Understanding Post Traumatic Stress

Post-Traumatic Stress (PTS) occurs following a traumatic experience as we attempt to process and recover from the event.  Many veterans returning from wartime conflict experience PTS, often diagnosed as Post Traumatic Stress Disorder (PTSD), but we shouldn’t think of it as only affecting our military population.  Trauma may result from any event in which we are exposed to actual or threatened death, serious injury, sexual violation, or the firsthand witnessing of any such event. We are designed in such a way as to respond quickly in an emergency (the fight/flight’freeze response) and then to recover our natural function afterwards.

 

Sometimes experiencing the kinds of events described above is overwhelming and the natural healing and recovery process stalls, leaving us unable to make sense of our experience, and even life in general.  Truths we formerly took for granted may now seem unreliable.  We may respond by feeling vulnerable to attack, sensing the need to defend and protect ourselves at all times.  We may experience intrusive recollections of the trauma, nightmares, haunting thoughts about what the experience means, problems sleeping, loss of interest in life and a diminished ability to experience pleasure, difficulty concentrating, or general irritability and anger.  These symptoms center around four main clusters:

 

  1. Re-experiencing: Thoughts, dreams, flashbacks, intrusive memories, etc.
  2. Arousal:  Disruptions in normal sleep patters, irritability or anger, inability to concentrate, hyper vigilance (always watching for an attack) and increased startle-response.
  3. Alterations in Mood:  Guilt, anger and self-blame.
  4. Avoidance:  Attempting to avoid thoughts, places, people or situations that might remind us of the event.  Avoidance can take many different forms, such as using alcohol for its numbing effect, staying busy all the time, physical illness, blanking out periodically, or any number of other mechanisms.

 

Well-meaning friends and relatives may think the problem is just a memory of the traumatic event that we can’t forget, and may counsel us to “just let it go.”  But it isn’t simply a memory of the event.  Rather, it may be a certain person, or a word, or smell, or sound or sight, or any combination of those things, that launches us immediately into that situation again, where we are again experiencing in real time, the emotions we experienced before.  Far from a simple memory, post traumatic stress is an unwanted and often gravely feared re-experiencing of the event, over which we have little control.

 

As we attempt to cope with the new stress created by the experience of a trauma, one thing that occasionally occurs is a cycle consisting of:

 

  1. Avoidance:  We try not to think about the event, using various methods to avoid the thoughts and memories of it, that leads to . . . 
  2. Distress:  We re-experience the event despite our efforts at avoiding it, leading to . . .
  3. Inaccurate interpretation:  
    • We attempt to alter our memory of the experience based on our beliefs.  “I know there is justice in the world, and yet this terrible thing happened to be, so God must be punishing me for something.”
    • We attempt to alter our beliefs based on our memory of the event.  “I used to think the world was a safe place where justice prevailed, but now I know different, and so I won’t be so stupid in the future as to allow something like that to happen to me again.”  In either case the conflict in our thinking may result in feelings of guilt and self blame, anger or irritability, leading to . . .
  4. Greater Distress:  As we try even harder to eradicate all memory of the event and anyone or anything associated with it.   

            . . . and so on.  

 

Fortunately post-traumatic stress can be successfully treated! At The Banyan Group we employ an evidence-based protocol, Cognitive Processing Therapy (CPT),  in which you learn to identify and re-pattern your thinking about the event.  This helps you develop better coping mechanisms, and allows you to re-initiate the naturally restorative healing process.  The therapy occurs over a 12 week period, and involves some homework, but gives you tools to deal with intrusive thoughts, negative interpretations of events and provides not only relief from immediate stress, but long-term healing, as well.

 

Sources:  

  • Resick, P. A., Monson, C.M., & Chard K. M.,(2014).  Cognitive Processing Therapy:  Veteran/Military version:  Therapist's manual.  Washington, DC:  Department of Veterans Affairs.
    
  • Post Traumatic Stress Disorder (PTSD) - The Center for Deployment Psychology - Preparing Professionals to Support Warriors and Families - http://deploymentpsych.org/disorders/ptsd-main     
    
  • Yehuda, Rachel PhD; Post Traumatic Stress Disorder - Current Concepts, New England Journal of Medicine, Vol. 346, No. 2 · January 10, 2002 · Boston, MA, Massachusetts Medical Society - Accessed 08/06/2015 - http://old.impact-kenniscentrum.nl/doc/kennisbank/1000010585-1.pdf.
    
Cognitive Processing Therapy
Center for Deployment Psychology's document describing CPT for PTSD.
CPT.pdf
Adobe Acrobat document [77.8 KB]

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