What is PTSD
PTSD stands for Post-Traumatic Stress Disorder, a psychological disorder caused by exposure to a traumatic event. When you hear the words “traumatic event,” you may think of horrible things that have happened to other people. But research conducted by “Kessler, Sonnega, Bromet, Hughes, and Nelson (1995) found that 50 percent of U.S. women and 60 percent of U.S. men are exposed to a traumatic event during their lifetime. Similarly, the Detroit Area Survey (Breslau et al., 1998) found that 75 percent of individuals are exposed, at some point in their lives, to a stressor that meets criteria for a diagnosis of PTSD” (Acceptance and Commitment Therapy for the Treatment of Post-Traumatic Stress Disorder and Trauma-Related Problems, Robyn D. Walser, Darrah Westrup, 2007).
A traumatic event is anything that involves actual or threatened death or serious injury to yourself or others. You might think of people who have lived through the horrors of war, fighting in combat or being a prisoner. There are those who have experienced physical or sexual assault as children or adults. And yet, many of us have known the sudden death of a loved one, or natural disasters, or acts of terrorism, or a serious automobile accident. Even the challenges of the COVID-19 pandemic can be experienced by many as traumatic.
For example, I have lived in the state of Oklahoma since 2003, and in that time, I have come to know lots of people who have been victims of a tornado, some of them more than once. I am aware of how many people were touched in some way by the Oklahoma City bombing. They had some relationship with a person who died or was injured. Even those who were not directly connected to a victim were impacted emotionally by the immensity of the event.
Three Types of Symptoms
So many of us have experienced a traumatic event. And yet, most of us do not have PTSD. What makes the difference? It is the impact of the event and how you respond to it that leads to PTSD. There are three major types of symptoms that are needed for a PTSD diagnosis: reexperiencing, hyperarousal, and avoidance.
Reexperiencing symptoms include intrusive remembering of the event, reliving the event in the moment so it feels like the event is actually occurring. They also include emotional distress and reactivity when exposed to internal or external reminders of the event.
Hyperarousal symptoms include difficulty falling or staying asleep, difficulty concentrating, and an exaggerated startle response. You may feel constantly irritable and have sudden outbursts of anger,
Avoidance symptoms include attempts to avoid any thoughts or feelings associated with the trauma. You may avoid activities or places that have the slightest reminder of the trauma. You may have feelings of being detached or estranged from others, even those close to you. It is these avoidance symptoms that can make recovery from PTSD a challenge. When reexperiencing and hyperarousal symptoms show up, it makes sense to avoid the psychological distress these cause by doing all that you can to avoid them.
Experiential Avoidance
And yet, even if it seems to make sense, this experiential avoidance begins to restrict your living in many ways. In the present moment, at any given moment, you may be unwilling to experience what is happening. The present moment is interpreted negatively, carrying some kind of threat or risk, so you do what you need to avoid it, which leads to more restriction on your life. For example, if you have survived a car accident, you may get anxious when you have to drive or you refuse to drive at all. If you have experienced sexual abuse, you may do all you can to avoid any kind of intimacy. Finally, you may start or increase your alcohol and drug use as a way to avoid the trauma.
Experiential avoidance is an attempt to control all the negative thoughts and feelings associated with PTSD. Many of us have learned from our upbringing and the society around us that we should be able to control our thoughts and emotions. Control can be very helpful when dealing with situations in the world around you. You have been taught that if you have problems, you should take control of the situation and fix them.
But what works in the outside world does not work with the inside world. Trying to be a different you inside can lead to a lot of emotional pain for at least two reasons. One, you are always carrying these thoughts and feelings around with you. Let’s say you want to control an intrusive thought by pushing it aside. You picture how you want to push it aside, but you also have, in a more present way, the intrusive thought.
Two, if you think that your need to control what’s happening inside, that you need to think, feel, and be something other than what you are right now, you are seeing yourself as a problem, as someone who is broken and needs to be fixed. But the traumatic event is something that happened to you, and you are doing your best to get beyond it. You are not broken; it’s just that what you are doing to move beyond the trauma is not working.
Learn More
It is possible to move beyond the traumatic event. This moving beyond is more than dealing with it or coping with it. Even with its presence in your life, you can begin to act in ways that are more aligned with what you value and gives you meaning, Learn more about how I can help you by going to my trauma treatment specialty page.