Anger Management: 3 Ways to Channel Your Rage

Anger is a tricky emotion, especially in our society.  We get messages that anger is “bad” and that we should never show it.  While we certainly don’t want to take our anger out sideways on innocent bystanders and we don’t want to rage at people we have anger towards, anger isn’t a “bad” emotion to be pushed away and shamed for. It is healthy to acknowledge, honor and express our anger as long as we’re not hurting anyone in the process.  Here are three ways to channel your anger:

1.  Acknowledge: 

Mindfully check in with your body and notice where the anger lives.  You may notice that when you’re angry, you clench your jaw. Many of us store anger in our jaws. Perhaps when you get heated, you feel your face flush.  Do you notice that you make a fist?  Or are you more someone who feels ashamed for having anger, so it’s stuffed down and manifests itself in an upset stomach or feelings of self-loathing?  However your anger manifests itself, the first step towards freedom is to acknowledge that you are, in fact, angry, even if you’re not quite sure why.

2.  Honor:

Trying to put the judgment aside, see if you can think back to when you first started noticing the anger.  Sometimes people believe that the key to anger management is to push the anger away and try to ignore it.  But, I’m of the belief system that what we resist, persists.  So if you want to get free of your rage and really learn anger management, try allowing yourself to be angry without doing anything about it, just noticing it in your body.

3.  Expression:

Here are some skills you can try for expression of your anger.  Take what you like and leave the rest:

• Journal about the anger
• Write a ‘do not send’ letter to the person or thing you’re angry at
• Sweat it out - Go for a run or engage in another form of physical exercise
• Vent to a friend, therapist or another safe person not involved in the situation 
• Rip up a phone book
• Punch a punching bag
• Create some art expressing your anger
• Write out the story of what happened, then rewrite it with what you wish would have happened
• Practice progressive relaxation
• Learn assertive communication skills and directly address the issue with the person or situation

For more help with anger management, contact us here.  

What else do you find helpful for anger management?  Write your responses here:

5 Ways To Be A Better Listener: Communication Through DBT Skills

DBT for Communication

by Megan Delp, MFT

The Dialectical Behavioral Therapy (or DBT) tenant called Interpersonal Effectiveness teaches us how to be a more effective communicator through learned to be a better listener.  We have always known that progress depends on the ability to communicate effectively.  The most effective communication does not begin with what a person says, but how well they hear the person they are communicating with. Only by listening effectively can you respond appropriately inany situation.

Throughout all forms of communication (reading, seeing, speaking, listening), we spend 40% of that time listening.  And yet, we get less training in listening than in any other kind of communication. All throughout childhood, we are taught how to speak, how to read, but very little time is spent on learning how to listen.  Learning to listen is difficult, but worth it.

For instance:

• You can not NOT communicate.  We're communicating verbally or nonverbally all the time.

• Whenever contact is made, some form of communication does occur.

• The true meaning of something is not in the words we use, it's in how people interpret the words.

• Yet the meanings cannot be transferred. We can't just put a computer file directly in someone's head. We can only send the words. So listening becomes a critical skill if we are going to fully understand the meaning someone is trying to send us.

We have the ability to listen in many different ways - it is important to be able to distinguish how we are approaching our communication so that we are prepared to handle it effectively.

The Five Listening Approaches are:

1. Appreciative:

People are more likely to listen if you feel inspired by what you are hearing or if you are enjoying yourself. You’re not necessarily interested in the details when you are using Appreciative Listening, rather you are more focused on the impression of the experience.

2. Empathic:

This style is often a sounding-board to others. A person would offer support to the person they are listening to.  They focus specifically on the feelings revealed by the person they are listening to. If you are often approached by people who need to confide or vent about something, you will know that's your typical approach to listening!  This style is much more focused on offering compassion.

3. Comprehensive:

A comprehensive listener can recognize key details between one message and another even when the speaker is less than organized. They can also recognize when someone doesn't understand what is being said and can re-explain clearly in their own words.

4. Discerning:

This approach of listening wants to get all the information and may take detailed notes.  Distractions can be very disturbing when using this listening approach. An example would be when other people are talking in class and you are trying to get all the notes.

