Resources: Learn More

• “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” by Bessel van der Kolk, M.D.
• “A Terrible Thing Happened,” by Margaret M. Holmes

Things to Think About

• Trauma can result from any experience. It is not only a symptom of being in combat.
• PTSD is not a lifelong diagnosis. Therapy often only takes 8-12 weeks to be successful.
• The best trauma treatment is the one that you are willing to do.

About the Hosts

Dr. Hannah Baczynski works with people of all ages—providing diagnostic and psychological evaluations for children as young as 2, adolescents, and adults, as well as individual therapy for adolescents. As the clinical director of Dakota Family Services’ DBT Program for Adolescents, she also provides Dialectical Behavioral Therapy and is a firm believer in using treatments that are well-supported by research and that match the client’s goals. When she understands the “why” or the function of the behavior of difficulty a client is experiencing, she collaborates with them to set goals and find new, more productive skills and behaviors.

Lucas Mitzel provides therapy for children, adolescents, and adults, ages 5 - 30. He believes building relationships with clients is the most important piece of successful therapy. He loves what he does, because it allows him to walk next to people he would never have met had he chosen a different profession, as they work to make amazing life changes. He has the honor of meeting people at their worst, all while watching them grow into the people they’ve always wanted to be.

Transcript
PTSD: Signs, Symptoms, & Treatment (Community Chat Series)

Featuring Lucas Mitzel, LCSW, and Dr. Hannah Baczynski, Psychologist, Dakota Family Services

Host Tammy Noteboom:

Community chat recordings are presented by Dakota Family Services, an outpatient clinic with mental health providers in Minot and Fargo, North Dakota. Thank you for listening.

Host Tammy Noteboom:

Joining us are two presenters today. Dr. Hannah Baczynski is a psychologist at Dakota Family Services and Dakota Boys and Girls Ranch. She provides psychological evaluations for children, adolescents and adults and individual therapy for adolescents. Lucas Mitzel is a licensed clinical social worker at Dakota Family Services. He provides therapy for children, adolescents, and young adults. With that, I'll turn it over to Hannah and Lucas to get started.

Lucas Mitzel:

Awesome. Thank you Tammy. So again, thank you everybody for joining us. We're really excited to talk about this today. The, I think the best place to start with this sort of topic is talking about what, what even is trauma. So just for fun, I went on the Google and I started Googling different definitions of trauma. And the American Psychological Association defines it as an emotional response to a terrible event like an accident, assault, or natural disaster. The National Institute of Health defines it as referring to experiences that cause intense physical or psychological stress reactions and the substance abuse and mental health services administration defines trauma as an event or circumstance that results in physical harm, emotional harm and or life-threatening harm. Which is interesting because those are three really major mental health organizations. They're all very reputable, they know what they're talking about.

Lucas Mitzel:

And although the definitions are very similar, they're all very different. And this really goes to show that trauma is a very personalized and subjective experience for a person. And just because something isn't traumatic to me, it might be traumatic to Dr. Baczinski and like Dr. Baczynski and I could be in a car together and could get into a really bad accident, both rent a car the next day it'd be just fine for her. It'd be like, wow, that was just, that was crazy that that even happened. Whereas I could have an intense physical or psychological reaction to just being next to a car. The only difference being that our, we were like 12 inches apart from each other. So like you can have very different responses to the very same stimuli and there's a lot of reasons why that may or may not happen. But you never truly know how your brain is gonna react to a trauma until you experience it and it's all very personal. And because of that, there's a lot of misconceptions about trauma and PTSD as a whole and we're gonna cover some of those today. But I think it's really important that we first start off with what trauma is.

Hannah Baczynski:

Absolutely. And once you experience a trauma, whatever that is, a lot of times people really downplay their trauma. So I cannot tell you how many times in a therapy session I've told someone that I think they have PTSD and they're like, but Dr. Baczynski, I've never been to war. And like you can have PTSD from anything really, anything that makes your brain feel like you are at risk of losing something really important to you. So whether that's your life or even your lifestyle, like if you have been through workplace trauma where you thought you were gonna lose your job and that would destroy your lifestyle, like I've seen people like that. It can come from bullying, it can come from neglect, it can come from even lifetimes of being told that you're not worthy or you're not wanted or whatever.

