PTSD – Bumps in the Road Before I begin examining the current treatment options, medication and remedies available for PTSD symptoms in the next article, I am going to share some of what I experienced through my own personal journey of PTSD prior to being diagnosed with and overcoming the condition.  As I understood this disorder and recovery process more deeply I wanted this to become my life’s work, assisting others in moving beyond trauma and PTSD to find happiness within themselves and in life again. This article shares a more personal insight into the minefield of challenges that PTSD sufferers face. Raising Awareness According to recent studies, an average of approximately one third of the population are expected to develop PTSD at some point during their life, less than half of that number ever seek any kind of treatment. Many people suffer in silence, either not knowing what is wrong or hoping that the anxiety, depression and other symptoms will just go away or dissolve naturally on their own. This can cause people to suffer long term or find their own ways to self-medicate through prescription drugs and or recreational drugs and alcohol, which simply mask symptoms. Although many normal trauma response symptoms (PTS – see 1^st article) do commonly dissolve on their own over time, PTSD symptoms usually don’t. Sometimes people fear that if family members or employers find out about their inner turmoil they would be viewed and treated differently, even jeopardizing their job and security, so they suffer in silence. This is why I have written this series of articles to raise awareness about the symptoms, struggles and treatments available for this debilitating condition. My Story In the initial month after a near death car accident I experienced the “normal” stress responses of crying, angry outbursts, constant flashbacks and anxiety. Although these felt very scary, everyone assured me that it would subside soon. But, after months, my symptoms were only getting worse, it was like I was trapped in a big black hole that I couldn’t escape from. During the time I experienced PTSD, it was as if I had experienced a complete personality change, like the happy, sociable me that I and others knew had disappeared and been replaced with an anxious, emotional and angry stranger. Fear, terror and irrational behaviour became part my normal daily existence. I experienced physical heat rushes, shakes or panic attacks that could last for hours and left me exhausted for days.  I lost interest in all the things I used to enjoy and my whole system was on overdrive or exhausted. I swung between being overemotional or feeling completely emotionally numb and distant from everything as if I wasn’t really there. It was like a pause button was preventing me being in contact with my feelings or anything or anyone around me. This made me feel totally alone, even in situations and with people that normally made me feel comfortable and at ease. I couldn’t drive, sleep, think or focus properly, like everything was jumbled up inside. I couldn’t stop crying all the time and random people, places or situations could trigger flashbacks, panic and shaking, seemly without any rhyme or reason which was even scarier.  Although I managed to work some of the time, my relationships at home, work and socially disintegrated along with my confidence and self-esteem. The feeling of being in a dark lonely hole seemed deeper and more inescapable every day. The more I tried to fight against the symptoms, the worse they seemed to be. It was exhausting, like trying to battle something invisible! I went to the wrong type of therapist and because they did not know how to deal with trauma, told me “to pull myself together.” I constantly beat myself up for not being able to ‘pull myself together’. Of course, now I understand these symptoms were normal, but in the middle of it all without awareness, it was terrifying. Eventually I had an adrenal breakdown and slept for 20 hours a day for 3 months and finally got diagnosed. Just knowing this was an actual condition allowed me to start my recovery and as I understood PTSD more and started my healing journey, I found that the crash was not the cause, but had triggered PTSD from events that occurred many years earlier in my life.  My recovery was long and I just wanted so desperately for it to be over, for an instant solution.  Accepting there wasn’t one and it would be a gradual process was very hard to accept. As every layer was released, it was like being on the edge of a precipice as the fear of being in that deep dark seemingly inescapable hole loomed again, but I made it!  My healing journey led me to try the various therapies and approaches I now use so successfully with clients.  That’s why I believe it is important to be aware of the signs and symptoms of PTSD and the numerous routes available to overcome them. Bumps in the Road PTSD can affect each individual in totally different ways.  It can seem like going through a minefield with so many different bumps in the road, below I have described some common themes that are usually encountered along the way. Raw Footage Our nervous systems stores ordinary, non-overwhelming experiences as a story in the form of a memory which includes a sense of time, place and meaning. When we ‘remember’ a memory it is in past tense, we clearly know and understand that it happened in the past. With PTSD, although the memory is from the past, it is kept in the present by the unprocessed thoughts and emotions that need to be released. These memories have not yet been processed in the regular way because the body’s normal processing systems and rational thinking were temporarily hijacked and replaced by the unconscious fight or flight process during the event. While the fight or flight survival system was running the thoughts, emotions and experience were unable to be processed in the normal way and get ‘stuck’ in the present. This is how the brain and nervous system works, it processes the thoughts and emotions, contextualizes them, gives them meaning and files them away in the past memory library of the brain. In PTSD sufferers, they have not been stored in the normal past memory library, but rather left unprocessed as raw footage trapped in the fear part of the brain, unable to be put in the past memory compartment. If you imagine how a film is made, it starts with a lot of raw footage that is then edited and pieced together into a complete story that makes sense. For the PTSD sufferer the normal editing has not taken place and all the raw footage is stuck in the present moment, all jumbled up together unedited (unprocessed) and making no sense. Sometimes the memories can be completely blocked out or locked away to protect the person, either at the time of the event or afterwards, but these can start to surface later in life and cause havoc in the person’s life as the raw footage and attached thoughts and emotions are still floating around their system waiting to be processed and released. For example, someone who was sexually assaulted in a garden shed when they were 7 years old, never told anyone and managed to completely suppress that memory, however later in life, when they are 26 years old, they see a similar shed in a store and the fragmented memories of the event can come flooding back, along with all the terror and feelings that occurred. These can comeback in fragmented flashes, nightmares or a movie that repeats over and over and the person is left feeling like they are reliving the painful experience all over again because the memories have not yet been processed as a ‘past experience.’ If the memory is extremely traumatic and seems unacceptable, the logical mind tries to reject the memory as false, but the body keeps trying to resurface it to be released. These flashbacks and raw footage, although traumatic at the time, are the bodies way of crying out to say ‘hey we need to release all this so we can function healthily and be in happy and in balance.’ While all this is stuff rolling around the mind and body it plays havoc with all the body’s normal healthy functioning systems and robs the sufferer of the ability to be truly free to be themselves, balanced and happy, which is possible for everyone. It is NOT necessary to revisit these memories to recover from PTSD. It is important, however, to process the thoughts and feelings that the memories bring up. Once these are processed and released, the memory will be able to be filed into the past, instead of the present, without the emotional charge that it holds when relived as flashbacks. There are techniques that allow these to be released gently and safely and also there are many new modalities that allow this kind of processing and release without any conscious effort or recognition at all. These will all be discussed in detail in the next article.  It is very important to AVOID therapies that cause re-traumatisation as the client is already reliving the event through the flashbacks and nightmares. Conventional counselling, for example, where you talk over what happened could be extremely traumatic for the client. Triggers PTSD symptoms are extremely unpredictable, they can literally occur anywhere at any time. This is one of the factors that makes this condition so distressing for those experiencing it. One of the reasons for this is ‘Triggers’. A trigger is any internal or external factor that causes the sufferer to experience thoughts, memories and feelings related to a traumatic event, such as panic attacks, flashbacks, hyper-arousal, hypervigilance, anger or any other distressing emotion. Internal triggers can be a thought or a feeling, external triggers can be a place, a sound, a situation. The triggered responses can be so overwhelming that people attempt to avoid anything to do with the event to protect themselves. Whilst in some cases, this can sometimes be a healthy practise, it can lead to the avoidance of more and more people, places and activities, eventually isolating the person from the outside world , which then causes them more anxiety in dealing with normal situations later on and cause social anxiety.  Another avoidance technique is to avoid talking about the event, which can confuse people that are close to the sufferer, especially if they are normally relaxed and talkative, then suddenly have a nervous, angry and un-talkative person in their place. When the traumatic events occurred, the subconscious mind recorded everything, rather like the black box recorder of an aeroplane does. Even though the ‘raw footage’ was not processed properly and left in the fear part of the brain, it was all recorded by the subconscious in great detail. Therefore, whenever your subconscious is aware of anything that reminds it of the event, it ‘fires off’ thoughts, feelings and memories that are brought up to the surface in the same way described in the previous paragraph. Imagine a man witnessed a terrible accident, while he was in fight or flight mode he recorded the event in a flash, but his subconscious recorded everything that was going on around him at the time. Maybe there was a blue car parked across the road that he didn’t even notice at the time, but then at a later date, he is walking down the road with a friend past a blue car (that he didn’t even notice) and suddenly he is having feelings of panic and shaking and he doesn’t know what has triggered it. When somebody has a fear or phobia, they understand what causes the fear. For example, if someone is scared of spiders and they see a spider, they are scared, once the spider is removed, they feel ok again. With PTSD sufferers they are constantly thrown into fear, anxiety, distressing emotions and physical reactions, but they don’t always know what has triggered the response because it was triggered at the subconscious and not the conscious level. This is distressing in itself, never knowing what will trigger the symptoms. It is possible to become aware of what some of the triggers are and through that awareness develop techniques such as deep breathing or grounding to use to counteract the distressing effects when they occur. This at least puts the sufferer in a bit more control.  Although every case is slightly different, it is generally good practise to attend as many things that you normally enjoy and places (even if you don’t enjoy them as much whilst suffering with PTSD), you will enjoy them again as you recover and it makes the transition easier if you don’t have to start from scratch. You Survived! This sounds like it should be a great relief and certainly it is, however, in the midst of all heaviness and confusion of the array of other symptoms, it doesn’t always feel like that. In fact, the comments from others ‘to look on the bright-side’ ‘at least you survived’ can hold little sway when feeling depressed, detached, anxious, exhausted and alone in their suffering.  