Professionals: Graduate student asking about helping clients with PTSD

Q: Advice from Dr. Ochberg to a Graduate Student studying to be a Mental Health Counselor about working with a client that is having a mental breakdown.

Dr. Frank Ochberg:

I want to first say thank you for what you do for out military and for helping me to understand my son a little better. I am a graduate student at Walden University my degree that I hope to get is Master degree in Mental Health Counselor. We had to watch a video of the field that we want to specialize in and I choose yours. You helped me understand PTSD a little more and hope to understand it better in time. Is there any thing that you can tell a student that is coming into this field that would help them understand working with clients that have a break in their mental health?

A: Dear Graduate Student:

Thank you for your email and your interest in helping others. I’m going to give a short answer for now.

We used to call all forms of sudden shifts in mood, thought and behavior a “mental breakdown.” In some cases it was a depression, now termed “Major Depressive Disorder.” Unfortunately, this is rather common and it may be very severe, with suicidal thoughts, retreat into self-isolation, very low self-esteem, and little desire to seek assistance. Sometimes it is a first episode of schizophrenia, with hallucinations and delusions. When it comes after a terrible trauma, like the death of a child, it is usually PTSD and you know about that now from various descriptions on the Gift From Within website. A “mental break” may be more mild, but still difficult and confusing – a sense of shame or fear or demoralization during a period of frustration. Often, these have to do with bullying or rejection or mistreatment by a powerful family member.

The student who wants to be knowledgeable, sensible and helpful needs to learn about these conditions and to realize that they are NOT due to weakness or orneriness. Anyone can have a medical illness or an injury and, usually, these breaks from mental health are just that- a form of medical illness or injury. I want the label, PTSD, changed to PTSI -for INJURY.

Something has broken the ability of the nervous system to handle stress and it will take time to heal. During that time, the survivor has flashbacks and feels numb and cannot turn down the alarm system that makes him or her on edge – looking for danger everywhere.

My advice to the student: be a student and LEARN. Read all about these conditions. Also, be like a doctor and be KIND and CAREFUL and SCIENTIFIC. You can’t be all these things at once, but you can get there one step at a time.

We who stay in this field and who do well are all good listeners. We listen carefully. We don’t tell people how to think. A person who suffers an emotional injury often wants to tell us what they are experiencing. They benefit enormously when we “get it.” We may not be able to “fix it.” But we understand and we care and they can feel that. It is sometimes called “the ministry of presence.” We are there beside them and that, in itself, is a gift.

Frank Ochberg MD