256 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLANNER B. The client reported having been exposed to some reminders of the traumatic event without experiencing overwhelming distress. 7. Physiological Reactivity (6) A. The client experiences physio logical reactivity associated with fear and anger when he/she is exposed to the internal or external cues that symbolize the traumatic event. B. The client's physiological reactivity has diminished when he/she is exposed to internal or external cues of th e traumatic event. C. The client reported no longer experiencing physiological reactivity when exposed to internal or external cues of the traumatic event. 8. Thought/Feeling/Conversation Avoidance (7) A. The client described trying to avoid thinking, f eeling, or talking about the traumatic event because of the associated negative emotional response. B. The client is making less effort to avoid thoughts, feelings, or conversations about the traumatic event. C. The client reported that he/she is now abl e to talk or think about the traumatic event without feeling overwhelmed with negative emotions. 9. Place/People Avoidance (8) A. The client reported a pattern of avoidance of activity, places, or people associated with the traumatic event because he/she is fearful of the negative emotions that may be triggered. B. The client is able to tolerate contact with people, places, or activities associated with the traumatic event without feeling overwhelmed. 10. Blocked Recall (9) A. The client stated that he/ she has an inability to recall some important aspect of the traumatic event. B. The client's amnesia regarding some important aspects of the traumatic event has begun to lessen. C. The client can now recall almost all of the important aspects of the trau matic event, as his/her amnesia has terminated. 11. Lack of Interest (10) A. The client has developed a lack of interest and a pattern of lack of participation in activities that had previously been rewarding and pleasurable. B. The client has begun to s how some interest in participation in previously rewarding activities. C. The client is not showing a normal interest in participation in rewarding activities. 12. Detachment (11) A. The client described feeling a sense of detachment from others. B. The client reported regaining a sense of attachment in participation with others. C. The client reported that he/she no longer feels alienated from others and is able to participate in social and intimate interactions. 13. Blunted Emotions (12) A. The clien t reported an inability to experience the full range of emotions, including love. 