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Talking Trauma

14 Oct 19
Sue Smith
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Post Traumatic Stress Disorder (PTSD) is being spoken about more often nowadays. Its included within scripts for TV dramas, recognised more within the mental health arena and generally acknowledged by society as a real condition.

But what does it mean? And what does it look like?

This blog gives a brief overview of this fascinating area of psychology.

Firstly, its important for me to say that personally I dislike the ‘D’ the disorder bit of PTSD. The symptoms of PTSD are the resulting factor of the brain working as it should when we experience non-normal life events. Such events trigger responses in the acute stage, at the time of the event and those responses are triggered to protect you, to save your life. Indeed, given horrendous, terrifying circumstances I would be more concerned about the survivor who experienced them and stated they were fine with no effect than someone who presented with trauma related symptoms.

However, for some people, and I believe many more than those currently diagnosed, the symptoms do not subside or fade over a period of time. Rather they continue, keeping the event, the incident, the trauma ‘charged’ as if it were still happening. So, your logic tells you it happened in the past, but you feel like it just happened yesterday, indeed the most common symptoms are those of re-experiencing where the individual relives the event through flashbacks, dreams, intrusive thoughts and imagery. In this respect when symptoms persist and interfere with day to day life for a prolonged period then I guess its fair to refer to it as disordered. Though I prefer to consider the circumstance as the trauma is still charged.

Many sufferers suffer in silence, thinking they’re ‘mad’ or ‘bad’ and wishing they could return to be the person they were before the event. To those around them they may appear to be out of character, have mood swings, or lack interest in previously enjoyed activities.  Its difficult for friends and loved ones to comprehend because the traumatic event is not charged for them, it is a memory, consigned to the memory banks. This can amplify the negative beliefs of the person experiencing symptoms and silence them further.

Image if you will: ‘The grandma who was mugged on her way back from bingo, she was pushed to the ground and her handbag snatched. That was over two years ago, but she still does not go to bingo and she still repeats the story over and over. Family response initially was good but now she often gets reminded that it was years ago and its been to court and she needs to put it behind her.’      Sounds familiar? She could have PTSD.

To be diagnosed with PTSD a certain number of symptoms must be present from three categories. The categories are: Re-experiencing, Avoidance and Arousal.

Individuals can also suffer with some symptoms, say for example from just one category, thereby not meeting the threshold for diagnosed PTSD, and still find themselves struggling to cope. This is because the symptoms can keep the traumatic incident charged even when there are not enough for full PTSD. The most draining of the symptoms are usually the re-experiencing ones.

Avoidance symptoms are; as the name suggests, methods of avoiding the re-experiencing symptoms being triggered. So people avoid talking about what happened, avoid watching their favourite soap opera because of the current story line, avoid the news, throw themselves into distraction by doing a task or turn to substances as a way of blocking it out.
The ultimate avoidance for some sadly is suicide.

Imagine this then:

Your gut, your feelings, your emotions are screaming at you ‘ this is difficult this is painful you need to deal with it’ while your head is shouting back ‘yes this is difficult this is painful, I’m not going to think about it’.

This conflict is a continuing battle of Re-experiencing VS Avoidance and the outcome is Arousal.

Arousal symptoms include: Sleep disturbance, irritability, hyper vigilance, lack of concentration to name a few.

The cycle continues: You have put the trauma in the suitcase and place the closed suitcase on the shelf behind you. You’re aware of it but you’re leaving it there as you want to get on with life. But every now and again something reminds you that the suitcase is there. Not only are you reminded of the suitcase, but something opens it and shows you the content within. You are back there, reliving not just the memories but the associated feelings and emotions that went with it. You desperately want that case closed and back on its shelf. So, you use whatever avoidance technique is at your disposal and regain control. Until the next time….

As a therapist with a passion for trauma I am in awe of the courage needed by traumatised people. Not only in surviving the extremely draining symptoms and continuing to find ways to function, but also in the strength it takes to access therapy. Think about this vicious circle, the trauma needs to be worked on to take the charge from it, the last thing you want to do is to re-experience the trauma, so naturally you’re going to avoid therapy if you can. Therapy is the act of doing exactly what your head is trying to stop you doing!

It stands to reason for all clients, particular those with traumatic memories that a safe environment along with a working pace timed to suit the individual is paramount to building a healthy therapeutic relationship.

Further information about symptoms and treatment is available at: 

More trauma talk in future blogs.

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