PTSD
 

Does anyone know if someone who has recently experienced trauma can start stuttering?

I'm so worried. My dad's work friend was killed on the job Wednesday, right in front of my dad. They were running heavy equipment, and apparently the friend stepped off his dozer and it was still running and he was run over. He was killed instantly. My dad witnessed this.

He flew home last night, and is with my mom right now. He will be playing golf with my brothers this afternoon and working on a contraption he is making for my nieces (it's a water balloon thingy.) So, I know it will take some time for him to feel better.

I just called him, and he's really stuttering. My dad never stuttered. My dad is a very strong person. I love him so much and I'm worried about him.

Has anyone heard of anything like this? I'm sitting here at work and I can't stop crying and I just don't know what to do.

That was a terrible thing to see especially in the context of work. He should talk to someone with some training in this sort of thing. Does he have a clergyman he can talk to or maybe get him to a professional? When wolf sees this maybe she could point you in the right direction.

They had a grief counselor visit him and the other people who were on the jobsite. I hope he has plans to follow up. My dad is not a therapy type, but I hope he sees that he may need to do this.

Thanks Griff.

Try to make sure he knows this is a special case, it doesn't say anything about his mental toughness.

I'm seriously not saying this to be funny, but on this episode of 21 Jumpstreet... ya rly ...this cop (Peter Deluise) had to kill somebody in the line of duty, so the cop shrink said he had to go hold crack babies at the hospital. Serisouly, after having witnessed death, he had to spend some time doing something life-affirming. It sounded like a good idea, I don't know if that's a real thing or not.

I know what joy he gets out of my nieces. It might sound silly, but I think it will be life affirming to him to get the water balloon contraption done and watch the fun the girls will have with it. I hope that helps, too.

Yeah, that right there sounds like just what the doctor ordered.

Shawnee, the stuttering is just as you think: a response to the trauma. No matter what your dad appears to be doing, he's still moving through this. The stuttering will almost certainly fade with time.

Some PTSD things are hard to shake. This particular affect in someone who hasn't had it before is something he'll overcome.

Thank you lizzy, I appreciate your response. I appreciate the nice people here.

(btw, lizzy, I love your user title)

wow, that's just horrible. I have no experience with PTSD, but I hope things get better for your dad.

P.S. Sex is also life affirming, but I guess you can't very well suggest that to him, can ya?

heheheee...no, but I'll pass the suggestion on to mom!

I talked to the resident licensed counselor here at work. She said it is acute ptsd, and suggested he go ahead and see someone just to kind of "debrief." I talked to my mom and she said they are going to talk about that, but right now she just wants him to be home and enjoy his family. My 17 year old nephew stopped by today to help plan the balloon thingy, and he is now playing golf with my two brothers (and it's a gorgeous day.)

I don't know if he will want to go back to work, at least not to that jobsite (he travels all around for his job, this was in CA.) He may go ahead with his plans to retire, which he had decided to hold off on.

I know he will have a good father's day, but I am sure in the back of his mind will be his buddy, who has 5 grown children. That's so sad, and my heart aches for these people I don't even know.

Shawnee, try not to worry too much.
I know you love your Dad very much, but as you say he is a strong man, has your Mum to support him and is going to get professional help.

Just carry on loving him and he will sort himself out as best he can.

Try not to get yourself too upset about it. Although I know what you mean - I feel for all involved too and I don't know anyone except you!

Thanks sweetie. I just hate to see the people I love in pain, and wish I could take it all away and feel it for them, so they don't have to. I know he will be alright, and he's been through rough stuff before. As you know, SG, we are a very close family. I'm very lucky that way.

Your resident licensed counsellor is probably a nice person, but doesn't know a lot about dealing with traumatic stress ...

First off, your dad does not have PTSD, or even "acute" PTSD (there's no such thing as acute PTSD, incidentally). Post Traumatic Stress Disorder develops over a period of months. To be classified as a disorder there have to be significant impairments in a person's ability to function.

Don't decide your dad is sicker than he is.

He's not mentally ill.

He's seen some bad shit.

There's no need to pathologize him.

Your dad is experiencing the NORMAL reactions of a NORMAL person when exposed to an ABNORMAL situation.

In the first 24-48 hours, the reactions are just starting to set in. There's a tendency to jump right in and think that things need to be addressed in a particular way, like bringing in the grief counsellor.

Grief counsellors are great, but grief is something you're not even capable of dealing with in the first 24-48 hours. There's a lot of shock, emotions aren't even really processed or sorted out. Head for the grief counsellor in a couple of weeks if there are still some issues.

The licensed counsellor where you are probably knows or heard a little bit about something called "CISM" or Critical Incident Stress Management. That's where the term "debriefing" is used a lot ... but people also misuse that term, leading to a lot of confusion about what is or isn't CISM and whether CISM is useful or harmful. There's a lot of literature on that, so I'll let that discussion go for right now.

I am a Mitchell Model CISM trained debriefer and have been active on a Critical Incident Stress Management Team for 12 years. One of the more important pieces of the process right now relates to eduction ... about normalizing the experience for your dad, finding out what reactions he is having, what he's noticing as changes in himself, or that others notice in him ... you mentioned stuttering. He may have stuttered when he was younger and has been in very strict control of that ... but now, he's overwhelmed and strategies he's used in the past aren't working. He could be irritable, sleepless, less or more hungry, an increase in smoking or drinking wouldn't be unusual.

