What is PTSD?

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates

Volume 9, Number 6

June represents the official start of summer and vacation season has begun. Children are off to camp and many of us are finding time for our well deserved vacations. While events in the world continue to be worrisome, to reduce stress we encourage you to keep your perspective on life. Things seem to slow down during this season and it is a good time to evaluate how you are living and caring for yourself. Are you eating well? Are you sleeping well? Are you doing meaningful things in your life? Are you maintaining your friendships and supports? Are you doing any relaxation activities? Are you engaging in any self destructive behaviors such as drinking to excess, taking non-prescribed drugs, or overeating? This is a good time for you to answer these questions and make some changes in your life.

This month’s E-letter focuses on PTSD. Our email of the month is about the paradoxes of our times and our Ask the Doc question is about chronic lateness. We hope you find the enclosed information helpful. As always, we appreciate your questions and comments are welcome.

Practice News

Therapist Opening. We have an opening for a full or part-time therapist to join our practice. Therapist must be licensed as a psychologist, social worker, marriage and family therapist, or mental health counselor in the state of Florida. Therapist must have at least 3 years experience and membership on insurance panels. Experience in treating children and adolescents as well as families is preferred. Resumes can be sent to: DrKimmel@KimmelPsychology.com or faxed to 954 344-6007.

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.


Our E-Letter this month focuses on PTSD or Post-Traumatic Stress Disorder. People tend to become afraid when they face a dangerous or threatening situation. In response, the body responds with a “fight-or-flight” response to defend against the danger and protect oneself from harm. In PTSD, the threat or exposure is beyond the range of typical human experiences. It is usually a situation that involves either being a victim of or being exposed to a terrifying, emotionally intense situation. It is often associated with military veterans returning from combat situations. However, PTSD can result from a variety of incidents including hurricanes or other natural disasters, domestic violence, being kidnapped, child abuse, robbery, car accidents, plane crashes, and seeing others harmed or killed.

While PTSD can have many symptoms, they are usually grouped into three categories: re-experiencing, avoidance, and hyperarousal. Re-experiencing the event includes flashbacks, nightmares, and frightening thoughts. Avoidance symptoms include feeling emotionally numb, guilty or depressed, a loss of interest in previous pleasurable activities, and staying away from places or objects that are reminders of the experience. Hyperarousal symptoms include being easily surprised or startled, feeling edgy and tense, difficulty sleeping and having angry outbursts.

Whether a person gets PTSD or not can depend upon the severity of the event as well as personal risk and resilience factors. Event factors include how intense and how long the trauma lasted, whether a person was the victim or an eyewitness, how powerless the person felt, and how close they were to the event. Risk factors for PTSD include having a history of mental illness, exposure to previous trauma, having little or no social support, actually getting hurt or maimed by the event, and feeling terror and helplessness. Resilience factors that may reduce PTSD include having a social support system from friends and family, attending a support group of others who have been in the same or similar events, taking some action in the face of fear, having coping strategies, and generally feeling good about oneself.

Treatment for PTSD usually involves psychotherapy, medications, or both. Psychotherapy can help people to understand what they have been through and how they have been affected by the trauma. It can teach relaxation skills and ways of controlling anger and other emotions. It can help people identify and deal with their feelings of guilt, shame, helplessness, and other feelings about the event. One particular technique, Cognitive Restructuring, helps people to look at the event differently and more realistically. They can realize that what happened was not their fault and that they were no different from others in the same situation. Group therapy can be quite supportive as a person can learn that others have experienced similar situations and learn how they are coping with it.

We offer the following information on PTSD:


“You can’t patch a wounded soul with a Band-Aid”— Michael Connelly


  • Post Traumatic Stress Disorder or PTSD occurs after a terrifying situation in which a person is harmed, threatened, or a witness to a harmful event
  • PTSD affects about 7½ million Americans with women more likely to feel its effects
  • PTSD can occur at any age and anyone can get it not just veterans but also survivors of assault, accidents, abuse, disasters, and other serious incidents
  • PTSD symptoms are grouped into 3 categories:
    • Re-experiencing which includes flashbacks, bad dreams, and scary thoughts
    • Avoidance including emotional numbness, loss of interest in activities, staying away from reminders of the event, and feelings of guilt, shame, or worry
    • Hyperarousal such as being on edge, difficulty sleeping, having angry outbursts, and being easily startled
  • The re-experiencing of an event, or flashback, can start from memories or exposure to situations, objects, or words that are reminders of the event
  • Reminders of the event can also cause people to avoid places, people, or things
  • Hyperarousal is usually constant in PTSD; it can cause people to be excessively vigilant and prepared for fight-or-flight to a perceived or misperceived threatening situation
  • Not everyone who experiences a dangerous event develops PTSD
  • Risk factors for developing PTSD include: actually getting hurt, having a previous trauma, having little social support, continuing to deal with the consequences after a traumatic event, and feeling horror and helplessness
  • Resilience factors that inhibit PTSD include: support from friends and family, having a coping strategy during the event, taking some action, and not feeling helpless
  • People with PTSD:
    • avoid anything related to the trauma including talking about it
    • avoid behaviors, places, or people that might remind them of the trauma
    • may be unable to recall major parts of the trauma
    • have decreased involvement in general life activities
    • may be numb to their emotions
    • may be pessimistic about their future
    • may have irritability or angry outbursts
    • may feel guilt and self-blame
    • may have suicidal thoughts
  • People with PTSD can have secondary problems including shame, depression, alcohol or drug problems, chronic pain, employment difficulties, and relationship problems


