Post Traumatic Stress Disorder / PTSD
What is trauma?
Trauma is the experience of surviving an event that threatened sense of safety and/or life. Trauma is defined through an individual’s subjective experience to an event, not the event itself. This means that two people can survive the same event and have different perception and memory of what transpired.
One person may remember feeling empowered and stronger than life during a dangerous situation, while another individual may later report feeling helpless and paralyzed during the same event. One person’s emotional response to an event is not the blanket response for all other survivors.
When we think of trauma we also tend to think of big events, but the truth is that we experience “mini traumas” every day. Events that we replay in our minds that bring up feelings of unease, shame, embarrassment, guilt or anger are also mini traumas. The brain replays these events in an attempt to make sense of the event or work through it, but this can be difficult to do without the work of a therapist.
Trauma is different for everyone, and not all traumatic events lead to emotional and psychological trauma.
Trauma can happen as a result of years of repeated events like years of childhood abuse/neglect, living in a refugee camp, being a prisoner of war, serving in a war or being in an abusive relationship. Trauma can also be the result of a singular event such as surviving an accident, experiencing a rape, living through an extraordinary event or witnessing someone get seriously hurt. Chronic conditions like homelessness, witnessing some close to you struggle with addiction or living in a dangerous community can also perpetuate trauma.
Once an individual experiences trauma, the brain structure changes. In time, the brain loses its ability to cognitively differentiate between being in a dangerous situation and being in a perceived dangerous situation that is actually safe, which is why people with trauma will report, for example, feeling unsafe (despite being in a safe environment), waking up in the middle of the night in panic or having a high startle response if surprised.
Sometimes trauma and Post Traumatic Stress Disorder (PTSD) are used interchangeably. Both terms take into account the following prior to making a diagnosis.
- Experience of a particular event (or multiple events)
- Current coping
- Present distress as a result of the real or perceived event
What are the symptoms of Post Traumatic Stress Disorder?
According to the DSM V, Post Traumatic Stress Disorder (PTSD) is:
the exposure to actual or threatened death, serious injury or sexual violation, which must result from one or more of the following scenarios, in which the individual:
- directly experiences the traumatic event
- witnesses the traumatic event in person
- learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental) or
- experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related).
The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s social interactions, capacity to work or other important areas of functioning, not due to the use of drugs, alcohol, medication or a health condition.
The symptoms of PTSD then fall into four categories:
- Re-experiencing: The unwanted re-experiencing of the event through memories of the traumatic event, recurrent dreams related to the traumatic event, flashbacks or other intense or prolonged psychological distress.
- Avoidance: This includes distressing memories, thoughts, feelings or external reminders of the event that (in time) alter a person’s behavior.
- Negative cognitions / Mood: This subgroup refers to the myriad of feelings, from persistent and distorted sense of blame of self or others, to estrangement from others or markedly diminished interest in activities, to an inability to remember key aspects of the event.
- Arousal: Identified by aggressive, reckless or self-destructive behavior, sleep disturbance hyper-vigilance or related problems.
Generally speaking, symptoms of Post Traumatic Stress Disorder (PTSD) may look like:
- Depression or a numb feeling
- Startling easily
- Intrusive thoughts
- Emotional numbness
- Extreme distress when reminded of the trauma
- Sleep disturbances
- Struggling to maintain close relationships
- Withdrawing from activities or hobbies
- Difficulty concentrating
The brain will continue to try to make sense of the trauma through the re-experiencing of symptoms discussed above. Until the body and mind have processed the trauma together, in a safe environment, the trauma-related symptoms will persist.
What type of therapy helps Post Traumatic Stress Disorder?
Trauma is most commonly processed through three methods:
1. Cognitive Behavioral Therapy (CBT)
CBT helps individuals process thoughts and feelings connected with a traumatic experience.
Using Cognitive Behavioral Therapy skills, a person learns to be more aware of thoughts. Since thoughts influence behavior and a person’s view of the world, these thought-balancing techniques help you (and your brain) process the feelings connected to thoughts, determining the relevancy and rationality of those spontaneous thoughts.
2. Eye Movement Desensitization and Reprocessing Therapy (EMDR)
Through bi-lateral stimulation (left/right eye movements or left/right knee tapping for example) the left and right hemispheres of the brain “talk” together, unfreezing emotional and cognitive memories while reprogramming the brain’s neural pathway.
Walking through EMDR exercises in therapy sessions desensitizes the intense feelings connected to a traumatic memory. By helping the left and right hemispheres of the brain talk together (as opposed to being dominated by painful emotional memories of a traumatic event), healing begins.
3. Somatic Experiencing
This approach gives permission for the client to focus on the body’s memory of the event, allowing the client to follow the body’s physical trauma memory while riding through the sensations and ultimately releasing the physical trauma memory from the body in an experiential exercise.
I know it sounds difficult, but the only way to process trauma and heal from it is to confront the trauma head on through the therapies highlighted above.
Recovering from a trauma event takes time and requires that you and your therapist have a trusting relationship together. That said, once the trauma is processed and you have some skills to apply when traumatic events surface, you will find yourself more present-focused, less distressed and happier.
Trauma memories are painful. With the help of a good therapist, those memories become less painful.
If you’re ready to find peace and cope better day to day, contact me.