your thoughts, feelings and behaviors to change how you are feeling.  You will keep track of your thoughts, feelings and behaviors until you can do it automatically.  Therapy is relatively brief.
  2. Neurolinguistic Programming--this type of therapy works very rapidly and can include forms of hypnosis.  The goal is to dislodge how the traumatic information is stored and to replace it with information that conflicts with the trauma.  Therapy is extremely brief.  For individuals with head injury, or physical injury treatment takes longer.
  3. Eye-Movement Desensitization and Reprocessing (EMDR)--this type of therapy works very rapidly by using specific eye movements to reprocess traumatic information.  Therapy is extremely brief.

General supportive psychotherapy is not generally helpful.  If you are going to a therapist and talking about traumatic events and the therapist is responding about the same way your hairdresser or barber is then don't expect much in terms of improvement.  Supportive therapy may feel good while you have the visit, but there is little showing any lasting effect from that type of treatment especially for trauma, anxiety or depression.

Medication can help:

  1. Medication designed to slow down heart rate (beta blockers) can help confuse the brain that you aren't feeling as anxious as you think.
  2. Antidepressant medication--for moderately severe symptoms of depression, this can help improve sleep, and lessen feelings of being numb.  The most commonly used antidepressant medications take 6-8 weeks to start working, and therapy will provide you with tools to use for the future.  You may want to do both medication and therapy.
  3. Antianxiety medication--this can be used for a brief period of time to help with feeling scared.  Long term use isn't advised because these medications can be addictive.

Support groups and crisis counseling.  These groups provide you with the opportunity to talk to other people that went through the same or similar experiences.  Crisis counseling is a specific 6-12 week program designed to get people back to functioning.

If you were at SMC and want to seek counseling, crisis ciounselors are available all weekend.  Campus officials had crisis counselors available to students at the Bundy Campus Friday evening and said they would be there all weekend from 9 a.m. to 3 p.m. There is also be a crisis hotline for students and faculty — (866) 315-7370.


If you need therapy for medical trauma, a serious injury or accident, or want more information about services we provide, feel free to contact our office or any of the psychological assistants.

Categories: General Psychology

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