Post Traumatic Stress Disorder

Our friend Whale was a Vietnam vet who exhibited several of the symptoms associated with Post-Traumatic Stress Disorder – an anxiety disorder caused by an event “Outside the Normal Range of Human Experience”. Although the trauma of war was the probable cause of Whale’s PTSD, dealing with an accident or death on the river could also trigger this response. Any person, of any age or sex may develop PTSD following an extremely disturbing event; in fact, simply witnessing such an event can put one at risk for PTSD.

“PTSD can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat. PTSD can be extremely disabling.” from the National Institute of Mental Health (NIMH) website.

For reasons scientific research is still trying to pinpoint, some of us are unable to process the emotions generated by a traumatic event. Any major shock, or life-threatening situation you experience, needs to be dealt with, understood and accepted by you. In order to do this, you need to go through a grieving process:

  • Experience the Shock.
  • Deny it temporarily.
  • Become angry at the violation of your person.
  • Bargain with yourself, God, the universe, whomever (“if only I had…”).
  • Experience the grief/sadness/depression you feel over the loss.
  • Understand the nature of the experience.
  • And finally Accept it!

The grief process is not a linear one, and you may go back and forth between these different stages. This is normal. However, if at the time of the experience you were unable to go through this process, your mind will put it away for you to deal with when you are able. This is called repression. Feelings, memories, or both may be repressed. Even if you have always had memories, you may need to allow repressed feelings to surface. Repression may occur due to the nature of the trauma, or due to family messages, which blocked natural feeling processes.

Signs and Symptoms:

Folks with PTSD experience a wide variety of symptoms: forgetfulness, confusion, lethargy, insomnia, nausea, headaches, obsessive and/or intrusive thoughts, hallucinations, panic attacks, self hatred, numbness, severe mood swings and suicidal thoughts and gestures are all within the realm of this disorder. “Many people with PTSD repeatedly re-experience the original ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is generally diagnosed when symptoms last more than 1 month.” (NIMH)

Researchers are just beginning to uncover physical reasons for PTSD. Studies in animals and humans have focused on specific brain areas and systems involved in anxiety and fear. Probable factors that may lead to PTSD range from an abnormal activation of the area of the brain responsible for coordinating the body’s fear response, to the tendency for sufferers to have abnormal levels of key hormones involved in response to stress.

Treatment:

When someone suffering from PTSD is able, and not before, their mind will slowly remind them of the traumatic experience – in the mind’s own language – symbols. These symbols may appear to be hallucinations, but they are not – and when translated into actual memories, the person will go through a split. He or she will feel the feelings, especially the terror, and vividly see, hear, touch, taste, and smell what was repressed. Flashbacks and spontaneous regressions may occur.

If you are going through this process, it is important to remember: you will not actually be in your experience from the past – you are only remembering it for the first time. You will not go insane and you will not stay in your experience. It will pass. If it is more than you are able to deal with at the time, your mind will repress it again. Repressing on top of repressing is called “overload”.

As a PTSD sufferer is able to remember the experience fully, it becomes theirs, to do with as they please: the ordeal no longer controls the person, the person controls the event. As the magic spell of regression is broken, the person is released from a “cage of terror”. Remembering is a gift of recovery: once able to accept the past, the person becomes free of it.

Until this happens, the process can be extremely confusing and troubling. Certain situations can trigger a stress reaction – or an experience of the symptoms listed above – such as feeling overwhelmed, anxiety or panic attacks, nausea, etc. An excellent way to begin healing is to identify specific triggers and start tracing them to their source. Answering the following questions will allow the sufferer to work through their unfinished emotional business, journal their answers and/or the original experience.

  • What is the last thing you remember before the triggered stress reaction?
  • Who were you with at the time?
  • Where were you?
  • Do you have a glimmer of any other feeling coming up before you reacted?
  • Is this reaction something you’ve felt before? It is a new or a familiar one?
  • Were there uncomfortable thoughts, which you quickly pushed away? Are these familiar thought patterns?
  • Was there anything disturbing that happened to you in the last day or so?
  • Have you been under any unusual stress? Examine your stressors: money, work, time, diet, relationships, children, sleep habits, illness, etc.
  • Did any of these things remind you of previous abuse, trauma or loss?

It may take a series of episodes with similar dynamics before you pinpoint the source – but the effort is worth it in order to break the cycle.

Remember: emotions are energy looking for expression. Despite one’s awareness “feelings are alright”, at times the feelings may be extremely overwhelming. Listed below are some things to do to help ease the feeling of desperation and move through the emotions.

Practice this “AWARE Strategy” (by Beck & Emery)

A = Accept the emotions – don’t fight them, it only makes it harder. Accepting means saying “Yes, this reaction is here, and it is not responsible for how I think, feel and act.”

W = Watch the emotions. Look at them without judgment. They are neither good nor bad, they just are.

A = Act despite the emotion. Act as if you’re not _______ (whatever the feeling is). Slow down. Don’t feed the fear.

R = Repeat these steps until the emotion is more manageable or fades. Rate the feeling on a scale of 1 – 10 to acknowledge the changes.

E = Expect the best. Surprise yourself with how well you handle the emotion. Emotions pop up; expect to handle them well.

Things to do when you feel desperate

  • Breathe – deeply and slowly.
  • Anchor yourself in the here and now, this physical reality: notice where you are, what you see, smell, hear and touch.
  • Visualize yourself in a “safe place”.
  • Listen to relaxing music.
  • Pray/meditate
  • Talk to someone; talk to someone else.
  • Take a hot bath, a cool shower – whatever helps you “center yourself”.
  • Walk slowly around a courtyard.
  • Hug a stuffed animal.
  • Use the AWARE strategy listed above.

PTSD has serious complications: suicide, violent rages, substance abuse, ulcers, marital and job failures are all very common. If you are experiencing symptoms, you may need professional assistance in your recovery – please, call the Whale Foundation hotline.

“People who have suffered abuse as children or who have had other previous traumatic experiences are more likely to develop the disorder. Co-occurring depression, alcohol or other substance abuse, or another anxiety disorder are not uncommon. The likelihood of treatment success is increased when these other conditions are appropriately identified and treated as well” (NIMH – www.nimh.nih.gov).