Dr. Mark Lerner

Know What “Traumatic Stress” Is and What It’s Not

2009-08-18T05:53:00.000-07:00

When we think of stress, we generally associate it

with the potential wear and tear on our mind and

body as we adjust to daily changes and challenges in

our lives. Yet there are both negative and positive

attributes to stress. On the negative side, stress can

compromise our ability to think clearly, cause us to

feel anxious, disrupt our ability to sleep and,

ultimately, lead to physical illness. On the positive

side, stress can be a powerful force that enables us to

get things done and be more productive. Some

people describe how they work better under stress—

when they’re feeling pressured.

Some events in our lives can be so overwhelming

that we perceive a serious threat to our physical wellbeing,

or the well-being of others. We may experience intense feelings

of fear, helplessness and horror. We may feel overwhelmed,

unsafe, insecure and vulnerable. This is traumatic stress—

our feelings, thoughts, actions, and physical and spiritual

reactions when we’re exposed to, or even witness,

events that overwhelm our ability to cope.

People experience traumatic stress when they’re

exposed to a disaster or catastrophe—a plane crash,

terrorist attack, the battlefield, or an earthquake. Yet

it doesn’t have to be a highly publicized event with a

two-inch newspaper headline. People also experience

traumatic stress during the personal disasters that

color their lives: facing an illness or injury, dealing

with the tragic loss of a loved one, being physically or

sexually violated, experiencing an accident, or

living through a divorce.

Like stress, traumatic stress can also have a positive

side. It can be the force that propels people to

cultivate a mission and purpose and, ultimately,

the ability to live with a new sense of passion. By

understanding what traumatic stress is and by

knowing that it’s a normal response to an abnormal

event you’ll be empowered and in a better position

to survive and thrive.

What to Do ... Now

2009-08-08T06:06:00.000-07:00

What you do during and in the wake of this crisis

will depend on what’s happened. Have you

experienced the loss of a loved one? Are you battling

an illness? Have you been injured? Have you been

victimized? No matter what’s happened, at times

you’re feeling overwhelmed. This is your crisis.

Try to surround yourself with special friends and loved

ones. Be there for each other and know that it’s okay

to feel. Former Prime Minister of Britain Benjamin

Disraeli once said, “Never apologize for showing

feeling. When you do so, you apologize for truth.”

As much as possible, and with the help of people

who are close to you, try to obtain facts. Knowing

what’s happened, or is happening, is generally easier

than the unknown. Depending upon the event, it

may not be possible to know the facts early on; they

may come with time.

While you’re vacillating between uncomfortable

thoughts and feelings, keep bringing yourself back

to your “thinking and problem-solving mode.” Take

care of your basic needs. Drink lots of fluids, eat

small meals, and keep yourself in a safe place.

If at any time you experience difficulty breathing,

chest pains or palpitations, or any other disturbing

physical reaction, speak with your physician or

health care provider immediately. In fact it’s a good

idea, in general, to make your doctor aware of what

you’re going through.

The answer to what you need to do now lies within

you.

Make Decisions and Take Action

2009-08-02T05:07:00.000-07:00

So much of what happens in our lives results from

our decisions. This is often why it’s so difficult for

us when we face a tragedy. We naturally see what’s

happened as the result of our decisions. We blame

ourselves and we feel guilty. If we don’t perceive

what’s happened as the result of our decisions, we

often believe that the tragedy was the result of

someone else’s decisions/actions.

Whether we’re feeling guilty about causing the event

or feeling anger towards those we feel were in some

way responsible, the reality of our loss still exists.

Remember, whatever you decide to focus on,

whatever you choose to think about, will become

your experience. And what you think and do during

this crisis, during this peak emotional time in your life,

will stay with you forever.

Although establishing goals and making decisions

are a constructive way to use your energy, unless

you take action to reach them, goals are no different

than a colorful map that never gets used.

When is it best to act on your decisions and to work

toward achieving your goals?

There’s no simple answer. There’s no rulebook or

time line for your crisis. Some people will act

immediately or soon after a tragedy. Others will wait

to act, taking some time to heal.

