Praise for

How to Cope with Stress after Trauma

 “I started reading the manuscript for this book because Anna Goodwin asked me to see how she was utilizing my poem “The Healing Wall” throughout the book. She also asked me to share my honest response as a veteran to what she was saying. It took less than three pages for me to realize I wasn’t reading a book about someone else with PTS, I was reading about me! That realization caught me off guard. And in so many unexpected ways, this book has changed my life. I know it will do the same for you. Every veteran (and your family members), regardless of the war in which you served and regardless of the experience you had in that war, needs to read this book. I know you and those who love you will be as grateful as I am that you did.”

— Patrick Overton, Ph.D. in communications, and Vietnam veteran

Author of Rebuilding the Front Porch of America: Essays on the Art of Community Making


“This book offers our veterans and their loved ones a path towards resilience and healing. It is a strong reminder that we cannot always choose what happens to us but we can practice choosing how we respond, and how we respond to the challenges after trauma can make all the difference. The author’s perspective and approach are well informed and reveal the depth of her experience.”

— Dante Rumore, MSW, post-war readjustment therapist and Marine Corps veteran


“My experience with Post Traumatic Stress is different from most others. Although I am a retired U.S. Marine, I never saw combat. My trauma came in Los Angeles during Operation Desert Storm, when I had the heart-wrenching duty of informing a young wife that her Marine had been killed in the war. My response, like so many others, was to bury my emotions. Deep! How dare I consider my own feelings when a brother Marine had made the ultimate sacrifice and left a shattered family behind and I was alive!? Years later my emotions erupted to the surface and sent me on a years-long journey of ups and downs that continues yet today. It was only in recent months, through the interaction with the author, that I discovered that I have been dealing with Post Trauma Stress for over 23 years. I tell my story to show that PTS appears in countless forms and is all too often cloaked in shadows of misunderstanding and denial. This book is a beautiful weave of human stories, scientific research, and insightful, practical guidance to bring trauma out of the shadows and to help veterans and those who care about them to begin the healing process.”

— Dr. Mark William Cochran, holistic health practitioner and speaker

Author of Oby’s Wisdom: A Caveman’s Simple Guide to Holistic Health and Well-being


“Anna Goodwin has written an extremely important book for friends and families, and most of all for veterans and anyone who has been affected by a crisis or trauma. She artfully describes the challenge of responding to trauma in the most effective and accessible way to achieve health and wholeness. I am excited to use Anna’s book in my psychotherapy practice working with healing emotional wounds.”

— Neil Bricco, M.S., LCPC, psychotherapist

Author of Wisdom of the Wound: Discovering a Path to Wholeness


“I have found in my personal and professional experience, many people have PTS and PTSD symptoms. These symptoms are often misunderstood or undetected and often go untreated for lack of understanding on the part of family, friends as well as denial on the part of the individual. PTSD symptoms impact a person’s behavior and interaction with others, as well as their ability to function on a daily basis. Anna has written an excellent book that is very helpful for individuals suffering from stress after a trauma as well as families, friends, and professionals to assist in understanding and treating PTSD.”

— Kathy Crawford, LCSW, psychotherapist in private practice


“Anna Goodwin has written an easily read, helpful and thoroughly authoritative guide. It should be read by all those who’ve experienced battle or other trauma and by all who come in contact with them.”

— Jim Minard, Sleep Researcher


Non-Fiction Books

Also by E. Anna Goodwin

Sandplay Therapy: A Step-by-Step Manual for Psychotherapists of Diverse Orientations

Barbara L. Boik and E. Anna Goodwin

published by W.W. Norton (2000)





 What you need to know to help yourself or someone you love


E. Anna Goodwin, M.S., NCC


Bitterroot Mountain Publishing,  Hayden, Idaho

How to Cope with Stress After Trauma: Especially for Veterans, Their Families, and Friends

© 2014 by E. Anna Goodwin

All names and identifying characteristics of clients described in this book have been changed.