5. Evaluative:

When listening with an evaluative approach, the listener will not automatically accept what is being said as true just because an expert says it. If they disagree, they will simply stop listening. They will also be more doubtful if the speaker is too passionate about their topic. This approach can be helpful when evaluating something and making a decision about it.

It can be highly useful to adapt your listening approach to the needs of the situation.  For example, if a close friend is sharing their difficulties with you, you would want to be empathic and not evaluative.  You have probably had the experience of someone giving you unsolicited advice when you really just wanted them to empathize with you!  The opposite can also be true. When you recognize the correct listening approach in any situation, and use the appropriate listening approach, you can build better relationships, make the correct decisions and use your interpersonal effectiveness skills.  It all starts with learning how to listen!

Megan Delp, MFTI

Megan is a pre-licensed Marriage and Family Therapist specializing in couples counseling and individual therapy for those struggling with depression, anxiety and relationship issues.  Megan practices with Spilove Psychotherapy in West Chester, Pennsylvania and on the Main Line of Philadelphia in Bryn Mawr.  For more information or to schedule a free 15 minute phone consultation, contact us here.

5 Things You need to know before you start counseling

So, you’ve decided to start counseling and you’re ready to go.  Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach.  Here are some things you need to know before you start counseling.

1.  Finding a therapist that you feel safe with is most important. 

You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do.  The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals.  If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely.  Your therapist should be someone you can relax around and speak freely without fear of being judged.  Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.

2.  Specialties mean that there’s been special training in a particular issue. 

Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions.  So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues.  If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert.  This will give you a better idea of how equipped we are to help you with your specific struggle.

3.  When you hire a therapist, you are paying for a space that is yours, for you.

I’ve heard people say that therapy is like paying someone to be your friend.  This is actually not true.  When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work.  It is an energy exchange.  You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else.  In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them.  In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially.  This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.

4.  The more consistently you go, the more effective therapy is.

Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month.  While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule.  You don’t have to be in therapy forever.  You can establish and work towards specific measurable goals with your therapist and see regular progress.  However, progress is more difficult to measure when you attend therapy inconsistently.  You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction.  If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge.  Don’t take my word for it, check it out for yourself.  Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period.  You may be surprised with the results.

5.  Therapy happens in stages.

Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions.  The reality is that there’s a therapeutic process which happens in stages.  The first stage is joining with your therapist or learning to trust them.  When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend.  A similar concept is applied in therapy.  Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more.  Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work. 

The second stage is where the work is done.  Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability.  There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history.  This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors.  The second stage of the therapeutic process is where clients reach their goals.

The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference.  This stage is for maintenance.  The client continues therapy but perhaps doesn’t come every week any longer.  They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage.  Some people choose to forego this step and skip to the fourth stage.

The fourth stage of counseling is a closure process.  After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship.  If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss.  Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication. 

I hope these tips have been helpful.  Please feel free to comment below with any other tips or feedback you have on this topic.  If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at TiffanySpilove@yahoo.com or call 610-314-8402.  I wish you luck in your endeavors and look forward to hearing from you soon!!

"We cannot love others until we love ourselves" by Mikala Morrow

 "We cannot love others until we love ourselves"

by Mikala Morrow, Villanova Graduate Counseling Intern

This saying has been a cliché statement that has been thrown around as a way to encourage self-care or even used as a convincing statement to those who find it hard to love themselves. What does this statement truly mean?

It means that someway, somehow we must find, within us, love. This must mean that love is an innate ability and we all possess the ability to love ourselves without the assistance of others.

Personally, I do not believe this to be true. Can we truly have an innate ability to love ourselves without any help from others? If we truly cannot love others until we love ourselves, we have to be able to love ourselves without help, right? Which comes first, the chicken or the egg? Which comes first, our innate ability to love? Or is love taught to us from our caretakers, partners, peers or a higher power?

What if, “We cannot love others until we love ourselves” becomes “We cannot love ourselves and others until we have been loved.” My argument is that in order to learn to love others, we must first be loved. We must learn how to love and what love is.

Imagine a child who is neglected by their caretaker. This child never truly learns love. Instead, to them, love means neglect. Later on in life when meeting new people, how will they love them? If all this older child has known is that love is neglectful, they too will neglect those that they love.

Compare the first child with someone who has a loving caretaker who has shown interest in who they are. This child will grow up with the idea that love is showing interest in others and will love in this way. These examples may not be true for all, but it is something to think about. The child in the first scenario may

learn somewhere how to truly love but this will not come as easily as the child in the second scenario.