I would suggest that your dad talk to someone ... not a therapist, though, not at this point. Remember that whole "you're normal" focus? Critical Incident Stress Management Debriefing is a peer driven process. If there isn't someone in your dad's company that's trained, there may be someone else available, or even the CISM team that serves Emergency Services Personnel in that community might be called upon for this kind of industrial accident ... I know that we've gone out and done that kind of defusing and debriefing. If you want to let me know where your dad is, I can look into resources for him (I have them worldwide, not just in the U.S. This is an internationally utilized process).

Thank you SO much, wolf. You have helped more than you can know, and I will forward your expertise on to my mom. I feel so much better, and realize in my compassion for my father I was pathologizing him, as you said. Your perspective is just what I needed.

Thanks again.

I can give you a link to some printable brochures that will explain the CISM process and stress managment.

That would be great. Thanks.

CISM Pamphlet from the International Critical Incident Stress Foundation (pdf)

Local version, similar info (word doc).

Some other resources

(just a note ... the resource page for the ICISF is good, but tends to be heavy on journal articles, which make most people's eyes glaze over, which is why I don't link directly to it.)

Thanks wolf.

You rock Ms. Wolf.

About CISM and PTSD
 

Wolf has some really wise things to say -- especially about not pathologizing your dad. It's normal for people to have strong emotional and physical reactions when they see or are involved in something horrible -- what is called trauma.

Before going any further I should make clear that I have no official pedigree in this area. I'm not a therapist or a counselor or anything like that, much less a psychologist. I am, though, a journalist who for the past couple of months have been working on an article about PTSD and have talked to a lot of pros and read more of those eye-glazing articles than I care to think about.

One thing I've found out is that for every expert who says one thing, you'll find two or three others who say something else.

For example, Wolf says that there is no such thing as acute PTSD. Well, maybe so, maybe not. In the DSM -- the Diagnostic and Statistical Manual of Mental Disorders, the official handbook of the American Psychiatric Association -- there is something called Acute Stress Disorder (ASD).

According to the DSM, PTSD doesn't usually manifest until one to three months after the traumatic event. But some therapists think that a strong immediate reaction to trauma should have some sort of official DSM classification and so they have called it ASD. Sometimes, ASD is a forerunner of PTSD.

This ASD is probably what your counselor was referring to as acute PTSD.

Now, all of this stuff is very controversial within the profession.

Another controversial thing is the best way to deal with the immediate aftermath of trauma.

CISM or Mitchell debriefing was designed by a firefighter turned psychologist to help his fellow emergency workers. It has gained wide acceptance in a number of areas. Matter of fact, just about any time you hear about counselors going in to help people after various disasters, either natural or man-made, these folks are Mitchell-type debriefers of one sort or another.

At first glance, this seems like a really good idea. However, a number of studies -- usually done by folks associated with the Veterans Administration -- claim that debriefing causes more problems for more people than it helps. They say that debriefing, basically, implants the trauma more firmly in the patient's mind causing more intense and longer lasting problems down the line.

Many of these VA-connected therapists say that a bit of time -- say a month -- should be allowed to pass to see if the issue resolves itself naturally. The studies are all over the place, but usually anywhere from half to two-thirds of people exposed to severe trauma get over their problems without any intervention other than their own natural resiliency and support from family, friends and loved ones.

They seem to make a good argument, but not one that is absolutely convincing.

In any event, just about everyone seems to agree that if the patient (or victim or whatever term you care to use) is still having problems after a month or so, professional help is definitely called for.

Not to have this thread devolve into a defense of Mitchell Model CISM ... but the studies showing debriefing is harmful tend to be flawed ... not actually done using Mitchell Model CISM, incorrect study populations (burn victims), and don't all define 'debriefing' in the same way.

CISM focuses on emergency services providers. There has been some generalization beyond that population, such as involving industrial accidents, but it's not generally applied in instances of disasters, for example. The Red Cross has their own way of going about things, as does the Salvation Army.

Jeff Mitchell isn't perfect (although George Everly may be), but CISM, which is a comprehensive stress management system rather than a single debriefing session, isn't harmful.

Welcome to the cellar, neofarmer. :D

I'm no expert in anything, but that said, if I were to experience a traumatic experience I'd prefer the treatment be lots of sex. Physical exertion for good sleeping and it takes my mind off everything.

life affirming activities, yeppers.

Hi neofarmer, and thanks for the input.

Thanks to you all. We had a great weekend with Dad. His stuttering has lessened (unless he is talking about the event, which he doesn't like to do, or when his boss called.) Mom said he is staying home at least this next week, and will go back when SHE thinks he's ready (and you don't mess with the Mom!)

He finished the water balloon contraption and it worked marvelously. The nieces loved it. We all laughed and had a great day, and laughter is the best medicine.

Thanks again to you all for your concern and advice.

Really pleased to hear he is finding ways to cope with it and has the support of a loving family.