An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates
Volume 9, Number 7
Not only is July National Anti-Boredom Month but it also contains the holiday of Parent’s Day. Not widely known, nevertheless, it is a good time to call or visit one’s parents and remember them. Often we get too busy and too plugged in to remember what and who is important. During this summer when we are in a vacation mindset, take the time to truly relax and appreciate what you have and who you have.
This month’s E-letter focuses on understanding the effects of trauma. Our email of the month is about 12 steps for self care and maintenance and our Ask the Doc question is about concern about an eating disorder. We hope you find the enclosed information helpful. As always, we appreciate your questions and comments are welcome.
Practice News
Divorced Women’s Support Group. An eight week support group for women who are divorced will begin on Thursday evening September 11, 2014 from 6:00 to 7:15 P.M. In response to a request both from patients and attorneys, we are beginning this educational and support group, facilitated by Dr. Terry Newell. Areas of focus will include, but are not limited to:
- Co-parenting issues
- Living life as a single parent
- Dealing with depression
- Navigating finances
- Developing personal interests
- Managing stress
For further information or if you are interested in joining this group, please contact Jillian at 954 755-2885.
Depression group. A weekly depression therapy group meets regularly in our office. This group is run by Dr. Jim Kaikobad and meets for one and one-half hours. The group is educational, supportive, and confidential and is limited to 8 people. If you are interested in attending, please contact Jillian at 954 755-2885.
Research Study. If you are overweight, you might consider participating in a research study. Our practice has been asked by Life Extension Institute to participate in conducting research assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Informal results continue to show success for those subjects who are in the study. For more information about the study, contact Jillian, at 954 755-2885.
Parent Education and Family Stabilization Course. Our practice is one of the few offices certified to provide the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages. The course is offered live on a flexible schedule, based on the availability of those attending the course. Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.
Handouts from previous E-Letters can be found on our website, www.KimmelPsychology.com. We invite you to read and download them if desired.
UNDERSTANDING THE EFFECTS OF TRAUMA!
Our E-Letter this month focuses on Trauma which is a normal reaction to abnormal events. Trauma is the emotional, cognitive, and physical reaction to an event or series of events where stress overwhelms one’s ability to cope or deal with the event. Examples of trauma include both natural and manmade events. Trauma can be the result of natural disasters like earthquakes and hurricanes. Trauma also can occur when one’s life is threatened or when one observes injury or death to another. Examples of human induced trauma include bullying, sports injuries, robberies, homicides, car accidents, medical procedures, verbal, physical, or sexual abuse, abandonment, domestic violence and terrorism. Trauma can sensitize people so that they remain on-guard in a heightened state of anxiety. Often, trauma occurs unexpectedly and without warning. People usually feel powerless in these situations as they cannot stop the event or events from occurring. One’s sense of mastery over their own lives is destroyed as well as their sense of safety and trust.
Traumas can occur repeatedly and over longer periods of time especially to those who may be held captive and sexually abused, prisoners of war, or victims of domestic violence. Often first responders or emergency health care workers experience secondary traumatization where they frequently are exposed to traumatic situations. They may develop burn out or compassion fatigue as a result. As they frequently experience what most of us never see, their sense of reality can be quite sharpened and cynical.
After a traumatic experience is over, triggers and cues may cause the person to re-experience the trauma through flashbacks and extreme anxiety. People often will isolate themselves as a way of trying to protect themselves. Drug addiction, alcoholism, and food addiction are behaviors people turn to numb their feelings and suppress their thoughts. In extreme cases, trauma victims will dissociate where there is a splitting off from themselves and they experience a sense of unreality. Emotionally, they may have intense feelings of anger that can sometimes seem like it comes from nowhere. They tend to have intrusive thoughts, frequently worry, and can be suspicious of others. They have difficulty sleeping and eating and can cry very easily. Physically, after a trauma a person may be nauseous, have stomach problems, have a rapid heartbeat, and be lightheaded. They may have difficulty remembering, feel like they are another person, have concentration problems and memory lapses, and may be indecisive. They may emotionally detach with difficulty in forming bonds with and trusting others.
