PTSD, or meeting a long-lost friend

The last three months were a challenge to me. And it doesn’t look like it’ll stop soon.

Old wounds ripped up, old pain butted its head and I tried my best to welcome it like an old, long lost friend… It’s an understatement, if I’d say that it’s easy.

I had some years in mindful and buddhist training; so I observe. I learn, about me, my situation, my hidden puppet strings, the booby traps I set for myself, and how others are capable of manipulating me.

My past isn’t pretty. I’ll leave it at that. But I’ll never move forward, if I back down.

My psychological strength isn’t what it used to be too, I guess there aren’t any reserves left. I jump at the smallest, unexpected noise. I cry at the news (which is very unusual for me- been called “Iceberg” before) and stopped watching TV and read the newspapers. I do the same with pictures of disasters, personal and global… My emotions and feelings overwhelm me, and I seize to function.

The part of acknowledging it, is the respect, the knowledge and the intro-/retrospection I need to practice. Mindfulness, first of all. The other part of the equation is the realization how much it changed me, my personality.

Drop by drop, it hollowed me out.

So here you go, for all who need this (fellow writers, you can use this for character development):

Symptoms of PTSD

There are six types of PTSD symptoms:

• 1. Reliving the event (also called re-experiencing symptoms):  Memories of the traumatic event can come back at any time. 
  • • You may have nightmares and sleeping problems.
    • You may feel like you are going through the event again. This is called a flashback. -> COPING WITH FLASHBACKS
    • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
    • You may re-experience the bodily symptoms, chronic pain or have intruding thoughts. 

• 2. Avoiding situations that remind you of the event:  You may try to avoid situations or people that trigger memories of the traumatic event.You may even avoid talking or thinking about the event; avoid crowds, because they feel dangerous;  avoid situations, that resemble the traumatic one. You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
• 3. Negative changes in beliefs and feelings: The way you think about yourself and others changes because of the trauma. This symptom has many aspects, including the following:

1. • • You may not have positive or loving feelings toward other people (society in general) and may stay away from relationships.
     • You may forget about parts of the traumatic event or not be able to talk about them.
     • You may think the world is completely dangerous, and no one can be trusted.

• 4. Feeling keyed up (also called hyperarousal): You may be jittery, or always alert and on the lookout for danger. You might suddenly become angry or irritable. This is known as hyperarousal. For example:

1. • You may have trouble concentrating.
   • You may be startled by a loud noise or surprise.
   • You might want to have your back to a wall in a restaurant or waiting room. Security and the need for control gain importance.

• 5. Feeling of distance and numbness (Depersonalization, Derealization):  You may feel a certain kind of emotional numbness, or being on “auto-pilot”. Typically, people talk about watching themselves remotely, doing something, not being able to intervene.
  •  You might not be able to connect with your friends and family. You might have trouble with finding your place in your life.
  • You may feel stuck in a perpetual  loop of fear and sadness.
  • You may feel that you only function. You’re on auto-pilot.
  • You may experience a distorted sense of shame and guilt.
  • Your hobbies become a nuisance. You might have a severely reduced interest in pre-traumatic activities.

• 6. Alteration of  memory, mood and concentration, depression: feeling of fear, agitation, shame, guilt, devastation, feeling of meaninglessness. You may feel irritable for no reason at all. You may develop a deep feeling of mistrust, up to paranoia. 

Following trauma, it is normal to experience the range of symptoms typical of PTSD. However, when these symptoms persist longer than 3 months, they are considered part of the syndrome of posttraumatic stress disorder.

In some cases, however, symptoms may take a long time to appear. Delayed PTSD is often typical in cases of childhood sexual or physical abuse and trauma. Symptoms can be hidden by emotional constriction or dissociation and then suddenly appear following a major life event, stressor, or an accumulation of stressors with time that challenge the person’s defenses.

Risk factors for PTSD include lack of social support, lack of public acknowledgment or validation of what happened, vulnerability from previous trauma, interpersonal violation (especially by trusted others), coping by avoiding — including avoiding feeling or showing feelings (seeing feelings as a weakness), actual or symbolic loss — of previously held beliefs, illusions, relationships, innocence, identity, honor, pride.

 

If you recognized yourself in the symptoms, what’s next?

Seek help! Go to your family doctor, or a specialist. Psychotherapy is most important! This is a treatable condition.

Don’t wait for over two decades, like I did. PTSD changes you, it changed me. I’m a different person now, and I only resemble myself rudimentary. I’m not the best version of myself anymore. Maybe I never was… 

• build up resilience 
• seek a healthy relation to danger and security
• build up self esteem
• find new meaning and purpose in your life
• if necessary, take prescribed medication (it’s only for some months, not forever)

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Something interesting I just found: COMPLEX PTSD

Below the “Continue Reading Tag” is an article about the cumulative effect of traumata.

