Post Traumatic Stress Disorder
Trauma is any event that falls into these categories:
- It happened unexpectedly.
- You were unprepared for it.
- You felt powerless to prevent it.
- It happened repeatedly.
- Someone was intentionally cruel.
- It happened in childhood.
After trauma some people develop symptoms that interfere with living. For me, it was how I lived nightmares, hyper-vigilance, heightened sensitivity, easily startled, and other symptoms were all part of my everyday and night living.
Reaction to trauma is on a continuum from little or no reaction up to debilitating suicidal life threatening terror.
One big trauma or many repeated smaller traumas create similar effects.
PTSD became first studied in soldiers. (Timeline for PTSD http://historyofptsd.wordpress.com/timeline-2/) An early name for it was ‘shell shock.’ Later they recognized that it was not just about shelling. The syndrome was pieced together and eventually therapist and psychiatrist recognized the same symptoms in survivors of child abuse, earthquakes, severe weather, and other disasters. Sept 11 tragedy affected the world and survivors both watching on TV and living it had symptoms of PTSD just like the soldiers in war zones around the world. There are some people that lay claim to PTSD without fully understanding its impact. In my opinion, where ever you find yourself on the continuum if you choose to lessen your symptoms with knowledge, hard work, and practice a better life is possible. However, if a person decides there is no help for them and they are stuck, no amount of lecturing or persuasion will get them to budge. I know it may not make sense but some people will wrap themselves in victimhood with no desire to change their suffering. Another consideration is TBI, Traumatic Brain Injury, combined with PTSD makes improvement more difficult.
Longer history and overview of PTSD: http://www.ptsd.va.gov/professional/PTSD-overview/ptsd-overview.asp
PTSD is brutal. Severe dissociation is an elaborate hiding game from yourself. The most difficult challenge is to choose authenticity in a world that wants you to “Don’t worry, be happy.” Feeling what you feel when others tell you to ‘fake it until you make it’ is a difficult challenge. Sometimes I prefer to be home with my feelings then to try to live a socially acceptable lie. I lived without feelings for years. Dissociation allowed me to totally disconnect how I felt. Numbness at a level that no one could reach my authentic self, including me. My counselor was surprised at how completely I could disconnect from my emotions. He used anger as a way to get clients talking about their life more openly. He attempted to make me angry. He said things that would most likely irritate or upset most people. It started working with me. I realized I was getting angry. I was well trained like a Pavlov dog not to show anger. I made my anger vanish. Please, understand it wasn’t really gone. I would dissociate the emotion and tuck into a mental hiding place. My counselor stopped when he saw that my anger was gone. He pointed out that there was no tension in my face. I was totally relaxed when seconds before I was getting angry. He then asked the 6 million dollar question, “Where did it go?” I looked at him blankly. I didn’t know. I had no idea how to reach it. I couldn’t feel anything. When I shut off my feelings I didn’t just shut off anger. I shut off hurt, disappointment, frustration, happiness, joy, love in other words the entire spectrum of emotion was stuffed away in little ugly boxes in my mind with ‘do not disturb’ stamped all over it. To be authentic, I had to disturb those boxes. I do not recommend this activity without counselor supervision for a reason. Unfortunately, to reconnect my feelings the ugly, violent emotions came first. They demanded center stage at every session for weeks…months and sometimes it felt like years. I finally did reach my authentic self. Clearing away the puss of years of emotional neglect was painful and frustrating but oh so worth it. I still remember the first day I felt pure happiness. I can guarantee you no amount of faking it ever got me to this emotion. The reward for cutting through the tough stuff is joy. First, I accepted my own disconnection. Next, I faced my own emotions, then I accepted that my authentic self was much different from the masks I hid behind. I accepted that who I am was worth the effort of getting through the pain to get to me. ‘Faking it until I make it’ just slowed down becoming my authentic self.
TW gave me Frank Ochberg’s name to look up. I found his interview by Rebecca Aponte http://www.psychotherapy.net/interview/ochberg-interview
She asked the same question that I wanted to know, “To start, trauma is a word that is thrown around a lot these days. What does it mean when we say someone is traumatized?”
Frank Ochberg: I was part of the team that wrestled with that definition, and I think it is still an interesting challenge because the word is in general use. I think most of us consider something traumatic as usually something frightening, difficult, that could have relatively minor or huge life shattering consequences. Let’s compare it to stress. We get stressed by minor things that get us upset, sometimes mobilized with a lot of energy. But those of us who were part of a new generation that defined Post-Traumatic Stress Disorder really wanted trauma to be way beyond the usual stress.
In the beginning we said a traumatic event is something that is beyond the realm of usual human experience. But then we discovered it isn’t—not in terms of living our whole lifetime. You live long enough and something happens that is terrible, unless you are very, very fortunate. And some people are having terrible things happen with great frequency.
So to try to define this, we said at the time that you have to have been very scared, or horrified, or feeling helpless. And it had to have the characteristic of the kind of thing that could kill you, or kill somebody else, or radically change you in a biological way.
We walk through life with the wonderful myth of invulnerability and we think our humanity is something special, sacred and precious. And then all of a sudden you are treated like a piece of meat, like you are prey to another human being or to a devastating natural event: you are just a bunch of muscle and bone. And when you visualize that transformation in yourself or in a loved one, it is traumatic.
That is the meaning of trauma to those of us who were in the field of traumatic stress studies and are doing therapy with people who have been traumatized.
I believe this is a statement that would satisfy most people. It may not be a perfect definition. Some people may say that it excludes someone that has suffered emotionally. I do not want to do a case by case study of this is trauma, this is not. Trying to define trauma it is not my intent to imply that anyone’s suffering didn’t hurt. I am not trying to setup a criteria of someone’s suffering is not great enough to be counted as traumatic. I believe that trauma like so many things in life is on a continuum. There are events in my life that I consider much more severe than others. Emotional betrayal hurt as much or more than those events that threatened my life. I wanted to have the clinical definition establish so that when I say trauma it has the same meaning. Trauma is just one part of the realm of human suffering. When I changed counselors, I was asked what kind of abuse had I suffered? I felt a bit irritated because I believe that abuse is abuse and suffering is suffering. Emotional pain is as real and terrible as physical suffering. However, when I quote an expert or talk about these issues I want others to realize that the professional field has a very clear and somewhat narrow definition.
This is how I would reword this definition: ‘at the time that you have to have been very scared, or horrified, or feeling helpless. And it had to have the characteristic of the kind of thing that could kill you, or kill somebody else, or radically change you in a biological or emotional way.’ But it is not my definition to change. I want the official definition represented so that people will know what it means when I say I have PTSD by clinical standards. My life was threatened so many times I got to the point of ‘kill me, get it over with.’ A child can feel threatened by a parent telling them they wished they were never born. The hyperbole of ‘I want to kill you’ is too realistic to a child. I do believe that mental illness is a killer, it is called suicide, and more die every day.