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In a Blink of an Eye; Understanding Trauma and PTSD

by Angela Fitch, LCPC, Psychotherapist, Clinical Care Consultants

In a blink of an eye, someone’s life can change for the positive.  Hearing a baby’s first sound following birth, seeing a sunset after a hard day, or feeling a loved one’s first kiss are examples of just that.  It is a wonderful privilege to recall positive, happy, healthy experiences, yet that is not the case for many people.  Positive memories become blocked, or overshadowed, by the impact of traumatic experiences.  In fact, the National Institute for Mental Health (NIMH) reports that one out of two adults in the US will experience a traumatic event at some point in their lives.

Someone who is either a victim or a witness to trauma can develop a diagnosis of Post Traumatic Stress Disorder (PTSD).  They “blink” and their life can take a negative turn.  Listening to their child tell of abuse, seeing a loved one get severely injured, or witnessing firsthand a car suddenly crash are events that all involve a threat to a person’s life.  Young or old, it takes just one situation that is perceived as threatening to one’s life, for a rapid-fire change to occur within the brain.  Namely cortisol, the stress hormone, and the brain chemical norepinephrine rise to infinite heights and alarm a person to fight, flee or freeze in response to life threatening situations.  Depending on the person, one can adjust to the trauma witnessed and continue to function well, or as NIMH reports, seven or eight out of 100 adults could develop PTSD at some point in their lives. 

Entering Volcanic Land                                                               

If you look close enough at the picture, you will see a person standing nearby the lava.  Similarly, a person suffering with PTSD will be an onlooker within his mind at the horror that occurred to himself or someone else.  Analogous to land, whether flat or mountainous; before the traumatic event the land was still and safe.  The sun would be seen shining and stars would be seen at night.  Peaceful, right? 

Following a horrific event, the person suffering with PTSD “moved” in their mind to a “volcanic land”, and stands near the hot lava, feeling the intense heat on his body and the intense emotion of fear and shame.  The brain is drastically changed following a traumatic event.  It “erupts” with various symptoms that can also show-up in the body.  The brain will never be the same unless there is treatment, and depending on the impact of the trauma, treatment may be intensive in nature and time.  That person cannot “walk away” from the pain and horror in his mind.  This is when professional help is needed.

The Diagnosis

To be diagnosed with PTSD, the trauma survivor (older than six years of age) will have to be assessed by a qualified mental health provider and be experiencing the following types of symptoms beginning after the event(s) occurred and having lasted for at least one month, as identified in the Diagnostics and Statistics Manual (DSM-5). 

To start, the person would have been exposed to the possibility of death, serious injury or sexual assault.  This can also mean that a person who learns about a loved one having been exposed to the above can also experience PTSD.  Childhood attachment trauma is also trauma.  This is a fallacy to many especially to the parental figure who abandoned or neglected the child.  Childhood attachment trauma may not be known by the, now, adult until trauma symptoms present later in life.  A child who was psychologically abused and neglected likely constitutes as the greatest risk factor to the child’s psychological health as an adult.  

PTSD Indicators

Intrusion symptoms following the traumatic event, such as recurrent distressing memories and dreams of the event(s) may occur as well as what’s called dissociative reactions.  This is more commonly known as “flashbacks”, in which case the survivor feels or acts as if the event is occurring.  Other intrusion symptoms include psychological distress and physical reactions.  Avoidance to anything or anyone that could trigger the aforementioned symptoms is possible as well. 

Some of the following symptoms, when described can appear as if the survivor has a mood disorder.  However different than anxiety or depression, negative mood and thoughts about oneself is common.  Forgetting about details of the event(s) or unable to persistently experience positive emotions could happen as well.  Similarly to depression, one with PTSD may also not find pleasure in the interests he or she had before.  Problems with sleep and concentration may take place too. 

The following symptoms can be both confusing and frightening for loved ones or helpers/healers.  Seeing their loved one have a sudden angry outburst with no provocation, or becoming hypervigilant and engaging in reckless or self-destructive behaviors can all be alarming.  A person with this condition may feel out of touch with reality of their surroundings and/or feel “outside” of their body as if in a video game, for example.  These symptoms are called derealization and depersonalization, respectively. 

Treatment, Return to Safe Land

Now look at the person pictured.  How can that person “relocate” from the volcanic land to this serene landscape?  How can the view within the mind and feelings get back to a calm, peaceful and, most of all, stable state?  What does it take to heal and grow out of a traumatic experience?  It goes without saying that help is needed when PTSD is diagnosed.  Various treatments exist and are to be administered by a qualified mental health professional.  Treatment may be weekly in either an inpatient (hospital) or outpatient setting and last for six to twelve months, several years or for a lifetime if chronic for a person.  As with most major mental health conditions, psychopharmacology (medications) and psychotherapy (talk/relational therapy) combined are shown with the greatest efficacy or help in healing and resolving the trauma.  Consistent, incremental changes towards the stable and predictable “destination” are possible.  Talk therapy can help with reducing negative emotions, and change thoughts about the trauma event and one’s self.  Relaxation strategies are employed as well to help the body connect with the mind.  The following is a list of specific types of psychotherapy techniques to treat PTSD.  An example or a brief description within the categories are provided:

• Psychoeducation (information on trauma and effects)
• Mindfulness (the focus on one thing and the practice of being in the present moment)
• Meditation (the practice of “letting go”, loving kindness)
• Relaxation strategies (progressive muscle relaxation)
• Cognitive Interventions (reframe to rational thoughts)
• Emotional Processing (exposure therapy)
• Eye Movement Desensitization and Reprocessing (EMDR) (weaken effects of negative emotions)
• Emotional Freedom Technique (EFT) (releasing traumatic energy)
• Spirituality (integrated prayer)

PTSD Grows Anywhere

Most of us associate PTSD with our armed forces, active or veteran, or those that have suffered through and survived a nearly catastrophic situation.  While this is true, PTSD occurs in people not just from war zones or combat.  It is interesting to note that although a traumatic event affects one person, another person may not be affected in the same way.  This means that two people could experience the very same, nearly fatal, situation and one of those individuals may not ever have symptoms of PTSD.  This is a phenomenon that continues to remind us that no two people are alike and not everyone has the same capacity to be resilient in the face of trauma.   

Post traumatic stress is the diagnosis, but post traumatic growth is the goal.  A person is not a label and does not have to endure a lifetime of suffering if effective treatment is consistently sought.  Treatment improves when you gain a network of support from loved ones, friends and support groups to “walk” with you back to a stable “land”.  There is always calm after a storm.  No catastrophe lasts forever.  If any of what was talked about in this article has resonated with you please call me, or a trusted mental health professional, and start your journey to health and healing now.