Traumatic life events require a period of adjustment before one can resume daily activities. It is common, for example, for businesses to grant a three-day bereavement leave when employees lose loved ones. If trauma is severe enough, however, the time needed to transition back to an everyday routine can be much more prolonged and even traumatic itself. Periods of recuperation from severe trauma may significantly interrupt work, intimacy, social interactions, financial security, and healthy physical functioning. Coping with losses and grief—both profound experiences—will often layer on another set of problems after adverse events. Loss always precipitates a period of grieving before a more normal life routine can be re-established. Once emotional and other accommodations are made, many traumatic experiences become ‘simply’ difficult life events and poignant memories. For some, however, the transition back to functioning with a healthy daily routine will be far more complicated. Survivors may also experience what is called complicated grief, or complicated bereavement, if significant others die during the trauma. The usual grief experience in bereavement complications is prolonged and more intense than would normally be expected in a period of bereavement. Trauma abruptly interrupts and overwhelms our abilities to function normally. Altered functioning–such as disrupted sleep, nightmares, poor concentration, flashbacks, fear and anxiety–are common direct and immediate effects of trauma that can interrupt even the ability to grieve. If trauma symptoms persist, and are intense enough, the natural process of grieving itself can become more complex and prolonged, even delayed. Attempting to manage both trauma survival and a period of grief can be an overwhelming emotional and psychological load. Professional support and guidance through recovery is often needed. Some traumatic events in themselves cannot be easily accommodated by anyone. Severe and extreme situations can be disorienting and injurious on many levels whether actual physical injury has occurred or not. Severe violation of one’s personal boundaries —such as that experienced in abuse and neglect— can cause psychological and emotional injuries that are debilitating for some time. Often long-term support is needed to resolve related issues that arise. Survivors of sexual assault, for example, will frequently have difficulty accepting even the loving touch of trusted intimates for some time after the incident Additionally, the aftermath of trauma may incur other losses if normal functioning and development are interrupted by symptomatology. Developmental milestones can be missed and the usual gains of daily life can slip away as individuals cope with persisting symptoms. Trauma recovery in these cases must involve reclamation of ‘lost ground’ that the time needed for recuperation has caused. Post-traumatic Stress Disorder (PTSD) is a medical diagnosis given when the transition between a trauma event and non-crisis functioning has not been fully completed. In PTSD, trauma symptoms, or disturbances in thought, emotion, perception, physical functioning and behavior, continue past the initial shock and usual post-trauma recuperative time. Some of these disturbances will manifest quickly after the event and persist. Such disturbances are known as acute PTSD. In another form of PTSD, PTSD with delayed onset, an individual may appear for some time after the trauma to have no problematic symptoms. In this second form of PTSD, trauma symptoms will occur after some time has passed. They will also persist and interrupt daily functioning. PTSD is a common complication of trauma survival as are depression, anxiety, substance abuse and other compulsive behaviors such as eating problems and gambling. At times, individuals with PTSD will require concurrent treatment for these co-existing conditions. Treatment based upon well-documented research for effective recovery is available for all trauma-related problems.