C(omplex)-PTSD

The concept of Complex Post Traumatic Stress Disorder, known as C-PTSD for short, was first developed in the early 1990s. As with all scientific advances, not everyone realized its importance immediately and time was required to both refine and propagate the idea. The World Health Organization, for example, still does not recognize C-PSTD as a distinct health problem, though it may be included in the new list, scheduled for publication in 2018. The widespread slowness in recognizing C-PTSD is sometimes frustrating for those of us working in the field of psychology, trauma, and behavioral health. C-PTSD can produce severe depression, anxiety, and even psychotic episodes, which in turn can lead to serious physical symptoms. When healthcare practitioners are not aware that the problems they are dealing with are really results of C-PTSD, then treatment is much less likely to be effective.

The traumatologist, John Briere, was once quoted as saying, only half in jest, that “if Complex PTSD were ever given its due …. the DSM (The Diagnostic and Statistical Manual of Mental Disorders used by all mental health professionals) would shrink to the size of a thin pamphlet.” There is certainly very good evidence that C-PTSD is a much more prevalent problem than generally recognized. The C-PTSD advocacy organization, Out of the Storm, makes a strong case that there are hundreds of millions of undiagnosed cases worldwide. While the data we have is incomplete, what there is paints a picture in which, as they put it, “the numbers are staggering to contemplate”.

 

One obstacle, then, to giving the best help to sufferers of C-PTSD is a lack of awareness. Another is that, as a relatively new diagnosis, much still remains to be discovered about the mechanism by which C-PTSD comes about. A promising new study¹, however, may represent a major advance in our understanding of what C-PTSD is, which in turn would help us better identify and treat it.

C-PTSD and Childhood Trauma

C-PTSD differs from its better-known cousin PTSD mostly in that it is the result of a series of destabilizing incidents that happen over a period of time, even years. Each one on its own would not be sufficient to induce trauma, but their cumulative effect does. The typical case of C-PTSD involves an adult who, as a young person, was the victim of repetitive, chronic, and prolonged trauma involving harm and abandonment by a primary caregiver. Such mistreatment can include ‘passive’ slights, such as a parent withholding love or affection, or never giving praise.

It may seem intuitive that people react to such unhealthy relationships by developing the common symptoms of C-PTSD, such as, among others, shame, guilt, and an inability to regulate emotions or find enjoyment in life. This is because, unfortunately, we all know of too many examples where children of abusive parents go on to develop mental health problems. However, on reflection, this is not such an obvious result. Human beings have been forged by millions of years of evolution in order to survive, grow and procreate. Wouldn’t it make more sense for evolution to endow us with the ability to shrug off childhood traumas so that we can get on with having a successful life?

The new study suggests that C-PTSD is best understood as a learning process that has gone wrong. Part of the way we are designed for survival is that we are flexible enough to learn to thrive in very different environments. The skills you need to survive and succeed in the Savannah are very different from those you need in a modern city. During childhood, we go through a long process of learning how to avoid danger and how to deal with danger when it comes around. This is an essential part of adapting to our environment.

During this process of learning and adaptation, the relationship of the young person to his or her caregivers plays a central role. There are many dangers that a vulnerable child might face that they are unable to cope with alone. To navigate these kinds of danger and discover the appropriate way of responding, the child relies on caregivers, especially parents, for guidance and also protection. If the caregiver does not fulfill this role, or, worse, is perceived by the child as a source of danger then this process is interfered with. The child experiences dangers which he or she cannot adapt to and learns self-protective strategies that are actually deeply maladaptive in normal situations. In adult life, they are more likely to mistakenly interpret situations as dangerous and then respond in ways that are self-destructive. When a child grows up learning that the world around them is not safe, he or she takes this view of the world into adult life, with wide-ranging and damaging consequences.

Progress in Treating C-PTSD

The study suggests ways that treatment of C-PTSD can be improved. In particular, conceptualizing C-PTSD as a result of a learning process perverted through mistreatment indicates that successful treatment involves the therapist facilitating a new learning process by functioning “as a transitional attachment figure, using the therapy to generate the missing resilience-building processes of childhood.” Providing individualized treatment would mean looking closely at the ways in which the adaptive process of learning has been distorted. Some sufferers from C-PTSD will fail to process information, leaving them feeling helpless and unable to interpret the world around them. Others will err in the opposite direction and overinterpret details, which should be filtered out. To use an example given in the study, if they receive ill treatment at the hands of someone wearing a red jacket, then they will erroneously “focus on red jackets as signals of danger.”

 

Successful therapy is based on identifying the specific ways in which the way each individual processes information about potential and actual danger, in order to guide them to healthier thought patterns. In this way, the psychological profession can make a meaningful difference to the life of those suffering from this extremely serious, and still under-recognized condition.

References:

1. Crittenden, P. M. & Heller, M. B. (2017). The Roots of Chronic Posttraumatic Stress Disorder. Chronic Stress, 1, 1-13. doi: 10.1177/2470547016682965