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PTSD: Definition of PTSD How Common, Who Gets PTSD? Is PTSD a normal event? Does PTSD Affect The Brain? Duration Pregnancy Delayed Onset PTSD PTSD Tip Sheet for your Doctor Medications for PTSD Distinguishing PTSD from BPD Generalized Anxiety Disorder Can the Wounds of PTSD Heal? Complex/Chronic PTSD: CPTSD Explanation Long Term Prognosis & Complex PTSD PTSD vs. CPTSD Managing Past Intense Feelings Overcoming Complex PTSD PTSD Symptoms: Anger and Brain Injury Anger Flashbacks Loneliness Feelings Of Loss And Sense Of Self Anxiety Numbing Re-Traumatization Differences bet. Depression, Dysthemia, Major Depression Depression vs. Sadness and Grief Biological Depression Memory Loss Triggers and Body Sensations PTSD & Facial Tics Emotional & Physical Reactions Delayed Stress Response after Experiencing a Shock Can A False Memory Happen? Differences Between Hypervigilance and Hyperarousal Negativity & Pessismism after Trauma PTSD/PTSI Insomnia: Not Being Able To Sleep PTSD/PTSI & Psychosis Relationships: Peer Support Issues Explaining PTSD To Children False Memory Toxic Family Of Origin Protection From Unwanted Contact Preventing Intergenerational PTSD Numbing in Male Survivors of Domestic Violence How To Increase Social Support Caregivers/Partners with PTSD: Starting a Conversation about PTSD Both Partners with PTSD & its Complications Fiancé Doesn't Believe in Therapy Managing PTSD After Partner Pushes Too Hard Childhood Abuse: Emotional Abuse Childhood Trauma & Intrusive Images Revisiting The Scene Of Trauma And Abuse Gaslighting Stockholm Syndrome & Child Abuse Survivors Can a Child be Born Depressed Childhood Survivors and Being a Parent Work Issues: Disability Letter for Attorney-Sample Low Stress Jobs Doctor's letter for Employer Sample Dealing with Co-Workers Job Searching with PTSD Recovery: Frank Ochberg's Color Wheel of Positive Emotion Triggers Rebuilding Self Esteem Life After Trauma Coping During The Holidays Substance Abuse Improving A Damaged Self-Concept Explaining PTSD is a Responsibility Grief & Loss from a Tragic Death The Trauma Bond & Forgiveness Sudden Panic, Anxiety & Flashbacks Stockholm Syndrome, Trauma Bond and Undue Influence Therapy: Dialectical Behavior Therapy (DBT) Inadequate Therapy When to End Therapy Repeating Your Trauma Story PTSD Symptoms After The Therapy Hour Exposure Therapy Service/Therapy Dogs & PTSD ECT (Electro-Convulsive-Therapy) Bipolar & ECT Therapy: An Interview Telling Trauma Story to Therapist PTSD Client Expectations from Therapy Sessions Veterans & PTSD: PTSD A Disease Seasonal PTSD & Anniversary Reaction. Emotional Injury Therapy Sessions Active Listening for Moms and Friends Military Sexual Assault Professionals: Compassion Fatigue Consequences Of Emotional Numbing School Teachers And PTSD Using The Counting Method with Clients Helping Clients with PTSD Other Conditions: Borderline Personality Disorder Social Phobia Dissociation Obsessive-compulsive disorder (OCD) Cutting & Self Harm Link between PTSD, BPD and Bi-Polar Somatization Disorder or Briquet's Syndrome Stockholm Syndrome & Child Abuse Survivors Dealing with Psychopaths & Narcissists

PTSD Questions & Answers with Joyce Boaz & Dr. Frank Ochberg, M.D. Read "Survivor Psalm" by Frank Ochberg