Published by Bitterroot Mountain Publishing LLC

9030 N. Hess Ave., Suite 331 Hayden, Idaho 83835

Interior design by Jera Publishing

Cover design by Jason Orr

Authors website:

All rights reserved. This book or parts thereof, may not be reproduced in any form without permission, except by a reviewer who may quote brief passages in a review to be printed in magazines, newspapers, or on the web.

The ideas, procedures, and suggestions in this book are intended to supplement, not replace, the medical and psychological advice of trained professionals. The author and publisher disclaim any liability arising directly or indirectly from the use of this book.

For permission to reproduce excerpts of this publication please contact: Bitterroot Mountain Publishing at

For information about special discounts for bulk purchases, please contact: Bitterroot Mountain Publishing at

Library of Congress Control Number: 2013922157

ISBN: 978-1-940025-10-0

Printed in the United States of America

10 9 8 7 6 5 4 3 2 1

  1. Post Trauma Stress—Recovery 2. Cope with stress—After trauma
  2. Anxiety and depression—After stress 4. Veterans and Families—PTS Recovery I. Title.


This book is dedicated in loving memory to my husband Ronald H. Goodwin, a former military officer, who passed away in August 2014. He helped me with the research and editing of the book. But most of all his passion to help the veterans he cared about so much, continuously encouraged me to write this book and make sure it was published.
Thank you dearest Ron.



Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Whom is this book for?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

How to use this book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Post Traumatic Stress Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Where To Get Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

PART ONE: Information about Stress after a Trauma . . . . . 19

What Are Post Traumatic Stress (PTS) and Post Traumatic Stress Disorder (PTSD)? . . . . . . . . . . 20

A definition of PTS and PTSD. . . . . . . . . . . . . . . . . . . . . . . . 26

Where does the diagnosis of PTSD originate?. . . . . . . . . . . . . 30

What types of trauma can cause severe stress?. . . . . . . . . . . . . .31

What qualifies as an unusual and/or severe trauma?. . . . . . . . . 34

Are some people more vulnerable to stress after a trauma than others?. . . . . . . . . . . . . . . . . . . . . . . . . 37

How prevalent are PTS and PTSD?. . . . . . . . . . . . . . . . . . . . . 42

What are the symptoms of PTS and PTSD?. . . . . . . . . . . . . . 49

What happens in the brain and body during and after a severe trauma?. . . . . . . . . . . . . . . . . . . . . . . . . . 59

Which military personnel are most affected by PTS or PTSD in War? . . . . . . . . . . . . . . . . . . . . . . . . . 66

PART TWO: Twenty Steps to Help You Heal. . . . . . . . . . . . .71

It’s time to deal with your trauma. . . . . . . . . . . . . . . . . . . . . . . 73

Profile of a Resilient Person . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Step One: Become stable.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Step Two: Remain connected to others.. . . . . . . . . . . . . . . . . . 89

Step Three: Empower yourself.. . . . . . . . . . . . . . . . . . . . . . . . . 99

Step Four: Learn to relax.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Step Five: Become aware of yourself. . . . . . . . . . . . . . . . . . . . .116

Step Six: Check with a doctor to see whether medications can help. . . . . . . . . . . . . . . . . . . . . . .124

Step Seven: Change your thinking.. . . . . . . . . . . . . . . . . . . . . . 129

Step Eight: Change unwanted behaviors . . . . . . . . . . . . . . . . .145

Step Nine: Work with your emotions (“energy in motion”).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

Step Ten: Reconnect spiritually.. . . . . . . . . . . . . . . . . . . . . . . .170