What appears to be the most upsetting psychologically is that traumas destroy our sense of safety and our ability to protect ourselves. They shake up our personal beliefs and assumptions about the world. They cause us to feel powerless and damage our beliefs about our ability to control our lives. We learn real quickly about how insignificant we can be with little control over our lives and our decisions.
Traumas can be treated with the end result of people integrating the trauma into their lives, adjusting to the challenges, and developing a new perspective on reality. However, that often takes time and requires a lot of support from loved ones. Cognitive Behavior Therapy can be particularly effective in changing beliefs and perceptions of the trauma resulting in changes in emotions and behaviors. Systematic Desensitization is a behavior therapy treatment procedure where a person’s reactivity is diminished through the gradual exposure of threatening stimuli. Eye Movement Desensitization/Reprocessing (EMDR) is a treatment modality frequently used with trauma victims. The goal is to process disturbing memories, reduce their lasting effects, and develop better coping mechanisms.
If a loved one has been traumatized, it is important for you to be patient and understanding of the magnitude of their reactions. Do not take their behaviors personally and encourage them to relax and not to isolate. Be supportive and realize that they have gone through something major. Listen or help them find a support group so they can express their thoughts and feelings.
If you have been traumatized by something that happened to you or something you saw, find a support group to talk about it. Take one day at a time and realize that life will settle down. Take care of yourself; maintain good hygiene, eat well, and try to sleep well. Accept the love and support from your loved ones. Exercise and do not isolate. Learn and use stress reduction coping strategies. Seek out professional help if you continue to have difficulty. Remember that your reactions are not abnormal…the event or events were.
We offer the following information on Understanding the Effects of Trauma:
UNDERSTANDING THE EFFECTS OF TRAUMA!
“There are wounds that never show on the body that are deeper and
more hurtful than anything that bleeds.” – Laurell K. Hamilton
WHAT TO KNOW!
- Trauma is a high intensity, often short lived event, that causes damage to one’s psyche
- Traumatic events: often happen suddenly and unexpectedly, when you are unprepared, when you are powerless to prevent it, when someone is intentionally cruel or threatening
- Emotions after a trauma are often normal reactions to abnormal events
- Trauma is the result of an overwhelming amount of stress that exceeds a person’s ability to cope with or emotionally process the event
- Trauma can be one event or it can be repeating events
- Trauma shakes up our ability to manage our lives, our safety, and our ability to trust
- Secondary traumatization, or compassion fatigue or burnout, often effects first responders or others who help trauma victims
- Often the experience of being traumatized can be delayed by weeks, months, or years
- Sufferers of trauma include those who were victimized and those who have observed it
- Those who have been traumatized often develop patterns of living that include addictive behaviors which are attempts to avoid the feelings and memories of the trauma
- Common traumatic events that involve physical or emotional damage include: harassment, verbal, physical or sexual abuse and neglect, bullying, criminal activities, domestic violence, death, medical conditions, abandonment, war, earthquakes and hurricanes, terrorism, discrimination, accidents, relationship breakups, sports injuries
- Triggers and cues can cause a person to re-experience the trauma and can produce extreme anxiety, intense anger, withdrawal, insomnia and dissociation or numbing
- Psychological symptoms after a traumatic event often include intrusive thoughts, worry, trouble focusing, difficulty sleeping, difficulty eating, crying, blame, fear, and anger
- Physical symptoms after at trauma can include nausea, stomachaches, diarrhea, dizziness, rapid heartbeat, lightheadedness, feeling sick, and rashes
- Cognitive symptoms include memory lapses, indecisiveness, difficulties in concentrations, feeling distracted, and difficulty paying attention
- Intense traumatic symptoms tend to lessen within 2 weeks and often disappear in 4 to 6 weeks with many people feeling better in 3 months although others can recover slowly
- Survivors of trauma often adjust to the challenges, integrate the event into their lives, and rebuild their lives with a new perspective on reality
- Treatment approaches to trauma include Cognitive Behavior Therapy. Eye Movement Desensitization/Reprocessing (EMDR), and Systematic Desensitization
WHAT TO DO!
