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Post Traumatic Stress

People respond to traumatic events in their own way and according to their individual coping skills and available support systems. Research on the impact of trauma on various populations indicates that the great majority of those not immediately and personally affected by a terrible tragedy sustain no lasting damage. Most of those involved in witnessing or being a part of devastating events are able, in the long term, to find ways of going on with their lives with little change in their capacity to love, trust, and have hope for their future.

People can develop PTSD when, out of necessity, they react to and survive traumatic events by emotionally blocking them during and after the trauma. This allows the experience to dominate how they organize their lives and causes them to perceive most subsequent stressful life events in the light of their prior trauma. Focusing on the past in this way gradually robs their lives of meaning and pleasure.

The severity of the impact of trauma depends on the age and development of the person and the source of the trauma i.e. whether the trauma was relational and/or involved a close other, a natural disaster, war, or by a person outside of the family.

It is important to note that people can be affected by trauma and not be diagnosed with PTSD. A diagnosis does not necessarily legitimize a traumatic experience. People can experience a traumatic event and have it significantly disrupt their lives and never officially receive a diagnosis of PTSD.

The diagnosis of PTSD usually focuses on four elements:

Negative Cognitions & Mood

This could include various feelings such as:

persistent and distorted sense of blame toward self and others
estrangement from others
diminished activities
an inability to remember key aspects of the event.

Pattern of Increased Arousal

A pattern of increased arousal as expressed by hyper vigilance, irritability, memory and concentration problems, sleep disturbances, and an exaggerated startle response. Hyper arousal causes traumatized people to become easily distressed by minor irritations. Their perceptions confuse the present and traumatic past, such that traumatized people react to many ordinary frustrations as if they were traumatic events.

Avoidance of Reminders

Avoidance of reminders of the trauma, as well as emotional numbing or detachment. This is associated with an inability to experience pleasure and with a general withdrawal from engagement with life.

Repeated Reliving of Memories

The repeated reliving of memories of the traumatic experience in images, smells, sounds, and physical sensations. These are usually accompanied by extreme physiological states, as well as psychological stress that may include trembling, crying, fear, rage, confusion, or paralysis – all which lead can lead to self-blame.

The core issue of PTSD is that certain sensations or emotions related to traumatic experiences are dissociated, keep returning, and do not fade with time. People with PTSD seem unable to put an event behind them and minimize its impact. They may not realize that their present intense feelings are related to the past, so they may blame their present surroundings for the way they feel.

PTSD can be placed on a continuum from minimal traumatic impact to moderate effects, to high or complex PTSD that includes additional symptoms associated with severe long-term childhood trauma, i.e., sexual and physical abuse, residential school experience.

The more prolonged the trauma and the more interpersonal in nature, the more severe the impact will be.

Suggested readings:

8 Keys to Safe Trauma Recovery, Babette Rothschild

Waking the Tiger, Peter Levine

Trauma Essentials, Babette Rothschild

Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach, Christine A. Courtois and Julian D. Ford

Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, Lisa M. Najavits

Trauma and Recovery, Judith Herman

Principles of Trauma Therapy: A Guide to Symptoms, Evaluation and Treatment, John N. Briere and Catherine Scott