PTSD is where the feelings that occurred during the trauma, e.g. intense fear, helplessness or horror, confusion, moral dissonance become stuck. People with PTSD are triggered by reminders that cause a loss of perception of time and space and cause a reliving of the event in real time. In PTSD the trauma is not a recalled memory rather it is another traumatic experience that is fragmented and can occur at anytime.
People with PTSD then develop coping strategies to avoid these overwhelming relived experiences of trauma, which can involve: avoidance, hyper-vigilance, substance and alcohol use, compulsive behaviours, overworking, detachment, numbing, distraction to try to avoid re-experiencing. The effort it takes to keep traumatic re-experiencing at bay is exhausting and can lead to depression, irritability, and lack of engagement in life. PTSD has a huge toll on family members. People with PTSD have trouble with intimacy and sex as this requires one to open up feelings. This is very hard to do if opening feelings can lead to further traumatic experiences.
Trauma can be related to a one time event that profoundly reshapes your world view, such as a rape, assault, car accident, life threatening illness. It can also develop through repeated exposures such as those experienced by front line responders. PTSD was first described in veterans after their experience of the atrocities of war, and more recently has been described in Defence members who sustained moral injuries during combat.
Recently, childhood abuse and neglect has been found to cause Complex PTSD, which is a more severely debilitating form of PTSD, which profoundly destabilises ones identity and trust in humanity.
Single incident PTSD can be treated with cognitive processing, EMDR, and prolonged exposure therapy, alongside a somatic approaches that helps down-regulate the body.
Complex PTSD requires more intensive multimodal interventions.
For more information visit Blue Knot Foundation.