The Anniversary Of A Trauma!

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates
Volume 14, Number 1

In less than one month from now, it will be the anniversary of the shooting at Marjorie Stoneman Douglas High School. While the rest of the country celebrates Valentine’s Day, we in the Parkland-Coral Springs area will continue to deal with the effects of this trauma upon our community. It is still hard to believe that such a nightmare happened so close to us. In our practice, we continue to see the children and adults who have been traumatized by being in the school, living across the street from the high school, or having family or neighbors who attend the school.

Everywhere in our community, there are reminders of MSD Strong. These signs are powerful in letting people know that they are not alone. Everyone feels some degree of pain since they know someone who has been affected by this horrific shooting. There is widespread support with people wanting to help in any way they can. The activism that has come out of this tragedy is truly amazing and has already brought about change on some levels. Yet more must be done and hopefully, it will be soon.

This month’s E-Letter is about the Anniversary of a Trauma. In addition to the therapeutic and assessment services we provide, our monthly E-Letter offers educational information and suggestions for dealing with psychological issues. It includes what typical reactions to expect on the yearly anniversary and what one can do to deal with them. Please read the E-Letter and share with others whom you think can benefit from such information. The handout can be downloaded and given to others. If you have been reluctant to seek professional help or do not think you are improving over time, please contact us because we can help.

We thank you for reading our E-Letters and for the suggestions and comments we have received. Downloads of this handout and others from our previous E-Letters can be found on our website, https://www.kimmelpsychology.com/e-letters/. We encourage you to read and download them.

THE ANNIVERSARY OF A TRAUMA!

Traumas are high intensity events that happen infrequently. But when they do, they have great impact and can disrupt a person’s life for many years to come. They leave huge emotional and sometimes physical scars that can take a long time to heal. Long after the trauma itself is over, triggers or reminders can cause a return of feelings of anxiety, depression, anger, and helplessness.

A major triggering event is the anniversary date of a trauma. Leading up to that date, many survivors of the trauma experience feelings of anxiety, anger, and depression related to unresolved grief from significant losses. This reaction can last several days or weeks and can include flashbacks, nightmares, isolation, hypervigilance, and fear.

Not all survivors experience the anniversary reaction. Depending on their psychological makeup and how they have processed their grief, their anniversary reactions may be quite minimal. But for a lot of people, the anniversary brings on strong emotions without understanding their reactions or knowing what to do. Common reactions include intrusive memories or dreams, feelings of grief and sadness, hypervigilance, jumpiness and irritability, startle responses, survivor guilt, anger to others, isolation, and avoidance of reminders of the trauma.

However, the anniversary of a trauma is an opportunity for self-reflection and emotional healing. It is an opportunity to recognize one’s personal strengths and the challenges that have been overcome. It is an opportunity to recognize how one has moved from being a victim to being a survivor. It is an opportunity to deepen relationships with supportive friends and family. It is also an opportunity to remember and honor those who did not survive the trauma.

There are several actions one can take to get through the anniversary of a trauma. Remember that while the trauma is in the past, the anniversary reaction can last a few weeks. It is important to know when the anniversary date is coming to be prepared. Do not expect it to be a normal run-of-the-mill day. Understand that the feelings you have are due to an anniversary reaction and that your acceptance of the trauma is not complete. Reduce everyday stressors and plan ahead as to how you will spend the day. If you think it will be too emotionally overwhelming, take some time off and get away. Reduce watching the news or your social media as their attempts to report the news may actually trigger unwanted emotions and memories. Turn to friends and family for extra support. If you are seeing a therapist, ask to have another session that week. Be proactive and honor the memory of those who did not survive the trauma by remembering them with a poem or a writing. Make a donation in their memory. Participate in a charity event in their name. Give blood, volunteer at shelters, and participate in an activity they enjoyed. Most importantly, if you find the anniversary reaction overwhelming and you are unable to cope with your feelings, seek professional help. Many resources are available.

We offer the following information on The Anniversary Of A Trauma! This information can be downloaded as a handout at https://www.kimmelpsychology.com/e-letters/.

