An Unexpected Traumatic Change in Life: Where to Go from Here?

Abstract

Trauma exists in two, often interlocking forms: psychological and physical. Psychological trauma can be succinctly defined as “a psychic or behavioral state resulting from mental or emotional stress or physical injury” (Ehde and Williams 2006. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association 2000) provides the criteria of a traumatic event to involve “either the experiencing or witnessing” of “an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others” (American Psychiatric Association 1994). It is significant to note that a traumatic event will cause only a proportion of individuals who experience such an event to become traumatized. Estimates suggest that 14% of people living in the United States will develop post-traumatic stress disorder in their lifetime (Yehuda 1999). Although this reveals a high prevalence of the disorder, it actually represents only a small sector of people who experience a traumatic life event, given the fact that most people will experience such an event of some kind during their life. For this chapter, the act of “becoming traumatized” will be clinically referred to as “experiencing symptoms of post-traumatic stress disorder or PTSD.”

The prevalence of trauma in the United States is examined closely by Lawrence Robinson in his book entitled Trauma Rehabilitation. Trauma is the leading cause of death for 1–34-year olds and the second leading cause of death for 35–44-year olds. Death rates, however, are a misleading factor when determining the breadth of the problem. Traumatic injuries accounted for 29 million nonfatal injuries in 2001 (Robinson and Micklesen 2006). Motor vehicle crashes (MVCs) were the most common cause of traumatic deaths (31%). Traumatic brain injury (TBI), largely caused by MVCs, is the most common neurological disability (300 cases per million), yet many of these individuals survive and require either inpatient or outpatient rehabilitation. Patients with traumatic injuries represent approximately one-fourth of the inpatient rehabilitation patient population in the United States according to Robinson and Micklesen (2006).