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Relationships: Peer Support Issues. Q: Dear Frank, People meet people online and it is wonderful how they sometimes becomes peer support friends Someone recently wrote to me about PTSD and peer-support. Do you have an answer for this person? Hi Joyce, I frequent the Web site and find it very helpful. Could you answer a question I have about peer support? I do find that I sometimes get stressed when I think about my trauma. The approach my therapist and I take is not to focus on the trauma unless it needs to be addressed. When I discuss the current issues related to the trauma, I tend to "shut down" emotionally and become numb. So, what to do with my online peer support friend when I need to take a break and do not want my friend to feel I am rejecting her? I have not handled this so well in the past with other friends and feel bad about that. The last thing I want to do is hurt someone who is reaching out to me. I hate this trauma stuff and wish it would go away and NEVER happen to another person. BUT, it will not go away (believe me I have tried all available options). Thank you Joyce for the services you are providing. A: Dear Joyce, This is a very important, sincere question, from a survivor who clearly has the compassion to help others and the wisdom to protect herself. She asks, "So, what to do with my peer support friend when I need to take a break and do not want my friend to feel I am rejecting her?" Let me offer a few thoughts. I believe there could be an informal contract between peer support friends and even offline friends who are trauma survivors. And it includes the fact that a friend is not a therapist and is not a next-of-kin. This online peer support friendship depends upon the ability of the one in the role of supporter to back away when the emotional burden is too heavy, and the understanding of the one in the role of support-receiver to accept that with grace and thanks. When this works as it should both parties come out ahead. It is a good idea to talk this over before, during and after the issue arises. Within families, and among close friends, there often are feelings of rejection and resentment. Even without trauma histories, close relationships are fraught with similar challenges. Who hasn't been short with a family member and said something in frustration that escalated into a regrettable war of words? Or into a cold-shoulder and a period of estrangement? Intimacy isn't easy to sustain under ideal circumstances. The survivor with PTSD has a condition that includes a higher probability of anxiety and hyper-vigilance, regardless of the topic of discussion. It also includes a risk of re-experiencing a memory that one wants to forget. And it includes the reflex reaction of numbness and avoidance-- shutting down and losing the full and normal range of emotion. Survivors with remnants of PTSD are, in a way, like cardiac surgery patients. It is good to gradually build up strength, endurance and resilience, but not to overdo the exercise and damage recovering muscle. With online friends, both parties are fully capable of understanding this. Both should pace themselves and one another. So let your support partner know if it is a bad time for communication, or if a particular theme is difficult to handle. You are not rejecting your friend when you ask for a break. You are explaining your own needs to someone who is in a good position to understand and care about these needs. There are many trauma survivors with a condition called "rejection sensitivity." This is a feature of atypical depression, but occurs without depression, too. You who read this may be very sensitive to slights from others. Or you may have family members and friends with that condition. It usually is a feature of personality, unchanged through time, but more or less in evidence as life becomes more or less stressful. I am heartened to learn that the person who wrote to Joyce, is concerned about the way another survivor might feel if she backs away. Sometimes, however, this is a matter of too much empathy. The one who worries about another person's sensitivity may be very sensitive herself. And in that case, out of well-meaning concern, the person opts out of the system entirely. It is just as likely that a receiver of support, learning that a friend needs a break, will feel honored to bestow that break. It is a gift. And when looked at in that light, the friend who says, "Of course. Take care of yourself," has given a gift and therefore has something to feel good about. This is complicated business - helping others and receiving help from others during recovery from traumatic and tragic episodes. Naturally, there are feelings of responsibility and, at times, obligation. Peer support friends and with any form of friendship, there are risks. We all have to do our best to share and manage those risks, to be honest with ourselves about when we are ready and able to empathize, sympathize and handle the burdens -- and the rewards-- of contact with others who share the experience of PTSD. I'm suggesting we be as open as possible with our peer support friends. It is always OK to back off. It is not a rejection of the person. It is a wise decision to take exposure to trauma stimuli in small, measured, tolerable doses. Tweet Was this helpful to you? If so, please consider supporting our work.

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