PTSD Awarness Day – June 27, 2023
Post-Traumatic Stress Disorder (PTSD) is a condition that can occur when a person fails to recover from an upsetting event. The specific “trauma” can be anything, but it almost always involves the threat of death or physical harm, which makes sense from an evolutionary point of view: We are ‘wired’ to pay special attention to things that threaten our survival. Think about a situation where two people go into the woods foraging and one becomes sick after eating a certain type of plant. Remembering that the next time they go foraging and feeling moved to stay away from similar plants would help both people avoid getting sick.
PTSD is a disorder of non-recovery, and its ‘symptoms’ are actually normal and expectable parts of healing, until they become problematic. When we perceive a threat or anything that resembles something dangerous from our past it is completely normal to have intrusive thoughts about that thing or event. This can take the form of memories that suddenly burst into awareness and can include sensory memories, like recalling specific smells, sounds, or physical sensations, like the feeling of something touching the skin. We can also experience feelings of hyperarousal as the body’s level of physiologic activity spikes up, as if to prepare us for some instant response. We might feel a sudden increase in heart rate or tension in the muscles. Breathing might become more shallow and we can start to hyper-focus on specific sounds or visually scan every detail of our surroundings. It can be as if we are suddenly unable to pay attention to whatever we were doing because we have become so completely focused on the task of looking for danger. In those situations, it makes perfect sense to feel the urge to escape or avoid. The body can feel sudden impulses to flee or, in some situations, to fight, even when nothing bad is actually happening. People who have experienced a trauma can also develop strong and persistent negative beliefs about themselves (eg, “It’s my fault,”), others (eg, “No one understands. I can’t trust anyone.”) and the world (eg, “This place is dangerous. I have to be on-guard at all times.”).
These types of experiences are all normal and extremely helpful when something truly dangerous remains present. But when the danger has passed and a person continues to react as if it is still there they can begin to develop into symptoms of PTSD.
How Does a Person Develop PTSD?
It is natural to experience painful and difficult emotions when something upsetting happens, especially something shockingly different from what your life experiences have led you to expect. It is completely understandable to feel sadness, fear and rage when unfair and scary things occur. It’s also completely normal to look for explanations — if I can pinpoint what the cause was, then I can prevent it from ever happening again, right? Makes sense. But sometimes, we develop unhelpful ideas that end up creating more problematic types of painful feelings, like guilt and shame. For instance, a person might insist “I should have just known it would happen” when they can’t find any other reason to explain why something terrible occurred.
Those types of thoughts and feelings can become unbearably painful to have, especially for people who may lack tools to cope with them, or who haven’t received enough supportive or loving care in their lives. The diagnosis of PTSD may be given when a person’s ability to function effectively day to day is limited by their efforts to avoid or escape from thoughts and feelings. This avoidance takes many forms, but can include using substances to numb emotion, and keeping oneself so busy that there is no opportunity to think or feel. We can also avoid by losing our connection with the realities around us (that is, “dissociating”), isolating ourselves from other people, places and things that remind us of our traumas, or by becoming aggressive to keep people and the feelings they bring up away. In more extreme cases, we can unconsciously experience painful thoughts and emotions as physical aches and pains that resemble medical issues. As long as we have something else to focus on, we don’t have to address the painful emotions underneath.
Escape and avoidance are legitimate survival strategies when a danger is actually present, but they increase the chances of developing PTSD when they prevent a person from working through their experiences and finding healthier ways to include whatever happened into the overall ‘story’ of their life.
In the same ways that the body actively works to heal any other injury, like a cut on the skin or a broken bone, it also works to heal from emotional injuries. The key ingredient to healing from trauma is giving ourselves the chance to feel the painful emotions the trauma brings up. Feeling allows healing, and avoiding maintains suffering.
How to Recover From PTSD?
Recovering from PTSD can involve a combination of many activities, including therapy, peer support, physical exercise and, in some circumstances, medication. The perfect combination depends on the individual, but the common feature is reducing avoidance and promoting healing through feeling.
Some types of psychotherapy are specifically geared to trauma, including Cognitive Processing Therapy for PTSD (CPT for PTSD), Cognitive Behaviour Therapy (CBT) and Intensive Short-Term Dynamic Psychotherapy (ISTDP). All are available at Shift Cognitive Therapy.
Other, non-psychotherapeutic activities like peer support for first responders and other public safety personnel can be extremely helpful in creating a community where it feels safe enough to explore and change the unhelpful beliefs that might otherwise keep a person stuck in their trauma. Badge of Life Canada is one organization that provides peer support activities to those populations.
How to Treat PTSD?
Our psychologists, registered psychotherapists and social workers all work with trauma. Many of our clinicians can also assist with workplace injuries that might be covered under WSIB benefits.
Let us know if you are struggling to recover from trauma. There is a lot we can do to assist.