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Joyce Boaz & Dr. Frank Ochberg, M.D.

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Professionals: School Teachers and PTSD.

Q: Dear Dr. Ochberg:

I have received calls and emails from teachers who want to know about PTSD, sometimes in order to explain the syndrome to students but more often because they want to be sensitive after a student has
been traumatized by violence or suicide at the school. Briefly, what should a teacher be taught about PTSD?

A: Dear Joyce, Teachers should know the essential facts:

PTSD is a medical condition that affects some but not all who experience severe trauma. The diagnosis is given only when three different clusters of symptoms persist for at least a month.

(1) The first of these clusters is called "re-experiencing" and differs from normal memory. The feelings and images from the horrifying or terrifying event come back unbidden as traumatic memories, flashbacks, nightmares or sensations. Because this cluster may be very debilitating and strange, some people are afraid they are "going crazy" and feel deeply embarrassed. "Triggers" may bring on these feelings or flashbacks. A "trigger" is a reminder such as a person who resembles a victimizer or a movie with a violent scene. Columbine students with PTSD did not enjoy Fourth of July fireworks.

(2) The second group of symptoms includes feeling numb or avoidant. It causes detachment from others and pessimistic feelings about the future. Students with this set of symptoms may seem aloof and unfriendly. It doesn't mean they dislike classmates. The PTSD creates a social barrier.

(3) Finally, the PTSD survivor feels anxious, irritable, jumpy and has trouble sleeping and concentrating. This dimension will interfere with academic performance and, in some instances, cannot be easily helped. A student with PTSD may appear similar to a student with ADHD, needing extra time for assignments or test-taking in a quiet room because of the concentration problem. Fortunately, PTSD resolves relatively quickly and students are not usually hyperactive or disruptive. Accommodations can and should be made in
consultation with family and counselors, to identify individual needs. A PTSD expert may be able to help by phone or email.

An educator friend who deals with this situation observed, "an act of kindness towards a struggling student goes much farther than detention."

Teachers should know that PTSD affects survivors without regard to intelligence, physical health, courage, age, race or gender -- although there are some interesting statistical difference by demographic group. My point is that no one is immune. Given enough trauma, almost anyone will suffer PTSD. And suffering is no sign of weakness.

PTSD deserves expert treatment. Not every doctor or therapist is experienced in treating the syndrome. Experts can be found through academic centers and the International Society for Traumatic Stress Studies (www.istss.org).

PTSD improves with time and, now-a-days, responds well to straight-forward treatment. There is no way to predict the duration of symptoms, because the type of trauma and the resilience of the survivor varies so much. A welcoming and supportive school community will shorten the duration of the disorder and reduce its negative impact.

Persons with PTSD and no other complicating condition are seldom dangerous to self or others. But PTSD does accompany depression, alcoholism and interpersonal estrangement. When all that is added together the outcome can be volatile. Soldiers who are armed, trained to respond to threat with aggression and cycled through many tours of duty can pose risks when they are badly stressed and poorly treated. The same can be said of combatants in urban war zones.

It isn't easy to be a teacher these days. Expectations are high, resources are scarce, respect is not what it was when I was a schoolboy after World War II. But knowing a bit about PTSD can make the job easier. There are many experts who would appreciate an invitation to talk about the problem in class. I've taught the subject as a guest in high school and middle school. It can be done in a way that promotes understanding. A faculty conversation with a PTSD expert has helped as well.

A colleague who was a high school principal and now teaches education in college has designed a "teen summit" program for secondary schools. Students spend a day teaching, learning and interacting with subjects that include bullying, abuse and self-respect. This program is especially useful after teen violence has been in the news (see http://www.seattlepi.com/local/303684_kian15.html ).

When a teacher wants more than this half-page of facts, she or he can browse the pages of the GFW website. If the survivors who visit GFW on a regular basis had teachers who recognized the signs of
abuse and trauma, and who were comfortable calling for help, all of us would be far better off.

And if you are a teacher, reading this, thank you, thank you, thank you. Teachers can do more than doctors to reduce the stigma and fear that haunts those who survive victimization. A little knowledge goes a long, long way.

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Page created on 9 Febrruary 2010
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