PTSD 101
When he returned from Vietnam, he told his mother not to come into his room to wake him, but to stand at the door and call out to him if she needed to wake him, but she was busy one day and forgot. She was doing chores when she looked at the clock and realized her son was going to be late for an appointment, so she went into his room and shook him to wake him. She had done this a million times when he was growing up, and it was her habit, but this time was different. He came out of bed with one lithe movement and pinned her against the wall with his hands around her neck. She stared, terrified, into the eyes of a cold stranger whose strength she could not overcome. She felt her breath go, and she was not able to tell him he was safe. Suddenly his eyes changed, and he became himself and let her go. She never shook him awake again, but would stand at the door and call to him if she needed to wake him. He was home, he was safe, and yet somehow, he was still back in the jungles of Southeast Asia fearing for his life. Even now, decades later, he still comes out of his chair if there is a loud bang with an exaggerated startle response. How can this be? He hasn’t been at war for forty years, but still the hypervigilance is part of his core.
The Body Keeps the Score
In his book, The Body Keeps the Score, Dr. Van Der Kolk explores the results of trauma on the brain and body. The body actually stores traumatic responses creating the exaggerated startle response and hypervigilance that do not fade over time, but can increase with time into panic and anxiety. When someone develops Posttraumatic Stress Disorder from terrifying events such as car accidents, battle, crime, sexual trauma, or domestic abuse, the impact on the body, not just the mind, is significant. Clients talk about tightness in the chest, or a ball of energy like fire, or tingling sensations when they are triggered. The result of the body storing trauma is depression, anxiety, panic, irritability, recurring disturbing memories and nightmares.
What About the Family?
For family members, the over reactivity and the exaggerated startle response is confusing because it is often accompanied by anger. A small boy startling his father who has a trauma history may receive a severe tongue lashing which causes fear and heartbreak in the child. The child becomes confused about small every day occurrences that should be safe, but evoke an angry and irritated response. The child loses trust in his father because he fears that anger.
Families who familiarize themselves with the symptoms of PTSD can gain a better understanding of their loved one and can formulate strategies to assist them with the reactions of their bodies.
The Symptoms of PTSD are:
Hypervigilance – a feeling of never being safe and secure. The body has a heightened sense of danger all the time leading to exhaustion, irritability and a feeling of being overwhelmed.
Exaggerated startle response – the tendency to over react to normal stimuli causing the body to tighten, tense and get ready for flight or fight.
Panic attacks and anxiety – leading to sleep disturbance, racing thoughts, inability to relax and let the body come to rest.
Irritability – shortness, lack of patience, and controlling behaviors.
Flashbacks – recurring, disturbing memories that feel real as if they are reliving the event.
Dissociation – this is a coping mechanism where the brain is so overwhelmed, it shuts down. For families, this means that the person is not always present and may be accused of never listening.
Treatments
There is help for the person who has a trauma history. Eye Movement Desensitization and Reprocessing, or EMDR, is a robust therapy for helping the body to release the stored trauma, allowing the body and mind to rest and be at peace by addressing the negative cognitions, such as “I am not safe” and creating new positive cognitions, such as “I am safe now.” Cognitive Behavioral Therapy also addresses the negative beliefs that drive the responses to trauma.
For families living with the behaviors that seem confusing and frightening, it is important to get help as well by talking to a counselor or joining a support group. It is not always possible to be patient and loving, but providing as safe an environment as possible is helpful. Ultimately, trauma is about safety and feeling vulnerable, and the traumatized person needs to come back to a place of feeling safe and that being vulnerable is not a bad thing.
Scripture for Reflection:
God is our safe place and our strength. He is always our help when we are in trouble. So we will not be afraid, even if the earth is shaken and the mountains fall into the center of the sea, and even if its waters go wild with storm and the mountains shake with its action. Psalm 46:1-3
Next Steps:
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