Alyssa Paul LCSW
What is PTSD?
Updated: Jun 13, 2021
Not every painful experience is considered a trauma. What makes an experience traumatic? Is it in the eye of the beholder? Or only determined by a doctor? Why do people respond differently to the same event?
Historically, the majority of our understanding of trauma originated from the analysis of behaviors and symptoms of veterans, especially following Vietnam War. "Shell Shock" and "Combat Stress Reaction" were commonly used to refer to the severe symptoms displayed by soldiers returning to civilian life after war. Since then, additional research has been conducted to uncover more information on the etiology of trauma and who is impacted by these experiences. Trauma can happen to anyone at any time. Throughout the research, trauma has been categorized as Type I and Type II incidents. Type I, are single, unexpected incidents such as natural disaster, single episode of abuse, mugging, car accident, terrorist attack, witnessing violence, etc. Type II, are repetitive traumas such as ongoing abuse, war, domestic violence, childhood neglect, etc. Type II is commonly associated with betrayals of trust in a primary relationship and if occurring during developmentally crucial times can have deleterious effects on an individual psychobiological and socioemotional development.
“There are no crisp boundaries demarcating ordinary stressors from traumatic stressors. Perception of an event as stressful depends on subjective appraisal, making it difficult to define stressors objectively and independent of personal meaning.” (Treating Complex Traumatic Stress Disorder)
PTSD is a secondary form of suffering. Meaning some people will have peritraumatic responses (immediately after exposure to experience) and others will have posttraumatic responses ( weeks, months, years following exposure to experience). PTSD is a state of continued suffering manifested through body, emotions, self-worth, relationships, and sleep. Although researchers, providers, and policymakers typify trauma, a combination of genetics, temperament, and environment all play a role in the personal reaction to trauma. What defines a traumatic event is truly in the eye of the beholder.
In short, the PTSD diagnosis outlines the result of an unprocessed threatening experience. A traumatic incident whether Type I or Type II triggers alterations in the brain, body, and personal belief system. Associated stimuli become encoded and easily surface in daily life triggering intrusive beliefs and thoughts, intense emotions, flashbacks, and impulsive behaviors. With heightened sensitivity to potential threats, a traumatized individual can find it very burdensome to move through daily life without activating their sympathetic nervous system (i.e. Stress Response System). A nervous system that lacks healthy resources resorts to maladaptive strategies (e.g. isolation, drug use, pervasive distrust, alcohol use, anger, etc.) to attempt to soothe and activate the parasympathetic nervous system (i.e. rest and digest system). Our brain and body don't fail at protecting themselves, it just resorts to strategies that diminish an individuals quality of life.
The DSM-V is a diagnostic reference that guides healthcare professionals in making an accurate diagnosis. Simply put, the criteria for PTSD are experiencing the following symptoms for longer than a month following the exposure to actual or threatened death, serious injury, or sexual violence;
Re-experiencing of the trauma (e.g. Flashbacks, Night Terrors)
Persistent avoidance of stimuli associated with the trauma ( i.e. avoiding hospital because it reminds you of your invasive surgery)
Negative alterations in cognitions and mood associated with the trauma
Marked alterations in arousal and reactivity associated with the trauma (i.e. intense panic thinking about going to hospital)
Functional impairment due to disturbances (i.e. impacting work, relationships, school, etc.)
Disturbances not attributable to the effects of a substance or medical condition
How this criterion presents itself is different for every individual. For some, flashbacks and night terrors are their primary source of distress. For others, it may be the persistent negative beliefs about themselves, the world, and others. Still for some, it may be the intense arousal that accompanies incessantly looking over your shoulder or preparing for danger every second. While others what predominates may be the absence of emotion or the ongoing sense of detachment from their body or environment.
It's important to remember that a healthy response to a traumatic experience involves healthy experiencing the feelings of grief, helplessness, horror that typically accompany trauma and addressing the parts of your life and self that have been negatively impacted. Find communities that can help support you, such as Facebook, professional support groups, etc. Healing is possible and there are many existing treatment options. Find some useful tips here. This information does not replace a medical diagnosis from a professional healthcare provider.