Regardless of your timing, when you choose to make

a decision and take action, you’ll be consciously

making a choice and, therefore, you’ll be taking

control of your life.

Crisis and Opportunity

2009-07-28T06:41:00.000-07:00

During and in the wake of a crisis, some people seem

to “get stuck.” They withdraw, shut down and

become reclusive—staying inside, closing off the

world around them. They begin a pattern of avoiding

people, places and things. Do you see yourself as

getting stuck?

Other people use the painful energy from their crisis

to make destructive choices. They turn to alcohol

and drugs, or become engaged in serious conflicts

with their families, friends and coworkers.

I have a passion for working with people during times

of crisis because I believe that the pool of painful

energy inside you presents enormous potential. It

can provide the fuel that propels you to make

constructive choices. It can open the door to

opportunity!

Seize this opportunity from your crisis and use your

painful emotional energy to propel you to live your

dreams!

From Victim to Survivor and Ultimately ... Thriver

2009-07-20T05:54:00.000-07:00

A victim is someone who’s been harmed and who’s

suffering.

A survivor is someone who, despite hardship and

adversity, continues to function.

A thriver is someone who grows and flourishes.

You can move from being a victim to a survivor and

ultimately, a thriver. While it’s certainly okay not to

be okay during a crisis, you have the capacity to

ultimately grow and flourish from your experience.

You can be better than okay!

Instead of seeing yourself as a wilting rose, begin to

see yourself as a badly bruised bud that still has the

potential for a beautiful and lasting bloom.

Know What “Traumatic Stress” Is and What It’s Not

2009-07-18T05:54:00.000-07:00

When we think of stress, we generally associate it

with the potential wear and tear on our mind and

body as we adjust to daily changes and challenges in

our lives. Yet there are both negative and positive

attributes to stress. On the negative side, stress can

compromise our ability to think clearly, cause us to

feel anxious, disrupt our ability to sleep and,

ultimately, lead to physical illness. On the positive

side, stress can be a powerful force that enables us to

get things done and be more productive. Some

people describe how they work better under stress—

when they’re feeling pressured.

Some events in our lives can be so overwhelming

that we perceive a serious threat to our physical well-

being, or the well-being of others. We may

experience intense feelings of fear, helplessness and

horror. We may feel overwhelmed, unsafe, insecure

and vulnerable. This is traumatic stress—our feelings,

thoughts, actions, and physical and spiritual

reactions when we’re exposed to, or even witness,

events that overwhelm our ability to cope.

People experience traumatic stress when they’re

exposed to a disaster or catastrophe—a plane crash,

terrorist attack, the battlefield, or an earthquake. Yet

it doesn’t have to be a highly publicized event with a

two-inch newspaper headline. People also experience

traumatic stress during the personal disasters that

color their lives: facing an illness or injury, dealing

with the tragic loss of a loved one, being physically

or sexually violated, experiencing an accident, or

living through a divorce.

Like stress, traumatic stress can also have a positive

side. It can be the force that propels people to

cultivate a mission and purpose and, ultimately,

the ability to live with a new sense of passion. By

understanding what traumatic stress is and by

knowing that it’s a normal response to an abnormal

event you’ll be empowered and in a better position

to survive and thrive.

It's OK Not To Be OK

2009-07-17T04:13:00.000-07:00

The tragic loss of someone special in your life. An

illness or injury. A relationship problem. Divorce.

Physical or sexual abuse. A work-related crisis. An

accident. Criminal victimization. War. A disaster....

What’s happening in your life?

During a crisis, when you find yourself struggling

to function and it feels like your whole world has

changed, it’s okay not to be okay.

As human beings, we’re built to survive. We have

inborn mechanisms that help us to recover and heal

from the overwhelming challenges that we face

during our lifetime. Yet we experience so many

normal reactions during a crisis: We’re anxious and

scared. It’s difficult for us to focus and make

decisions. It’s hard to turn off the painful tape of

what’s happened. We’re excessively watchful and

cautious. We’re startled by every loud noise. We

withdraw from people. We experience headaches and

body aches. We have difficulty sleeping. We’re

disturbed by dreams. We may question our faith.

