PTSD: Q & A

A powerful emotional, physical, and cognitive response to a distressing event that overwhelms a person’s existing or past coping mechanisms. Trauma may occur by exposure to different types of abuse, loss of a loved one, combat experience and many other negative events.

Note: Trauma is subjective, what may be traumatic for one person, may not be viewed as traumatic for another.

Risk factors include:

• The event was unexpected
• Experiencing past traumas
• The experience happened repeatedly or over a prolonged period of time
• The trauma occurred during childhood
• Feeling of helplessness during the experience
• Experiencing other major stress, unrelated to the trauma when it occurs

Common reactions include:

• Fight: facing perceived danger with aggression
• Flight: running away from the danger
• Freeze: inability to move or act against a threat
• Fawn: immediately acting to try and please to avoid the traumatic event

Remember, trauma responses are based in survival. Your body acts on instinct.
No matter how you respond to trauma… your reaction is what your body felt had the highest chance of keeping you SAFE!

Less commonly known trauma reactions include:

• Flop: Total bodily collapse, may involve blacking out, loss of consciousness, loss of control over bodily functions, or muscles becoming “floppy” like a rag doll.
• Flood: Outburst of uncontrollable emotions
• Fatigue: Total body shut down when body and brain are overwhelmed by stress

• Re-experiencing the trauma: potentially through thoughts, feelings, memories, and other means. This can be distressing and may trigger uncomfortable emotions such as fear, anger, or sadness. Examples include:
  • Nightmares related to the trauma
  • Flashbacks (uncontrollable memories and emotions of the trauma)
  • Distressing thoughts and feelings about the trauma
  • Emotional distress or physical responses after being reminded of the trauma
• Avoidance: To cope with the associated distress, people who have experienced trauma may:
  • Use drugs and alcohol to avoid negative thoughts and feelings
  • Avoid activities related to the trauma
  • Avoid people, places, things related to the trauma
  • Suppress thoughts relating to the trauma
  • Avoid conversations relating to the trauma
• Negative thoughts and feelings: People who have experienced trauma may experience:
  • Excessive blame themselves or others for its occurrence
  • Loss of interest in activities
  • Feeling isolated or disconnected from their surroundings
  • Difficulty in experiencing positive feelings
  • Loss of memory related to the trauma
  • Excessive negative thoughts about oneself or the world
• Hyperarousal: Reactivity, or feeling on edge, examples include:
  • Increased irritability, quick to anger or aggression
  • Heightened startle response (i.e., “feeling jumpy)
  • Difficulty concentrating
  • Frequently scanning the environment or watching for trauma reminders
  • Sleep disturbances
  • Risky or impulsive behaviors
  • Feeling anxious and related symptoms such as, heart racing, upset stomach or headaches
• Other symptoms may include:
  • Depersonalization: Persistent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling like you are in a dream, a sense of unreality of self and body or of time moving slowly).
  • Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant or distorted)

When trauma occurs, the more “primitive” parts of our brain related to survival take over. These primitive parts do not have the ability to process on a “higher” level (I.e., logic, reasoning, rationalization) and as a result, trauma is encoded in the body on an emotional [but not rational] level. Therefore, trauma survivors tend to react based on emotion and not reasoning.

Considering this, most trauma therapy works by re-experiencing the trauma in a safe, controlled environment while applying logic and rationality to the traumatic experience. Over time, this will help decrease the emotional intensity of the trauma and reduce the resulting PTSD symptoms.

Coping skills include, but are not limited to:

• Education
• Meditation or grounding techniques
• Support (i.e., therapy, friends, family, etc.)
• Medical Check-up
• Distractions (i.e., art, music, sports, etc.)

Treatment options include, but are not limited to:

• Cognitive Behavioral Therapy: CBT works by identifying and challenging unhealthy thought patterns contributing to trauma symptoms.
• Exposure Therapy: Re-exposure to aspects of the traumatic event in a safe controlled setting, through continued exposure, it’s emotional intensity can subside.
• Medication: Helps by managing emotional symptoms of trauma including depression, anxiety, insomnia, and mood instability.
• Narrative exposure therapy, Eye Movement Desensitization and Reprocessing (EMDR), group therapy, play therapy and more….