Evolution of PTSD

PTSD is the unhealthy response to trauma.  It is connected in most people’s minds with soldiers returning from battle.  The reason for this is that a soldier cannot afford to respond emotionally to the sights and events of the battlefield, or he/she  would not be able to do his/her  job.  So it is only after he/she  is removed from the scene that the psychological impact hits him or her.

However, PTSD can effect anyone after a trauma. This is illustrated well in my book, Pieces of Paris, where trauma occurred to a normal, healthy adult woman.  At particular risk, are adults who experienced trauma as children and were prevented by harsh circumstances from reacting normally.  My own PTSD was a compound of years and years of abuse, two deadly assaults, as well as many years of sexual abuse.

The normal phases of reactions to traumatic events are as follows:

  • Either an emotional outcry (fear, anger, sadness) or denial (numbing and avoidance)
  • Both of these behaviors lead to intrusion (unbidden thought, images, and distress)
  • A person in a loving, supportive environment will work through these feelings (facing them)
  • This results in completion (going on with life:  remembering without pain)

If the trauma is excessively prolonged or repeated the following unhealthy intensifications will occur

  • The emotional outcry will be panic, exhaustion, feelings of being overwhelmed, dazed, or confused or a “reactive psychosis.
  • The denial phase will include some or all of the following: maladaptive avoidance, emotional numbing, withdrawal from activities, sense of unreality, dissociative reaction (the person goes somewhere else in his/her mind), drugs, alcohol, suicide.
  • Intrusion will occur at some point causing the following: flooding of emotion, nightmares, flashbacks, anxiety, hypervigilance, startle reflex, work and social impairment, obsessive thoughts, compulsive repetitions, guilt, depression, despair.
  • These behaviors block progression to the phase of working through the trauma, resulting in frozen emotional states where people cannot “feel.”
  • Failure to work through the trauma blocks completion which can result in a chronic inability to trust, love, or act.

(Adapted from Marmar, C.R. and Horowitz, M.J., “Diagnosis and Phase-Oriented Treatent of Post-Traumatic Stress Disorder.” In Wilson, J.P. et al. (Eds.) (1988) Human adaption to extreme stress. Plenum Publishing Corporation.)

My own PTSD was the most severe kind, resulting in the last bulleted item.  I tried every kind of therapy to which I had access.  Nothing worked.  The PTSD had been growing in my mind and body during the whole of my life.  I trusted no one.  Finally, after years of being outside of faith and looking in, I decided to take the scariest step of all.  I knelt on my knees and gave up control (who really has control over their life?) of my life to the Lord.  I ventured to trust Him, and I let go of my anguish in a way I can’t describe, except that it was like letting go of a helium balloon.  I could almost see my troubles leave me.

One week later, my doctor was given sample of new medicine.  He gave them to me to try.  Overnight, I was given respite  from my PTSD and my bi-polar disorder.  A deep feeling of well-being I had never known in my life settled over me.  That was four years ago.  In that time, I have had only one crippling episode and that was in my therapist’s office, when my husband was trying to explain what my parents were like.  I stay away from those thoughts naturally now, but they are not stuffed down anymore.  I am learning, little by little to be an optimist about my life.  Now I believe in miracles.

Warning:  In some cases the stalling on denial or intrusion phases may require medical intervention with pharmacological therapy for depression or anxiety.  If suicidality occurs, hospitalization may be necessary.  Addictions to drugs, alcohol, pornography, overeating, or other harmful behaviors require intervention and help through a 12 step program designed to overcome the particular addiction.

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