The mind has a tendency to store away the details and memories of a traumatic event, only for them to resurface unexpectedly later on. This recollection can be unsettling, similar to the initial event itself.
Post Traumatic Stress Disorder (PTSD) is the term used to describe the psychological condition that develops after experiencing a distressing event that is not typical for humans (Bernstein, et al).
There are five diagnostic criteria for this disorder, and currently there are no known cures. However, there are various therapies available to help ease the symptoms.
The disorder occurs when a traumatic event is firmly imprinted in the mind, causing the person to continuously suffer without relief. Rather than focusing on the present moment, their thoughts remain fixated on the past, hindering their capacity to consider what lies ahead.
The research on this topic is relatively recent as the disorder was recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) within the past twenty years. However, it is a common disorder that impacts approximately eight percent of the American population, with 5% of men and 10% of women being particularly susceptible. Anyone can develop PTSD when exposed to sufficient stress. The beginning of PTSD cannot be anticipated or determined by any specific factor.
Although people’s reactions to a traumatic event may differ, not everyone will develop post-traumatic stress disorder (PTSD). The probability of developing PTSD is determined by an individual’s ability to handle catastrophic events effectively. Moreover, the symptoms experienced can vary among individuals; some might only experience temporary mild symptoms while others could be profoundly impacted. Furthermore, there is also a possibility for individuals who have undergone significant trauma to never display any symptoms at all (Friedman).
Psychological problems can be attributed to either a single intense external event or a series of events. In the past, the recognition of post-traumatic stress disorder (PTSD) played a significant role in changing the perception that disorders were solely due to internal flaws in individuals. Instead, it highlighted the possibility that external factors could be responsible (Friedman).
According to Bernstein et al., PTSD can occur due to various factors. These factors encompass personally experiencing life-threatening situations that jeopardize one’s own well-being, as well as the safety of children, spouse, or close friends/relatives. Furthermore, the devastation of one’s home or community and witnessing accidental or violent incidents resulting in death or injury to others are also potential catalysts for PTSD.
According to Johnson, the key signs of PTSD involve reliving the event, avoiding triggers linked to it or feeling emotionally numb, experiencing heightened alertness not previously experienced, and lasting for at least a month. The 1996 bombing incident at the Oklahoma Federal building had a significant impact on many people. This includes not only those who were present during the explosion but also bystanders and rescue workers who witnessed the aftermath.
The survivors of the explosion experienced both physical injuries and the tragic deaths of their colleagues and children. Enduring such a horrifying ordeal, which many others did not survive, can lead to significant emotional consequences. The rescue personnel who arrived at the scene also witnessed distressing scenes of death and individuals they were unable to help. These feelings of powerlessness and guilt may cause intrusive memories and nightmares.
To further elaborate, the initial requirement is that the individual experienced a traumatizing event that involved actual or threatened death or injury. The person’s response to this event was characterized by intense fear, horror, or helplessness (Pfefferbaum). This event could have occurred recently, within weeks, or could be as distant as forty years in the past. The disorder is most often observed in survivors of war, abuse, and rape. It can also manifest following various incidents of crime or car accidents, as well as in the aftermath of community catastrophes like hurricanes and floods. Rescue workers frequently face highly stressful situations. Many emergency responders such as police officers, nurses, and medics may become overwhelmed by the trauma they witness, resulting in intrusive recollections of these experiences themselves.
In addition to experiencing trauma through nightmares, flashbacks, intrusive memories, or restlessness in situations resembling the original traumatic event (Pfefferbaum), individuals may also be triggered by auditory or visual stimuli, leading to distressing emotions such as panic, terror, dread, grief, or despair. For example, war veterans may mentally revisit their traumatic experiences when startled by loud noises like a car backfiring, mistaking it for gunfire. These flashbacks can last from seconds to minutes or even days and cause the person to behave and react as if they were back in that initial traumatizing situation.
Furthermore, individuals suffering from PTSD face a numbing of emotions and reduced interest in both people and the external world. This occurs as a protective measure to decrease the likelihood of encountering traumatic triggers. If exposed to such stimuli, their goal is to minimize the intensity of their emotional response (Pfefferbaum). As a result, establishing meaningful interpersonal relationships becomes extremely difficult for individuals with PTSD.
Furthermore, there are various additional symptoms linked to this condition such as difficulty sleeping, being easily irritated, being overly alert and experiencing sudden bursts of anger. Additionally, the natural mechanism that prevents startle responses may be less effective, leading the patient to be easily startled or disturbed by unexpected stimuli.
Lastly, it is necessary for symptoms from each category to greatly impact the individual’s social, vocational, or other crucial aspects of life. This consequence seems inevitable if the person is truly undergoing the aforementioned symptoms. Furthermore, these symptoms must endure for a minimum of one month.
