Post Traumatic Stress Disorder (PTSD)

We will all be hearing much more about this as our soldiers come back from Iraq.  However, you don’t need to go to war to experience PTSD.  It is much more common among the general population than is generally appreciated. Post trauma is caused when you experience an event that in some way destroys personal safety.  Simple PTSD is when you live through one overwhelming event such as a natural disaster, interpersonal violence or a severe accident.

Complex PTSD is where you have experienced repeated lapses of safety usually when growing up.  Even if each incident was relatively small and you don’t think about it now, the repetition adds up.  If the trauma was either caused by your caretakers directly or permitted by their failure to protect you, the effects can be profound. Your ability to trust can be severely compromised.  A history of complex PTSD sets you up to be more easily overwhelmed by trauma later in your life.

The established symptoms of PTSD can include:

1. persistent re-experiencing of the traumatic event through intrusive images thoughts or perceptions, flashbacks, confusion or nightmares,

2. numbing of feelings, loss of interest in parts of life and avoidance of people or activities that might in some way bring back memories, your world gets smaller.

3. hyperarousal such as impaired sleep, irritability or anger, difficulty concentrating, hypervigilance, exaggerated startle response.

     My work has convinced me that chronic physical pain or other unpleasant mysterious sensations can be an indicator of PTSD. Please see the section on Chronic Back Pain TMS

      If you have PTSD, it tends to be hard to handle pressureful situations with other people. You can find it difficult to calibrate your response when people seem to be mistreating you, sometimes under-reacting, sometimes over-reacting. You might explode or freeze. It seems hard to find the right amount of forcefulness to defend yourself.

      PTSD is produced by threat, shock or injury that occurs in a state of helplessness.  It can be anything that destroys our feeling of being safe or protected.  Helplessness is very toxic in general. We all know that power corrupts. Well, helpless is the same thing. Just as too much power corrupts, so does too little power. It just does it in a different way. The effects on us of too much helplessness are profound and pervasive. If we get too big a dose of helplessness, we might do anything from get depressed to get drunk. We might explode, hide out, give up on life, or never trust anyone again. Time does not always “heal all wounds.”

     In his book, The Body Bears The Burden. Robert Scaer, M.D., says the following about the reaction of most physicians to people who are emotionally injured. “The Mainstream medical profession refers to the constellation of symptoms resulting from traumatic stress as psychosomatic or psychological. Yet this syndrome may well account for many of the unexplained and poorly managed chronic illnesses that afflict us, and perhaps constitutes the major source of visits to the physician’s office.”

    An interesting unhappy fact we will see with our returning soldiers is that you can be a tough person, who can push an experience out of your mind, and still be heavily affected. Your subconscious and your body both remember what happened to you, even if you succeed in forgetting that it happened. Your subconscious and your body are waiting for it to happen again. That state of being braced emotionally and physically wears us down.

     Succeeding in pushing an experience out of your mind without really processing it can result in what is called Delayed Onset PTSD.   Even though you believe you have put it out of your mind, you may have only put it outside of consciousness. Underneath it may be percolating, stamping itself into your nervous system.

     POST TRAUMATIC STRESS DISORDER IS VERY TREATABLE.  Treatment has multiple goals. The key is to restore a sense of safety. Effective treatment teaches you how to modulate your arousal level, calibrate your reaction to situations, be comfortable in your own body and be free from being haunted by the past. You and your therapist can work to return you to a state of flow where your interest in your own life and your confidence in yourself motivates you. You can learn how to be accurate in deciding who to trust. You can learn to remain mentally present instead of being explosive or intimidated.

     There are many approaches to treating PTSD. The best approaches work with both the mind and the body. I am a certified EMDR Practitioner. EMDR is a very powerful approach to resolving post trauma and its symptoms. EMDR also lends itself to being highly customized for each individual client and therapist pair. Please see the section on EMDR for Trauma Recovery.  My toolbox contains various other approaches to PTSD besides EMDR.