  • Recognize that PTSD is not a weakness but a normal reaction to an abnormal event
  • Getting treatment and getting it early will improve family and work life
  • Therapy will help explore thoughts and feelings about the trauma, resolve feelings of guilt and blame, teach coping strategies, and help solve work and relationship problems
  • Join a support group and do not abuse drugs or alcohol
  • Seek professional help if you have disturbing thoughts and feelings about a traumatic event or if you have trouble managing your life

We Can Help!

Call us at (954) 755-2885 or email us at drkimmel@kimmelpsychology.com

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

SR writes: No matter what I do, I am always late. When I have to be at school or at a doctor’s appointment, I am 15 to 20 minutes late. My friends expect me to be late and put up with it but I know it’s wrong. My husband gets frustrated and we fight. When we go to the movies, we get the worst seats and the movie has started. Even when I start out early, I arrive late. What can I do about it?

Dr. Joel Kimmel replies: First of all relax. Many, many people have this problem of chronic lateness and they often make themselves and others miserable. Constantly rushing to be on time and knowing that you will be late has to be quite frustrating and can make others angry and even give up on you.

To solve this problem, first consider why you are late. What is the real reason? Do you try to get one more thing done just before you leave? Do you continually underestimate how much time it takes to get where you are going? Do you spend time looking for your keys or phone or something else? Are you late because you are waiting for others who are always late? Do you try to do too much in too short a period of time? Are you too self absorbed and do not consider the feelings of others?

These are the most common reasons why people are chronically late and you may see yourself in some or all of the above questions. Facing them and being honest with yourself will help you get in control of your time. Consider doing the following:

  • Start out earlier and get up earlier in the morning to give yourself more time
  • Recognize that it is your style to do just one more thing and change your style. Do the one more thing when you get home or if possible, take it with you and do it at your destination.
  • Learn to add on 15 minutes more to how long you think a trip should take
  • Designate a specific place like a basket for your keys, cell phone, or other objects and train yourself to use this place
  • Give yourself a negative consequence, such as a monetary fine, for each time you are late
  • Rather than saying you are sorry for being late, write an apology so that it means more

If you actively commit yourself to changing your style of being late and put in the effort, you will change this behavior pattern. The rewards will be your sense of accomplishment, less arguments with your husband and friends, and a reduction in frustration.

Email of the Month

We would like to thank Richard L. for the following email:

Paradoxes of Our Times

The paradox of our time in history is that we have taller buildings but shorter tempers, wider Freeways, but narrower viewpoints.
We spend more, but have less, we buy more, but enjoy less.
We have bigger houses and smaller families, more conveniences, but less time.
We have more degrees but less sense, more knowledge, but less judgment, more experts, yet more problems, more medicine, but less wellness.
We drink too much, smoke too much, spend too recklessly, laugh too little, drive too fast, get too angry, stay up too late, get up too tired, read too little, watch TV too much, and pray too seldom.
We have multiplied our possessions, but reduced our values.
We talk too much, love too seldom, and hate too often.
We’ve learned how to make a living, but not a life.
We’ve added years to life not life to years.
We’ve been all the way to the moon and back, but have trouble crossing the street to meet a new neighbor.
We conquered outer space but not inner space.
We’ve done larger things, but not better things.
We’ve cleaned up the air, but polluted the soul.
We’ve conquered the atom, but not our prejudice.
We write more, but learn less.
We plan more, but accomplish less.
We’ve learned to rush, but not to wait.
We build more computers to hold more information, to produce more copies than ever, but we communicate less and less.
These are the times of fast foods and slow digestion, big men and small character, steep profits and shallow relationships.
These are the days of two incomes but more divorce, fancier houses, but broken homes.
These are days of quick trips, disposable diapers, throwaway morality, one night stands, overweight bodies, and pills that do everything from cheer, to quiet, to kill.
It is a time when there is much in the showroom window and nothing in the stockroom.
A time when technology can bring this letter to you, and a time when you can choose either to share this insight, or to just hit delete…
Remember, spend some time with your loved ones, because they are not going to be around forever.
Give time to love, give time to speak! And give time to share the precious thoughts in your mind.

Please continue to send us your comments, questions, and favorite emails for our e-Letter.

Till July…

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.

If you no longer wish to receive future e-Letter reminders, please send an email to drkimmel@kimmelpsychology.com requesting to be removed from this list.

If you find this information interesting or helpful, please forward this e-Letter to your contacts and friends.

Copyright © 2014 by Joel I. Kimmel, Ph.D., P.A. and Associates.