Post-Traumatic Stress
What is Post-Traumatic Stress Disorder?
A person with post-traumatic stress disorder (PTSD) may re-live traumatic events. These events may be highly personal as in the case of rape or sexual assault or sexual abuse. They may be motor vehicle accidents, plane crashes or natural disasters like destructive floods, earthquakes and cyclones as Australia has recently experienced.
The person might relive the events in flashbacks or other images that intrude on their waking hours, or in dreams and nightmares. The flashbacks and dreams feel vivid and real as though the event is occurring, even though it actually is not real.
Physical Symptoms of PTSD
These reminders may also trigger physical symptoms such as heart palpitations or chills, profuse sweating, shaky legs, blurred vision, inability to focus or concentrate, and difficulty in thinking clearly. The person may even appear as though they are in shock.
Emotional Responses of PTSD
Additionally, there may be emotional problems, like anxiety, depression, dread, paranoia and guilt, particularly if this person survived a disaster and others they knew did not.
Persons suffering from PTSD may also experience sudden feelings of anger or irritability, they may snap suddenly and then feel great remorse later.
People with post-traumatic stress disorder may avoid any reminders of the trauma, whether that is people associated with the experience, or places, or even thoughts of the trauma. They may keep constantly busy to avoid their own thoughts.
They may distance themselves from family and friends and withdraw from everyday activities and things they used to enjoy.
Relationship Issues
Relationship problems may occur or problems communicating, particularly in social situations where the person feels unable to control events. Another characteristic of post-traumatic stress disorder is being on guard all the time, again because there is so much uncertainty.
Feeling Out-of-Control
Previous to this event, most people think of their world as relatively safe, ordered and controlled, and that they are in control and can manage most situations that arise.
After the traumatic event, there is no such certainty any more, so they will avoid situations where they feel they cannot control the outcomes or where safety may be an issue.
Sleeping Difficulties
There can be problems with broken sleep or difficulty getting to sleep, and difficulty concentrating because of lack of sleep. PTSD sufferers may also be startled easily, with a high startle response when there are sudden loud noises or movement that was not anticipated.
Self-destructive behaviours, such as gambling, risky sex, drug use, alcohol abuse, or other problems like dangerous driving, may be present. Depression, disassociation, or other mental health problems can also develop.
It is very important to note that not all of these characteristics may be present in PTSD, and the degree to which a person experiences them may vary also.
Assessment is required to provide an accurate diagnosis.
When do Symptoms of PTSD Occur?
PTSD may not develop until months or years after the trauma. Particularly in relation to abuse in childhood, symptoms of PTSD can pass, then reappear later in life. This can make it difficult to recognize when PTSD is occurring, as survivors may not associate their current feeling and behaviours with past events.
Often, symptoms do not appear for 3 to 6 months after an event, such as a natural disaster of catastrophic proportions like the floods that South-East Queensland experienced earlier this year. The reason for this is simply due to practicality as the survivor of the disaster is often kept very busy in the aftermath of the event. They are cleaning up, attending funerals, attending inquiries, organising repairs or rebuilding, and simply do not have time to process the emotions.
They may also shut down the emotions as a preferred coping mechanism while there is so much to do, and then later, when there is time, be surprised by the feelings that come to the surface. This is the reason that many war veterans do not exhibit symptoms for some years after the trauma of war has passed.
Each time symptoms appear however, they provide an opportunity for healing.
Treatment of PTSD
3 types of psychotherapy can be used to treat PTSD. These are exposure management, cognitive therapy, and anxiety management. A combination of all 3 may be used, or one individually, depending on what the client finds works best for him or her.
In exposure therapy, which takes place in a safe therapeutic environment, the client is confronted with the situations, people, and memories associated with the trauma. People with PTSD usually avoid any semblance of the trauma, but it is an effective process, which requires training in breathing and self-monitoring processes before it is commenced.
Cognitive therapy helps by understanding how our thoughts affect our feelings, and provides ways of shifting thoughts that were having a negative impact. Those negatively impacting thoughts that go round and round on the rat-wheel of the mind may perpetuate a loss of self-worth and ability to cope.
By changing thinking patterns and subsequently effecting emotional responses more positively, a new framework is built and used to process the trauma, and allow healing to occur.
Anxiety Management
In anxiety management, skills are learnt that help one cope better with the symptoms and triggers of post-traumatic stress disorder. They can help reduce the intensity of the symptoms, though they need to be practised to be effective. Some techniques used include relaxation, breathing techniques, mindfulness meditation and hypnosis.
Trauma Technique
In my work, I have used the Trauma Technique, which comes from Timeline Therapy (and NLP), for sufferers of PTSD. I explain the process of the technique first so that clients are able to follow along with a mental visualisation of what is happening.
In this technique, clients do not talk about the event, and any imagery that occurs is extremely fast, blurred, and grey, like a super fast-forwarded film strip, which is quite neutral to observe.
Hypnosis may also be used to treat PTSD and the work of Dr Michael Yapko has identified hypnosis as being highly favourable for the treatment of depression, anxiety, pain, stress and trauma.
If you would like to speak with me about post-traumatic stress disorder, or have any questions, please do call on Ph: 07 3040 2322.