The list goes on.

Am I talking about you?

During a crisis, we experience normal reactions in

the face of an abnormal event and it’s okay not to be

okay.

www.ItsOKNotToBeOK.com

A Crisis is in the Eye of the Beholder

2009-07-15T04:05:00.000-07:00

How would you define a crisis?

Many people think that a crisis is an overwhelming

event. In actuality, a crisis is our unique experience in

the face of what we perceive to be an overwhelming

event. A crisis for me may not be a crisis for you.

And, similarly, what you perceive to be a crisis may

not be for me.

How we interpret and label our experience will

determine whether a particular event leads to feelings

of fear, helplessness and even horror—whether our

experience rises to the level of a crisis. This process

of interpreting and labeling is based on many things

like our past, the nature of the event itself and the

kind of support we receive after the event—the

before, during and after.

Understanding that a crisis is the human response to

an overwhelming event brings us hope. Although

you can’t change and undo what’s happened in your

life (the event), you can choose what you do now

and how you interpret and label your experience

(your crisis).

When It’s Time for a Mental Health Professional

2009-07-10T07:10:00.000-07:00

It’s very common for people to ask when it’s necessary to turn to a mental health professional for help. Following are four basic indicators that will help you to know if you’ve experienced more stress than you can handle yourself, or with the help of your friends and loved ones:

1. Persistent suicidal or homicidal thoughts.

It’s not unusual for us to experience thoughts of non-existence, or thoughts of harming ourselves or others, particularly during a crisis. However, if these thoughts persist, and you begin to think of how and when you may act on your thoughts, pursue professional help immediately. Don’t give yourself the chance to act impulsively.

2.An inability to care for yourself

You’re withdrawing from people, not eating, not sleeping, not taking care of your basic needs. Any one of these or a combination of several is an indication that it’s time to pursue professional help.

3. Ongoing painful symptoms

If you’re experiencing ongoing physical pain or discomfort, speak with your doctor. In the same way, if you’re experiencing ongoing painful feelings, such as panic attacks or depression, speak with a mental health professional.

4. Abuse of substances

If you’re turning to alcohol, tranquilizers or sleeping pills on a regular basis, or if you’re using drugs to “self medicate,” see a professional who can offer healthier and more effective solutions. If you don’t know of a particular mental health

practitioner, turn to your doctor, a hospital or perhaps your spiritual leader, for a referral.

A Personal Message for All Caregivers

2009-07-09T03:37:00.000-07:00

Firefighters race into buildings, into the smoke and flames, ultimately to save lives. In the same way, I feel compelled to rush into the heat of emotions. It’s my conviction that there’s a critical opportunity to reach and help people, early on, during the most painful and challenging times in their lives. Here’s a message that I would like to leave for all caregivers who choose to help others during times of crisis....

Years ago, I was warned by an esteemed psychologist never to build a clinical practice around, or specialize in working exclusively with, people in crisis. He explained how the stress of helping others, during intensely emotional times, would be too overwhelming for anyone.

Because of my belief that crises present unique and powerful opportunities for people to grow, I chose not to heed my colleague’s warning. Instead, I immersed myself in helping people to live through and overcome adversity. I chose to focus on the healing process and the hope and potential of empowering people to look beyond today and live their dreams! This is my mission and purpose, and I’ve never found it to be overwhelming.

And another thought. There’s nothing magical about what we say or do with people during times of crisis. In fact, it’s generally not what we say that helps people the most, it’s often what we don’t say. Let’s remember that we are not experts in solving other people’s problems. No one has the right to question another person’s beliefs or to tell them how they should feel. Instead, we should strive to become experts in helping people to find the answers within themselves. We should try to give back a sense of control that their experience seems to have taken away.

Let’s support people during their crisis and help them to look beyond adversity ... toward their blessings and their unique potential.

Take care of you.