We need to learn what love looks like towards us and we also need to learn how we love.  We may love by giving others gifts or our time. We may show our love through compliments or by offering a shoulder to cry on. We all have a unique way to show love. In order to practice our ways of loving, we need people around us to accept our love. If our unique way of showing love is rejected, we learn that we are not good at loving, or our way of loving is wrong.

Let’s say you show love with your time but your partner becomes annoyed and tells you they just want space. Your way of loving has been pushed away. We need other people around us to affirm the way we love.  While the statement, “We cannot love others until we love ourselves” has a good message at the core, it can be damaging for those who have never learned how to love themselves.

We all need love whether it is from other humans on earth (maybe even from a pet) or a supernatural love. Then we can truly love others’ authentically and comfortably.

Mikala has an intensely compassionate and unique way of connecting with you to help you identify and express your feelings and your deepest sense of self.  She is persistent and encouraging in the face of hopelessness and despair.  She especially loves working with women to provide tools to alleviate anxiety and depression.  Mikala has a wealth of experience and is skilled in the mental health field working with domestic violence, food & body issues and addiction.  If you're struggling to tolerate your emotions and you're looking for a guide to help you get to know yourself better, give her a call now at 570-412-4516. 

Dealing with Anger About Your Past: 5 Ways to Channel Your Rage

You’ve been through a lot of scary, horrible situations - more than most people.  It’s in the past now, but it still feels so present.  Every time you take a shower, eat a meal, hear a certain song or smell that familiar, sickening smell, the memories are right there - alive and well in your life.  You’ve tried to get past them and move on.  You’ve tried talking about them and it hasn’t helped.  You’ve cried about it, cut your skin, cursed your perpetrators and done everything in your power to make it go away, but you’re angry.  They hurt you.  They took parts of your life from you and you can never get it back.  Here are some healthy ways you can channel your rage:

1.  Sweat it out:

What we resist, persists.  If we continuously try to squash the anger and make it go away, it will continue to resurface.  Find ways to move the energy through you rather than trying to stuff it down.  Find a self-defense class - the physical activity and the techniques to learn to defend yourself as well can be empowering, even retroactively.  Bikram Yoga is a yang activity, as opposed to most other yin yoga.  The heat, the intensity, the discipline and repetitiveness along with the pain are quite cathartic.  Additionally, some of the poses are meant to help move emotions through, my favorite is the camel, heart opening pose - lots of emotions and no one will notice if you shed a few tears in the midst of all the sweat that happens.  Beat up a punching bag - you can imagine it’s your perpetrator or not, but either way, it’s a physical reflection of your internal state and it helps to externalize.  Other physical activities such as running, biking, swimming, etc are all excellent ways to boost your neurotransmitters AND the bi-lateral stimulation has a similar effect as EMDR.  Just be careful to make sure you stay in your body - if you dissociate while you engage in these activities you can injure your body, so feel your feet and stay present.

2.  Loud Music:

Create an angry playlist or find a favorite angry song or two.  Listen while you drive, or walk or run.  Listen and write down the lyrics.  Create your own lyrics or your own song, change the lyrics in your favorite song to make it more relevant to your memories.  Find music that talks about resolve and peace.  Depending on your mood you might want to lean into the anger or you might be ready to cool it down.  Music is an excellent way to reflect feelings and feel connected to others’ who might have gone through some similar things.  Here are some excellent bands that write songs about anger: Pearl Jam, Nirvana, Rage Against the Machine, Perfect Circle, Disturbed, Pierce the Veil, Bush, Emarosa, Dance Gavin Dance, The Amity Affliction, I Prevail.

3.  Get Creative:

Write a poem or a song, create some art, write a story about your trauma, then re-write it with the ending that empowers you - it’s transformative.  Write an angry letter to your perpetrator and/or another person involved in your trauma - perhaps someone who didn’t protect you.  Create a box to hold all your anger - as things come up, write them down or create something to represent it and put it in your box.  Even if you don’t think you’re good at art, do it anyway (you don’t have to show anyone), use magazine images, clay, paints or all of the above.  Get messy, rip up a phone book, find a safe space to burn things in.  