It is normal after any traumatic event to process it as a loss, there is a grieving process involved, either for others, for self, or for aspects of life that seem ‘lost’ or ‘different’ since the event. Guilt, self-blame and judgement of actions and of perceived non-actions can also cause a lot of mental torment and complicate and impede recovery. It can cause feelings of hopelessness, depression and left unresolved there is a higher risk of further problems such as self-harm, suicidal feelings, and substance abuse. When safety is threatened, the mind’s normal rational thinking and actions are totally replaced with fight, flight or freeze to find immediate ways to survive. During those moments actions may have been taken or not taken that was later regretted, but the body’s survival was totally in charge. For example, 9/11, people rushed to get out and some made it and some didn’t make it, or someone witnessed an attack and was glued to the spot, they literally couldn’t move. The truth is they could not have done anything else in that moment as they were not in charge of their own thoughts, actions and body in those moments; the normal systems were hijacked and over-ridden in those moments by the survival system. After the event people then judge their behaviour even though it was thoroughly out of their control at the time. Guilt, self-blame and judgement of actions and of perceived non-actions can also cause a lot of mental torment and complicate and impede recovery. It can cause feelings of shame, hopelessness, depression, and left unresolved there is a higher risk of further problems such as self-harm, suicidal feelings, and substance abuse. Relationships can suffer as a way of self-punishment. It is important to release guilt. The assistance of a trauma specialist would be advisable for this. Security shaken One of the main symptoms that nearly everyone experiencing PTSD exhibits is the total sense of unsafety. It’s as if their sense of security and safety has been shaken to the core and the feeling of helplessness and hopelessness about how to feel safe again, safe from the anxiety, pains, insomnia, the physical symptoms and the emotional responses seems impossible to reach.  It’s as if the inner realisation about physical mortality or vulnerability has become locked into their body and system at such a deep level that they get rid of it, before it was a theoretical understanding, but now it a reality, a knowing and that is very different. This causes a constant state of hyper-arousal of the nervous system. It’s as if the whole system is constantly on alert for danger. It can’t ‘switch off’ or relax. This can cause jumpiness, insomnia (especially in those who experienced trauma during sleep time). I have encountered many clients who had learned how to ‘rest’ as they couldn’t truly sleep, so strong was their bodies anxiety), affect ability to concentrate and cause high level irritability. Everything feels totally out of control and that in itself causes people to feel unsafe, which is not a comfortable place to be.  This constant hyper-arousal that keeps the survival mode on for far longer periods than is needed, this can lead to adrenal fatigue, where the sufferer is totally physically, mentally and emotionally exhausted, affecting health dramatically. PTSD sufferers are also more at risk of developing other anxiety related disorders such as OCD or eating disorders. This is because when everything feels totally out of control, a person can develop a habit of cleaning, eating or certain routines that temporarily relieve the anxiety and makes them feel safe. It makes them feel in control of something and that feels good because it gives them relief from the anxiety. They then become addicted to that particular action or behaviour. Trauma shakes up relationships with self, colleagues, family and friends and the larger world. A traumatic experience can cause a deep re-examination and reassessment of the sense of meaning about the event and of life in general, profoundly impacting the ability to trust and affecting our connections with others. Once the mind and body starts to process the experience and the emotions are released these feelings will start to subside. It is possible to start building up a foundation of safety within the person through the practise of breathing techniques, regular relaxation training and attending classes such as yoga and meditation that allow the body to start experiencing feelings of safety, calm and relaxation to support this process. Detached and Numb One of the other debilitating factors of PTSD is the feeling of emotional numbness and being totally detached from self, others, feelings and the world, except when having the overwhelming feelings of fear, anxiety and panic. In situations where there would normally be a strong emotional response, they can’t feel anything, which can be quite distressing for them and others around them. They can find it hard to feel emotions and connect with people in the same way they used to. It’s as if the overwhelming feelings have become so unbearable that the whole system shuts down the rest of the time to try and avoid them. But the overwhelming emotions can’t be turned off without turning off the normal emotions too. For me personally, this was the worst part, I learnt to reduce the triggers, control the panic attacks, but not being able to feel anything was for me truly unbearable. The best way I can describe it was as if there was a pause button on all my feelings and experiences. I joined in with life as much as I could, but I felt removed and distant from myself, like everything was being experienced at a distance away from me, through a layer that I couldn’t quite reach. This constant fluctuation between feeling detached, unemotional and numbed out to being overwhelmed by distressing feelings is an exhausting roller coaster ride that leaves the PTSD sufferer feeling powerless and depleted. They are literally trapped on a roller coaster from which they can’t seem to get off, up, down, up, down. However as the thoughts, feelings and experience is processed and released gently with the right therapy, with the best choice of therapist and at the right pace for the client (because each client is different), then the ability to feel good feelings does come back.  As the trauma is healed and released and the whole system finally realises that it really is safe, then the roller coaster finally slows down, allowing the free person to get off slowly and calmly and step back into life, sometimes with more calm and balance then they had before. It is possible to feel safe again after trauma. Calm is possible after trauma, joy is possible after trauma. It may be a longer healing journey than preferred, but it is possible and totally achievable. In the next article I will be examining the pros and cons of various treatments available including conventional approaches as well as some new modalities that are having fantastic results working with the body’s wisdom. Views:]]>