Post Traumatic Stress Disorder
PTSD can be isolating. Feeling overwhelmed mentally and emotionally is a part of it. Therapy can help clients feel that they are back in control.
Post Traumatic Stress Disorder (PTSD) is prevalent in our society. The causes are many. Clinically, in order to develop PTSD one must be exposed to a life threatening situation, directly experiencing the threat or being a witness to it. Common causes range from serious car accidents, physical or sexual abuse, assault, domestic violence, or combat. Secondary PTSD occurs when people vicariously experience trauma through another. Family members and friends of survivors; law enforcement; first responders; and mental health providers are susceptible.
When a person experiences a “normal” memory, the brain processes all the sensory and cognitive information from the event. During sleep, this information is “sorted” in the brain, with essential information stored, and non-essential information released. In life-threatening situations, the chemistry of the brain, and brain functions change dramatically. Most people are familiar with the term “fight or flight”, a brain and body condition related to the body and brain processing a significant threat. This state of “fight or flight” actually changes how information is processed by the brain.
In these situations, the brain records all the sensory data related to the threat in extreme detail: all the information related to sound, smell, visuals, taste and touch is stored. Due to the change in the way this information is handled in the brain, it does not process like other information. Instead it is stored, in the brain and body, in the way it was experienced. All the sensory information is stored with the memory of the event.
Because of how those traumatic exposures are stored in the brain and body, people with PTSD are triggered by things that reactivate the memories associated with the trauma they experienced. Sounds, smells, things seen--can all reactivate the original memory. This can show up in unexpected ways. For instance, while the rest of us are enjoying fireworks, some of our veterans are sitting in their homes with headphones on trying not to hear the concussions of their neighbors’ celebrations. For them, fireworks may no longer be a pleasurable experience. For some, it takes them back to dangerous, life-threatening situations.
This example can be seen by the person involved with a traumatizing car accident. Driving can, after an accident, be very challenging. People can find themselves very anxious, with constant triggering possible from other drivers driving recklessly, to coming “too close”, or just the fear of being hit again.
These PTSD cues can play out over and over again because the brain learns to scan for danger in the current environment. Ask anyone with law enforcement or war experience where they want to sit in a restaurant! They typically want the wall behind them so they can watch the room and not have a blind spot behind them. This hypervigilance is part of the world of dealing with PTSD. And the triggers can be as varied as the people experiencing them.
There are real concerns for the well-being of our veterans, law enforcement and first responders. They have been exposed on a regular basis to incomprehensible dangers and the aftermath of human tragedy. Friends in law enforcement have told me that they do not feel free to disclose their PTSD for fear of being stigmatized or face reassignment.
Medication can be a great help to those dealing with PTSD. I believe that trauma counseling and medication combined is the most effective means of assisting those with this condition actually process their exposures. Many advances have been made, and are continuing to be made in assisting people in recovering from the impact of experiencing traumatic events.
As a society and a community, we must remember to treat those with service related PTSD (military, law enforcement, other first responders) with respect and care as they work to process the difficult, if not overwhelming, things they were exposed to. They have been there for us; we need to be able to lend support and be there for them as they seek to heal.
A specific therapy, discovered in the late eighties, is EMDR. Dr. McHenry was trained in EMDR by the originator, Dr. Francine Shapiro, in 1994 and has successfully worked with people with PTSD to fully resolve or improve their PTSD symptoms.
For more information on EMDR, please see the EMDRIA.org website. I will write more on EMDR in another post.