THE ANNIVERSARY OF A TRAUMA!
After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment …Judith Lewis Herman

WHAT TO KNOW!

  • The anniversary of a trauma can cause flashbacks and a return of the terrifying emotions that can last a few days or weeks
  • It can also provide an opportunity for emotional healing and the opportunity to work through the grieving process
  • Movies, pictures, media coverage, sounds such as the police or helicopters, and social media can all trigger memories and emotions of the trauma
  • Common anniversary reactions include:
  • Feelings of terror, fear, anger, helplessness, depression
  • Painful memories, restless sleep, dreams, and nightmares
  • Mental replaying of images and scenes of the trauma
  • Grief over losses and disbelief related to the event
  • Jumpiness, irritability, hypervigilance, and startled responses
  • Survivor guilt
  • Recovery from a trauma takes time and it is important to understand that these emotions are normal for a very abnormal experience
  • The anniversary of a trauma also provides an opportunity to reflect upon changes that have occurred since the event including personal rebuilding, challenges overcome, recognition of supportive family and friends, and awareness of personal strengths
  • WHAT TO DO!

  • Recognize that anniversary reactions are common for those who experience a trauma
  • Do not expect it to be a normal day and do not isolate
  • Change your thinking to being a survivor rather than a victim of the trauma
  • Seek extra support from family, friends, and therapists
  • Remember that the event is in the past but the hurt and anger can linger; the anniversary reaction will be over within a few weeks
  • Plan ahead for emotional reactions and reduce everyday stressors
  • If the date is too emotionally overwhelming, avoid being home and take time to get away
  • Reduce watching the news or social media that reminds you of the trauma
  • Honor the memory of those lost by participating in a charity event, making a donation, or remembering them with a poem, a writing, or a song
  • Create a ritual like lighting a candle, listening to soft music, visiting a religious institution
  • Be proactive and help others; donate to charities, give blood, feed the homeless, etc.
  • Seek professional help if you are unable to cope with your anniversary reactions or think that you have not made progress in healing from the trauma
  • WE CAN HELP!
    Call us at 954 755-2885 or email us at info@kimmelpsychology.com

    Joel I. Kimmel, Ph.D. P.A. and Associates
    5551 N University Drive, Suite 202
    Coral Springs FL 33067

    Copyright © 2019 by Joel I. Kimmel, Ph.D.

    Dr. K’s Blog

    2019

    January 21, 2019
    Recently, I had the opportunity to attend both Art Miami and Art Palm Beach. I have attended these exhibitions for several years and almost always come away impressed. Both of these events showcase contemporary artists whose creativity and imagination is truly amazing. Unlike conventional paintings and sculptures, art is made from very unique items. Portraits of rock musicians are made from broken vinyl records. Dresses are made from plastic forks and spoons. Sculptures of animals are made from bullet casings. Other sculptures are made from used text books. Abstractions are made from buttons and pins. Large pictures of celebrities are made from smaller pictures of the same celebrity. Famous art scenes are replicated in bubble wrap. I often wonder how these artists come up with their medium. How do they think of what materials to use to create their works?

    Simply put, artists think differently that ordinary people. I don’t believe they are bound by our conventional cause and effect thinking. Rather they think out of the proverbial box.
    The artists seem able to see things differently and create what they see in ways than most people wouldn’t even dream. They not only can conceptualize differently but they are able to construct their vision. Who would think of painting each bubble of a bubble wrap section a different color and then be able to complete the picture to be a likeness of a Seurat?

    Our world is fortunate to have artists and other creative spirits. They cause us to expand our own thinking and appreciate seeing objects and even the world in different ways. In this manner, we grow and evolve.

    2018

    December 21, 2018
    Every year at this time, I set aside time to do some thinking about what happened in my life this year. Was it better than last year and if not, why not? Did I do everything I wanted? Did I improve my health? Did I tell those who I love and care for that I do love them and do care for them? Did I grow myself and help others to live a happier life? I think being a psychologist causes one to be more introspective than others. And yes, I actively spent time with those I love and care for and tried to help this who I treat to live better lives.