4.  Get Verbal: Scream!  

Take a drive, blast the music and scream loudly.  Go into the woods and scream.  Talk to a safe friend, find an online community who understands, find a good counselor to talk to.  Talk about it with your spiritual community.  Phone a hotline or attend a meeting or a group.  Contact me at TiffanySpilove@yahoo.com if you need help finding any of these resources.

5. Center and Redirect:

If you imagine your rage as a fire hose, blasting towards unhealthy behaviors, you can learn to turn your hose towards something productive.  In order to do this, breathe deep into your belly, feel the fire of the rage, allow it to be there, then imagine you can channel this energy towards something else that benefits you.  Perhaps it’s helping others’ who’ve been through the same thing, maybe it’s writing a book on the subject or to building a support group.  Go inside and ask yourself - if a miracle happened to you and tomorrow you woke up in your own personal miracle, what would your life look like?  Where would you live? Who would be around you?  What would you do with your days?  Take that rage and channel it towards creating that life for yourself.

You can let your trauma destroy your life, or you can use it to rise from the ashes like a phoenix.  Don’t let your perpetrators have any more of you.  Take back your power, your body and your life.  If you need help doing that, I’d be happy to help.  Call me at 610-314-8402 now for a free 15 minute phone consultation.  www.TiffanySpilove.com

The Number 1 Trauma Treatment: EMDR Explained

Lucky us!  Scott Giacomucci, MSS, LSW, CTTS, CET III, trauma specialist, psychodramatist and all around amazing therapist has shared his insights and explained that complicated title: Eye-Movement Desensitization and Reprocessing, also known as EMDR.  The following is a handout Scott put together for his clients to help explain what EMDR is and how it's done:

EMDR: Eye-Movement Desensitization and Reprocessing

Often, when something traumatic happens, it seems to get locked in the nervous system with the original picture, sounds, thoughts, feelings, etc.  Since the experience is locked there, it continues to be triggered whenever a reminder comes up. It can be the basis for a lot of discomfort and sometimes a lot of negative emotions, such as fear and helplessness that we can’t seem to control. These are really the emotions connected with the old experience that are being triggered.

What is EMDR?

 Eye Movement Desensitization and Reprocessing, is a late-stage, trauma resolution method.  Developed in the late 1980's, EMDR currently has more scientific research as a treatment for trauma than any other non-pharmaceutical intervention. Based on empirical evidence as well as thousands of client and clinician testimonials, EMDR has proven an efficacious and rapid method of reprocessing traumatic material.

EMDR appears to assist in processing of traumatic information, resulting in enhanced integration - and a more adaptive perspective of the traumatic material. The utilization of EMDR has been shown to be effective with a variety of conditions including generalized and specific anxieties, panic attacks, PTSD symptoms (such as intrusive thoughts, nightmares, and flashbacks), dissociative disorders, mood disorders and other traumatic experiences. Theoretically, EMDR is about integration - bilateral hemispheric (right/left brain) integration; triune brain (brain stem, limbic system and cerebral cortex) integration; and mind/body integration, but practically, it’s about convincing the mind and body that the traumatic event is, indeed over. EMDR helps to put the past in the past, where it belongs, instead of staying stuck in it (feeling like it is happened all over again in the present-with the same thoughts, emotions and body sensations- that accompanied the event in the past).

The eye movements (or other bilateral stimulation) we use in EMDR seem to unlock the nervous system and allow your brain to process the experience. That may be what is happening in REM, or dream, sleep: The eye movements may be involved in processing the unconscious material. The important thing to remember is that it is your own brain that will be doing the healing and you are the one in charge.

How is EMDR Done?  (Parnell, 2006)

• Establishment of Safety and Resources - Safety within the therapeutic relationship and safety within each individual EMDR session. During each EMDR session, your therapist will begin by activating your own internal resources. (S)he will guide you in an imaginal, multisensory imagery exercise designed to activate images, emotions and body sensations of safety, protection, nurture and comfort. Once these images have been activated, the actual trauma reprocessing will begin.
• Activating the Traumatic Memory Network - The therapist will ask a series of questions regarding the traumatic memory. The purpose of these questions (or script) is to activate the entire traumatic memory network.
• Adding Alternating Bilateral Stimulation - Once the entire traumatic memory is activated, the therapist will add alternating bilateral stimulation using:

a) buzzing in your hands by turning on the Theratapper

b) alternating auditory tones via headphones or ear buds

c) moving his/her hands back and forth, so you may visually track the movement

• Reestablishment of Safety - regardless of whether the traumatic material was completely processed or not, the session will end at a pre-set time. Before you leave, you will be stable, embodied, oriented and calm. Depending on you and your therapist’s preferences, this may be accomplished in a variety of ways including, but not limited to re-activating your own internal resources, breathing exercises, prolonged muscle relaxation, etc.

