Post Traumatic Stress

When humans are confronted by trauma, they often experience lasting aftereffects. Whether the trauma is sexual abuse or assault, exposure to combat situations, involvement in natural or man-made disasters, or other events, coping can be difficult.

Some people experience acute stress in the first weeks or months following an incident. In addition, or instead, they may experience delayed or chronic reactions that continue to pose difficulty years or decades later. These later difficulties may be sufficiently severe to merit a diagnosis of post traumatic stress disorder (PTSD).

This is not to say, however, that everyone exposed to a traumatic event will experience lasting ill effects, nor that everyone who has been in a difficult situation needs therapy.

In full PTSD, the person generally experiences three categories of symptoms:

First, re-experiencing the trauma via flashbacks, bad dreams, intrusive thoughts or memories, acting as though the event is happening in the present, and/or showing heightened distress to cues that remind the person of the trauma (eg, vehicles like the one involved in an accident, the scene of the incident, or depictions of similar events in media).

Second, avoidance of reminders of the trauma and/or a type of psychological numbing characterized by detachment, difficulties showing or feeling affection or connection, and/or a sense of having less of a future ahead.

Third, generally increased signs of stress-related problems such as irritability, sleep problems, difficulty concentrating, excessive watchfulness for signs of danger, and/or an exaggerated startle response.

Treatment

Treatment of traumatic stress reactions depends on the nature of the trauma and the type of reaction.

Much of the work involves a conscious examination of the meaning that the event has had for the person, with the goal of overcoming automatic responses and developing a genuine and thoughtful sense of what has happened and its implications for one's life.

In addition, most cases require some form of exposure-based work. Because the event has been so overwhelming, the automatic desire is to shut out the memory of the event. This is seldom successful, as the more we try not to think of something, the more it seems to intrude (try VERY HARD not to think of a pink elephant and you'll see what we mean). Contrary to popular portrayals, the problem in PTSD is not so much that people forget the trauma as that they cannot forget it, often finding it difficult to think of anything else.

Given that we cannot go back in time and undo the event, much as we might like to, the mission becomes one of allowing the event to have happened and allowing the memory of it to exist.

Therapy for PTSD can be difficult and challenging, but generally not so difficult as living with untreated PTSD.

Treatment always proceeds at the client's own pace. As with the treatment of any problem, it is vital that the client have full control of the process.