    This year, unfortunately, will live in history as a tragic year. It is just a few months short of the one-year anniversary of the horrific tragedy that occurred at Stoneman Douglas High School on Valentine’s Day. While life does go on, many, many, many members of the community have been traumatized by the shooting. Even though life seems to have returned to normal, people have not. I find myself wanting to know more about what happened that fateful day and then feeling angry and appalled by the numerous failures of the systems designed to protect our students and all of us. What good is it to “See Something, Say Something” when many people did say something yet nothing was done. Who is being held accountable for the failures that day? Are they still in positions of responsibility or are they just trying to pass the blame onto others? Will we ever know who failed to protect our kids? What messages are we teaching our kids?

    I truly hope that this new year brings some solace to those who are still grieving, still fearful, and still in shock from that horrible event. My New Year’s wish is for speedy healing of those who have been traumatized so that one day in some year soon they can look back and say that this was a good year.

    November 16, 2018
    Last week, I had the pleasure of meeting, over dinner, a Holocaust survivor who spent three years in Auschwitz. A friendly and outgoing individual, Morris is more than 90 years old and in very good health. His cognitive abilities were great and he easily spoke about his life. He detailed his experiences including showing his tattooed arm and what it was like being liberated. He said that he spends a lot of time talking to students in school and enjoys opening their eyes to his experiences with the message of “Never Again”. One wonders and I am often asked, how can these survivors enjoy life after what they have been through? Aren’t they filled with hate?

    Was it a coincidence that I met him on Kristallnacht? Who knows? I told him that I had visited that death camp many times and perhaps that was the one of the things that bonded us. There was a genuine warmth and good feelings making this connection. Having had a horrific childhood, he now lives on his own but is he lonely or bitter? Not a chance. He has found a purpose which adds meaning to his life.

    This is a man who took the worst and turned it into the best for himself.

    A lesson for us all.

    October 20, 2018
    Unfortunately, politics has been good for my business. While I believe that few people have sought treatment because of being upset about politics, there is not one patient I have who has not talked or made comments about politicians. It seems to me that people are angry, scared, and worried about the future. Rightly or wrongly so, their emotional states have escalated and they report feelings of powerless. The question of what can I do is followed by a shrug of the shoulders and a reluctant acceptance of the current situation.

    Ironically, as a psychologist, I work to empower my patients with new ways of thinking and behaving to resolve their problems and deescalate their negative feelings. We work towards avoiding harmful, negative situations and learning how to handle them when they occur. We model respect for ourselves and for others. We develop strategies to deal with difficult people and situations and develop ways to handle the anxiety, anger, and frustration.

    The current political and societal climate have given us a lot to work with.

    September 21, 2018
    Like many others I have spoken to and have heard, I am appalled by the lack of decency and respect in our society today. I believe that this is a bigger problem than just politics where much of it comes from. What are the messages we teach each other and our children? What will the future be like if we cannot trust or respect each other? What values do we live by and how can we feel secure in a world where the main entertainment is winning or getting the better of the other guy? I believe this is a time when all of us need to evaluate our own values and behaviors and determine whether we are contributing to the collapse of decency and respect. We all need to decide how we want to live and relate to each other.

    It is also the time that each of us individually need to take the responsibility of bettering society by how we live and by being an example of respect and decency. We cannot wait for society’s
    leaders and influencers to set an example because they haven’t yet and probably won’t. It is my belief that only each of us can repair the world in our way.

    Be kind and respectful to others. Hold the door and say please and thank you. Smile at others. Cooperate and help those who need it all the time not just in times of illness or catastrophes. Think of others not just ourselves. Be charitable and see others not as competitors but also trying to make their way in the world. Refrain from watching or listening to rabble-rousers as well as television shows or movies that degrade your values. Let others know that disrespect and indecency will not be accepted. Be a leader and not a follower.

    If not now, when?