Symptoms of Traumatic Stress in Adopted Children

2009-07-08T08:53:00.000-07:00

Many adoptive children have, unfortunately, faced traumatic events. Having an understanding of the symptoms suggestive of traumatic exposure can aid in identifying children who may be experiencing traumatic stress reactions. Ultimately, by identifying symptoms early, we can keep adoptive children functioning and mitigate long-term emotional suffering.

First, it’s important to understand what traumatic stress is. Traumatic stress refers to the emotional, cognitive, behavioral, physiological experience of individuals who are exposed to, or who witness, events that overwhelm their coping and problem-solving abilities. More simply stated, traumatic stress refers to the feelings, thoughts, actions and physical and spiritual reactions of people who experience seemingly overwhelming events in their lives.

In the case of young children, immature and regressive behaviors, behaviors that have been abandoned in the past, are often manifested again (e.g., thumb sucking, bed wetting, fear of the dark, loss of bladder control, speech difficulties, decreases in appetite, clinging and whining, and separation difficulties). Older children may manifest periods of sadness and crying, poor concentration, fears of personal harm, aggressive behaviors, withdrawal/social isolation, attention-seeking behavior, anxiety and fears, etc.

Children who are quite verbal may discuss the nature of their exposure to a traumatic event if they are asked. Caregivers can specifically ask the child to talk about a “happy time” in their life—something that made them feel good. Following such a discussion, the conversation could shift to a discussion of a “sad time”—a time when the child was hurt or had something bad happened to them. Many children who are not particularly verbal will act-out their thoughts and feelings concerning prior traumatic exposure in their play. Look for aggressive play—play that provides a window into the conflicted mind of a traumatized child.

In the same way that we respond to the physical needs of the adoptive child, we must also address psychological needs. Emotional, social and behavioral problems, precipitated by a significant traumatic event, are all too common among people who were adopted. By understanding traumatic stress and knowing the symptoms that are manifested in young children, we can intervene early and ultimately make a difference in the life of the adoptive child.

www.AdoptionPsychologist.com

What is Traumatic Stress?

2009-07-07T05:50:00.000-07:00

Traumatic stress refers to our feelings, thoughts, actions, and our physical and spiritual reactions when we are exposed to, or witness, events that overwhelm our coping and problem-solving abilities. These events are often unexpected and uncontrollable. They compromise our sense of safety and security, and leave us feeling insecure and vulnerable. Traumatic stress is a normal response to an abnormal event.

How to Tell Our Children the Bad News

2009-07-04T04:04:00.001-07:00

People frequently ask, “What should I tell my children?” My answer is always, “… the truth.” However, information must be conveyed at a developmentally appropriate level. For instance, young children don’t need to hear every detail that may only confuse and upset them—and likely cause greater distress.

Tell children what they need to know, don’t share more information than they’re able to hear, encourage them to articulate their feelings, and answer their questions honestly and directly. And if you don’t know the answer, it’s okay. Tell them that you don’t know.

It’s important that you don’t lie to children in an effort to protect them—even if the truth is painfully difficult. Children will only come to know the truth at a later time. And it’s generally sooner than later. There’s no reason to add additional pain to loss due to feelings of being misled or being lied to. Again, just be sure to share what’s appropriate for the child to hear at his or her age. And if you’re not sure, seek the help of someone works regularly with children.

During a crisis, children, particularly little ones, will take their cues from the adults around them. They’ll model the behavior of the adults in their lives. The problem here is that depending upon their age, and unlike adults, they may lack the ability to use language to express their thoughts and feelings. Instead, we see reflections of what’s going on inside conveyed in their actions—their behavior.

Drawing pictures and coloring, or shaping Play-Doh or clay, can be helpful for children to begin to expose themselves to, and to share their feelings.

Try as best as you can to use your crisis as a powerful learning experience for the children in your life. You’re setting the stage for how they’ll respond to tragedies, both large and small, for the rest of their lives. Again, for further guidance, turn to people who regularly work with children (e.g., pediatricians, educators, counselors, child psychologists, etc.).

from www.ItsOKNotToBeOK.com

How Do People Typically Respond During a Crisis?

