Post-traumatic stress disorder, or PTSD, has been called many names over the years. It was known as “shell-shock” in World War I and “battle fatigue” in World War II. The term post-traumatic stress disorder became well known during the war in Viet Nam. It simply means a person has experienced an overwhelming trauma and there is a delayed reaction that occurs days, months, or years after the original stress has occurred. However, the dynamics of post-traumatic stress disorder are very complex.
The Three Brains
I believe there are two ways that post-traumatic stress disorder develops. One is an overpowering, unusual event that is shocking to the human emotional system and blows the system out, such as the Oklahoma bombing or the Twin Towers in New York. The second way to develop post-traumatic stress disorder is by experiencing a host of smaller or more moderate traumas or abuses over an extended period of time, such as a person growing up in an alcoholic family.
PTSD is based on very natural phenomena. Imagine a person who becomes involved in a car accident. That person will immediately go into fight, flight or freeze mode, which is a reptilian brain activity that is discussed in more detail later in this chapter. The heartbeat begins to race, the pupils dilate so the person can see any other threat from the periphery, the muscles become taut, and insulin and adrenaline flow into the system. A person will fight, flight or freeze immediately, which takes them out of homeostasis. Homeostasis is the ability to maintain internal equilibrium and balance by adjusting the body’s physiological processes. At that moment, the person doesn’t have any spare time for regular activity. If the person is digesting their food, they will stop digesting; or they will lose their sense of hunger, even if they were hungry a moment before.
During this period of time, a person will not be in touch with their feelings because they have other business at hand. After the accident, it takes several minutes until the feelings and reality of what has occurred hits. The person may suddenly begin to shake when they realize how they feel. That is normal and natural. What makes PTSD abnormal is that the repressed energy and emotions become trapped in a number of areas in the body and mind for an extended period of time, which prevents the person from returning to homeostasis. In fact, it gets caught in every single cell of the body. To understand post-traumatic stress disorder, we must discuss what symptoms characterize the disorder and then understand some of the basic facts of brain chemistry.
Some of the symptoms of post-traumatic stress disorder occur long after the precipitating event, from several months to several years later. Insomnia, anxiety, difficulty concentrating, dissociation, time distortion, depression, appetite and sleep disturbances are all common problems associated with PTSD. A person can actually relive a vivid memory or even hallucinate about events that happened years ago. Drug and alcohol abuse are often used as inadequate coping skills to keep the traumatic memory buried in the subconscious. Other addictions and compulsions, as well as hyper arousal and intense anger that can flare up at a moment’s notice, are other common symptoms that result from this condition.
A person with PTSD often has recurrent and persistent recollections of the original traumatic event. They can experience nightmares. They often act or feel as if the traumatic event is happening all over again spontaneously. They often feel intense distress related to internal or external events that remind the person of the traumatic experience. The person attempts to avoid the thoughts, feelings, or conversations associated with the trauma. Efforts are also taken to avoid any activities, places, or people that might be associated with the trauma.
The sufferer often displays memory deficits concerning important aspects of the traumatic event or even the event itself. Many times the person shows a decreased interest or participation in certain activities. They feel a sense of detachment or estrangement from others. There is also a sense that time is short, and there is no future. Often this leads to the development of learned helplessness, which is the belief that no matter what a person does they can not truly effect change or control their life.
PTSD is delayed grieving. What is so confusing for people who suffer from PTSD is that in their mind they’ve gone through the trauma without any major negative effects, but later they start to have odd and disturbing symptoms. They are confused by this and believe they’re getting worse. In reality, these very symptoms indicate that they’re actually getting better. If the trauma had been less severe or environmental support greater, the symptoms would have occurred faster and in a milder form. The person would have talked out the stress and returned to homeostasis quickly. With PTSD this normal process of dealing with stress and grieving has broken down.
Oftentimes, it’s not the original abuse that causes the most trouble, but the secondary abuse. If a person has been raped, which is tremendously abusive and an overwhelming shock, this could well cause PTSD in its’ own right. However, what might make the trauma even more difficult is if the person who has been raped went to the police station and was treated as if the rape were their fault. PTSD can also develop from those secondary abuses.
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