Hannah Baczynski:

Over and over and over again. All can cause PTSD and PTSD from something like bullying is the exact same syndrome as PTSD from witnessing war. The symptoms are all very, very similar. And they come in four categories. So the first category is intrusive symptoms. And intrusive symptoms are your flashbacks, your nightmares. Those are the things that we think of when we think of PTSD in movies and stuff where someone hears a car backfire and then all of a sudden the veteran is like fighting a war downtown that no one else can see, right? That is one of the most extreme examples. But a lot of times flashbacks just feel like an emotional response of that thing is happening again, even though you know that it's not happening again, you're not in that moment, you know it's not happening again, but your brain is convinced that that same thing is happening.

Hannah Baczynski:

So you get that emotional response. It can also be way less dramatic just reacting, having your heart race. When you think about the trauma that you went through, having a fear reaction, having a anger reaction when you think about the trauma. So those are the intrusive symptoms. They just, you can't make those things go away. They keep happening, they keep happening, they keep happening. If you've had PTSD for a long time, sometimes those intrusive symptoms go away. It's not really what they're doing, but you get used to them so you don't notice them anymore. You've become sort of like PTSD is a lifestyle, it's now your habit. PTSD is your habit. So you don't notice the intrusive symptoms as much anymore. The other thing that can happen, why they seem less prominent over time is because you get better at the second category of symptoms, which is avoiding, if seeing a car, being next to a car makes Lucas feel really scared, really afraid, really like he's gonna die.

Hannah Baczynski:

If he is standing next to a car, it's really natural that he's gonna avoid standing next to cars. You would stop doing that. You would stay as far away from cars as you could. Same as if you got bit by a dog. You would avoid dogs. You'd walk to the other side of the street, right? And so over time, as you start to avoid the stuff that makes you feel scared because of your trauma, essentially you build a life that insulates you from those intrusive symptoms and you don't notice them as much. So then you might come to therapy 20 years, years later and be like, but I don't have PTSD because I don't have nightmares and flashbacks. And that's because you built a life really that avoids those so strongly that you are now anxious of those things popping up. You're now depressed and you think of yourself as just anxious or depressed and you've missed sort of the, the foundation, the trauma because it's just become your lifestyle.

Lucas Mitzel:

One thing I just touched on too is that our brain's, number one <laugh>, its primary job is to keep us alive. Like number one is living. And then the number two is to make sure that we're, we're comfortable while we're living, right? And so when we have a traumatic experience, obviously that is a very uncomfortable, and it potentially makes us feel like we're in a lot of danger. So then our brain likes to prevent that from happening in the future. So it makes connections as to what happened, what happened around that to prevent that from ever happening again. So that when we come in contact with it, maybe those like things that remind us of the event, oh, we need to avoid that. And it, it does that in a very, a very aggressive way many times with PTSD because it's like, you are not doing that again.

Lucas Mitzel:

We're not going through that car crash. We are not getting bit by a dog. We are not, whatever is going on, right? The problem with our brains is that they don't always make the best connections or like the most convenient connections. If I had a connection like going back to the car crash example, that it's because I was in a car that I got into a car accident. And so my brain's like, you are never going into a vehicle or a car again. I mean, I guess I could bike everywhere, but that would just be really, really hard and make life really difficult. So part of therapy, and we're, I'm getting a little bit ahead of ourselves here, but part of therapy is going to be trying to tackle some of those things and disconnect those inconvenient connections, if you will, <laugh> to that trauma and try and make appropriate connections to what actually was causing that.

Lucas Mitzel:

Because yeah, I agree. I don't ever want you to go through that again, but let's just make sure we're actually connecting the logical connections and not just whatever our brain wants to decide to connect things to. So going into the other categories, so like the next part is we, we have negative alterations in our mood and thinking. So we might have an inability to remember important details to traumatic events. This is really frustrating for people that I talk to. 'cause I'm at, when I ask them like, what happened? They're like, well, I remember this, but then I don't remember X, Y, and Z. It's super normal for that to occur. And it's also, it's, it's okay to not necessarily remember everything. I don't really think it's necessary to remember every single detail of a traumatic event. Like if you've forgotten something that's, that's okay.

Hannah Baczynski:

Then the reason for that is because it's, it's biological. Your brain actually remembers trauma memories different from regular memories. They're not stored in order. That's why they're not a story. That's why pieces are missing. They're stored, stored as chunks in your brain and your brain is meant to do that. There's nothing wrong with you because you don't remember pieces or it doesn't make sense or it's not in order. Like that's how your brain remembers those things. And one of the things that trauma treatment does is that puts it in order, makes it a story. So you can process it and it becomes just a story rather than these like flashes of horror and fear.

Lucas Mitzel:

Some other things that might happen is you might begin to have some exaggerated negative beliefs about the world or yourself. So Fargo's really dangerous place to live or all cars are metal death traps or I am bad or I can trust to nobody in this world. And so, and obviously those blanket statements aren't true, but they make sense based on the trauma. We just have to figure that out together. You might have to start thinking about the cause of the trauma that leads you to blame yourself. This is really common with people who have suffered intense abuse or just an event like, I could blame myself for the car crash. Maybe I feel like I was distracting Dr. Baczynski and it's my fault that this happened and I just feel really guilty when in reality the person was texting and driving and that's what caused this to occur.

Lucas Mitzel:

You're gonna struggle with being happy <laugh> when you're going through PTSD when you're having all this, when you are on edge constantly because you're trying to avoid whatever this trauma was from ever happening again, you are going to be irritable. You might struggle with some anger and guilt or shame. And so it's gonna be hard to just feel good things again, until we can get through this. You're gonna have potential diminished interest in participation with significant activities. So things that you used to really enjoy, you might not want to do them as much. And this is where sometimes PTSD can get confused for depression because depression also shares this with PTSD. And you can have both, but there are times where because you have a hard time feeling happy again and you don't want to be around other people, that's the next thing.

Lucas Mitzel:

Feeling detached from other people. Maybe you're isolating from others. It can get really mixed up with depression and then we're treating the wrong thing when in reality it's all because this trauma happened. And if we can get this under control, all of those other symptoms are going to improve. And then lastly, it kind of tied into everything that I've already been saying is, you're unable to express positive emotions like happiness, excitement, or in some cases I've had people who feel like they can't love their spouse the same way that they've, they've been able to in the past or like they're unable to do so anymore. Moving on to the next, the final section is the alterations around or reactivity associated with the event. So this is where you might get some, you might be a little irritable, there might be some anger outbursts in relation to like if you're being feeling triggered or if there's something that comes up like with kids, if they <laugh>, I've had this before, I'm like, well, can you tell me what you remember?

Lucas Mitzel:

And they're like, no. And they get really upset and angry and it's an, it's an attempt to avoid talking about it. It goes back to the avoidance. There might be some reckless or self-destructive people. We might see some self-harm occurring. We might see people making really risky choices. Maybe as a reaction to my PTSD in the car thing, I start driving really fast. And part of this, it's a way to cope with whatever is going on in your brain and to maybe distract you or you're feeling this adrenaline rush or just trying to make the negative thoughts and feelings go away. And so it's just a maladaptive coping skill, if you will. The next part would be hypervigilant. So like people who are hypervigilant can walk into a room and they know all the exits immediately they're aware of their surroundings.

Lucas Mitzel:

They maybe sit in a way where nobody can get behind them and they are just asking people questions, making sure that you're safe to be around. They're fairly distrusting people because they just don't want to get hurt. Again, people who are going through PTSD may also startle really easily. So like if you go up behind somebody or you accidentally scare somebody and it, it may not make sense to you, but they're always on edge because they're trying to avoid whatever happened to them again. And so they're gonna have this startle response that's abnormal because of that. They're al they're like a, a loaded spring all of the time, ready to jump out of the way or protect themselves. Difficulty with concentration, difficulties with sleep. It's really hard to sleep and concentrate when you are always on edge because when we're anxious, when we're stressed, just it's really hard to relax enough in order to fall asleep. And then also nightmares wake people up. So you're gonna have a hard time with that. And since you're not sleeping, when you do actually get to sleep, you're gonna have a hard time waking up because you're really tired all the time.

Hannah Baczynski:

In some cases as well. There's a fifth set of symptoms, they're called the dissociative symptoms. Not everyone gets these but essentially in their worst form, it's where you lose periods of time like blackouts. Generally speaking for people, if they have that, it's when they're really angry or when they're really scared that that will happen. But the lesser extreme versions of dissociation are feeling like you're walking through a fog feeling like the world isn't real or you're in a dream or even kind of like seeing yourself from the third person or, or those kinds of things. Just feeling disconnected from your body and from reality is dissociative symptoms. So when should you seek treatment for PTSD? If you experience traumatic event probably 99 times out of a hundred you will experience trauma symptoms immediately. Everyone who experiences trauma experiences some trauma symptoms afterwards.

Hannah Baczynski:

And for the most part, for most people, most of the time those symptoms go away within two or three months you kind of get back to your regular life, those symptoms go away and you don't think about it again. For some people, which we are not 100% sure on why some people end up with PTSD and some people don't, a lot of the reasons have to do with the support. Did you get the support you needed afterwards? Sometimes people get support but it's not the support they need, right? Some people need people to leave them alone. Some people need people to be around them. And so if you get the wrong kind of support, that can increase your difficulty recovering. If you have a repeated history of trauma, you're more likely to get PTSD. Like if something happens to you over and over and over again.

Hannah Baczynski:

And if you like, have other mental health problems when you experience a trauma, kids and adults, people who are neurodivergent, so who have ADHD and autism are more likely to experience events as traumatic. And they're also more likely to experience kind of those, those traumas that aren't like the big bloody death traumas. The the, some people call 'em the little T traumas, which doesn't mean they're not as bad, they're just not as bloody in most cases, bullying and things like that. They're more likely to experience those things as traumatic. So you should get treatment for PTSD if your symptoms have not gone away within a couple months after the trauma, if you continue to have them for 6, 7, 8 months, if you continue to have them for years after the trauma, you should get a trauma treatment. The one thing that we know about PTSD and treatment is that it is in fact a very, very treatable.

Hannah Baczynski:

I cannot tell you how many times people are like, well okay, well then I have PTSD. So I guess that's just forever and there's no point. I had one kid fight me, fight me, fight me, fight me. I don't have PTSD, I don't have PTSD. And when we finally finished trauma treatment, I asked him why he did that. And he's like, I thought you were essentially giving me a death sentence. Like I thought that's what it was. I thought that I couldn't get over it. PTSD was thought to be a life sentence in the past because we didn't have trauma treatments and PTSD is resistant to what's known as the placebo effect. So basically if you go to treatment and you're like, I am depressed, but you are misinterpreting your symptoms as depression and they're really PTSD, you'll get treatment for depression but you won't feel any better.

Hannah Baczynski:

You might show up to therapy and say, I'm really anxious and you'll get treatment for anxiety but you won't feel better. Maybe a little bit, but it won't really go away. And people who do this for years think, well, there's nothing to be done. I guess I'm just stuck like this. But the fact is you're not treating the cause, you're treating a symptom at that point. It's kind of like if you broke your arm 10 years ago and showed up to the doctor and the doctor's like, oh, I see you have a little cut, you're bleeding and they just slap a bandaid on your arm and send you on your way, right? If you're trying to treat depression when it's PTSD, you are slapping a bandaid on a broken arm, it's not gonna solve the problem. So PTSD treatment is extremely effective in most studies.

Hannah Baczynski:

It's effective for at least three out of four people in a lot of cases it's more than that. Some of the older studies that showed less effectiveness were actually re-looked at in the last five years or so. And it turned out that a lot of the people that it was thought that the trauma treatment didn't work for were actually early responders. So they dropped out because they were already feeling better before the end of the, of the trial. So it's really, really effective. In every case that I have given one of the trauma treatments, it has worked. I'm not saying that it is 100% all the time, but every time I've ever done it, it's worked. And I've heard very similar stories from a lot of therapists. If you do the treatment, you will feel better. The reason that people don't do trauma treatment is because it sucks.

