Will PTSD Counseling Help My Disorder?
PTSD—Post Traumatic Stress Disorder—has gone by many names over the years: Shell shock. Battle Fatigue. Trauma.
The term was first coined to describe a category of symptoms that gained notoriety because of their disproportionate expression in Vietnam War veterans—symptoms that included extreme anxiety, combat-related flashbacks, unpredictable aggression, and mood and memory disturbances.
But the symptoms weren’t exactly new… War has existed for practically as long as humans have and developing an anticipation of impending harm can actually be adaptive—like when you’re walking home alone at night and you suddenly realize that someone has been following behind you, a little too closely. But existing in a state of permanent hyperarousal can make your everyday reality a living nightmare.
Following a traumatic event, stress-related symptoms, including hypervigilance, are upgraded to a diagnosis of PTSD when the following indicators present for longer than a month:
- You experience intrusive flashbacks, memories, or nightmares that force you to relive the traumatic event on continuous playback. Re-experiencing the event can occur consciously (at the level of your awareness) or by dissociation (you “blackout” and retain little or no memory of the intrusive episode)
- When you encounter a trigger that stimulates your memory of the traumatic event, you experience an intense, physiological reaction, characterized by extreme distress or anxiety
- You become hyper-vigilant or develop an exaggerated startle mechanism. For instance, if you were in a bad car accident in which another vehicle T-boned you at a stoplight, you may flinch whenever you notice cars in your periphery that are traveling up side roads
- To avoid slipping into this unpleasant state of hyper-arousal, you avoid situations, places, people, or conversations that dredge up memories of the incident
- As your symptoms worsen, you experience detachment (numbness or lack of connection) and self-estrangement (social withdrawal) as you attempt to distance yourself from others
- You develop anhedonia: you can no longer obtain enjoyment from activities that once gave you pleasure (including hobbies, interests, sex, etc.)
- Insomnia: you have nightmares or an overly active mind that switches to “on” before bedtime and you lie awake for hours, staring at the ceiling
- You may develop a distorted world or self-view, in which you perceive your world and the people who inhabit it as inherently dangerous. You may feel emotions associated with guilt, shame, or self-loathing—despite not being to blame for your situation and your condition
- When someone startles you or you feel endangered, you may respond with unpredictable aggression—something in you snaps and you react without taking time to assess the situation.
- You may also display impulsivity in other ways: reckless driving, frequent, unprotected sexual encounters, substance abuse, self-harm, or anorexia/bulimia/binge-eating, etc.
- Suicidal ideation: if your symptoms become severe enough, you may begin to wish for your own death as a means of escape from negative emotions and anxiety that sets your perpetually on edge. Although not everyone who considers suicide as an alternative will go on to attempt it, we advise that you seek help immediately if you begin to feel this way: PTSD is treatable—but suicide is permanent!
I’m not a veteran, but I have symptoms of PTSD: What constitutes “trauma”?
Although PTSD was first introduced into the world of psychiatry to characterize stress-related symptoms that veterans would sometimes develop following combat, “trauma” is a much broader term that extends far beyond acts of war.
Since the introduction of the term in 1980, “PTSD” has been expanded to describe any life-threatening event, whether experienced directly or relieved second hand, that precipitates the very specific set of stress-related responses outlined above. These traumatic events may include:
- Acts of terrorism or war (e.g. bombings, executions, genocide)
- Sexual or physical violence (e.g. rape, assault, human trafficking, being held at gunpoint)
- Accidents (e.g. explosions, airplane and car crashes, severe injuries)
- Natural disasters (e.g. fires, hurricanes, earthquakes, floods)
- Imprisonment (e.g. incarceration, prisoners of war, victims of abduction)
- Occupational Trauma (e.g. first responders such as police officers, firemen, and paramedics who encounter repeat exposure to emergency events)
…Among many others.
Does everyone who lives through a traumatic event go on to develop PTSD?
Nope, and there isn’t really a good reason to explain why some individuals are more prone than others to developing PTSD. We do know that if you have a personal or family history of depression, anxiety, or another psychiatric concern, that your risk for developing PTSD may be elevated. Similarly, individuals with better familial and social support systems are less likely to develop lasting stress-related symptoms.
How Can Therapy & Counseling for PTSD Improve My Condition?
Counseling as a treatment for PTSD is the most effective form of known symptom relief, and multiple, customizable interventions exist to combat your PTSD. Your therapist may recommend:
- Cognitive Behavioral Therapy, to identify maladaptive thought patterns (for example, distorted world- and self-views) that may be perpetuating your condition. Your therapist will assist you to modify your thinking and in turn, your means of engaging with your world and the traumatic memory
- Eye Movement Desensitization and Reprocessing (EMDR), a therapeutic technique that combines exposure (guiding a client with PTSD through negative memories and cognitions—beliefs held about the self as a result of the traumatic event) and bilateral stimulation (sounds, eye movements) to assist in reprocessing the event. Because traumatic events become preserved in the mind, the eye movements—which resemble the movements of the eye during REM sleep—allow for the brain to unlock and alter feelings surrounding the once immutable memory. The therapist then helps the client replace a negative belief with a more positive cognition, which promotes lasting resilience
- Medications, to treat more challenging cases of depression, anxiety, suicidal ideation, mood disturbance, or nightmares
- Group therapy to connect with other trauma survivors and develop a solid support system
- Alternative and unconventional therapies, such equine therapy, mindfulness, meditation, or psychotherapeutic yoga, that address your condition from an innovative and holistic perspective
Trauma survivors deserve to live normal, healthy, recovered lives. If you or someone you love is struggling with PTSD, don’t give up hope: even the deepest wounds can heal with qualified intervention and a support system that makes you feel safe again.