Treating Trauma in Virginia and Washington DC

Trauma is exposure to a stressor that involves actual or perceived threat, danger, serious injury, or emotional injury to the self or another person.

The response to the event may involve fear, helplessness, and can manifest in persistent avoidance of triggers associated with the trauma, and/or hyper-vigilance to events surrounding the trauma.

Some traumatic experiences can lead to Post-Traumatic Stress Disorder where the event is relived in various ways and causes intense emotional distress and physiological arousal. Clients who have trauma in their backgrounds often have both trouble relaxing as well as trouble connecting to their immediate ‘here and now’ experience. People who enter therapy for trauma do not always meet the diagnosis for P.T.S.D. but they typically relate to some of the following symptoms:

Post Traumatic Stress Disorder (DSM-IV Criteria)

The person experiences a traumatic event in which both of the following were present:

1. The person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person’s response involved intense fear, helplessness, or horror
3. The traumatic event is persistently re-experienced in any of the following ways:
4. Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions
5. Recurrent distressing dreams of the event
6. Acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated)
7. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
8. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:

1. Efforts to avoid thoughts, feelings or conversations associated with the trauma
2. Efforts to avoid activities, places or people that arouse recollections of this trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (eg unable to have loving feelings)
7. Sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:

1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response