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Some individuals are surprised when they find out that they meet criteria for Post Traumatic Stress Disorder (PTSD). Often times they believe that only combat veterans would be in circumstances to create something like PTSD. However, any experience that feels threatening to one's very existence and sense of self can cause symptoms of PTSD. PTSD includes multiple symptoms. Some of these are flashbacks to the incident, intrusive images of the event, feelings of irritability / outbursts of anger, being startled easily,  a feeling of needing to avoid things or people that serve as reminders, nightmares, feeling numb and detached from the world or others around you, difficulty with relationships, feelings of low self worth, and a sense of hopelessness about the future.

Though the above issues are common symptoms of PTSD, PTSD can still show up differently in different  individuals. How it shows up can inform the clinical approach needed to help a person heal. PTSD can show up in the case of an acute, single incident in a radically different way to how it appears in cases where there are multiple traumatic episodes over years.


The treatment for different kinds of expressions of trauma can take very different forms. For instance, individuals who have experienced abuse at a later age tend to lean more towards fight/ flight responses and individuals who experience trauma at a very young age can experience more of a freeze  and shut down response.  Both types might utilize a fawning response to manage potentially difficult people or situations. No person solely relies on one single way to process, hold and express the impact of their past traumatic experiences. It is important to note that there are approaches that work very well for individuals who lean more towards fight and flight and that these same approaches won't work as well for those who utilize freeze more often to cope.  


Catherine Keech, LMFT

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