Trauma by definition is an experience outside of the realm of experience(s) of your peer group. Clearly, this is a very broad interpretation. The more imminent or even explicit the bodily harm, the more overwhelmed the defenses may become. We have defenses from very early developmental stages of psychological growth. Some defenses are healthier and more efficient than others. When trau­ma or the serious threat thereof occurs, the mind shifts quickly into a defensive “ fight or flight” red alert. These choices are very primitive and haven’t evolved very much since their creation millennia before. These innate dichotomous reaction choices may be appropriate in certain cir­cumstances, however not all.

The biggest challenge occurs when we really need choice num­ber three and none seems available. More often than not, option three is more appropriate and effective, especially when created in advance. This requires self-confidence, independence and focus. All of these ego strengths are not always adequately present to perform such creative solutions. When serious trauma then occurs, the mind’s defenses often are overwhelmed which may lead to powerful and painful symptoms and dysfunc­tion.

There are many aspects of dys­function which may result from traumatic sources. There are also many variables to be considered when trying to understand where a person is when they present with this form of psychic pain. Sadly, physical and/or sexual abuse occurs in epidemic propor­tions. Violence and menacing aggression are woven into every­day life and some form of expo­sure to it is almost unavoidable.

There are basically three ways to be traumatized:

• You are the victim of an assault or threat of one directly
• You were the perpetrator of the assault or threat
• You were the witness of someone else being assaulted or threatened. Witnessing includes not just visually, but also any sensory input (hearing, touch, etc.).

Variables that often times directly influence the severity of the resulting pathology are many. Some significant ones are: the relationship – if any – between perpetrator and victim (i.e. par­ent, relative, friend, stranger), age of onset of the assault or threat; duration of same (i.e. single epi­sode or repetitive); type of assault – if sexual to what extent was the violation(s), was there physical harm or threat of it to the victim or even to the victim’s loved ones; physical harm or threat of it is equally as overwhelming. Similar modifiers of intensity, frequency and duration play pivotal roles in how we react to this form of trauma as well. The results can be devastating and permanent.

Being able to respond versus react to these tragic events is far better, but difficult to pre­pare for or predict. Being safe, secure and spontaneous are much better, but challenging to guarantee. Hypervigilance and phobic fears often occur pre and post trauma if left to their own devices. Healing requires spe­cific forms of care and preferably well-timed whenever possible. Unfortunately, this care is gener­ally too little too late and the residual scarring leads to more scarring. In addition, a biased belief system which is under­standable, but not healthy or helpful may result also.

Women are more com­monly the victims of violence and aggression, but this is shift­ing. We see quite a number of males who have been traumatized as well. Substance abuse, self mutilation, severe depressive and anxiety symptoms, low self worth, rage, intense guilt and suicidal/homicidal ideation are common residual results to a mind overwhelmed by something and someone it didn’t expect and never, ever deserves.

We provide therapeutic care that involves cognitive-behav­ioral, supportive and gradual desensitization modalities to help process these emotions and assist the healing to occur. Medications may also play a beneficial role in specific circum­stances. Biofeedback and other alternative approaches can be of assistance and we have colleagues who offer these services locally.

We try to help.

Answers To Your Questions And Concerns

Q. What’s the best way to contact you?

A. Just call our confidential office 609-484-0770 and leave whatever information you wish. Our office manager may also be available to assist you with an appoint­ment and further details.

Q. How long does it take to get better?

A. Very varied. Trust is the most important element of care and that usually has been severely damaged in these patients. It takes time and treatment to regain it in order to become free of pain and grow.

Q. Will I need to take medication for life?

A. Generally meds are used for spe­cific intrusive symptoms and we want relief of those in order to do the harder work of repairing what was stolen. Whenever possible, if meds are involved, we attempt to be selective and as brief as possible.

Q. What about the substance issues that occur with this problem?

A. We treat substance abuse patients who have co-occurring psychiat­ric issues everyday. We also provide Suboxone services in combination with psychiatric care in a discrete office based private setting. We can help refer if more intense treatment is desirable.