Supportive Trauma Counseling Sessions

Many of us suffer from trauma due to past and recent events. If you, your friends, or your relatives are presently undergoing a traumatic experience, call Joseph Lanzone LCSWR. With caring and compassionate counseling sessions, I'll help you create a personalized treatment program focused on healing your PTSD, panic attacks, and any other mental health issues related to traumatization.

Facing trauma can be a challenging and painful experience. Fortunately, you don't have to do it alone. Turn to Joseph Lanzone LCSWR for counseling services designed to address all your needs in a safe environment. Call (845) 358-0925 today to schedule an appointment. Rest assured that I have the knowledge and expertise to help you begin to heal from the traumatic experiences you faced.

Common Symptoms of Trauma

• High prevalence of nightmares and flashbacks
• Disturbed sleep
• Poor anger management
• High alertness
• Low concentration ability
• Lack of social connectedness
• Increased isolation
• Substance abuse

Why Choose Joseph Lanzone LCSWR?

• Joseph Lanzone LCSWR is a certified psychotherapist and addiction specialist
• Provides effective counseling and therapy sessions for your overall mental health and well-being
• A professional grief and trauma care specialist
• He has 19 years experience as an adjunct professor at Fordham University graduate school of social service, Lincoln Center and utilizes state-of-the-art treatment theories

Trauma Work For First Responder

It was my honor to co-author this manual by writing this article , “Addiction, Trauma, & Mental Health”. (Pages 30-39)

The title First Responder is ascribed to any person who agrees to perform mentally and physically in a role that demands action, in the present moment, in exposure to spontaneous conditions and events in which one must respond (not react) as the primary initiator of the required solutions. Whether professional or volunteer, the vehicle of the response is the human body: the same organism that is experiencing the crisis at hand, the same internal systems and brain, but with unique and individualistic genetic and environmental histories. When we wide-lens the merging historically induced responses involved in Critical Response, the responders must call on their training, past responses, and clarity of mind in that moment, often bearing responsibility for the success or failure of any interventions which may ensue from their decisive actions. In my opinion, SUPERVISORY DEBRIEFING SHOULD BE MANDATORY. This is a made to order job for superhuman creatures. However, "super-or-sub", the human body absorbs every experience of exposure and creates physiological (physical and emotional) competencies and consequences, like the following:

ANXIETY (Source: National Institutes of Mental Health)

Anxiety is described as intense, excessive, and persistent worry and fear involving everyday situations.
It is often associated with elevated blood pressure, increasingly rapid heart rate, rapid breathing, sweating, ruminating thoughts and fatigue. It is quite normal in situations (happy or critical) like preparing a celebration and being evaluated. Excessive anxiety which becomes overwhelming and obstructive to normal daily living may indicate the presence of an Anxiety Disorder, such as:
•Generalized Anxiety Disorder (DSM5:F41.1)
GAD is an anxiety disorder characterized by chronic anxiety, exaggerated worry, or tension, even when there is little or nothing to provoke it.
•Obsessive- Compulsive Disorder
(DSM5:F42) OCD is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions) such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them disappear. Performing these ritual behaviors provide only temporary relief, and not performing them significantly increases anxiety.
•Panic Disorder (DSM5:F41.0)
Panic Disorder is an anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness or abdominal dis-tress.
*Social Phobia (Social Anxiety Disorder (DSM5.F40.11)
Social Phobia is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.

