Posttraumatic Stress Disorder

As defined by the DSM-IV, PTSD results when a person experiences an event that threatens life, injury or sense of self and the person’s response involves intense fear, helplessness or horror.  The traumatic event is persistently re-experienced in thoughts and dreams over which the person has little or no control and the person becomes re-traumatized each time the event is re-experienced.

People tend to react in one of two ways to this situation: either they become numb or they become hyper-sensitive or over stimulated.

When people become numb as a method of avoiding the stimuli of the trauma, they may forget what happened, they may go to great lengths to avoid thoughts or places associated with the trauma, the numbness may spread to other parts of their life and they may experiences diminished pleasure in life or detachment, they may lose the ability to feel love, joy, excitement or other feelings which are expansive, and they may lose their ability to foresee a future for themselves and not be able to plan ahead.

In the case of increased arousal people have trouble falling or staying asleep, have irritability or outbursts of anger, have difficulty concentrating, are hypervigilant (always super-aware, never laid back) and have an exaggerated startle response.

PTSD used to be called Shell Shock, then Combat Fatigue.  Then the symptoms were identified in non-combat situations such as car wrecks, airplane crashes, fires and earthquakes.  Finally the symptoms were recognized as responses that were more private and less overt such as rape, sexual and physical abuse, assault and other situations in which a person feels out of control and extremely upset, resulting in impairment in social, occupational or personal functioning.

I have been working with a Viet Nam veteran with PTSD for quite some time and recently became a Tricare provider which means I am now seeing Iraq and Afghanistan combat vets.  While the trauma circumstances are different than the survivors of sexual abuse I have been seeing for years, the path of healing is very similar: tell whatever parts of the story they are able to tell, identify and express the feelings, come to an understanding of the meaning of the trauma, and create plans for the future that do not allow their reaction to the trauma to dictate their future.  PTSD definitely requires professional help.  There are no short-cuts to this condition.