    July 19, 2018
    Recently I decided to do an experiment to put more balance in my life. Since I frequently talk to many people, I wanted to see if I could go a day without speaking to no more than three people. Would I be successful? The answer was yes and I was surprised and gratified. I went to the beach by myself prepared to snack, read, and listen to music. The weather in the morning and early afternoon was perfect. Just before the crowds descended upon the beach, I left having spent several hours under an umbrella in the sun. What serenity to have the day to myself to do what I wanted to do and I did. I made the time to relax, left all my responsibilities behind, and did not have to listen to or talk to anyone. I did however speak to both of my adult children but that was it for the day. I watched the fireworks through the rain while listening to music on the car radio. The day was just what I needed.

    My typical day is filled with responsibilities. I have deep, emotional conversations with multiple people every day. In addition, there are always things that need to be done at home and in the office. There are phone calls to answer, chores that need to be done, and plans made for the next day or week. I often feel like I am doing a lot just to keep up, doing what needs to be done. But researching a balanced life led me to thinking and the above experiment.

    I think it is hard to understand a balanced life until one actually experiences it. If you feel like your life just consists of things that need to be done, consider taking a day off and experiencing a balanced life. Maybe you will change your life to have more fun and relaxation and pursue the activities that you want to do not have to do.

    June 14, 2018
    I have just recovered from a cold. Like many of us, I suffered with congestion, runny nose, a cough, and difficulty sleeping. Fortunately, it did not last long after following my doctor’s advice. But it made me think of how lucky we are to usually be in good health. We often take that for granted as we busy ourselves with our responsibilities and activities. Once we are sick, we realize how debilitating colds can be. We have to cancel appointments, suffer with discomfort, and just wait until we get better.

    Being sick made me truly appreciate how good it is to be healthy. I have always taken steps to be healthy…eating right, exercising, and getting enough sleep. I spray disinfectant after sick patients come to the office and wash my hands multiple times during the day. But the truth is, despite doing our best, we get sick and have to rest up until it passes.

    We take our good health for granted and do not focus enough on maintaining it. It is important to recognize that good health is not a gift. It is dependent upon what we do, what we eat, what we drink, how we sleep, what drugs we put in our bodies, and how we work.

    Maybe by getting sick, we get refocused on living a healthy lifestyle and being conscious of all that we do.

    May 21, 2018
    Just as predicted, another school shooting happened. This time in Texas. Ten more lost their lives by an angry and probably mentally ill young man. Again parents, family, and a community grieve because there have been no significant changes. When the tragedies happen, we band together supporting each other and demanding change. Then everything quiets down and people become passive waiting for the elections, for the internal review reports, or for the notoriously slow legal system to take action. This passivity needs to be challenged and the marching must continue for there to be effective change.

    Years ago, I remember when there were the post office and workplace shootings that occurred because of disgruntled employees who believed they were harmed in some way. Today, it seems like there are disgruntled students who put such low value on human life, that they go into their schools to kill. When will this stop?

    The killing will stop not when there are changes in the gun laws. The killings will stop when politicians and society recognize that mental illness is a causative factor in these murders. Not all people who have a mental disorder are dangerous yet there are those who are just so angry, so disillusioned, so disenfranchised, so isolated that they somehow see killing others as acceptable.

    The signs are often there but ignored because mental illness is not taken seriously in our society. These people need to be identified early before they reach the point of rage and act out. They need to be understood and treated so that these tragedies can be prevented before they happen. These individuals need to be defused of their anger and connected to others so that they do not isolate.

    We need to march not only for a change in gun laws but also for a change in how we deal with mental illness before another tragedy occurs.

    April 20, 2018
    It has now been over two months since the terrible tragedy that happened at Stoneman Douglas. School and routines have resumed but people are not the same. A profound sadness is still upon the community and it will take a long time to overcome the anger and grief, if ever. But most people I have spoken to want to resume their lives.

    Town hall meetings and gun violence protests occur frequently and rightly so. Hopefully changes will be made to protect and ensure the safety of our society. However, it seems that little attention has been paid to those individuals who are mentally or characterologically ill. History has shown us that these types of individuals will continue to act out against society and will find the means to do so.

