Post Traumatic Stress Disorder:
What is PTSD?
Is There a Successful PTSD Treatment?
by
Ginny NiCarthy,
MSW,
counselor and author
You wake from a nightmare
sweating or shaking or screaming.
Startled by an
unexpected sound or touch, you nearly jump out of your skin.
You try to shut out
feelings about that awful thing that happened to you.
In hopes of avoiding
memory triggers, you take roundabout routes to work.
But certain smells,
sounds and sights re-stimulate the pain and fear of the past.
You might begin to use
alcohol or drugs in an attempt to diminish your feelings of fear,
grief, self-blame or anger.
Your nightmares, startle
reactions, flashbacks and avoidance behaviors might make you wonder
if you’re going crazy. But these are normal responses to
injury or threats to your psychological integrity that were
accompanied by intense feelings of fear, helplessness or horror that
can accompany a traumatic event.
Many people who
experience a single trauma recover within a few weeks or months.
However, if you’ve been raped or assaulted by someone you thought
you could trust, it can be hard to regain your emotional balance.
PTSD symptoms can persist for months or years, especially if the
trauma is repeated. If you have experienced realistic,
life-like terrifying flashbacks, sleep disturbances, depression or
relationship problems for longer than a few months, these symptoms
might indicate you’re suffering from Post Trauma Stress Disorder.
PTSD was first
identified as a treatable mental health problem among returning
combat veterans who had experienced one horrific event after another
in war time, with accompanying feelings of helplessness, fear and
dread. Now, certain sights, smells or sounds might suddenly
trigger a flashback—a realistic mental return to that place, time,
experience that is linked together in memory with the feelings that
accompanied it.
But you needn’t have
fought in a war to develop symptoms of PTSD. Your emotional
and physical wounds might be the result of physical, sexual or
emotional assaults as a child (sometimes called Complex PTSD).
Domestic violence--abuse and coercive control by a spouse, intimate
partner, parent or other family member--can result in injury and
traumatizing humiliation. PTSD also can result from car or
train accidents, hurricanes or floods--events that might be no one’s
fault. You might have lost your job, your home, your intimate
partner, or witnessed a crime or violent death. Any of these
events can provide the physical, emotional or spiritual shock that
results in the development of PTSD symptoms.
It takes resilience to
cope with traumas. If you’ve ever watched a toddler learning
to walk, you’ll see the development of resilience. The child takes
off joyously, and then, smack! She falls down. Maybe she cries a
little, but then gets up and courageously tries again. She keeps
recovering. That’s the way life has been for many of us. We crawled,
stood, walked and ran, refusing to give up when we fell flat.
However, sometimes a trauma is too much to just shake-off and
continue, especially if it’s followed by additional emotional or
physical assaults or if no supportive people are available to ease
the fear and pain and to offer encouragement. If that’s what
you have experienced, you might become fearful that as soon as
you’ve gathered the strength to try again--smack, you’ll be hit
again. We know that a history of childhood or other
complex
trauma make it much more difficult to cope with later trauma.
Your reaction to trauma
can change the way you look at the world, the people you know and
even how you internally criticize or judge yourself. If
depression and anxiety follow, you might start drinking or taking
drugs to shut out the pain of PTSD flashbacks and other symptoms.
(This may lead to “alcohol dependence secondary to PTSD,” or to
alcohol or drug dependence, as a second but equal diagnosis,
requiring chemical dependency treatment in addition to PTSD
treatment.)
The way you interpret
the meaning of the traumas has a lot to do with whether you recover
quickly and how long PTSD symptoms last. You might begin to
tell yourself you’re the one who is no good, blaming yourself for
having been in the wrong neighborhood, with the wrong person or
otherwise “asking for it.”
You try to avoid events that may trigger the vivid flashbacks in
which you re-experience the horrifying physical or emotional fear
and pain of the original trauma. In the short term, PTSD symptoms
might be kept at bay by such avoidance behavior. In the long
run, you discover that your short term efforts to avoid pain seem to
intensify the very PTSD symptoms you had hoped to avoid.
Believing the world is
an evil place, that you can’t trust anyone, or that you deserve to
be mistreated can result in even more grief. Wary of
emotionally re-experiencing the trauma with its intolerable feelings
of fear, anger or helplessness, you may find yourself avoiding
people whose company you might otherwise have enjoyed.
When you use these
avoidance methods of protecting yourself, you pay a high
price--missing a lot of life’s pleasures and satisfactions.
You discover that being alone and socially isolated increases your
troubling reactions instead of reducing them.
But the good news is
that new and reliable kinds of therapy are available for relief from
PTSD symptoms. A counselor trained in one of the
cognitive PTSD treatments can help you overcome the barriers to your
recovery from trauma, so that you can live the full life you want
and deserve.
A counselor can help you
understand the difference between past trauma and your
interpretation of it, which affects the way you feel in the present.
She or he will help you identify and root out the self-talk messages
you give yourself that make your situation worse. The
counselor or therapist will provide a safe environment for you to
explore new ways of viewing the situation and of modifying your
methods of avoidance. Then you will be on the road to
recovery.
Look for a counselor who
is trained and experienced in the use of one of the forms of
Cognitive Behavioral Therapy (CBT) which have been shown to be the
most effective techniques in diminishing or obliterating PTSD
symptoms. The most successful are Prolonged Exposure Therapy
(PET), Cognitive Processing Therapy (CPT) or Eye Movement
Desensitization and Reprocessing (EMDR). With these therapies,
your memories of what happened remain intact, but the memories are
no longer linked to the extreme emotional reactions that you
experienced at the time of the original traumatic events.
Each type of cognitive behavioral therapy uses a slightly different
method, but all are based on the counselors’ understanding of how
the effects of trauma can be significantly modified through
carefully guided step-by-step changes in your thoughts, feelings and
behaviors.
Many people suffering
from PTSD symptoms don’t begin the work of recovery for years after
the trauma occurred and are surprised to discover that it is never
too late to begin. After about three months in therapy there
is a good chance you can live the life you choose, based not on past
trauma, but on the pleasures, satisfactions, and realities of your
new life experiences.
Ginny NiCarthy, MSW is a Seattle area counselor and author of a number of
books relating to domestic violence victim treatment.
OTHER RESOURCES--Posttraumatic
Stress Disorder:
Find an EMDRIA Certified EMDR therapist in the Puget Sound area on CounselingSeattle.com.
Model program for
Prolonged Exposure Therapy..
Post
Traumatic Stress Disorder DSM IV Criteria,
Post Traumatic Stress Disorder (ptsd) diagnosis and criteria in the DSM-IV.
DSM-IV-TR criteria for PTSD - United States Department of Veterans Affairs,
National Center for PTSD FactSheet: DSM-IV-TR criteria for PTSD.
Clinical Capsule™: Posttraumatic Stress Disorder PTSD.
Domestic Violence and Post-Traumatic Stress Disorder PTSD
Severity for Participants of a Domestic Violence Rehabilitation
Program
Washington State Department of Veterans Department of Veterans Affairs--Veterans PTSD Program--PTSD Counseling Services.
"The Post Traumatic Stress Disorder (PTSD) Program attempts to create community-based avenues to counseling services that are less formal
in nature, offering the highest level of confidentially possible. Services provided throughout the program include individual,
couples, family, and veteran group counseling. Some contractors offer group services to women veterans and spouses of veterans. Veterans may be referred to specialized inpatient or outpatient treatment offered by the U.S. Department of Veterans Affairs Medical
Centers or Vet Centers within Washington State.
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