I see a lot of people who have been involved in traumatic situations. One of the biggest fears they express is that they will develop PTSD as a result of the trauma.
What does PTSD look like?
I am including this information to demonstrate how complex PTSD is. People are often afraid they have PTSD but are actually just experiencing a normal reaction to a really traumatic situation.
This information is not to be used to self diagnose. If you are concerned it is best to see a professional who is experienced with PTSD and can make a correct diagnosis.
Formal diagnosis of PTSD includes experiencing at least one of each category of the following symptoms for at least a month:
Re-experiencing the trauma – at least one of these:
• Flashbacks including reliving the event and experiencing physical symptoms of fear such as a rapid heart beat or sweating
• Recurring memories or dreams of the event
• Distressing thoughts about the event
• Experiencing a rapid heart beat, sweating or other physical symptom of stress
Avoiding reminders of the trauma – at least one of these:
• Avoiding places, events, objects or anything that reminds you of the trauma
• Avoiding thoughts or feelings related to the traumatic event.
• Changing routines to avoid anything that reminds you of the trauma
Symptoms of arousal or reactivity that have arisen or worsened since the event– at least one of these:
• Easily startled
• Feeling tense or on guard
• Difficult concentrating
• Difficulty falling asleep or staying asleep
• Feeling irritable, even having angry outbursts
• Engaging in risky, reckless or destructive behaviour
Thoughts and mood symptoms – at least one of these:
• Having trouble remembering parts or all of the trauma
• Experiencing negative thoughts about yourself or the world
• Feelings of blame directed at you or others that are exaggerated
• Experiencing negative emotions that persist. These include fear, anger, guilt or shame.
• Losing interest in enjoyable activities
• Feeling socially isolated
• Finding it hard to feel positive emotions such as happiness.
How likely is it that you will develop PTSD after a traumatic event?
More people recover from trauma than get PTSD.
Research has shown that previous trauma, especially in childhood, increases your likelihood of developing PTSD. But even that does not mean you will develop PTSD.
The Normal processing of trauma
Many people will report some memories of traumatic events for some time after the event, but these memories fade over time.
People can become stuck in the traumatic event. Triggers that throw them back into the event time and time again are distressing and interfere with healthy daily functioning. Others will avoid talking about the event and situations, people or places they associate with the event.
Trauma processing is similar to Grief processing
There is another life event that can have a similar effect. That is the death of a loved one. For some people the only way to cope with the grief is to avoid all reminders of the loved one.
Another thing that researchers have found is that the more you avoid memories and reminders of traumatic events, the more likely it is that you will develop PTSD. Just as the more you avoid memories and reminders of a loved one, the more likely it is that you will develop Complex Grief Disorder.
Avoiding these memories and reminders is usually due to the extreme discomfort of experiencing these memories and reminders. The emotions associated with them can be extremely difficult to experience.
The importance of processing trauma
When a traumatic event happens it is essential you emotionally process what happened. Much as with grief, it is considered the best way to process this is to titrate your emotional exposure to the event. You allow yourself time to think about it, then allow yourself time to think about other things.
Debriefing after a traumatic event is very important. 30 years ago it was considered essential for everyone to talk about what happened. People were forced to take part in debriefing when they weren’t ready to talk. This caused extreme distress for some people. Not everyone is ready to dive into processing something immediately after it has happened. They need more time to titrate the emotional exposure.
Debriefing today is more an opportunity to talk if you want to and access to trauma counsellors who can help you debrief.
Having your story witnessed and acknowledged
Sometimes after a trauma the focus may be on certain people who are considered to be “worse affected” than others. This may mean that you are not given the chance to tell your story and have the impact of the trauma on you acknowledged. In can be helpful to talk to a trauma counsellor to allow you to share your story and have that story acknowledged. This allows for a better resolution of the trauma.
Some people process things by talking and talking. Others process by reflecting. That is why the debriefing I do, and the format that is recommended, involves letting you talk if you want to or allowing you space if you don’t want to talk.
Sometimes you will need to talk to a counsellor to help with processing the trauma, especially if you are avoiding the emotions and memories due to the pain they cause. A trauma counsellor can help you learn how to cope with those overwhelming emotions and how to titrate your exposure to them.
Unhelpful coping behaviours
In trying to cope with trauma, some people may adopt behaviours that are extremely unhelpful and keep them trapped in the trauma. Substance abuse and increased alcohol consumption are the most common behaviours that I see. They may provide temporary respite from troubling thoughts and emotions, but they are dangerous in the long term and actually keep you trapped in that place of trauma.
When to seek help
Traumatic events take time to recover from. Most people will recover in time. Recovery will usually involve talking about what happened, reflecting on the incident, being willing to cry or experience other emotions.
If you feel that you are stuck in these memories and emotions and don’t seem to be getting better, then it is helpful to seek counselling.
Risk factors that increase the likelihood of developing PTSD:
• Previous trauma exposure, especially in childhood
• Getting hurt or seeing others hurt or killed
• Feeling helpless, horror or extreme fear
• Thinking you are going to die
• Having little or no social support after the event
• Being exposed to extra stress after the traumatic event such as pain and injury, loss of job or home, loss of a loved one.
Things you can do to reduce the likelihood of developing PTSD:
• Seek support from friends, family, support groups. Accept offers to engage in critical incident debriefing, either when the counsellors are present or at some point in the next few days.
• Allowing yourself to be upset and impacted by the traumatic event
• Allow yourself to process what has happened and learn from it
• Seek counselling if you need support with the impacts of the event and processing the feelings around the event.
Can I Help?
If you would like to talk to me about how I can help you with processing your trauma, please contact me on 0409396608 or firstname.lastname@example.org
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