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Post-Traumatic Stress In A Post-Katrina World             Murphy Toerner

             If you have any doubts as to whether Post-Traumatic Stress Disorder (PTSD) is alive and well in Louisiana , simply say the following to someone, “Hurricane season is just around the corner.”  Then, watch the expression on the person’s face.  Some people will look as though they had been punched in the gut or slapped in the face.  Others will look completely shell-shocked, stunned, and dazed.  They might look immobilized for a few seconds, as though they are being transported to a distant place and time.  They might tilt their head.  Their eyes might look down and to one side.  There might be a glazed, far-away look on their face, as if they are totally absorbed with a memory.  Then, within a few seconds, they “come back” to the present conversation.  

            If you mention “hurricane season” to someone who survived being stuck in New Orleans or someone who was a first-responder, you will most likely see them respond with that glazed look.  The term “first-responder” includes: police officers, fire fighters, SPCA workers, National Guard troops, members of the U.S. Coast Guard, helicopter and fixed-wing pilots, medical personnel (doctors, nurses, volunteers, etc.), utility crews (telephone and electricity), and mental health professionals.  Anyone who volunteered his or her time and the use of his or her personal water craft to rescue others could suffer from PTSD. 

Post-Traumatic Stress Disorder 

            Post-Traumatic Stress Disorder is a condition which most of us associate with someone who served in the armed services and fought in a war.  Survivors of various types of abuse (sexual, physical, and emotional abuse) often will develop PTSD. Other traumatic, life-events can cause PTSD.  These might include, but are not limited to: being a victim of a violent crime (robbery, assault, rape); surviving a serious motor-vehicle accident; or being a witness to a “traumatic event.”  

            To be diagnosed with PTSD, an individual must meet certain, specific criteria, which are listed in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR):

            First, the person has been exposed to a traumatic event, which involved actual or threatened death or serious injury.  The person’s response involved intense fear, helplessness, or horror.    

            Second, the person will re-experience the traumatic event in one (or more) of the following ways:  dreams, flashbacks, intrusive thoughts and/or memories.  They will also experience anxiety in situations that remind them of the original traumatic event.

            Third, the person with PTSD will exhibit a shutting down or numbing of their emotions.  They will demonstrate a lack of interest in or an avoidance of other people and the world in general. 

            Forth, a person with PTSD will experience symptoms of heightened awareness or increased arousal.  This might include: irritability, insomnia, agitation, angry outbursts, hypervigilance, exaggerated startle response, and difficulty concentrating.  

            Lastly, one must have exhibited these PTSD symptoms for at least one month and  the presence of their symptoms must have significantly impacted or affected his or her life.  

            People are, for the most part, resilient.  However when an event as devastating as Katrina (and the aftermath associated with it) hits, this event creates an enormous sense of corporate helplessness.  An expert in traumatology from Portland, Oregon, Byron Kehler predicts that anywhere from 20-25% up to 50-60% of the population in the hardest hit areas of Louisiana could develop PTSD. The national average occurrence of PTSD in the adult population is only 8%.   

Katrina Acting as A Trigger

            A trigger is anything that reminds a person of a previous traumatic event.  For many people in Louisiana , Katrina acted as a trigger for their previously unresolved traumatic issues.  Usually about six months post disaster, issues from the previously unresolved trauma will begin to surface. 

            I witnessed this first hand when I counseled the personnel from two different service companies immediately following Katrina. During the counseling sessions, within 15 or 20 minutes, the topic of conversation switched from disaster related issues to matters of unresolved childhood trauma.  This happened almost without exception.  

            Unresolved trauma hinders a person’s ability to recovery from a current traumatic event.  It is as though they have too many loose ends to deal with.  Unresolved trauma thwarts one’s ability to resolve current internal issues, including a person’s thoughts and feelings. Unresolved trauma also thwarts a person’s ability to maintain healthy relationships with those closest to them.

The Journey to Recovery 

            People with PTSD often report that they “feel crazy.”  The truth is people and events have hurt them deeply. They feel crazy because there are huge blocks of time where they don’t remember much about their childhood.  This inability to remember is directly connected to their use of dissociation and numbing.   These coping strategies preclude one’s ability to remember significant events.   

            When a client enters counseling, the counselor or social worker should explain that the journey to recovery is a long one.  PTSD will not be resolved in the usual 8 to 10 sessions allowed by managed care.  Another thing to remember about the therapeutic process is that it will usually get worse before it gets better.  During their recovery, the client and mental health professional will systematically look at, talk about, and examine the traumatic events and the fallout from these events.  This is difficult work in light of the fact that the client has spent a lifetime trying to push down everything associated with the trauma.   

            Trauma changes us.  It impacts every part of who we are.  When a person survives a trauma, his or her thoughts and feelings about themselves, life, other people, their safety, their ability to prevent trauma or protect themselves from trauma, their view of God are dramatically changed.  They develop irrational ways of thinking.  Irrational thoughts promote irrational feelings which, in turn, lead to irrational ways of behaving.  

Things Can Get Better 

            If you struggle with PTSD, with the help of a qualified mental health professional, things can get better.  Although no mental health professional can guarantee recovery, advances in recovery can be made. Also, recovering from trauma is a long, arduous journey.  

            The first step is to find a counselor/social worker with whom you feel comfortable.  Find a therapist who will help you navigate through your traumatic event(s).  During therapy, you will systematically examine your habitual ways of thinking, feeling and behaving.  There is a thinking road to recovery and there is a feeling road to recovery.  During this process, new ways of thinking, feeling and acting will be learned.   

            Don’t look at recovery as some horrible, never-ending process.  Instead, focus on making one step of recovery at a time.  It is easy for one to think that the cost of recovery is too much, but we need to also consider the cost of not recovering.  To me, that is the bigger issue.  

Murphy Toerner, M.A., is a Licensed Professional Counselor; a Licensed Marriage and Family Therapist; and a Nationally Certified Counselor.  She is the owner and director of Murphy Toerner and Associates, Inc., which is a Christian counseling and coaching center. Her work phone number is 753-7773.  Her email address is mtoerner@hotmail.com