Hannah Baczynski:

I'm not gonna like put it lightly. It is not fun. There are funner treatments out there, not that therapy's ever like a hoot, but there are funner treatments. So in order to treat PTSD, we need to expose you to the things that you've been avoiding. So whether that is places, let's say you are avoiding the grocery store because you were robbed in the parking lot, you gotta go back to the grocery store and that will be uncomfortable, right? Like if you, I, I had this a kid during his trauma, the mask was playing in the background so we had panic attacks whenever we saw Jim Carrey. Like that's not very functional and you don't see Jim Carrey as much as you used to, but that's not very functional, right? And so he had to be exposed to Jim Carrey like we looked at pictures, we watched the mask so that he would stop having panic attacks.

Hannah Baczynski:

For those things you have to be exposed and you have to be exposed to your memories in some way. And all the trauma treatments do that a little bit different. And what I really, really hope you get from this, if you get nothing else, if you're a therapist, if you're a person just interested in PTSD, you wanna get treatment for your own PTSD or your kid's PTSD. The best trauma treatment is the one you will do. There is no scientific way to choose between the four of them, which I will talk about in a second. So if someone tells you that the only one that works is this one or the only one that works is that one, they are wrong. They all work and you need to find the one that you feel connected with that feels comfortable ish for you, the one that you will do.

Hannah Baczynski:

Because if you don't do it, it won't work. You gotta do it. Okay, so what are these four trauma treatments you say and the ones that are available really depend on your age. There are some that are just for kids. Well there's one that's just for kids and there are some that you shouldn't do if you're under a certain age, like 13, 14. So we'll start I guess with the one that's just for kids. This one is called trauma-focused cognitive behavior therapy or TF-CBT research shows it's effective from ages like three to 19. So if your three-year-old got bit by a dog and they're having trauma symptoms, you can get TF-CBT for your three-year-old to deal with that. And the way that TF-CBT works is it's about 18 to 24 weeks, generally in length. You start off with some psychoeducation, which is included in all four of them.

Hannah Baczynski:

You'll get psychoeducation, then you go through some skill building, some emotion regulation and cognitive like understanding your thoughts and then you'll do a trauma narrative. TF-CBT is nice in some ways because you can be really creative with your trauma narrative. Some people just write it up like a story. Some people tell it the thing that happened to them. And some people I've seen puppet shows, I've seen painting, I've seen people write raps or creative playlists. You can be really creative with what that trauma narrative looks like for you and your kid will do that with their therapist. And as the parent you are typically involved in the last couple minutes of each session, you'll hear the trauma narrative at the end and you'll be kind of coached through how to best support your child through that trauma narrative. So again, that's for kids. The other three can be used from like 13 or up EMDR they say you can use forever.

Hannah Baczynski:

So let's talk about EMDR. According to the research, you can use EMDR at any age. It is approved by the World Health Organization for Children for PTSD treatment. And what EMDR does is you start off with psychoeducation and then you go through some skill building, they call it resourcing. You go through some skill building and then you go through the eye movement reprocessing and desensitization. So basically what you do here is do you think about your memory in a way that your therapist will guide you through and you do bilateral stimulation. That could be with your therapist moving their fingers in front of your eyes. It could be through like tapping on each side of you. If you look back over here, this is my light bar. So this thing has a light that goes back and forth to help you do the bilateral stimulation.

Hannah Baczynski:

I also have like, they're called tappers. I think they're like little things that you hold in your hands that vibrate back and forth. So basically you are stimulating both sides of your brain while thinking about your trauma and that helps you process through it. I always feel a little weird explaining it, like I feel like I'm explaining magic, which maybe I am, I don't know, but it works. And some people really like that. It is thought to be a little more helpful for people who are neurodivergent because it's easier to not dissociate during and it works possibly through working memory and those kinds of things. There's reasons why some people think it's better for people with autism or ADHD than others. So that one's available, that one works. It depends on who you ask and what research you look at.