Social Phobia can be limited to only one type of situation - such as fear of speaking in formal or informal settings or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms anytime they are around other people.
*Post-Traumatic Stress Disorder (DSM5:F43.1)
Post-Traumatic Stress Disorder, POST TRAUMATIC STRESS, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger POST TRAUMATIC STRESS include violent personal assaults, natural and human-caused disasters, accidents, or military combat.
I heartily encourage you to read and discuss all the above information to impress upon yourselves the seriousness of "just anxiety"
'As we gather from the medical diagnostic picture, there are at least 5 specific categories-names-flavors, etc. of clinically diagnosable anxiety. Anxiety is a MENTAL HEALTH DISORDER.
"Anxiety isn't rational, it isn't all in your head, nor is it being occasionally worried. It isn't all the same, it's not depression, and it isn't making a big deal out of nothing. Anxiety isn't unmanageable, and it isn't something to be ashamed of!" (Bustle.com). Armchair "psychiatrists" cannot treat a diagnosable dis-order, even if desiring to be helpful. Do not believe the person who decides that assessment, treatment, and medication isn't necessary "because that's not you!". Be as cautious of non-medical advice from just anyone who's "been there". A chemically dysregulated brain is not the same as a vehicle with a blinking "check engine' icon. Although trust is a personal decision, if you are truly suffering with anxiety, speak with a credentialed professional about science-based solutions. I highly recommend the curative aspects of nutrition, exercise, support networks, spirituality and counseling or psychotherapy.

DEPRESSION According to the American Psychiatric Association (APA), "Depression (Major Depressive Disorder, DSMS:F32) is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/ or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work or at home. Depression symptoms can vary from mild to severe and include:
Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed

Changes in appetite - weight loss or gain unrelated to dieting
Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue

Increase in purposeless physical activity (e.g. inability to sit still, pacing, hand-wringing) or slowed movements or speech (these actions must be severe enough to be observed by others)
Feeling worthless or guilty
Difficulty thinking, concentrating, or making decisions
Thoughts of death or suicide
Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression. Several factors can play a role in depression:
• BIOCHEMISTRY. Differences in certain chemicals in the brain may contribute to symptoms of depression.
GENETICS. Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life. PERSONALITY. People with low selfes-teem, who are easily overwhelmed by stress, or who are generally pessimistic, appear to be more likely to experience depression.

ENVIRONMENTAL FACTORS. Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression." (APA) PERSISTENT DEPRESSIVE DISORDER (DSM5:34) may be diagnosed by the same symptom criteria as Major Depressive Disorder, except that it has at least a two years or longer duration.

BIPOLAR DISORDER (DSM5:31), often called "manic depression", creates symptomatic mood events that range from extremes of high energy with an "up" mood to low "depressive periods" . When one is in the low phase, the symptoms of Major Depressive Disorder are present.

SEASONAL AFFECTIVE DISORDER (SAD)
The DSM5 categorizes SAD as an affective disorder, with mild to severe characteristics of major depression. Its unique symptoms are relative to the time of year in which one experiences it, ex: Fall/Winter, Spring/Summer. Talk therapy, particularly cognitive behavioral therapy (CBT) is effective in treating SAD, often along with Selective Serotonin Reuptake Inhibitor (SSRI) medications. Light Therapy, either sunlight or artificial may also be beneficial, but should be prescribed and guided by a credentialed clinician. (APA)

Depression is not sadness. You may be sad for several hours at a time. After a negative experience your mood changes, at most for several weeks. Over time your mood will get a little better. With depression, most areas of your daily life become affected, showing a combination of DEPRESSIVE SYMPTOMS for most of your day for at least two weeks, causing general distress.
Sadness is an emotion. DEPRESSION is a mental illness.
Sadness is brief. DEPRESSION persists much longer.
Sadness is a specific reaction. DEPRESSION is an abnormal general state.
Sadness temporarily changes your mood.
DEPRESSION changes your life.
Sadness is subjective. DEPRESSION is diagnosed. (Source: Mind Doc www.mymood-path.com)

ABOUT ADDICTION:
The American Medical Association identified addiction as a DISEASE in 1956. In 1987, after voluminous further research and practice, the AMA and other leading, established medical organizations definitively termed addiction AS A DISEASE. Like hypertension, heart disease, diabetes, etc., addiction is caused by a combination of behavioral, psychological, environ-mental, and biological factors. In 2013, upon more evolving evidence and research, the Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) by the American Psychiatric Association clarified that addiction is a DISORDER. The terms "dependence and addict carry an extremely hard social stigma, and we now understand, for example, that a person who becomes "hooked on painkillers" may NOT have a predetermined condition that creates the symptoms of a disorder, but due to their medical need for painrelleving prescriptions, may develop a disorder due to the power of opiates to literally hijack the central
nervous system.
The symptoms of Substance Abuse Disorder (SUD) in the DSM5 include: Missing school, work or other responsibilities due to substance use Building up a physiological (physical and psychological) tolerance to the effects of a substance