Step Eleven: Deal with memories. . . . . . . . . . . . . . . . . . . . . . . 181

Step Twelve: Take responsibility for yourself.. . . . . . . . . . . . . . 198

Step Thirteen: Deal with alcohol and drug addictions.. . . . . . 204

Step Fourteen: Use your creativity.. . . . . . . . . . . . . . . . . . . . . 209

Step Fifteen: Have fun. Laugh. Learn to play again.. . . . . . . . 215

Step Sixteen: Spend time in nature.. . . . . . . . . . . . . . . . . . . . .217

Step Seventeen: Work with your physical body.. . . . . . . . . . . 220

Step Eighteen: Rebuild your purpose in life. . . . . . . . . . . . . . .233

Step Nineteen: Explore new technologies. . . . . . . . . . . . . . . . .238

Step Twenty: Try some special techniques.. . . . . . . . . . . . . . . .241

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247

PART THREE: For Families and Friends. . . . . . . . . . . . . . 249

Introduction to Families and Friends. . . . . . . . . . . . . . . . . . . . 251

What you can do to help the veteran you love.. . . . . . . . . . . . .254

What you need to do to take care of yourself.. . . . . . . . . . . . . 270

What your children need.. . . . . . . . . . . . . . . . . . . . . . . . . . . . .278

The Healing Wall (Complete Poem). . . . . . . . . . . . . . . . . . . . .283

Suggested Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293

About the author. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295




If you are a veteran—or a veteran’s friend or family member—this book is for you. Why did I write a book to help veterans and their families deal with the trauma faced in war? As a former psychotherapist, an important part of my work has been building an understanding of the unique issues veterans face. But on a more personal level, I knew a man who was severely traumatized by war. I’d like to tell you about his experiences, but I can’t. Why? Because he never spoke of them. He never admitted, maybe not even to himself, that something had happened that changed him forever. He did his best to hide his emotions, but regardless of how hard he tried to repress his war experiences, his wife and two children could tell when the memories flashed. Sometimes he screamed out in the night and walked the floor. After those nights he became withdrawn, anxious, and depressed. He wouldn’t speak to anyone for days. Then he would burst into uncontrollable rages for what seemed no reason. There were times his family worried he would hurt someone or himself.

This man lived with the trauma of war most of his life. How do I know that the story is true? He was my father, and I was his youngest daughter. Often I felt torn inside, wondering if I was somehow to blame for his struggles. I wished I could help, but I did not know what to do. As my father suffered day after day, so did my mother, my sister, and I.

Eventually my father did receive some help, albeit inadvertently. Because he had lost much of his hearing in one ear, he sought out a well respected surgeon who replaced his eardrum. During my father’s appointments, the doctor noticed his shaking hands and agitated manner and asked him what was going on. My father said, “Nothing,” as do so many people who carry the stress from a severe trauma. But the surgeon understood. He gave my father a prescription for Valium. That little white pill felt like a miracle, both to him and to our family. Fortunately he never abused the drug.

My father passed away several years ago, still not able to admit that his problems stemmed from the war. Did it matter that he could never accept what had happened to him? I don’t know. He was an ardent rancher who loved the earth and spent most of his time working alone on acres and acres of land. I knew him as a somber man who rarely mingled in large groups. But according to his sisters, before the war he had been a talkative, outgoing youth who loved to laugh and have fun.

What troubled me the most was that he never received the help he needed. Thus he never recovered. And I never learned to know the real person—the happy, compassionate, and loving father—of whom I only caught glimpses once in a while.

My father’s story may, at least in part, resemble your father’s story, and his father’s story, and now your story. And my own story may well have elements in common with your family’s story. Many people have been traumatized by warand need to deal with the consequences. I could not help my father, but now I have a chance to help you and your family reintegrate and live your lives in a more positive way.

The reason I chose psychotherapy as my profession may well have been directly related to my father’s history. In 1980 I graduated from the University of Maryland with a Master of Science degree in psychological counseling. I later became licensed and nationally certified. I have taught at two universities, conducted workshops nationally on several topics, and spoken on Post Traumatic Stress to both lay and professional groups.

I worked for a crisis counseling center and ran a large private practice for many years, specializing in counseling children, adults, and families who struggled with Post Traumatic Stress Disorder (PTSD). My clients included veterans and survivors of abuse, traumatic accidents, and natural disasters. Five days a week, I listened to seven or eight people per day who had experienced severe traumas. Underneath those often brave exteriors, I recognized the same types of pain for all people with PTSD. Although their experiences were varied and their traumas occurred in many different circumstances, the resulting physical and emotional symptoms were similar.

