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Post Traumatic Stress Disorder, PTSD, Trauma & Shell Shock

What is Post Traumatic Stress or PTSD?

Post Traumatic Stress Disorder is often shortened to PTSD. PTSD may be triggered by real or believed threat to life, serious injury or sexual violation. This traumatic exposure can happen in few different ways. It can mean actually experiencing such a traumatic event, personally witnessing a traumatic event, learning about somebody that we are very close to having undergone a traumatic event or through extreme or repeated exposure to distressing aspects of (a) traumatic event(s).

“Shell Shock” and “Battle Fatigue” are just older terms used for expressing what we typically understand as PTSD today. Unlike shell shock and battle fatigue, PTSD is not primarily connected to combat. We now know that many people experience PTSD outside of combat experience. PTSD occurs in people of all ages. It is often connected to experiencing rape, assault, childhood abuse and serious accidents or disasters. It is also more likely to result following multiple, repeated or ongoing exposure to traumatic events where support was not experienced as available.

PTSD results in ongoing problems for the individual. This may involve feeling a notable amount of distress and / or result in serious negative consequences in the person’s ability to manage in daily life such as at work, school or socially. The problems experienced in PTSD last beyond one month and exist at least six months after the traumatic event occurred.

What are the signs or symptoms of PTSD?

There are four key areas that are considered important in recognizing PTSD. They involve:

1). Re-experiencing. This can happen in a few ways. It may mean unnerving, repeated memories of the traumatic event that seemingly come to mind in a visceral, reflexive sort of way. It can involve reoccurring, perturbing dreams or nightmares that are connected to the traumatic event (for children the connection to the traumatic event may or may not exist in the nightmares). Re-experiencing can also occur through flashbacks or any other experiences involving powerful or lasting distress that mimic the traumatic event in some manner.

2). Avoiding. Avoidance with PTSD means spending energy to evade thoughts, feelings, memories or cues of the traumatic event. Cues remind the individual of the traumatic event in some way. This could mean staying away from certain places, people, activities, topics or things.

3). Negative mood and thoughts. This can involve a number of different feelings (e.g. fear, shame, anger or guilt) and thoughts. It may involve unrealistic and ongoing self-blame, or alternately blame toward another beyond what is logical. It can also involve a negatively skewed perspective of oneself or the world around. The person may not be able to remember parts or details of the event. It can also involve separating from others and reduced interest in doing things. The person with PTSD may seem unable to experience good feelings.

4). Arousal level. This means the individual responds as if they need to flee or fight regularly. This may involve being overly guarded, startling disproportionately to the actual situation or having problems with concentrating and sleeping. It can also involve aspects of the fight response where the person is reckless, engages in self-destructive behaviour or becomes aggressive easily and unexpectedly.

Dissociation also occurs for many individuals experiencing PTSD. Dissociation can involve feeling as if one is separated from their mind or body, either with mental numbness or detachment, or a sense of physical disconnection. Dissociation can also involve experiencing the world around as dreamlike, altered or surreal.

Treatment for Posttraumatic Stress Disorder

Fortunately, there is help for PTSD.

Treatment typically involves psychotherapy, and sometimes also, the use of prescribed medication such as antidepressants.

With psychotherapy or counselling a few options are available. A common method is the use of Cognitive-Behavioural Therapy (otherwise known as CBT). Using CBT the individual is helped to change patterns of thinking and responding. CBT may also involve exposing the individual with PTSD to previously triggering material or thoughts in order to progressively desensitize the person from distressing cues to the traumatic event.

Another popular method involves using eye movements to reduce and eliminate symptoms of PTSD. EMDR (or Eye Movement Desensitization) and an EMDR offshoot, OEI (or Observed Experiential Integration) involve the therapist progressively and gently minimizing the distressing response to imagined distressing material.

The goal here is not to change the past but to change how the traumatic experience is stored and remembered. Helpful psychotherapy allows the individual to experience daily life without feeling haunted by ghosts of past. When successfully treated, the traumatic memory no longer causes the individual to feel as if the past were happening in the present. The memory feels like a real memory; with a start and an end.

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