    We must as a society find ways to help these people and get them connected so that they are not isolated and angry. Early identification of behavioral or emotional problems can help these individuals before their anger and resentment grow into acting out behaviors against society. This is not just a suggestion; this is a necessity.

    We very well may be looking at a mental health epidemic. Combine this with the availability of weapons is a recipe for disaster. Just providing money to have more counselors at schools or to failed mental health clinics is not enough. Just as we would with a medical illness, we need to have mental health tools, quality training of therapists, and research-based screening programs to identify and help those individuals at risk before they escalate.

    The time has come. Mental illness needs to be recognized as an epidemic and treated and not hidden because of stigma or not being an exciting topic for the media. Guns do kill people but people pull the trigger.

    January 20, 2018
    During the past year, many of my patients have come to their sessions angry about politics. It doesn’t matter what party they belong to or whether they are right-leaning, left-leaning, or centrist, they are all angry and frustrated. They feel powerless and worry about the future of our country and of themselves. Perhaps, rightly so. Many hours have been spent in conversation attempting to reduce their anger and to focus on their daily lives.

    One of the suggestions that have come out of our discussions seems to work. That is, to reduce or eliminate the number of hours spent watching the news on television or listening to it on the radio. It doesn’t matter what network you watch or listen to. All of them seem intent on stirring up feelings of unfairness and anger but offer no solutions. I guess the ultimate goal is to get watchers or listeners glued to their stations. Perhaps this is a media addiction. Yet there is no high but only worry and anger.

    I recently read an article about a self-imposed news blackout by Christopher Hebert, an assistant professor of English at the University of Tennessee, in the January 18 edition of The Guardian. The following is an excerpt:
    Ignorance is far easier than I thought. I finish two or three audiobooks a week. I read novels instead of newspapers. Five months into my blackout, I’m happier than I ever was back in the days when I was informed. My fingernails are growing back. The sleeping pills remain in the bottle. I’m getting more work done. My family comes home at the end of the day to find me smiling, chopping things for dinner without my old regicidal rage. And yet, part of me can’t stop feeling guilty about feeling good.
    Perhaps, this is one solution to the anger and frustration of a media news addiction.
    2017

    December 18, 2017
    Today, a patient of mine told me that his daughters were graduating from college in a few months. I was surprised to realize and remember how fast time passes. I know that it does but was nevertheless surprised. It seemed like it was just yesterday, that we were discussing their separating and leaving home for college. We spent many sessions discussing being an empty nester and the changes and opportunities it brings.

    Time is relative in that it seems like some moments go on forever and some go so quickly that if we blink, we miss them. Life just seems to happen while we are waiting for whatever we are waiting for. While we are looking at what we don’t have and didn’t do, we miss out on what we did do and the wonderful experiences that we did have. I think the answer lies in living in the moment. Taking in as much as we can, both good and bad, is the best we can do.

    I recently saw a friend of mine who was depressed about turning 70. We talked and I tried to get him to see that age was just a number and how he viewed that number would determine his mood. I don’t think I got very far trying to convince him that he was not old and was still vital and helpful to so many people. Maybe it sunk in.

    For myself, I have been practicing mindfulness and trying to live in the moment. I am looking for stillness and sometimes am successful. I try to use all my senses in savoring the moment and some simple experiences defy description in their beauty. Yet reality and our society seem to have a way of intruding so that stress and worry are created. I look at mindfulness and appreciating natural beauty as the antidote to the constant troubling news and feeling of powerless generated by politicians, news people, and other media types.

    The past year has been difficult in some ways yet I have had some wonderful experiences with my family and friends. None of us knows what the new year brings for us but I am determined to enjoy as much of it as I can. It will take work and discipline and sacrifice and commitment. But what is the alternative?

    November 18. 2017
    On Thursday nights, I take a restorative yoga class. This class is not a typical yoga class. Rather, it is more of a meditation and relaxation class. Guided by the instructor while in postures of relaxation, I find myself letting go and truly relaxing from the business of the week. In fact, when the class is over, few yogis want to leave and “I needed that” is frequently heard.