I have often wished that my clients and their families had understood how to deal with the traumas shortly after they happened. With proper treatment, perhaps their symptoms might have disappeared, or at least not worsened into severe disorders. Together, my clients and I worked to discover techniques that could help them recover. I give them a great deal of credit for many of the ideas shared in How to Cope with Stress after Trauma.


Whom is this book for?

Though this book is intended primarily for veterans, the strategies given are as valuable for anyone suffering from stress after any severe trauma, regardless of the cause. Psychotherapists and anyone working with survivors of severe trauma can use How to Cope with Stress After Trauma with their clients as an adjunct to therapy.

If you have picked up this book, you may be concerned there is something “wrong” with you or someone you love. If you are a veteran, you may be experiencing nightmares, sleeplessness, anxiety, and/or depression. You may have turned to addictive medications, illegal drugs, or alcohol for relief. You may feel agitated, or at times even become violent, reliving the terror of war, avoiding anything that triggers memories of traumatic events. Your hands may shake, or you may jump at unexpected noises or movements. If you or your loved one has any of these symptoms, this book is for you.

1 NOTE: This book is addressed to veterans who are experiencing Post Traumatic Stress (PTS), which is a milder condition with fewer stress symptoms than full-blown PTSD. However, I will refer to PTSD as well, because much more scientific research has been conducted on PTSD than on PTS. The other reason I refer frequently to PTSD is that the lesser stress symptoms of PTS may lead to a full-blown disorder if neglected for too long. That said, the strategies and steps offered here are intended for veterans who, although experiencing war-related stress, are still functional, and have not been diagnosed with PTSD. If you have been diagnosed with a “disorder,” please seek counseling and medical help first and then add these steps to your recovery strategies where appropriate, and with your counselor’s advisement.

 How to Cope with Stress After Trauma offers useful information and a recovery action plan geared toward veterans dealing with the trauma and stress caused by war who wish to cope with their problems before they worsen into a “disorder.” It also offers help to families and friends who, nine times out of ten, are the people who make sure veterans get the help they need. These family members and friends desperately need to understand what is happening to their loved ones, and what they can do to help them.

According to a 2008 Rand Corporation study, about 20% of all veterans who have returned from Iraq and Afghanistan have been diagnosed with PTSD and, as a result, are no longer capable of leading what most of us would call “normal daily life.” Their brains have malfunctioned due to excessive stress. The actual statistics may well be higher. Some veterans have chosen not to report their problems out of fear of negative repercussions, such as being stigmatized as weak and unfit for promotion or service.

At this point, let me debunk an old myth that has been believed for far too many years: People who experience a lot of stress following a trauma are weak. This myth is not true. The brain is an organ, just like any other organ in the body. When it malfunctions, certain symptoms arise. We don’t consider people weak because they have had heart attacks, or because their lungs or kidneys have failed. Neither should we think of people as weak because their brains are not functioning normally.

Post Trauma Stress (PTS), as I use the term in this book, has similar but less severe symptoms than Post Traumatic Stress Disorder (PTSD). It affects many more veterans than does PTSD. Survivors with PTS remain functional, at least to some degree, and often have difficulty admitting that they somehow feel “different” than they did before joining the military. Family and friends usually notice these changes before the veteran does, as in the case of Josh.

Since returning from Iraq about two years ago, Josh has held five different jobs. Nightmares prevent him from sleeping more than a couple of hours a night. He becomes easily agitated and depressed, but the Veterans Administration (VA) does not consider his symptoms severe enough to be called PTSD. Recently his wife left with their two children, saying she couldn’t handle his anger and inability to create a stable life for them. Like Josh, many veterans may be grappling with similar issues and problems every day, with little or no help.

And then there was Ellen who came to me after the first Iraq war. She had been a fighter pilot. When she called and I asked her what was going on she said she was afraid she was “going crazy.” She would wake up in the middle of the night with nightmares of dropping bombs on the wrong targets and killing innocent children. Now she had panic attacks each morning when she sent her two girls off to school, afraid they would never return.