Hannah Baczynski:

But six to 18 weeks, they really don't put an end date on that one because they say it could go on forever. But really six to 18 weeks is probably what you're looking at for EMDR. The third one is called cognitive processing therapy. And this one is very worksheet based. So if you are into worksheets and filling out worksheets, cognitive processing therapy is for you. It really is. It's fantastic. If you're not into worksheets, probably it's not for you. A fun fact about that is that the research shows that if you find a therapist that'll do cognitive processing therapy with you every day, Monday, Tuesday, Wednesday, Thursday, Friday, you can get through the treatment in two weeks and it will be just as effective as if you did it once a week for 10 weeks. It's a lot of processing your thoughts and less exposure.

Hannah Baczynski:

So if the exposure piece, thinking about your memory doesn't really float your boat, then maybe cognitive processing therapies for you. The final one is called prolonged exposure. And this one is in some ways the most in your face about processing your trauma. You will do what are called imaginal exposures. You'll explain your trauma to your therapist, you'll record it and you'll listen to it. And it's called prolonged exposure. 'cause Typically you do those imaginal exposures for 30 to 45 minutes and you're supposed to listen to 'em every day. It really is exposure heavy and there is less of the emphasis on the processing, though the processing does happen. It's just not like the main focus of everything. Like I've given all four as the therapist and I've seen all four of them work fantastically. So whichever one like really speaks to you is the one that you should do.

Hannah Baczynski:

There is a website that I direct people to. If you Google PTSD decision aid, there is a VA website that will walk you through CPT, prolonged exposure, medication options, EMDR, all of those things, the pros and cons of them and their little videos and testimonials. And it's, it's a really great website to start exploring those different options if you're more of a movie person. There's also a documentary that the VA made called Here is Better. And it goes through a treatment program of EMDR, A treatment program of cognitive processing therapy and a treatment program of prolonged exposure. And it is a really good documentary to watch if you're interested in more of those things. And also, as a note, I'm not like employed by the VA or anything, they're just the leaders in PTSD treatment. And so they're the ones that have all these resources.

Lucas Mitzel:

I think just some like general tips when you, or if you're looking for your child to get any sort of trauma treatment, it's really important to remember not to project your expectations of what their trauma should be experienced like, if that makes sense. So for example, and this goes both ways. So if your child experiences a traumatic event, it's important that you're not saying like, wow, you should be more traumatized <laugh> than than this. Like, like we talked about, like some people don't have the reaction that we think they maybe should have. Like I've, even just recently I've had a case where the person that I was talking to experienced something that was truly horrific and they were fine <laugh>, they were fine. And, and then, and parents were really worried because obviously it was something that was really horrific and who wouldn't be really disturbed by, whatever by the thing that had happened.

Lucas Mitzel:

But that can happen. We don't know why. Sometimes a brain has a poor reaction to something and or sometimes it responds really well. We have theories like whether or not they received adequate support, if they felt like they could talk about it freely. You know, even just like proximity to the event can have a different reaction. We don't exactly understand why, but it's important not to put what you think you would react onto your child or or onto another person that you're talking to about this. And on the flip side, not minimizing what they're experiencing because like we had talked about, you can have a traumatic reaction to hearing a story, to learning about somebody's trauma hearing an event unfold in real time, even if you didn't see it, even if you didn't like witness like the whole thing or something like that. Like you can have PTSD from a lot of things and people don't understand that it's actually a lot easier to develop PTSD than just we have to go to war and experience full atrocities.

Lucas Mitzel:

So you can even experience PTSD from medical emergencies where you thought you might die or if you didn't think you were gonna die everything. And then somebody's like, oh my god, you would've died had you not come in that alone. That message alone can cause you to have a PTSD sort of reaction. So it's really important that we're not projecting how we think somebody should feel. And so some, some tips for going through PTSD treatment or having a loved one go through it is it's really important that you trust your therapist and have a really good relationship with them. You're not gonna wanna talk about the scariest moment in your life. Like, I don't know why I would want to talk to some guy in an office if I did, if I thought that they sounded annoying, for example.