2009-06-28T18:43:00.001-07:00

A crisis is the human response to an event, or series of events, that overwhelms our coping and problem solving abilities. There’s no standard pattern in which people respond during a crisis. Some of us respond immediately, while others may experience a delayed reaction, sometimes months or even years down the road. Some people’s reactions may last for a long period of time. For others, traumatic stress reactions are short-lived.

The following reactions/responses are frequently experienced during times of crisis It’s important to recognize that these reactions do not necessarily represent an unhealthy response. Rather, they may be viewed as normal responses to an abnormal event.

If these reactions continue to be experienced in the future and are joined by other symptoms (e.g., recurrent distressing dreams, flashbacks, avoidance behaviors, excessive jumpiness, etc.), and interfere with social, occupational or other important areas of functioning, a stress disorder may be present. Consideration should be given to consulting with a mental health professional.

Emotional Responses may include:

• shock

• denial

• dissociation

• panic

• fear

• aloneness

• hopelessness

• helplessness

• emptiness

• uncertainty

• horror

• terror

• anger

• hostility

• irritability

• sadness

• depression

• grief

• guilt

Cognitive Responses to traumatic exposure are often reflected in:

• impaired concentration

• confusion

• disorientation

• difficulty in making a decision

• a short attention span

• suggestibility

• vulnerability

• forgetfulness

• self-blame

• blaming others

• lowered self-esteem

• thoughts of losing control

• hypervigilance

• perseverative thoughts of the traumatic event

Behavioral Responses may include:

• withdrawal

• “spacing-out”

• non-communication

• changes in speech patterns

• regressive behaviors

• erratic movements

• impulsivity

• a reluctance to abandon property

• seemingly aimless walking or pacing

• an inability to sit still

• an exaggerated startle response

• antisocial behaviors

Physiological Responses may include:

• elevated blood pressure*

• difficulty breathing*

• shock symptoms*

• chest pains*

• cardiac palpitations*

• rapid heart beat

• muscle tension and pains

• fatigue

• sleep difficulty and disturbing dreams

• fainting

• flushed face

• pale appearance

• chills

• cold clammy skin

• increased sweating

• thirst

• dizziness

• vertigo

• hyperventilation

• headaches

• grinding of teeth

• twitches

• gastrointestinal upset

*These require immediate medical evaluation.

Spiritual Responses to a traumatic incident often include:

• anger and a distancing from God

• withdrawal from attending religious services

or an uncharacteristic involvement in

religious community activity

• feelings that faith practice (e.g., prayers,

scriptures, hymns, worship, communion) is

empty and without meaning

• a questioning of one’s basic beliefs and anger

at clergy

www.MarkLerner.com

What is Posttraumatic Stress Disorder (PTSD)?

2009-06-28T18:39:00.001-07:00

PTSD refers to the development of certain symptoms following a traumatic event. Events that trigger PTSD are experiencing, witnessing or being threatened with serious danger to your own or another person's life or physical integrity. The traumatic event that triggers PTSD causes intense feelings of fear, helplessness and horror. People who are diagnosed with PTSD find themselves re-experiencing the event, avoiding stimuli associated with the event, and experiencing symptoms of increased arousal. The disturbance causes significant distress or impairment in social, occupational, or other important areas of functioning. Certainly not everyone who is exposed to a traumatic event develops PTSD. By reaching people early, during times of crisis, we can ease their emotional pain, keep them functioning and lessen the likelihood of chronic and debilitating traumatic stress disorders.

21 Things You Can Do While You're Living Through a Crisis

2009-06-28T18:34:00.000-07:00

1. Take immediate action to ensure your physical safety and the safety of others. If possible, remove yourself from the event/scene in order to avoid further traumatic exposure.

2. Address your acute medical needs. If you’re having difficulty breathing, experiencing chest pains or palpitations, seek immediate medical attention.

3. Find a safe place that offers shelter, water, food and sanitation.

4. Become aware of how the event is affecting you (your feelings, thoughts, actions and your physical and spiritual reactions).