When a veteran comes home from the battlefield, loved ones with only the best intentions may expect him or her to forget the months or years spent in a war zone. They hope that if no one mentions it, life will return to normal. But that strategy didn’t work for my father, the man of all strong men, many years ago, and it will most likely not work for you either.

The steps in this book work. Many of my clients over the years have used them with great success. Although the verdict is still out on some of the newer technologies, I believe they are worth mentioning so you can explore them if you wish. But regardless of which strategies you decide to use, they all require an earnest and dedicated commitment to the healing process.


How to use this book

 How to Cope with Stress After Trauma begins with a self-test to let you determine for yourself your current level of stress. Next I give you some basic information about Post Traumatic Stress (PTS) and Post Traumatic Stress Disorder (PTSD), such as symptoms to watch for. Then I offer several proven and effective strategies to stabilize and to deal with your pain, depression, and anxiety. The steps work somewhat like steps on a ladder. As you climb them one by one, they lead you closer and closer to your goal of recovery.

These steps and strategies form a comprehensive and detailed recovery program for everyone suffering from stress-related issues. I realize that you may feel overwhelmed when you look at all of them at once. Start by choosing only those that apply to you and fit with your lifestyle and beliefs. It may take a long time for you to complete a single step. That’s okay. Sometimes slower is better.

If you feel unstable at this point, please start with Step One, which focuses on becoming stable. Then choose another step that you are willing to try, and so on. Some steps will work for you and some won’t. Don’t give up. Choose the ones that help you and practice them. There is a simple difference between those individuals who recover and those who don’t: people who recover learn new ways to cope and dedicate their lives to using them.

Our understanding of PTS is growing rapidly. The information I provide is current as of 2014. We live in an age of groundbreaking brain and memory research, and what is considered factual today may be superseded later by new information. I recommend you look online occasionally for the very latest data.

I wish I could grant you a quick solution to your problems, but I can’t. The truth is that you will never be exactly the same as you were before you underwent a trauma. This is true of all human beings. Each memorable experience changes us. But it’s also true that if you are willing to heal from the trauma, you may well change for the better. I have seen positive changes in attitude, inner peace, wisdom, and compassion develop in ways I would never have thought possible. Many of my former clients have gone on to help others with similar experiences and have changed individual lives and the greater world around them.

We, the people of the United States of America, have sent you to war and asked you to fight or even die for our freedom when necessary. Now it is time to act and help you, our veterans, regain healthy, happy, and productive lives at home. We will not abandon you now when you need us most. You have served us well. Now give us the chance to serve you.

You deserve to heal and prosper regardless of what you have experienced. If you feel a full recovery is too hard to commit to for yourself, please do it for your country and your loved ones. Even if you’re not prepared to do all the steps involved in recovery, read this book anyway, and reread it when you are ready to make positive changes in your life.

You have already proven to our country that you are a positive force for change. And we are a grateful nation for your contribution to our freedom and security. Now it’s time for you to take the next step and make that same contribution to yourself. You deserve it, and so do those around you whom you love.

It is not essential to read the entire book from beginning to end. Please check the table of contents and go to any step you may wish to use immediately.

Although I mention veteran’s stories, I do not highlight traumatic details experienced by veterans in war. Instead I emphasize recovery after the trauma has occurred. All names of people in the book have been altered and stories are changed somewhat to assure the anonymity of my former clients.


The Healing Wall, Part I

by Patrick Overton, Ph.D. and Vietnam veteran


I ignored the Wall –

for a long time.

I had managed to keep out unwanted reminders

of the memories of what I saw and did and felt

and the wall threatened to violate this self truce.

For a while I refused to go to the Wall.

I came close, but could not bring myself to go down

into that black hole –

So I stood there alone, on the perimeter

of the large descending block of large, cold stone,

and watched from the vantage point on the hill above.

Concealed by the autumn shadows,

hand pocketed, I turned my back and walked away,

mumbling to myself in a voice so low

even I couldn’t hear what I was saying,

“Not today, I cannot do this today.”


This passage is Part I of “The Healing Wall,written by a Vietnam veteran twenty years after his return to America. The poem appears in full at the end of the book.

