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PTSD is a term given to family members, friends, and 

colleagues who are negatively affected by the ripples 

of strife from loved ones (even patients) who have had 

direct exposure to severe trauma.

The symptoms of PTSD include the following: chronic 

anxiety, nightmares, flashbacks, insomnia, loss of appe-

tite, memory loss, hypervigilance, emotional detachment, 

clinical depression, helplessness, restlessness, suicidal 

tendencies, and substance addictions (MayoClinic.com). 

Typically a person suffering from PTSD has several of 

these symptoms at one time. Whereas the symptoms 

for some individuals may last months, for others PTSD 

becomes a lifelong ordeal, particularly if treatment is 

avoided, neglected, or shunned. The key to working with 

PTSD patients is to access the power of the unconscious 

mind by identifying deep-seated memories so that they 

may be acknowledged and released in a healthy manner 

rather than repressed and pushed deeper in the personal 

unconscious mind.

Specialists who treat patients with PTSD recommend 

that treatment begin as soon as possible to prevent a 

worsening effect. Initial treatment (intervention) is 

referred to as critical incidence stress management 

(CISM). The purpose of CISM is to (1) significantly 

reduce the traumatic effects of the incident and (2) 

prevent further deep-seated PTSD occurrences. Spe-

cific treatment modalities include eye movement 

desensitization and reprocessing (EMDR), counseling, 

and group therapy as a means to promote emotional 

catharsis. The Trauma Recovery Institute also cites 

art therapy, journal writing, and hypnosis as comple-

mentary coping skills for emotional catharsis. Many 

patients are also prescribed medications. Although 

medications may help reduce anxiety, it should be 

noted they do not heal emotional wounds.

Stress and Insomnia

Muscle tension may be the number one symptom of 

stress, but in our ever-present, demanding 24/7 society, 

insomnia runs a close second. Insomnia is best defined 

as poor-quality sleep, abnormal wakefulness, or the 

inability to sleep, and it can affect anyone. Overall, 

Americans get 20 percent less sleep than their 19th-

century counterparts. According to a recent survey by 

the National Sleep Foundation, more than 60 percent 

of Americans suffer from poor sleep quality, resulting 

in everything from falling asleep on the job and marital 

encounter truly horrific events of death and carnage. 

The repeated horrors of war, however, have notoriously 

ranked at the top of every list as the most unbearable of 

all stressors that anyone can endure psychologically—

and for good reason. To quote Civil War General 

 William T. Sherman, “War is hell.” Exposure to these 

types of events typically include those that threaten 

one’s life, result in serious physical injury, expose one to 

horrific carnage, or create intense psychological shock, 

all of which are strongly influenced by the intensity 

and duration of the devastation either experienced or 

observed first hand. The result is an emotional wound 

embedded in the unconscious mind that is very hard 

to heal.

Every war seems to have its own name for this type 

of anxiety disorder. Somber Civil War soldiers were 

described as having “soldier’s heart.” Affected military 

personnel returning from World War I were described 

as being “shell-shocked,” whereas soldiers and veterans 

from World War II exhibiting neurotic anxiety were 

described as having severe “battle fatigue” or “combat 

fatigue.” The term post-traumatic stress disorder—more 

commonly known as PTSD—emerged during the 

treatment of returning soldiers from Vietnam who 

seemed to lack industrial-strength coping skills to deal 

with the hellacious memories that haunted them both 

day and night. This emotional disorder was first regis-

tered in the Diagnostic and Statistical Manual of Mental 

Disorders (DSM) in 1980 and has been the topic of 

intense investigation ever since. Sadly, the wars in Iraq 

and Afghanistan have provided countless case studies 

for this anxiety disorder today.

Although mortal combat ranks at the top of the list of 

hellacious experiences, one doesn’t have to survive a 

suicide bomber in the streets of Baghdad to suffer from 

PTSD. Survivors and rescue workers of the World 

Trade Center and Pentagon catastrophes are known to 

still be dealing with this trauma, as are several thou-

sands of people displaced from the wrath of Hurricanes 

Katrina and Rita. Violent crime victims, airplane crash 

survivors, sexual/physical assault victims, and occasion-

ally first responders (e.g., police officers, fire fighters, 

emergency medical technicians) are also prone to this 

condition. Given the nature of global warming and cli-

mate change and terrorism, it is suggested that PTSD 

may become a common diagnosis among world citi-

zens, with the ripple effect affecting legions of friends, 

colleagues, and family members alike. Secondary 

 

The Nature of Stress

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when researchers observe sleep-deprived subjects, it’s 

the mind—not the body—that is most affected, with 

symptoms of poor concentration, poor retention, and 

poor problem-solving skills.

