Here is the third section of of The Post-Traumatic Gazette #1, copyright Patience Mason 1995, 2005, What are Post Truamatic Stress Reactions?

Here is the third section of of The Post-Traumatic Gazette #1, copyright Patience Mason 1995, 2005, What are Post Truamatic Stress Reactions?

This doesn’t go away by itself either.

Unfortunately when survivors numb fear, despair and anger, all their feelings, even good ones, are numbed. Numbness is comfortable. Thinking about what they have been through is so painful, survivors wind up avoiding thinking about, feeling, or doing anything that reminds them of the trauma. For example, if they feel the trauma was their fault, they may spend the rest of their life having to be right so they won’t ever be at fault again. If they were happy when the trauma hit, they may avoid happiness forever. If they lost those close to them, they may give up closeness.

Most trauma survivors do not know anything about PTSD, so instead of seeking help, they will turn to whatever is available, self-medicating to maintain numbness. Addictions and compulsive behaviors often are rooted in attempts to numb the thoughts and feelings associated with trauma. Until recently, a diagnosis of alcoholism or drug abuse made the effects of trauma invisible: because he’s (or she’s) an alcoholic, alcoholism is the cause of all these problems so he (or she) can’t have PTSD.

“Inability to recall important aspects of the trauma,” is another of the ways avoidance and numbing may work. This means the person cannot remember exactly what happened. Many trauma survivors forget in order to survive. This is well documented in the scientific literature for combat veterans, torture survivors, battered women, child sexual abuse survivors, natural disaster survivors and others, as well as in personal narratives. The current attack on traumatic amnesia by the parents of incest survivors, involving memory experts who know nothing about trauma and therapists who were trained back in psychiatry’s denial and delusion period (from Freud to 1980), will be the subject of a future issue.

Survivors usually also feel that no one can understand what they’ve been through, which is reality. Another form of numbing and avoidance is that they may feel like they’re not going to have a long life. This is realistic if the survivor has seen a lot of people killed. Survivors may also lose interest in what they once liked to do. What is the point? Small children are likely to go back to baby talk or forget their toilet training. Survivors may also feel like they have no emotions or be told by their loved ones that they have none. They may even be so numb to the damage that was done to them that they become perpetrators and cannot understand what the fuss is all about. “What are you crying for? I’m pulling my punches.”

Survivors may also have learned to dissociate, to literally not be there, to survive. Automatically checking out of stressful situations will make it hard to have relationships or to work in therapy.

Numbness will make it hard for survivors to take care of themselves. Feelings are there to tell us how to do that. If you can’t tell what you feel, you can’t choose healthy behaviors for yourself.

I’ve just described two of the symptom categories psychiatrists use to diagnose PTSD: hypervigilance and numbing. I’ve described them in this way because I think it is important for survivors, families and therapists to understand that this is not some random collection of weird behaviors, but appropriate and effective biologically based reactions to extreme stress. They have a purpose: survival. These reactions develop under conditions that most of us cannot imagine or comprehend, although such conditions are common in our society.

A person has to have two hypervigilant symptoms and three numbing symptoms, not present before the trauma, to be diagnosed with Post-Traumatic Stress Disorder. That means if the survivor already had PTSD from a previous trauma which the therapist doesn’t know about and is already numb, the survivor may be misdiagnosed.

Most trauma survivors turn out to have multiple traumas, but the diagnosis of PTSD was formulated as if trauma was rare and only happened in isolation from the rest of life.