Lucas Mitzel:

So the relationship is really important. Another thing to keep in mind is that when you are doing trauma treatment after you leave your therapist, you're gonna be tired. Like this is a really intense psychological and emotional type of therapy to go through. Like Dr. Baczynski had said it sucks <laugh> to do trauma treatment. It's not fun. I've never had somebody come in and be like, I'm so excited to talk about trauma today. Everyone's like, do we have to do it again <laugh>? And so or can I have a break this week? So you're gonna be tired if you are tired, if you feel like you need to go home and take a nap, you probably did it right. That means you're really working through some things. It's also not uncommon. And I see this a lot with, with younger kids that I work with there, there might be an increase in symptoms before the improvement actually happens.

Lucas Mitzel:

And this goes with trying to 'cause kids don't know how to communicate what's going on in their brain very well or just their emotions. And so we act it out, right? Because that's the only way they know how to communicate super well. So it's not abnormal to see an increase in symptoms and behaviors. Now I just caveat here, it should not go to the point where we are like completely unstable and unsafe. That means that we probably went too fast with trauma treatment and we need to pull back on that. So if you're seeing that with your child and stuff like, please let the therapist know because that's something we can adjust, but it's not uncommon to just see some sort of irritability or agitation while you're in the middle of trauma treatment. The other thing that's really important is that if you start trauma treatment, it's very important that you finish it.

Lucas Mitzel:

If you leave halfway through trauma therapy, it's like leaving surgery with an open wound and never getting it fixed. Like you're gonna get infected, you're gonna have to go back in. And it might even be harder to fix next time. Not impossible. 'cause It's always fixable. We can, we can make it better, but it's just, it's gonna, it's gonna suck even more. So really make sure that when you're committing to therapy with your therapist and you're gonna start it, that you're able to finish that and push through to the end. I think those are the big ones. Hannah, do you have any other tips that you can think of?

Hannah Baczynski:

And the end is not as far away as you think it is. So I think I only gave the, for most of the trauma treatments, most of the time you are done with therapy in eight to 12 weeks, at least the PTSD therapy. You can feel better in a month and a half, two months, a month. It depends on how fast you respond. And we find research finds that P s d treatment follows essentially the timeline of recovery from PTSD in general. So basically you just haven't recovered from that trauma. And by starting trauma treatment, we're starting that recovery process and that recovery process will resolve. And if you quit in the middle, like Louis said, it's, it's much harder. It's like if we go back to that broken arm or the surgery, right? You broke your arm 10 years ago and you come to the doctor today and you're like, man, my arm hurts a lot all the time.

Hannah Baczynski:

And the doctor says, yeah, it's 'cause you broke it 10 years ago. And so we can fix it. But I'm gonna have to rebreak it. And so that will be painful, but in a couple weeks or whatever, it'll feel better and you'll have full range of motion again and your arm will be healed in a way that it, it hasn't healed in the past 'cause it just healed wonky. You just healed wonky and we've got to open it up, fix it, and then you can heal. Like you were always meant to heal from PTSD. So in the same way, you can't walk out of surgery with an open wound. We can't let you stop trauma treatment. Or we hope that you won't because I guess we can't chase you down, but we hope that you won't stop trauma treatment because we want you to do the things that you wanna do and it's achievable.

Lucas Mitzel:

I think I, I thought of one more really important piece of advice too, is to make sure that you're not doing this by yourself. You sometimes people will try to do a trauma narrative or they'll try to do exposure by themselves, or very well-intentioned parents will try to do some exposure therapy with their children if you do it incorrectly or if you do it too fast or if you just, there's a lot of, there's a lot of ways it could go wrong and you can end up actually making the wound worse. So just like you wouldn't perform surgery on your child, I hope, there's a reason that there are such strict ways to do this and very like manualized and step-by-step approaches on how to do this because it, it's fragile and we wanna make sure we're doing it the right way so that you are healing the quickest way possible because we want you to get back to your best self as soon as possible.

Host Tammy Noteboom:

Thank you for listening to this community chat presented by Dakota Family Services. To make an appointment with one of our mental health providers or to learn other ways to mind your mind, go to dakotafamilyservices.org.

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