Post Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder is a response to a traumatic event, when a person witnessed bodily injury or felt intense fear for their life and safety.
1. What types of traumatic events are likely to cause PTSD?
Although most people associate PTSD with traumatic events such as war, violent/sexual assault, natural disasters (such as floods or earthquakes) or road accidents where a person witnessed bodily injury or experienced fear for their life, one may also develop symptoms of PTSD as a result of being in a prolonged abusive environment or relationship, where the abuser has complete power and control over the victim (e.g., with threats and intimidation), even if there wasn't a specific incident of physical violence or bodily harm. Traumatic events in which there is a betrayal of trust (such as sexual or physical abuse by a family member) and the victim feels trapped, and dissociates, is also more likely to result in PTSD. Other traumatic events that are likely to cause PTSD is the diagnosis of a life-threatening disease or learning about a serious injury or violent death of a close family member or friend.
2. WHat is the difference between the INITIAL stress response and PTSD?
At the time of the traumatic incident, the person has a heightened stress response, usually fearing for their life or sense of self. This may result in the person dissociating (i.e., experiencing the surroundings as unreal, or feeling detached from themselves and their body), and may not be able to recall the details of the traumatic event later. The unresolved trauma is stored as fragments of physical sensations, emotions and images. PTSD is characterized by:
- Re-experiencing the trauma via intrusive images and/or thoughts whenever they are exposed to triggers that activate the unresolved trauma fragments
- Avoidance of reminders of the trauma
- Hyper-vigilance that may result in sleep disturbances and difficulty concentrating
- Distorted perceptions and negative beliefs about self and others (such as "It was my fault" or "I deserved it")
3. How does PTSD affect relationships?
A trigger is anything (such as thought, image, sound or smell) that activates the unresolved trauma. Each of the symptoms (mentioned in the answer to Question 2 above) of PTSD affect relationships in different ways:
- When a person is triggered and has a trauma response (eg, lashes out in rage), the person (and others) may not associate the person's reaction (rage in this case) with the unresolved trauma, but instead look at the current environment or people present to blame as the cause for their reaction. So if the person with PTSD is not aware of their triggers and trauma response, they end up blaming their partner for their reactions.
- The avoidance symptoms of PTSD can result in the person numbing themselves from feeling too much, and in extreme cases, can result in the person dissociating (that is not feel connected in their body or feel that the environment is unreal). When such symptoms are activated, it is really difficult for the person to be present in the moment.
- This symptom shows up as having to be constantly "on edge" and on guard, and difficulty relaxing, which floods the body with stress hormones, causing physical health problems and difficulty sleeping and concentrating, which negatively affects their relationships as well.
- The trauma causes the person to view the world through distorted lens and negative beliefs , such as "I can't trust anyone" or "I an unworthy" that could sabotage their relationships, with the negative beliefs serving as self-fulfilling prophesies.
The first step to prevent it from negatively affecting the relationship is to first become self-aware of the PTSD symptoms and triggers and to then explain it to the partner, so that the partner does not take things personally when the person with PTSD is triggered. The partner can then be a part of the person's support system in helping to identify triggers and de-escalate a situation when the person with PTSD gets triggered.
4. Which populations are at the greatest risks of PTSD?
The highest risk factor for developing PTSD is if you've had depression or anxiety in the past, or if you don't receive adequate support from friends and family following the traumatic event. For example, the intrusive rape examinations following a sexual assault could be further traumatizing leading to PTSD, when done without empathy or emotional support for the victim.
5. WHAT ARE the TREATMENTS AVAILABLE for PTSD?
There are several psychotherapy treatments available that can effectively treat PTSD without the use of medication. Since the unresolved trauma response is stored in the body, treatment usually involves a somatic experiencing component to process and resolve the trauma. Eye Movement Desensitization and Reprocessing (EMDR), Neurofeedback, and attachment-oriented talk psychotherapy such as Internal Family Systems (IFS) are research-backed methods for the effective treatment of PTSD.
When working with a psychotherapist, who does IFS parts work (which is working on integrating different fragmented and dissociated parts of your self), such as inner-child work, some of these exercises, can be done on your own to enhance healing, and to increase self-compassion and acceptance of the wounded parts of self. The book "Self Therapy" by Jay Earley, PhD is written in an accessible way to help the lay-person heal from emotional trauma.
I use a combination of EMDR and attachment-oriented talk psychotherapy (AEDP, IFS) for the treatment of PTSD. Contact me now to schedule your complimentary initial consultation to learn how therapy can help you heal.