The textbook Psychology illustrates Mary, a 33-year-old nurse who underwent severe trauma after being attacked in her apartment. The attack involved rape at knife point, satisfying the first criterion. Subsequently, Mary developed a significant fear of being alone in her apartment, meeting the second criterion. Furthermore, she constantly worried about the possibility of another attack and this worry gradually transformed into an obsession with self-protection. Consequently, Mary installed multiple locks on all her windows and doors. Over time, her preoccupation with the attack became so overwhelming that she could no longer participate in social activities or return to work – fulfilling criteria three and five respectively. Ultimately, it became evident that Mary had developed an aversion towards sex, representing the fourth criterion.
Since the Gulf War, approximately three percent of United States Soldiers have been diagnosed with Posttraumatic Stress Syndrome. The individuals with the highest levels of combat exposure are the most prone to being affected, indicating that the severity of a traumatic event affects the difficulty of recovery.
Furthermore, it primarily develops in soldiers classified as having the lowest levels of “stress resistant personalities” and insufficient social support. A crucial aspect of recovering from any stress-inducing event is knowing that the sufferer is not alone or unique in their grief and that others genuinely care about their healing process. Soldiers who return from war without anyone to share their experiences with are prone to relive warfare through nightmares and flashbacks. After witnessing the deaths of both enemies and comrades, those lacking social support tend to internalize their pain, which increases the likelihood of manifesting the listed symptoms (Bernstein).
“Acute” Post-Traumatic Stress Disorder (PTSD) occurs within six months of the traumatic event, while “Delayed On-set” PTSD can manifest at any time afterwards. In certain cases, individuals have developed symptoms even decades later. Holocaust survivors, who have endured horrifying nightmares of the events they thought they had repressed for so long, have been diagnosed with PTSD forty or fifty years following the attempted genocide of the Jewish population. PTSD can transform into a chronic psychiatric disorder that may persist for numerous decades or even a lifetime. Chronic patients undergo phases of remission and relapse, similar to many other diseases. Clinical depression and addictions, such as alcoholism, drug abuse, and compulsive gambling, are some of the issues that can arise from untreated PTSD. Addictions often serve as a common method of “self-medicating.”
In certain cases, individuals experience the involuntary recollection of events that they cannot identify or comprehend. Occasionally, adults who were subjected to childhood abuse may not fully comprehend what is tormenting them, yet still battle similar symptoms. In these circumstances, hypnosis within a supervised setting proves advantageous. Following hypnosis, the patient and doctor will engage in a conversation about the emerged memories and collaboratively address the new knowledge.
Although drugs do not provide a cure for Post Traumatic Stress Disorder, they can temporarily calm patients so that they can engage in rational discussions about their torment. Moreover, children who have experienced the Oklahoma bomb blast may not be informed about the incident for a considerable period of time. Their initial memories may consist of blurry images that merely give hints about what actually occurred. Hypnosis may be employed to reveal the undisclosed details that the mind is reluctant to share. Once the specific details are revealed, patients have the opportunity to acknowledge and comprehend their experiences, and if fortunate enough, accept and cope with the trauma they have survived (Foy).
According to a study conducted by the “National Center for Post-Traumatic Stress Disorder” in New Haven, therapy is currently the only known treatment method with limited success in helping patients recover. The study specifically looked at Vietnam veterans who received four months of intensive treatment, which included individual and group psychotherapy, behavior therapy, family therapy, and vocational guidance. Although the veterans initially experienced an improvement in hope and self-esteem, their long-term outcomes were discouraging. A year and a half later, their psychiatric symptoms had worsened, resulting in increased suicide attempts and a significant increase in substance abuse (Johnson).
The purpose of therapy, according to the Harvard Mental Health Letter published in February/March of 1991, is to help patients think about their trauma without it overpowering them and to allow them to manage their emotions without constantly avoiding or redirecting their focus.
According to Johnson, individuals suffering from PTSD constantly feel unsafe as their fears control them. Nightmares and flashbacks further reinforce their perceived vulnerability and serve as reminders of their inability to defend themselves during the traumatic event. The healing process is only complete when these individuals can voluntarily recall and dismiss their memories, rather than experiencing involuntary intrusive recollections.
Reference
- Bernstein, Douglas A., Alison Clarke-Stewart, Edward Roy, Christopher D. Wickens. Psychology. Boston: Houghton Mifflin Company, 1997
- Foy, David W., ed. Treating PTSD : cognitive-behavioral strategies. New York: Guilford Press, 1992.
- Friedman, Matthew J. “Post Traumatic Stress Disorder: An Overview.” National Center for PTSD. Dartmouth Medical School, 1997.
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Johnson, David R., Robert Rosenheck, Alan Fontana. “Post-traumatic treatment failure.” Harvard Mental Health Letter. 13.9 (1997) : 7
Matsakis, Aphrodite. I Can’t Get Over It : a handbook for trauma survivors. Oakland.: New Harbinger Publications, Inc., 1996. - Pfefferbaum, Betty. “Posttraumatic stress disorder in children: a review of the past ten years.” Journal of the American Academy of Child and Adolescent Psychiatry. 36.11 (1997) : 1503-12
- “The Harvard Mental Health Letter.” Feb./Mar. 1991. Online. Internet. 14 Oct 1998. Available. http://www.mentalhealth.com/mag1/p5h-pts2.html
