T H E T H E R A P I S T  D I R E C T O R Y  O F  S A N D I E G O
Goal Setting



by Sara Gilman, MFT, FAAETS
Marriage and Family Therapist
Sara Gilman, San Diego EMDR Therapist

Traumatic events in our lives come with no warning. In light of our current global affairs and following 9/11 it would be useful to understand the nature of ‘traumatic stress’ and the negative effects it can have in someone’s life. We may not be able to prevent life’s traumas however, with a greater understanding of the impact it has on our lives, we can respond in the best ways possible. 

Traumatic experiences such as natural disaster, serious accident, victim of crime, death in the family, debilitating illness or witness to tragedy, tend to be sudden and overwhelming.  Often there are no outwardly visible signs of physical injury, but there is nonetheless a serious emotional toll. It is common for people who have experienced traumatic situations to have strong emotional reactions. These reactions are considered normal reactions to an abnormal event.

Experiencing trauma is an essential part of the human condition. How we adapt to these events is learned over time. However, there may be a time when our usual coping skills just don’t seem to be working. The psychological stress can cause a variety of symptoms. Most symptoms resolve in time. Here are some to pay attention to:
•  Having trouble sleeping or changes in appetite.
•  Recurring thoughts or nightmares about the event or something related to it.
•  Feeling depressed, sad, teary or having low energy.
•  Being on edge, being easily startled or becoming overly alert.
•  Having auditory sensitivity where everyday sounds seem ‘just too loud.’
•  Experiencing anxiety and fear, especially when exposed to events or situations reminiscent of the trauma.
•  Experiencing memory problems including memories of the trauma.
•  Feeling “scattered” and unable to focus on work or daily activities.
•  Having difficulty making decisions.
•  Feeling extremely protective of, or fearful for, the safety of loved ones.
•  Feeling emotionally “numb” withdrawn, disconnected or different from others.
•  Not being able to face certain aspects of the trauma and avoiding activities, places, or even people that remind you of the event.
•  Close relationships become strained. Greater conflicts with family of coworkers, or greater isolation and withdrawal.

Physical symptoms also occur. They might include: headaches, nausea, chest pain, thirst, fatigue, dizziness, weakness, teeth grinding, muscle tremors, visual difficulties, profuse sweating, shortness of breath, and intestinal problems.


After a traumatic event is over, emotional aftershocks or stress reactions begin to appear immediately, within a few hours or days later. In some cases reactions may take weeks or months to appear. When symptoms persist because the trauma has been too painful and overwhelming for the person’s natural defenses, and the brain has been psycho-physiologically impacted, professional intervention must be considered. A number of factors tend to affect the length of time required for recovery, including:
•  A person’s general ability to cope with emotionally challenging situations.
•  The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life is involved may take longer to resolve.
•  Other stressful events preceding the traumatic experience. A pile up of significant events can create a more intensified reaction to the current event.


There a number of steps you can take to help restore emotional well being and a sense of control in your life.
1.  Give yourself time to heal. Take life a little slower and reduce already stressful activities. Your mind and body are on over load and need additional rest and relaxation. This is only temporary so take the time when you need it most.
2.  Talk with the people who care about you. Talking is a way of releasing some of the thoughts and emotions that pile up inside.
3.  Pay close attention to health habits. This is a time to reduce or eliminate mind-altering substances (caffeine, alcohol). This will help the body release tension and restore a healthy balance. Drink a lot of water and get more sleep than usual.
4.  Establish or reestablish routines. Pursue hobbies for enjoyment. Eat regular meals and settle in to an exercise routine. Family and household routines can be comforting and create a sense of control.


It is not unusual to find that serious problems persist and continue to interfere with daily living. Some people may feel overwhelming nervousness or lingering sadness, which adversely affects job performance and personal relationships. If you have prolonged reactions that disrupt your daily functioning, seeking professional help is advised. If a family member, friend or co-worker says you just aren’t the same, pay attention!  They may be noticing something that you are not able to see. It is a good idea to write down what they are saying and share that with the counselor.

If symptoms persist for over 1-3 months you may be at risk of developing a more serious condition known as Post-Traumatic Stress Disorder (PTSD). When seeking help it is important to find a mental health professional who is experienced and specifically trained in the area of traumatic stress. Receiving the appropriate counseling will relieve the post-traumatic stress symptoms and restore the balance of the mind and body.

If you think you should be feeling better and you are not, or you feel better then you feel worse again, it is a good idea to get some additional help. Consulting with a professional can prevent things from getting worse and harder to change later. Post-traumatic stress symptoms left untreated can result in devastating levels of depression and anxiety and make your life miserable. Early treatment is the best medicine. Getting yourself back on track sooner than later can help the quality of your life improve rather than be diminished. You don’t have to live with the painful results of traumatic stress.

Just like the body knows how to heal a cut or bruise, the mind has an innate wisdom for healing emotional pain. Being proactive in the healing process creates greater strength and resilience for the future.

For more information about Sara Gilman, Marriage and Family Therapist, go to:
Sara Gilman, MFT, FAAETS

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