Background, Symptoms & Causes of PTSD
Symptoms of Post Traumatic Stress Disorder (PTSD) have been recognised since at least the sixth century BC, and have gone under many labels including shell shock, transient situation disturbance, combat fatigue, battle fatigue, stress breakdown and traumatic neurosis. PTSD is actually a primitive, critical survival mechanism causing an extreme anxiety response; this affects the person’s perception of safety or makes them feel helpless.
It is the individual person’s subjective emotional experience, rather than the objective facts which determine the traumatic event. Traumatic events are more likely to cause PTSD when they involve a severe threat to a person’s life or personal safety. The more extreme and prolonged the threat, the greater the risk.
Traumatic events which can lead to PTSD include war, natural disaster, car or plane crash, terrorist attack, rape, kidnapping, violent assault and sexual or physical abuse. The condition can also affect not only those who personally experience it, but those who witness it and those who subsequently pick up the pieces; including emergency workers and police officers. Symptoms may appear within hours or days of the event, or may take weeks, months or years to develop and can often get worse. They may also arise suddenly, gradually, or come and go over time.
The dominant features of PTSD are:
– emotional numbing, i.e. emotional non-responsiveness
– hyper-arousal, i.e. on constant alert for danger
– re-experiencing of the trauma through flashbacks and intrusive emotions.
The most disruptive symptoms of PTSD involve flashbacks, nightmares and intrusive memories of the trauma. The affected person will often experience flashbacks and nightmares both day and night, so realistically that the experience is re-lived, emotions and physical sensations can actually be felt. They will make attempts at avoidance and numbing, by working hard to distract themselves, and by attempting to keep themselves busy with other things like hobbies. Avoidance of people and places which serve as a reminder is common. So too is avoidance of talking about the trauma, and generally communicating less with others, which makes it particularly difficult for those who have to live or work with that person.
In addition to the chief symptoms of PTSD, an individual suffering the condition is also at risk of developing other psychological disorders such as panic attacks, phobias, major depressive disorders and obsessive compulsive disorders. Substance abuse with alcohol or drugs is common, likewise self-mutilation or other types of self-harm.
Most people who go through a traumatic or life-threatening event, will experience some symptoms initially, including such as anger, shock and anxiety; however not everybody goes on to develop PTSD. Whilst it is not possible to predict who will develop it, there are certain factors that appear to increase a person’s vulnerability as illustrated below.
A traumatic event is more likely to cause negative affects if it is inflicted by humans, repeated and ongoing, unexpected or unpredictable, sadistic or intentionally cruel, or experienced in childhood. Other risk factors for developing PTSD include previous traumatic experiences, especially in early life (cumulative trauma), a family history of depression, a history of physical or sexual abuse, substance abuse, depression, anxiety, high levels of stress in every-day life, lack of support after the trauma and lack of coping skills.
This is a separate category of PTSD and describes the type of psychological disturbance that arises out of having been held in a state of prolonged (i.e months or years) captivity in the total control of another. Examples of situations giving rise to complex PTSD include experience of concentration camps, prisoner of war camps, long-term domestic violence, long-term severe physical abuse, and ongoing childhood sexual abuse.
The first requirement for this diagnosis is a long period of time, i.e. months to years of total control by another. The other criteria for diagnosis include symptoms which tend to result from the chronic victimisation experienced during this period.
Symptoms include changes in the ability to control emotions, which may include symptoms such as persistent sadness, suicidal thoughts or explosive or inhibited anger. Changes occur in consciousness (dissociation), such as forgetting traumatic events, re-living traumatic events, or having episodes where they feel detached from their own body or mental processes. There may be changes in how the person views themselves, which may include a sense of shame, helplessness, guilt, or of being completely different from others. Changes may also occur in how the person views the perpetrator, such as attributing total power to them or becoming preoccupied with their relationship to them, including desire for revenge. Relationships with others are affected by being viewed differently, including feelings of distrust and isolation. There may also be a change in the affected person’s system of meanings, which may include a loss of faith or a sense of hopelessness or despair.
At The Therapy Hour, we use a variety of methods to treat PTSD, including CBT, Human Givens, One Move and the Linden Method. Our choice or combination of approach(es) is determined by the individual needs of any given client.
Whilst our strong preference is to treat sufferers of PTSD in a face-to-face environment, we recognise that some of the symptoms of this condition may make it difficult or impossible for a sufferer to leave his or her environment.
Under such conditions, we will usually agree to treat using a distance medium – i.e telephone, or chat online. While email may suffice in the initial phases of treatment, the “hands on” nature of procedures associated with successful treatment of this condition require a synchronous therapeutic process (i.e a process where client and therapist are directly communicating with each other in real time).
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