Patrick Overton attended college on the GI bill, and later attended the University of Missouri where he earned his Ph.D. in Communication. He taught at Columbia College in Missouri for many years. “The Healing Wall” appears in his book, Rebuilding the Front Porch of America, published in 1997 and scheduled to be released again in 2015.

Before you continue, please take this test to determine your present stress level.


Post Traumatic Stress Test 2

Place a number 1 to 5 in the blank next to each question according to how much you feel the statement applies to you:

Number 1 is “not at all”

Number 2 is “not often or not severe”

Number 3 is “sometimes or moderate”

Number 4 is “often or severe”

Number 5 is “very often or very severe”

1. How frequently do you have recurring dreams or memories of the trauma?

2. How distressing are these memories?

3. How vividly do you remember the trauma in your memories and dreams?

2 Note: Although there is a widely used assessment tool for PTSD called the Clinical Administrated PTSD Scale or CAPS, it is designed as a structured interview to be used by trained professionals. The following is not a formal test and has not been researched for validity or reliability. It is merely a short test I have created using the symptoms described in The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) to help you compare your levels of stress before the trauma and after. Please answer as honestly as you can. You may choose to share the results with someone else, or keep them private.

4. How often do you have flashbacks where you feel you are reliving the trauma?

5. How often do you feel like crying when you remember or speak about the trauma?

6. How often do you find yourself avoiding situations that trigger your memories of the trauma?

7. How severely do you think the trauma has affected you?

8. How often have your traumatic experiences or symptoms been ignored or belittled by others?

9. If you experienced trauma as a child, such as abuse, an accident, etc., how severe was it? How often did it occur?

In this portion of the self-test, “Now” means “Today.”  “Before” means “Before experiencing combat (or other traumatic event).”

10. How often do you feel distant from other people, even your family? Now___ Before___

11. How often do you have problems falling or staying asleep? Now___ Before___

12. How easily are you startled when something unexpected occurs? Now___ Before___

13. How often do you feel you are unable to function normally? Now___ Before___

14. How often are you on the lookout for threats or danger? Now___ Before___

15. How angry do you feel? Now___ Before___

16. How often do you have difficulty concentrating or feel confused? Now___ Before___

17. How often do you feel numb or have no feelings? Now___ Before___

18. How often do you experience outbursts of anger? Now___ Before___

19. How often are you depressed, anxious, or uninterested in things you used to enjoy? Now___ Before___

20. How often do you have symptoms such as a rapid heartbeat, shaking, perspiring, or tense muscles? Now___ Before___

21. How often do you think you may not live to be old? Now___ Before___

22. How often do you think about suicide? Now___ Before___

23. If you think about suicide, how detailed are your plans?

24. How often do you isolate yourself or spend time alone? Now___ Before___

25. How often are you ill or in pain? Now___ Before___

26. How often do you use alcohol or other drugs (legal or illegal) to help you cope with life? Now___ Before___

If most of your answers are marked 3 or under, you are probably a good candidate for the steps in this book. If your answers are mostly over 3, please seek professional help as soon as possible, and use this book in conjunction with more comprehensive therapy.


Where To Get Help

If you are thinking about or planning suicide, contact the VA suicide hotline at 1-800-273-8255, your doctor, or 911 immediately.


Text: 838255

The veteran’s hotline, chat, and text now have more than 300 trained staff to assist you.

If you are a veteran suffering from PTSD or severe stress after the trauma of war, call your local VA hospital or Veteran’s Center (Vet Center) for help. Vet Centers offer free counseling to combat veterans and their families. For more information about the services available for you, call the VA Health Benefits Service Center at 1-877-222-VETS or call your local VA, Vet Center, community volunteer programs or church.

For help locating a trauma therapist, treatment center, or support group in your area, contact the Sidran Traumatic Stress Institute at 1-410-825-8888, ext. 203

Also check the Internet and the Wounded Warrior Project.

There is help for you.


Do you want to read more? A portion of Chapter 1 is available free for readers who SIGN UP



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