TREATING PTSD
Hope for the Walking Wounded: A conversation with Wende Tedesco, LCSW-R Clinical Director at the Saratoga Center For the Family
SARATOGA SPRINGS, N.Y. >> Modern American culture has reached a tolerance to forms of violence to where many consider things like violence in our schools and workplace to be the new norm to be lived with.
Violent video games, movies, and television have created and manufactured an appetite for blood and horror that serve to deaden people’s ability to acknowledge that any one of us at any time could be the victim of an act of life-altering violence.
It also serves to create a denial and an inability to identify unacceptable behavior as violent, whether in actions or verbal hostility directed at others.
The after effects that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war or combat, rape or other violent personal assault can be crippling emotionally and physically.
It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fightor-flight” response is a typical reaction meant to protect a person from harm.
Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with post-traumatic stress syndrome or PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.
Now more than ever, the occurrence of PTSD is emerging as a mental health issue that impacts thousands of lives annually without regard to age or gender.
The American Psychiatric Association explains the condition as follows:
“PTSD has been known by many names in the past, such as “shell shock” during the years of World War I and “combat fatigue” after World War II. But PTSD does not just happen to combat veterans.
“Everyone with PTSD— whether they are veterans or civilian survivors of sexual assault, serious accidents, natural disasters, or other traumatic events— needs to know that treatments really do work and can lead to a better quality of life.
“PTSD can occur in all people, in people of any ethnicity, nationality or culture, and any age. PTSD affects approximately 3.5 percent of U.S. adults, and an estimated one in 11 people will be diagnosed PTSD in their lifetime. Women are twice as likely as men to have PTSD.” While veterans can seem unable to emerge from the sense of hypervigilance required to remain alive in battle, that same inability to feel safe regardless of the immediate surroundings or circumstance can be experienced when the “war” is happening where you liveat-home, at work, or in the family unit.
That feeling of no way out and an inability to discern when the commonplace is not a fight for life and death can be hard to get past.
The “ME TOO” movement has called to attention the fact that sexual harassment, domestic violence and child abuse all factor into traumas that can scar victims emotionally-at home, and in the workplace and in our schools, adding to a walking wounded culture that often seems to be trying to function while presenting with unmanageable emotional and physical pain on a daily basis.
A diagnosis of PTSD requires exposure to an upsetting traumatic event. However, exposure could be indirect rather than first hand. For example, PTSD could occur in an individual learning about the violent death of a close family. It can also occur as a result of repeated exposure to horrible details of trauma, such as police officers exposed to details of child abuse cases.
People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people.
People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.
For victims of ongoing violence at home, the experience of mind-numbing physical or verbal abuse can result in a paradoxical paralysis. It can appear to victims that they are living in a waking nightmare from which there is no escape.
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In Saratoga County, there is a safe place that offers hope to people of all ages and scenarios dealing with the effects of PTSD.
The following conversation with Wende W. Tedesco, LCSW-R Clinical Director at the Saratoga Center For the Family addresses some of the signs and methods of treatment available locally to the victims of wars that are fought on a daily basis at home by men, women, and children.
Who comes through your doors for help with PTSD?
Tedesco: “We see both adults and children for PTSD. One of our programs under the agency Saratoga Center For the Family is the Child Advocacy Center (CAC), which is the center for Saratoga County for any children who have been sexually or physically abused or neglected-they can come here to be interviewed by the authorities. It can be forensic interviewing, with nurses that come to do the physical examinations necessary.”
What is the progression of events?
Tedesco: “I’m not the director of the CAC, but in a general sense, if there is a report of abuse or neglect that comes in through child protective services or through law enforcement, or both.
“Either can utilize our facility to come here to a very safe, inviting place where they can feel like children and talk about the incidents.
“The non-offending spouse, if that’s the situation at home, the parent that’s not involved in the actual abuse would generally be here to gain support through the array of services we can offer the public. We have victim advocacy services for an adult or child who has been a victim of a crime.”
When we speak of forensics, we’re speaking of the reconstruction of an event.
Tedesco: “It has to do with law enforcement investigations; there are very specific protocols to follow to do a forensic interview for a child. It’s very delicate and has to be handled appropriately, so you don’t re-traumatize them by requestioning them.
“Sometimes we have children in here more than once — the interview is once with lots of follow up, but we always offer mental health counseling within our doors as well, so children may be referred between programs here.
“There is always a waiting list for mental health services. But children who have been to the CAC, they go to the top of the therapists’ lists.
“We treat people from the age of four at the youngest up until their eighties. A lot of people suffer from PTSD or they’ve had all kinds of other things happen in their lives they need to talk about and restructure to function in their lives.”
What are some of the things that people present with that would imply they might need help with PTSD?
Tedesco: “For children, we see symptoms fall into three categories: re-experiencing the trauma through things like nightmares; arousal-kids become very jumpy or have difficulty concentrating or sleeping. It’s affecting the physical body. You might see crying, temper tantrums, bedwetting.
“It’s the fight, flight or flee part of our brain that evokes the responses. The third aspect is avoidance. They avoid triggers of reminders of the abuse; places, people, smells, sounds. They might be triggered by the smell of diesel because the abuse happened in a garage, for example.
“We also treat the parents because a child getting better greatly depends on the reaction of the adults who care about them.”
They’re like sponges; they pick up on the “vibe” around them.
Tedesco: “If there’s a positive response from a parent; kids don’t want to hurt their parents, so they might not tell them everything that happened.
“People that have traumatic experiences don’t always develop PTSD. It occurs a little more often in girls than with boys. I don’t know all the research behind it, but we know that is what we see here in youth under 18 for child PTSD.
“We have clients that may have started here when they were 14, are now 19 and in college and still need support.
“We don’t want children who have been abused to feel they are mentally ill; their symptoms are expected based on the severity and duration of what they went through.
“You and I can be in the same car in an accident and come out with completely different reactions to what happened in the car; you were the driver; I was the passenger. You were older, I was younger. You experienced it before; I haven’t. Many things can influence how you respond long term. Not every soldier develops PTSD.
“PTSD can happen after a one- time event — a fire, a crash or there could be prolonged abuse.”
The response is unique to the individual and their ability to process what happened in a healthy manner.
Tedesco: “If an experience becomes PTSD, it has affected multiple segments of their life. School, home life, relationships with other adults, focus. It may look like ADHD or the other extremes, like being numb or they can’t remember great segments of the abuse.
“Our brain has the ability to screen out the impact, but it does come through, some way or another.”
Does the culture play a role in who seeks out help?
Tedesco: “We assess individually and don’t make any assumptions. There can be a lot of anger involved, self-blame or guilt in a child abuse case.
“We work with patient’s other providers - we don’t deal with medication here. We use tested, reliable, evidence-based models that have been proven to be effective forms of therapy, such as trauma-focused cognitive behavioral therapy.”
If you or someone you know appears to be suffering from PTSD, the Saratoga Center For The Family is one place that can offer a variety of services to help. More information is available at http://www.saratogacff.org/ , or by calling 518-587-8241.