Looking to continue EMDR therapy?

-You might begin by asking your IOP/PHP counselor for a recommended outpatient counselor who is skilled in EMDR.

-At the EMDR International Association website (EMDRIA.org) you can navigate to the “Find a Therapist” tab and search for a certified EMDR therapist in your community.

 The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies.

(Giacomucci 2017)(References: EMDRIA; Linda Curran; Laurel Parnell)

Scott Giacomucci, MSS, LSW, CTTS, CET III is a certified trauma treatment specialist and licensed social worker in Pennsylvania. He is a graduate of Bryn Mawr College where he received his Masters in Social Service (MSS) with a concentration in clinical social work. He facilitates trauma treatment services at Mirmont Treatment Center serving a variety of populations including young adults and emergency responders (veterans, police, fire, etc..) in both individual therapy and group sessions. Scott has a gentle, non-judgmental treatment approach that honors the inherent worth of each individual. He utilizes a blend of treatment modalities including both traditional talk therapy and experiential therapy which have been research-proven as the treatment of choice for treating trauma. 

To learn more about Scott Giacomucci and the work he does, you can visit his website at: http://sgiacomucci.com/

Any comments or questions?  We'd love to hear from you!  Please comment below.  For confidential questions, email TiffanySpilove@yahoo.com.  If you need help finding an EMDR therapist, please call 610-314-8402, I'd be happy to help.

100% Accurate Trauma & PTSD Symptom Assessment by Expert Scott Giacomucci, MSS, LSW, CTTS, CET III

Scott Giacomucci, MSS, LSW, CTTS, CET III

A colleague and friend of mine, Scott Giacomucci, MSS, LSW, CTTS, CET III has been up to some pretty amazing things in the world of trauma, psychodrama and PTSD healing.  He was kind enough to share some information he put together for his clients with us.  The following is a handout on Trauma and PTSD.  Let us know what you think and if you have any questions in the comment section below:

 

Trauma and PTSD

                                by Scott Giacomucci, MSS, LSW, CTTS, CET III

Client: "What's wrong with me?"

Therapist: "Well, given your symptoms, I think you have Post Traumatic Stress Disorder."

Client: "Post Traumatic Stress Disorder?  What are you talking about?  Trauma?  It doesn't make  sense.  What trauma did I have?  I wasn't in a war or survive a holocaust or anything.  I didn't even really get hurt."

This is a typical response following an assessment and diagnosis of this poorly understood disorder.  It seems appropriate that this diagnosis - like many other serious medical diagnoses - would be initially met with denial to temporarily protect the person from the reality of his/her own vulnerability.  However, in order to effectively treat the condition, the diagnosis eventually needs to be accepted, and in order to accept the diagnosis, one needs to understand it. To this end, I offer the following answers to the two most frequently asked questions: What is trauma? and How bad does it have to be to be traumatic? 

What Is Trauma?

According to one of the foremost experts in healing trauma, Dr. Peter Levine,

“Trauma is a basic rupture - loss of connection to ourselves, our families, and the world.  The loss, although enormous, is difficult to appreciate because it happens gradually. We adjust to these slight changes, sometimes without taking notice of them at all…although the source of tremendous distress and dysfunction, it (trauma) is not an ailment or a disease, but the by-product of an instinctively instigated, altered state of consciousness. We enter this altered state let us call it "survival mode” when we perceive that our lives are being threatened. If we are overwhelmed by the threat and are unable to successfully defend ourselves, we can become stuck in survival mode. This highly aroused state is designed solely to enable short-term defensive actions; but left untreated over time, it begins to form the symptoms of trauma. These symptoms can invade every aspect of our lives.”