    Although I have been trained in relaxation techniques and use them with some patients, it is hard for me to actually relax. Taking this class has allowed me to experience in some way what my patients experience. True relaxation necessitates the ability to let go; something most of us have a hard time doing. Whether we live hurried lives or we don’t have a sense of safety without our guards being up, relaxation takes practice. Letting one’s guard down takes trust. Letting go takes effort.

    In restorative yoga after a sense of stillness is achieved in a posture, the instructor uses guided imagery to describe peaceful and beautiful scenes to direct our attention towards relaxing. Following the teacher’s imagery, one can transcend the everyday world into the world of the imagery. Worries disappear, muscles loosen and smooth out, and the events of the day are forgotten for a few moments. Some people become so relaxed that they even fall asleep.

    Research has shown that relaxation has many psychological and physical benefits. In the hectic and stressful world in which we live, relaxation is not a luxury. It is a necessity. I have found my way to relax in restorative yoga. I hope you can find your way. Consider taking a yoga class.

    October 21, 2017
    Last night I watched the movie, “Woodstock: 3 Days of Peace, Music, and Love”, and was visibly moved by how much our society has changed in the almost 50 years since this festival occurred. As I remembered and confirmed in the movie, the Woodstock community was peaceful and loving. Numerous comments were made about how nice the kids were, how courteous they were to each other, and how helpful they were to each other. This happened despite the quantity of drugs, the rain, the lack of food, the lack of accommodations, and the difficulties in transportation. Townspeople went out of their way to comment on how courteous the kids were saying “thank you” and “please” and asking permission. They greeted each other warmly and were well behaved not wanting to trespass on the property of others. They respected themselves and each other. When food ran out, they shared. When it rained, they shared whatever they had to cover themselves. When disagreements occurred, they settled them peacefully. When someone overdosed or had bad trips, there were others and medics to help them. They worked together to make this temporary society flourish. As Spock says in Star Trek, the needs of the many outweigh the needs of the few … or the one.

    Contrast that with today’s society. It seems to me that disrespect has become the norm. The values of our society which has existed for generations seems to have become eroded. Language has deteriorated to the point that curse words are used commonly in language by both sexes in public and on television. Dress has become so casual that in some cases it borders on sloppy and unsanitary. Respect for institutions is not trendy nor important. Values seem to be only important when it serves the needs of the person. Verbal attacks upon others occur daily and fake news and innuendo have become okay to use as fact. People will trample others to get the sale item when in limited quantities. Often, we don’t hear thank you or please even when holding the door for others. Protests have replaced communication, problem solving, compromise, or even mutual discussion. Selfishness and materialism seem to have become the norm and are reinforced by our media. The needs of the one appears to be more important than the needs of the many.

    What has caused this in the past almost 50 years? We can point to many factors: fear, anger, the Vietnam War and others, the coming of age of the Internet, advertising, the pursuit of more money at the expense of others, the absence of appropriate role modeling by adults, drugs and alcohol, lies and deceit by politicians, celebrities, and broadcast news, serial abusers, Madoff type scandals, hidden agendas, and a silent society that allows these changes to occur. I am sure we can cite more causes.

    Can we ever regain respect for our society to function? I would like to be optimistic and think yes. We see it in the support our nation gives to others when there is a disaster. We see it when individuals volunteer their money and time to help those who are less fortunate. We see it in the dedicated teachers and first responders. We see it in many others who still honor our values.

    What can you do? Respect yourself. Follow the Golden Rule. Stick to your standards even though others may not. Say “thank you” and please. Smile at others. Be courteous. Let others get in front of you while driving. Just be concerned about the needs of the many rather than the needs of the one.

    As always, I am interested in your thoughts. If you would like to respond to this blog, email me your comments at DrKimmel@KimmelPsychology.com and I will publish them next month.

    Till February…

    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 info@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 © 2019 by Joel I. Kimmel, Ph.D. P.A. and Associates.