Craving the substance
Failing to quit using despite multiple times of trying to do so
Along with alcohol and other drugs, SUD's can include gambling, sexual activity, shop-ping, etc.
The American Society of Addiction Medicine (ASAM) defines addiction as characterized by inability to abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one's behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, ADDICTION IS PRO-GESSIVE and can result in disability or premature death (OF SELF OR OTHERS - in my opinion).

ADDICTION CHANGES THE BRAIN! In my youth, a popular cigarette commercial asked the question,
"Are you smoking more now but enjoying it less?" It went on to push its new product that added a little flavor to the filter. In hindsight now, it was a perfect "tasteful" addition to a substance that had already reeked death and destruction to millions of human beings, but it made smoking more pleasurable.

When a person becomes addicted, our brain receptors become completely overwhelmed. The brain responds by producing less dopamine receptors and we will do more but enjoy it less. According to Harvard Medical School, as we experience something pleasurable, something that we like, our brain registers all pleasures the same way. "Whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. Pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbent of the brain." Many addictive drugs (and behaviors) initially stimulate a flood of dopamine that creates the feeling of pleasure. However, as we move from tolerance to dependence, the brain begins to produce less and less dopamine, thus less pleasure. "At this point, COMPULSION takes over... The pleasure is no longer felt, but the memories exist. These memories help to create a conditioned response - INTENSE CRAVING, whenever the person encounters environmental cues" - TRIGGERS! "Conditioned responses/learning helps explain why people who develop an addiction risk relapse even after recovery."

ADDICTION and POST TRAUMATIC STRESS have something strikingly in common - TRIGGERS! To put it simply, a TRIGGER is a person, place, or thing (including an event, a sound, a taste, a smell, a memory) which stimulates an emotional and/or physical response. As a recovering alcoholic, I have powerful memories of oblivious states of pleasure. However, the smell of alcohol makes me instantly nauseous.

The possible trigger of my memory is counteracted by my stomach doing cartwheels. Walking or driving past a liquor store no longer has me pulling into a parking space due to my memories of hitting bottom and causing untold wreckage. I also have POST TRAUMATIC STRESS, and awfully specific memories.

People, places, things, thoughts, dreams, and feelings can trigger my instant readiness to fight, run away or play dead - and I spend most of my days in a chair in a tastefully decorated office! We all have unique personal lives, and one person's trigger may be another person's forever bachelor party. Memory and physical stimuli can be powerful, order-producing phenomena or create the impulse for chaos and destruction. Our present state, meaning in the present where our feet are, becomes the decider of how we experience triggers and how we respond to them.

All First Responders enter a mindset of HYPER AWARENESS as we report for duty. Our brain automatically creates an invisible barrier between our work life and our personal lifestyle. The training which we have received prompts us to take action IN OUR CHOSEN ROLES. Our ability to react and focus within seconds when necessary is a specific authentic experience. It requires extraordinary concentration which automatically occurs in hypervigilance. It also requires purposeful MINDFULNESS on and off the job to maintain optimal health of mind, body, and spirit. Do not assume that alcohol or other mood- altering substances IMPROVE OUR SKILLS! If that were true, then I'll sell you a car with no tires, just rims!

It is vital for us to IDENTIFY OUR TRIGGERS and how to respond to them in only healthy ways. We have a moral obligation to ourselves, our loved ones and to the human beings "on the other side of our FIRST RESPONSES" to nurture and constantly learn better tactics and skills. Our jobs are not who we are. Consider this, you can be easily fired from your job, but not who you are. Our bodies are the vehicles of our "selves" treat them with the love and respect you would treat your children with. DO NOT allow your thoughts to convince you otherwise. Allow yourself to speak up and own your humanity, especially when YOU KNOW you need help,
YES, YOU!

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