- Help loved ones by being patient and understanding, not taking trauma symptoms personally, encourage them to relax and be around others, listen when they want to talk
- If traumatized, take one day at a time, eat a balanced diet, drink water, and do not use or abuse alcohol or drugs
- Try to get enough rest, take care of your daily hygiene, and exercise
- Keep to a daily routine and find activities that make you feel better
- Do not isolate; join a support group or talk to others who have been trough traumas
- Learn and use stress reduction and coping strategies
- Seek professional help if you are not able to overcome the effects of a trauma
We Can Help!
Call us at (954) 755-2885 or email us at [email protected]
Joel I. Kimmel, Ph.D., P.A. and Associates 5571 N. University Drive, Suite 101 Coral Springs, Florida 33067
As always, we would like to welcome new readers to our e-Letter. We hope that you find it informational and enjoyable. We invite you to share this e-Letter with others. If you have received this from a fellow reader, please send us your email address to include you on our list.
Ask the Doc
BC writes: My 14 year old daughter is very conscious about how she looks. She exercises at least 2 hours a day and is very picky about what she eats. She looks in the mirror constantly and we are tired of telling her how good she looks. Is this normal or do you think she may have an eating disorder?
- Dr. Terry Newell: B.C. This is a good question. Although, teens generally have an increased concern in their appearance and may demonstrate concerns about looking like their friends, when it becomes excessive these may be signs of an eating disorder.
Most people believe that an eating disorder is characterized by someone who is extremely thin and that the person does not eat. The reality is Anorexia Nervosa, one type of eating disorder, actually comprises the smallest percentage of people with eating disorders. In Bulimia Nervosa, a person tends to be of average size or a couple of pounds overweight. They are highly concerned about their body size. They binge in secret, while being picky or having strict rules about what they will or will not eat.
People struggling with Bulimia maintain their weight through purging. This may be done by vomiting, the use of laxatives, or excessive exercise. People who are driven to exercise more than an hour a day or who cannot tolerate the idea of missing a day of exercise may be struggling with an eating disorder.
If you are very concerned, I would suggest you have your daughter evaluated by an eating disorders professional. I recommend that you not focus on her body size or weight. Rather, let her know you love and support her and are concerned about her eating habits. Avoid blaming her as she may be struggling. Resist saying things like “you just need to eat” or “if you don’t exercise one day it won’t hurt you”.
There are lots of resources available for people who have loved ones struggling with this disease, such as The Alliance for Eating Disorders and NEDA (the National Eating Disorder Alliance). While your daughter may just be a typical teenager, it may be a very good idea to have her talk to an experienced eating disorders professional.
Email of the Month
We would like to thank Ron E. for the following email:
12 Steps For Self Care
1. If it feels wrong, don’t do it.
2. Say “exactly” what you mean.
3. Don’t be a people pleaser.
4. Trust your instincts.
5. Never speak bad about yourself.
6. Never give up on your dreams.
7. Don’t be afraid to say “No”.
8. Don’t be afraid to say “Yes”.
9. Be kind to yourself.
10. Let go of what you can’t control.
11. Stay away from drama and negativity.
12. Love.
Please continue to send us your comments, questions, and favorite emails for our e-Letter.
Till August…
The information provided in this electronic newsletter is not a substitute for professional treatment. It is the opinions of the writers and is provided solely for educational purposes. For mental health care, seek a qualified professional.
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Copyright © 2014 by Joel I. Kimmel, Ph.D., P.A. and Associates.