5. Know that your reactions are normal responses to an abnormal event. You are not “losing it” or “going crazy.” It’s okay not to be okay, right now.

6. Speak with your physician or healthcare provider and make him/her aware of what has happened to you.

7. Be aware of how you’re holding-up when there are children around you. Children will take their cues from the adults around them.

8. Try to obtain information. Knowing the facts about what has happened will help you to keep functioning.

9. If possible, surround yourself with family and loved ones. Realize that the event is likely affecting them, too.

10. Tell your story. And allow yourself to feel. It’s okay not to be okay during a traumatic experience.

11. You may experience a desire to withdraw and isolate, causing a strain on significant others. Resist the urge to shut down and retreat into your own world.

12. Traumatic stress may compromise your ability to think clearly. If you find it difficult to concentrate when someone is speaking to you, focus on the specific words they are saying and work to actively listen. Slow down the conversation and try repeating what you have just heard.

13. Don’t make important decisions when you’re feeling overwhelmed. Allow trusted family members or friends to assist you with necessary decision-making.

14. If stress is causing you to react physically, use controlled breathing techniques to stabilize yourself. Take a slow deep breath by inhaling through your nose, hold your breath for five seconds and then exhale through your mouth. Upon exhalation, think the words “relax,” “let go,” or “I’m handling this.” Repeat this process several times.

15. Realize that repetitive thinking and sleep difficulties are normal reactions. Don’t fight the sleep difficulty. Try the following: eliminate caffeine for four hours prior to your bedtime, create the best sleep environment you can, consider taking a few moments before turning out the lights to write down your thoughts, thus “emptying” your mind.

16. Give yourself permission to rest, relax and engage in non-threatening activity. Read, listen to music, or consider taking a warm bath.

17. Physical exercise may help to dissipate the stress energy that has been generated by your experience. Take a walk, ride a bike, or swim.

18. Create a journal. Writing about your experience may help to expose yourself to painful thoughts and feelings and, ultimately, enable you to assimilate your experience.

19. If you find that your experience is too powerful, allow yourself the advantage of professional and/or spiritual guidance, support and education.

20. Try to maintain your schedule. Traumatic events will disrupt the sense of normalcy. We are all creatures of habit. By maintaining our routines, we can maintain a sense of control at a time when circumstances may lead us to feel a loss of control.

21. Crises present opportunities. Cultivate a mission and purpose. Seize the energy from your experience and use it to propel you to set realistic goals, make decision and take action.

Workplace CRISIS: Be Prepared. Be Responsive.

2009-06-28T17:12:00.000-07:00

In the event of a crisis involving a sudden death, a serious illness, an accident, a threat of violence, a criminal act, or other tragedy, what would you do to keep people functioning?

In businesses that range from a dozen employees to several hundred (98% of businesses in America), people generally turn to trusted friends and colleagues for support. During a crisis, it’s easier to talk to those we know, members of the organizational family, than “strangers with name tags.” Notwithstanding these caregivers’ efforts, the magnitude of traumatic events often overwhelms individuals and their families, and compromises an organization’s ability to function.

Bringing over two decades of experience to the business world I am offering dynamic, one day, on-site interactive seminars. After utilizing an effective strategy for identifying the “go-to” people within your organization, I will personally meet with this identified group and train them to effectively respond to a workplace crisis. By developing and enhancing peer caregivers’ repertoire of helping skills, your business can draw upon its own resources to keep people functioning.

Research has demonstrated that the best help early on is rendered by trained and empowered peers, not by strangers. Following this program, your businesses will have a Crisis Management Team in place—a small investment from your training budget that will ultimately protect your organization’s greatest asset—its people.

This seminar will not only save your business thousands of dollars in lost productivity per employee, but will also help to lessen the psychological damage and feelings of loneliness employees experience in the aftermath of a crisis. By reaching members of your organizational family early, we can ease emotional pain, keep people functioning and lessen the likelihood of ongoing suffering.

For further information, please visit www.InstituteforTraumaticStress.com