Betty W. Phillips, Ph.D., Psychology
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What is Post Traumatic Stress Disorder?

What Is Post Traumatic Stress Disorder (PTSD)?

Several Chatham County readers have asked questions about this problem and preferred methods of treatment. This disorder occurs after exposure to a life-threatening trauma in which the victim experiences intense fear, helplessness or horror. Soldiers returning from the battlefield may experience this problem after being trapped in intense combat or other deadly situations. Most rape survivors develop this disorder. Extreme natural disasters, house fires and deadly car wrecks may also engender trauma responses in the victims.

Traumatic stress responses are certainly expected after intense life-threatening situations and may lead to the full Post Traumatic Stress Disorder if they do not abate over time. Symptoms of PTSD occur in three clusters: re-experiencing of the traumatic event; avoidance and emotional numbing; and increased physiological arousal. The drama and intensity of the extreme traumatic event is often imprinted in the consciousness and memory of the victims and will recur in flashbacks, nightmares and other intrusive re-experiences of the original event. It is normal, then, for the victim to try to avoid recollections of the traumatic event and to develop different kinds of emotional and physiological numbing to dampen down the intensity of the trauma reactions. The victim often feels detached, loses interest in daily activities and begins to avoid recollections of the painful events. Given the fact that the original trauma and the re-experiences are extremely stressful, the avoidance and numbing fail to contain the increased physiological arousal caused by the flashbacks. Thus, the victim often feels hypervigilant, has an exaggerated startle response, has difficulty concentrating, is irritable and prone to outbursts of anger and experiences difficulty sleeping.

It is certainly understandable that a victim of these traumatic experiences would rather avoid dealing with the repercussions from the traumatic event. Well-meaning friends and family often attempt to protect the victim, urging the victim to forget and move on, and the victim is happy to comply. However, it is very important to note that this reaction, however normal and expected, will most likely interfere with recovery and can cause a normal stress response to turn into a longer-term disorder of PTSD. This simple passage of time will not be sufficient to heal the emotional wounds caused by PTSD.

How can friends and family help? It is important to realize that the individual needs to transition from victim to survivor. Instead of keeping quiet, the victim needs to tell the story of the trauma, sometimes over and over. The re-telling desensitizes the victim to the emotional intensity of the situation and robs the flashbacks of their horror and fear-engendering properties. At the time of the trauma the individual was helpless and controlled by the life-threatening events. With re-telling the individual begins to feel more like a survivor who is in control of the current situation as well as past memories. Friends and family should emphasize the bravery of the individual, stressing their courage in surviving a life-threatening experience. Public re-telling is very liberating and will free the victim from any feelings of guilt or responsibility for the trauma. When individuals are recognized for their bravery and commanded for their courage, they are often able to internalize this new image of themselves as survivor instead of victim of the horrible situation.

Sometimes this support is not sufficient, the anxiety continues and progresses to PTSD and the individual may need therapeutic intervention. An experienced therapist will have techniques to support the transition to survivor, to decrease guilt and anxiety and allow for systematic desensitization and cognitive restructuring. Relaxation techniques can be taught and practiced and are very effective in mobilizing the parasympathetic nervous system to deal with the increased physiological arousal. In many cases support of family and friends, perhaps with assistance from an experienced therapist, will provide effective treatment for PTSD, especially when the individual is dealing with trauma symptoms resulting from a single episode. In some cases PTSD results from a series of life-threatening experiences, and additional assistance, for example anxiety-relieving treatments, may be necessary to decrease the physiological arousal and allow for relaxation and systematic to sensitization. Although the treatment may require a time commitment longer than brief therapy, the results are usually quite positive and allow the victim to conquer the symptoms of PTSD.