Insomnia is categorized in three ways: transient (short 

term with 1 or 2 weeks affected), intermittent (occurs 

on and off over a prolonged period), and chronic (the 

inability to achieve a restful night of sleep over many, 

many months). Although each of these categories is 

problematic, chronic insomnia is considered the worst.

All-nighters, exam crams, late-night parties, and mid-

night movies are common in the lives of college under-

graduates, but the cost of these behaviors often proves 

unproductive. Unfortunately, the population of people 

who seem to need the most sleep, but often get the least 

amount, are adolescents younger than age 20.

Although sleep may be relaxing, it is important to 

remember that sleeping is not a relaxation technique. 

Studies show that heart rate, blood pressure, and 

muscle tension can rise significantly during the dream 

state of sleep. What we do know is that effective coping 

and relaxation techniques greatly enhance one’s quality 

of sleep.

Here are a few suggestions to improve your sleep quality:

1.  Avoid drinking any beverages with caffeine 

after 6:00 p.m., as the effects of caffeine on the 

nervous system promote a stress response rather 

than a relaxation effect.

2.  Physical exertion (cardiovascular exercise) is 

regarded as a great way to ensure a good night’s 

sleep.

3.  Keep a regular sleep cycle. Make a habit of going 

to bed at the same time every night (within 15 

minutes) and waking up at about the same time 

each morning (even weekends).

4.  Enhance your sleep hygiene. Create a sleep-

friendly environment where bright light and 

noise are minimized or completely eliminated.

5.  Avoid watching television right before you go to 

bed. Instead, try reading.

6.  Make your bedroom a tech-free zone. Avoid 

using your smartphone or tablet in the bedroom, 

even as an alarm clock, and turn off your WiFi 

router before you turn in.

problems to car accidents and lost work productivity. 

Does your stress level affect your sleep quality? Even 

if you sleep well, it is hard these days not to notice the 

proliferation of advertisements for sleep prescriptions, 

suggesting a serious public health concern.

Numerous studies have concluded that a regular good 

night’s sleep is essential for optimal health, whereas 

chronic insomnia is often associated with several 

kinds of psychiatric problems (Maas, 2001). Emo-

tional stress (the preoccupation with daily stressors) 

is thought to be a primary cause of insomnia. The 

result: an anxious state of mind where thoughts race 

around, ricocheting from brain cell to brain cell, 

never allowing a pause in the thought processes, let 

alone allowing the person to nod off.

Many other factors (sleep stealers) detract from one’s 

sleep hygiene and can affect the quality of sleep, 

including hormonal changes (e.g., premenstrual syn-

drome, menopause), excessive caffeine intake, little 

or no exercise, frequent urination, circadian rhythm 

disturbances (e.g., jet lag), shift work, medication side 

effects, and a host of lifestyle behaviors (e.g., prolonged 

television watching, alcohol consumption, smartphone 

use) that infringe on a good night’s sleep.

How much sleep is enough to feel recharged? Generally 

speaking, 8 hours of sleep is the norm, although some 

people can get as few as 6 hours of sleep and feel fully 

rested. Others may need as many as 10 hours. New find-

ings suggest that adolescents, including all people up to 

age 22, need more than 8 hours of sleep (Dawson, 2008).

Not only can stress (mental, emotional, physical, or 

spiritual) affect the quality and quantity of sleep, but 

the rebound effect of poor sleep can, in turn, affect 

stress levels, making the poor sleeper become more 

irritable, apathetic, or cynical. Left unresolved, it can 

become an unbroken cycle (negative feedback loop). 

Although many people seek medical help for insomnia 

and are often given a prescription, drugs should be 

considered as a last resort. Many (if not all) techniques 

for stress management have proven to be effective in 

promoting a good night’s sleep, ranging from cardio-

vascular exercise to meditation.

The field of sleep research began in earnest more 

than 60 years ago. Yet, despite numerous studies, the 

reason why we spend approximately one-third of our 

lives in slumber still baffles scientists. From all appear-

ances, sleep promotes physical restoration. However, 

Chapter 1

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