Awareness and Treatment of Post-Traumatic Stress Disorder (PTSD)

According to the National Institutes for Health (NIH), Post-traumatic Stress Disorder (PTSD) affects about 7.7 million Americans (2008). It can result from serious events, most commonly associated with traumatic war experiences affecting veterans, and physical and sexual assaults. A diverse range of other incidents can result in someone being impacted by PTSD, not limited to “torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes” (NIH, 2008). While the medical establishment may have done its part in healing an individual who survived some such traumatic event, the effects can linger for years, and there is a great need for PTSD to be identified in a patient and treated as effectively as possible.

The affliction of PTSD can cause “re-experiencing symptoms” which can bring the event back through nightmares, terrifying thoughts or flashbacks (NIH, 2008). For individuals suffering from the re-experience of a past traumatic event such as a school shooting, a feeling of helplessness arises, and situations that can bring up flashbacks are avoided. Either consciously or unconsciously someone will stay away from situations that might bring back a memory of the event, situations that might have brought joy in the past or that would have brought meaningful emotional contact with other people. Anxiety, easily being startled, and angry outbursts can result in avoiding situations simply because people are present. Aside from regular social contact, even the basic need for sleep can be hard to find by someone afflicted with PTSD. In other words, life as we expect it can be impossible when it seems someone is living more in a traumatic past event than in the moment.

Trying to forget the event seems an apparent solution. The last thing somebody whose life has been so immensely impacted by a single event would want would be to spend more time thinking about and confronting the event. Especially in an environment such as the military, one doesn’t want to complain when he or she has survived without any serious physical damage, while others weren’t so lucky. You would like to move on emotionally and psychologically as easily as you did physically, so you ignore signs of PTSD and avoid reminders of the event that caused it. While “it is normal to be affected by trauma,” as the American Academy of Experts in Traumatic Stress (AAETS) points out, “Society has its own way of dealing with trauma which can be both belittling or denying” (2006). The societal expectation that a victim of a traumatic event will move on and forget not only prevents healing, but it can also exacerbate the symptoms as one attempts to avoid the very cause of the disorder. The impulse to numb one’s feelings is a survival instinct, only by avoiding these feelings can one can live out the day. “However,” as AAETS describes, “when survivors numb their fear, despair and anger, all their feelings, even good ones, are numbed” (2006)

Luckily, the consciousness of PTSD is changing the way our society expects its victims to manage their recovery. Awareness has grown since the wars in Iraq and Afghanistan, as well as in the way sexual assault continues to impact its victims decades after. The attacks of September 11, 2001, and the impact of Hurricane Katrina have increased the public’s awareness of trauma, and, as Tori DeAngelis of the American Psychology Society points out, “have enabled researchers to learn a lot more about how best to treat PTSD” (2008). One such treatment, “Prolonged-exposure therapy” attempts to confront the event directly: “the therapist guides the client to recall traumatic memories in a controlled fashion so that clients eventually regain mastery of their thoughts and feelings around the incident” (DeAngelis, 2008)

Many are skeptical of exposure therapies because, as Sue Halpern wrote in describing one in development, “they worry that it might be cruel to immerse a patient in a drowning pool of painful memories” (2008). Virtual Iraq is the prolonged-exposure therapy in development for veterans of the Iraq war that allows them to confront the experience by reliving it in the form of a video game. Halpern spoke to JoAnn Difede, the director of the Program for Anxiety and Traumatic Stress Studies at Weill Cornell, who explained that “because numbing and avoidance are symptoms of PTSD, you’re asking the person to do in treatment the very thing their mind is avoiding doing” (2008). However, for the infantry soldier she spoke to, Virtual Iraq was more acceptable than speaking with a psychologist: “Even though there was no punishment for going to therapy, it was looked down upon and seen as weak. But V.R. sounded pretty cool. They hook you up to a machine and you play around like a video game” (2008).

Several developing therapies include exposure to memories of the long-term trauma but focus more on “cognitive strategies” that can “help people alter erroneous thinking that has emerged because of the event” (DeAngelis, 2008). Such “erroneous thinking” could include the feeling that they are never safe, that they are responsible for what happened and should always feel guilty. Strategies to confront and eliminate anxiety include the use of breathing exercises, muscle relaxation techniques, and positive self-assurance to drive out negative and self-destructive thoughts. Such therapy could begin at the first signs of PTSD and spare a victim years of avoidance, guilt, fear, or any of the other debilitating consequences of the disorder. As awareness of PTSD increases the stigma of talking about one’s trauma should decrease, and those who have served our country in war or lived through other personal trials won’t have to live isolated and numbed.

References

American Academy of Experts in Traumatic Stress (2006). Post traumatic stress disorder in rape survivors. Retrieved from http://www.aaets.org/article178.htm

DeAngelis, T. (January 2008). “PTSD treatments grow in evidence, effectiveness.” Monitor on Psychology, Volume 39, Number 1, page 40. Retrieved from http://www.apa.org/monitor/jan08/ptsd.aspx

Halpern, S. (May 19, 2008). “Virtual Iraq.” The New Yorker. Retrieved from http://www.newyorker.com/reporting/2008/05/19/080519fa_fact_halpern?currentPage=all

National Institutes of Health. (2008). What is Post-Traumatic Stress Disorder (PTSD)? Retrieved from http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml