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A soldier looks on with horror as his buddy is shot and killed.

A battered wife cringes at the sound of her husband’s voice.

A driver barely clings to life after an accident on Interstate 81.

Such scenarios have in common tangled-up emotions each person needs to work through to get on with life.

While some people are able to process the experience and take control of their reactions, others have adjustment problems that can linger and develop into post-traumatic stress disorder. If left untreated, PTSD could lead to depression or even suicide. It’s all individual.

“A person could be exposed to a traumatic event and recover in a matter of weeks,” said Lori Moskel, a Carlisle therapist. “They have the natural feelings that go along with the trauma and they recover.” But there are people who struggle with the circumstance, especially if there are other stressors in their life.

While PTSD is often associated with combat veterans, many of the clients Moskel and other local therapists see are adult female survivors of abuse. Statistically women are more vulnerable to PTSD because they are more likely to be in situations where they are dominated, Moskel said.

However, anyone can be vulnerable to PTSD if they witness or experience a trauma where they are put at risk of death or serious injury. Trauma could also occur indirectly if the person hears about a death by accident or violence from a relative or close friend.

For example, the person who finds the body of a suicide may fixate on why and if only they could have seen the signs. “Some people are blaming themselves,” Moskel said. “They feel they should have taken action or it would not have happened.”

PTSD in veterans 

Veterans are vulnerable because they hold strong beliefs they are responsible for service and the protection of others. “By virtue of what you have to do in the military, you become hypervigilant,” Moskel said. “You become trained to be superhuman so when something goes badly and a traumatic event occurs, it is harder to process that naturally.”

Scenes of war and man-made violence are always harder to work through than trauma suffered in a house fire or auto accident, Moskel said. But there can be other triggers.

Valerie Domenici is a licensed clinical psychologist in Carlisle. She said veterans who go into combat with some kind of childhood trauma are at an increased risk of developing PTSD when something in the war zone reminds them of the prior trauma. 

“War is a horrific thing,” said Neal Delisanti, director of veterans’ affairs for Cumberland County. “It is meant to impose your will upon the other side. It’s always by killing and destroying things.” A retired Army officer, Delisanti is a Vietnam War veteran.

“In the military, you are part of a team,” he said. “That team is only as strong as the weakest person on that team.” As in sports, the combat veteran does not want to be the one who drops the pass or misses the block to cause the team to fail on its mission. But the stakes are deadly serious.

Some are stronger 

Though combat increases the risk of it developing, it does not guarantee PTSD. So much depends on how the person was raised, on their faith and family background, Delisanti said.

“Some people are stronger than others,” he said. "They can go through the horrors and survive with no problems. They can say ‘I’m putting this aside … I’m getting on with my life.’"

Society today has lost some of that, Delisanti said. He cited as an example the reaction of his fellow college students at the news of the Kennedy assassination on Nov. 22, 1963.

While some of them were hoping for an early Thanksgiving break, there was no change in the schedule and students reported to class without complaint or the need for counseling, Delisanti said. They dealt with their emotions in learning the president was dead.

Fast forward 53 years to the presidential election of 2016 where college students who voted for Hillary Clinton were devastated by the upset victory of Donald Trump.

The Wall Street Journal reported that students at Cornell University staged a “cry-in” to mourn the results and were provided with tissues, hot chocolate and Play-Doh to cope with the loss.

Reflecting on the contrast, Delisanti believes society is coddling people to the point where they come apart when they are handed a setback or a disappointment in life.

First responders 

While it is important to address PTSD in veterans, the public should not shortchange the police officers, firefighters and ambulance personnel who deal with trauma on daily basis, Delisanti said. “They see the worst part of society. They don’t know what they are going to be exposed to.”

That said, first responders are better equipped to handle trauma because they expect it to be part of their job duties, Domenici said. “That’s what they signed up for. It’s part of the conversation that comes with being in that job.”

Like the military, first responders are trained to work as a team where members watch out for one another, Domenici said. She added they are trained to seek out help if they need it.

A major obstacle in the treatment of PTSD is the behaviors that go with trying to avoid reliving the experience.

Email Joseph Cress at


News Reporter

History and education reporter for The Sentinel.

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