One of the most effective ways to evaluate if you have been traumatized is to answer these simple questions about a significant incident: when you remember the incident, is the memory exactly the same every time? Is the memory unusually fragmented or difficult to recall?

If an answer is yes, then the memory is likely a traumatic one.  By no means does one traumatic memory constitute a diagnosis of PTSD; however it does indicate that the traumatic event has been dysfunctionally stored; remains inadequately processed; and continues to cause you distress.

What is a PTSD Diagnosis?

A diagnosis of PTSD is different from most mental-health diagnoses in that it is the only diagnosis that explore and places emphasis on “what happened to you”. The Diagnostic and Statistical Manual of Mental Disorders (5th edition) offers 4 criteria for a PTSD diagnosis.

1.     The first criterion relates to the actual trauma:

•  Directly experiencing the traumatic event(s)

• Witnessing, in person, the event(s) as it occurred to others

• Learning that the traumatic event(s) occurred to a close family member or friend

• Experiencing repeated or extreme exposure to aversive details of the traumatic event(s); this does not apply to exposure through media such as television, movies, or pictures

2.     The second criterion involves the persistent re-experiencing of the event in 1 of several ways:

• Thoughts or perception
• Images
• Dreams
• Illusions or hallucinations
• Dissociative flashback episodes
• Psychological distress or reactivity to cues that symbolize some aspect of the event

3.     The third criterion involves avoidance of stimuli that are associated with the trauma and numbing of general responsiveness, as determined by the presence of 1 or both of the following:

• Avoidance of thoughts, feelings, or conversations associated with the event
• Avoidance of people, places, or activities that may trigger recollections of the event

4.     The fourth criterion is 2 or more of the following symptoms of negative alterations in cognitions and mood associated with the traumatic event(s):

• Inability to remember an important aspect of the event(s)
• Persistent and exaggerated negative beliefs about oneself, others, or the world
• Persistent, distorted cognitions about the cause or consequences of the event(s)
• Persistent negative emotional state
• Markedly diminished interest or participation in significant activities
• Feelings of detachment or estrangement from others
• Persistent inability to experience positive emotions

5.     The fifth criterion is marked alterations in arousal and reactivity, as evidenced by 2 or more of the following:

• Irritable behavior and angry outbursts
• Reckless or self-destructive behavior
• Hypervigilance
• Exaggerated startle response
• Concentration problems
• Sleep disturbance

6.     The duration of symptoms is more than 1 month

7.     The disturbance causes clinically significant distress or impairment in functioning

8.     The disturbance is not attributable to physiological effects of a substance or medical condition

According to Levine,

“The symptoms of trauma may be continually present or they may come and go. They may even surface after being hidden for decades. Usually, symptoms do not occur individually, but in clusters grow increasingly complex over time. Unfortunately, they become less and less connected with the original traumatic experience, making it increasingly difficult to trace the symptoms to their cause, and easier to deny the importance of the traumatic event in one's life. However, if we pay attention to these symptoms, for what they are -internal wake up calls - we can address and begin to heal our trauma.”

Although there are pervasive misconceptions about trauma, PTSD is neither rare nor unusual. But unlike seeking treatment for symptoms related to diabetes or glaucoma, seeking treatment for the symptoms of PTSD is somehow interpreted as a weakness. Although this couldn’t be further from the truth, you may believe it. Maybe even said something like it; Real men don’t ask for help; Trauma couldn't possibly affect a well balanced person, there must be something wrong with me; or the all time favorite, It wasn’t really that bad; I should just get over it.

Don’t you think that if that were an option, you would have done just that?

(reference: DSM5 & Linda Curran)

Scott Giacomucci, MSS, LSW, CTTS, CET III is a certified trauma treatment specialist and licensed social worker in Pennsylvania. He is a graduate of Bryn Mawr College where he received his Masters in Social Service (MSS) with a concentration in clinical social work. He facilitates trauma treatment services at Mirmont Treatment Center serving a variety of populations including young adults and emergency responders (veterans, police, fire, etc..) in both individual therapy and group sessions. Scott has a gentle, non-judgmental treatment approach that honors the inherent worth of each individual. He utilizes a blend of treatment modalities including both traditional talk therapy and experiential therapy which have been research-proven as the treatment of choice for treating trauma. 

To learn more about Scott Giacomucci and the work he does, you can visit his website at: http://sgiacomucci.com/