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Milestones Staff

Cindy Westcott, Clinical Director
Dr. Neil Bomar, Medical Director
Robert Chapman, Primary Therapist
Janet Heilbronn, Primary Therapist
Ginny Leary, Primary Therapist
Trish Reynolds-Hastings, Primary Therapist
Marie Turley, Adjunct Therapist
Kim Rodgers, Clinical Liaison
Amber Higgins, LPN
Caitlin Byrd, Continuing Care Coordinator
Caren Marvin, Client Advocate Supervisor
Marquisha Adkisson, Client Advocate
Randall Smith, Client Advocate
Cheryl Forrester, Client Advocate
David Goodman, Client Advocate
David Steele, Client Advocate
Ariel Franklyn, Client Advocate
Carey Simpson, Client Advocate
Laurie Jordan, Client Advocate

Traumatic losses such as the death of a loved one by suicide are far outside of what we normally expect in life.  The reactions of suicide survivors often include and go beyond normal grief reactions in severity and duration.

Many survivors experience symptoms of post traumatic stress. Many counselors would say “these are normal responses to abnormal events.”  Recovery from these symptoms is a gradual process. Most survivors find that as time goes on, reactions become fewer and less intense.


Common reactions include:

• Distressing recollections of the death
• Distressing dreams about the event
• A feeling of reliving the experience
• Feeling numb
• Feeling emotionally detached from other people
• Always feeling “on guard”
• Difficulty working
• Difficulty in social situations
• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hypervigilance

Some survivors have a more difficult time healing.  They develop more severe and lasting symptoms which are diagnosed as “Post Traumatic Stress Disorder.” (PTSD)  There are many positive ways to cope with symptoms of trauma.  A trained professional, experienced in suicide loss or treatment of traumatic grief, can be very helpful.

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder is defined in DSM-IV, the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual. For a doctor or medical professional to be able to make a diagnosis, the condition must be defined in DSM-IV or its international equivalent, the World Health Organization’s ICD-10.

The diagnostic criteria for Post Traumatic Stress Disorder are defined in DSM-IV as follows:

A. The person experiences a traumatic event in which both of the following were present:

  1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;
  2. the person’s response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in any of the following ways:

  1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perception
  2. recurrent distressing dreams of the event
  3. acting or feeling as if the traumatic event were recurring (e.g. reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated)
  4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
  5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of: 

  1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
  2. efforts to avoid activities, places or people that arouse recollections of this trauma;
  3. inability to recall an important aspect of the trauma;
  4. markedly dimished interest or participation in significant activities;
  5. feeling of detachment or estrangement from others;
  6. restricted range of affect (eg unable to have loving feelings);
  7. sense of foreshortened future (eg does not expect to have a career, marriage, children or a normal life span.

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following: 

  1. difficulty falling or staying asleep;
  2. irritability or outbursts of anger
  3. difficulty concentrating;
  4. hypervigilance
  5. exaggerated startle response

E.  They symptoms on Criteria B, C and D last for more than one month.

F.  The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. 


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