2022 California Council of Community Behavioral Health Agencies (CBHA) Conference

Post-Traumatic Stress Disorder: The Person Within

Post-Traumatic Stress Disorder is not an inherent weakness in facing difficulty, nor is it a flaw in an individual’s personality, belief system, or values. The development and intensity of PTSD symptoms is concordant with the intensity and duration of the stressful event encountered.

The experience of death and/or trauma is always difficult to assimilate into our lives. A former reality based on a belief system that was rooted in a trust that life is good and will remain so, has been threatened and violated in some manner and the magnitude of its impact will forever change lives. The isolated or collateral experience/s result in grieving as we move towards acceptance to a greater or lesser degree; at a divergent pace; dependent upon such variables as age, illness, relationship, and the circumstances of the trauma.

There are residual effects that affect those involved in the aftermath of that trauma which evidence as Post Traumatic Stress Disorder (PTSD). PTSD is a psychological wound sustained when a person is exposed to an overwhelmingly stressful event. This may occur as a primary (direct) exposure that an individual witnesses or experiences in some manner. However, it may also be a secondary (indirect) exposure to a caregiver, family member, friend, or significant other as a result of his/her relationship to the directly affected person. For me, just as has been the case for many others, the personal experience of PTSD has been both secondary and primary.

In 1995 I fell in love with a man who initially appeared to be friendly, outgoing, and eager to love and be loved. However, after we began to share our lives together, it wasn’t long before he suffered dark symptoms related to PTSD. The love of my life was a veteran of the Viet Nam war and had served two tours of duty there surrounded by death and cumulative trauma. He was cynical, non-trusting, socially isolated, and had repetitive bouts of depression. These bouts would result in weeks of his being non-communicative and spending excessive amounts of time in complete darkness. I experienced a great deal of frustration as I expended limitless energy in firmly believing that my extroverted, optimistic, and accepting nature of being a “people person” would spill over and bring him into the light. Instead, I spent a great deal of time feeling sucked into the darkness. I can’t begin to calculate how many days I would return home from work to find my home in complete darkness which left me sitting almost paralyzed on the driveway not wanting to go in. The hours I spent alone always left me devastated and constantly searching within for answers, for strength, for solace.

For five years we lived together and weathered the highs and lows that are part and parcel to PTSD. We took small steps forward and made slow but steady headway towards compromises of light that could penetrate the darkness. We attended counseling, planning and working diligently for our future. We made a major decision to take a trip that would be a first experience for both of us; a short 4-day cruise to the Bahamas following a couple of days touring Florida. We shared new experiences and days filled with laughter and plans for a brighter future. On our way to Fort Lauderdale where we would board the cruise ship, our vehicle was struck by a drunk driver. The man I loved died in my arms from an open head trauma, and in that fleeting moment I entered an unfamiliar darkness and crossed the line from PTSD caregiver to PTSD victim. I could never have imagined that 8 years later my son, my only child would sustain a work-related severe brain injury that would pummel me back and forth across that line.

What saved my sanity? How did I endure the emotional trauma to find my way out of the devastation? After the initial trauma, I unsuccessfully tried a few therapists. Finally, I was referred to a therapist who had lost her only child to an automobile accident, and also had learned to be the caregiver of a Vietnam era veteran husband who lived with PTSD. The support and guidance she provided, and the strategies she shared, enabled me not only to rejoin the land of the living emotionally, but also to pursue my doctoral degree in a field in which I could help others. Every lesson I learned was painstakingly retrieved from my toolbox when once again I faced the terrible trauma of son’s accident. The two most important lessons learned: recognize the symptoms; bravely seek help and support!

PTSD symptoms are experienced and expressed in a manner unique to each individual and include: event re-experiencing; anxiety; avoidance; depression; isolation; social disconnect; arousal; hyper-arousal; occupational dysfunction; and substance abuse.

There are multi-variant factors that contribute to the following individual outcomes of healing. Those with a negative aftermath include: lack of network supports; feelings of aloneness; emotional unavailability; disbelief, stigmatizing, shame, shunned; secondary victimization; conspiracy of silence; lack of treatment; and ineffective coping skills. Those who exhibit positive healing include: accepting the reality of the experience; psychological debriefing; recognition and expression of feelings; revealing not concealing; rediscovering self, family, and friends; allowing network acceptance and support; being of service to others; and rejoining and reinvesting in life.              

The road to recovery may include, but is not limited to, the following treatments/approaches:

  • Cognitive Behavior Therapy: integrating emotionally disassociated/distorted thoughts
  • Acceptance and Commitment: recognition and moving forward
  • Stress Inoculation Training (SIT): exposure to lesser stressors to build or regain resiliency
  • Breathing and Relaxation Techniques: focused breathing/activities to decrease anxiety
  • Cognitive Processing Therapy (CPT): reinforcing strengths and teaching strategies
  • Review/revisit/restructure: confront, challenge, and control (from victim to survivor)
  • Autogenic training: a form of self-hypnosis that relaxes and utilizes imagery
  • Meditation: learning to free the mind of thought for increasing periods of time
  • Anger Management: developing internal controls and coping mechanisms

In summary, PTSD symptoms are normal responses by normal people to abnormal situations. The recovery and resumption of “normalcy” is highly dependent upon the multi-variant factors listed above. Too often, a remarkable recovery of a trauma survivor may be portrayed in a way that may cause others who are not faring as well in similar circumstances to feel incapable of healing.

References

Matsakis, Aphrodite,1994. Post-Traumatic Stress Disorder A Complete Treatment Guide. Oakland, CA: New Harbinger Publications.

Schiraldi, Glenn R., 2000. The Post-Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery, and Growth. Lincolnwood, IL: Lowell House

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