The initial stress response energizes the fight-or-flight sympathetic nervous system response or the arousal symptoms in PTSD. Physiological numbness, the response to overwhelming arousal, is more obvious initially than the arousal, but as a victim repeatedly re-experiences reminders of the distressing event, arousal repeats and, then, exacerbates distress. For example, I overreacted for months whenever a car approached from behind while I slowed to a stop. Both the reminder and the arousal were specifically related and did not generalize to all driving situations. However, Baxter’s distress, reinforced by her supervisor’s multiple acts of mistreatment (not all were discussed), expanded (over-generalized) so that she now avoids former co-workers not involved in her dismissal because their association with her former employer elicits substantial distress. These arousal or distress responses are mediated in part by the endocrine hypothalamic-pituitary-adrenal (HPA) axis, and the normal stress response occurs roughly in the (grossly simplified) manner illustrated in Table 1 (Bear, Connors, & Paradiso, 2001).