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Saturday, October 15, 2016

What are Post-Traumatic Stress Reactions? Part 1 (from Vol. 1, No. 1, The Post Traumatic Gazette, Revised © 2002 Patience H. C. Mason May-June 1995)

Post-Traumatic Stress reactions start with a traumatic stressor “outside the range of usual human experience and that would be markedly distressing to almost anyone,” according to the American Psychiatric Association’s Diagnostic and Statistical Manual, III-R. Since it is almost impossible for a non-survivor, or a numb survivor, to understand or imagine what a survivor experiences at the time of the trauma, and therefore to identify what is traumatic, the DSM III-R offered four categories of traumatic stressor for diagnosticians and therapists: (1)-threat of death or loss of physical integrity to the survivor (combat, rape, incest, earthquake, etc.), (2)-death, threat of death or loss of physical integrity to family or close friends (survivor does not have to be present) (3)-sudden loss of home or community, and (4)-seeing another person who has recently been seriously injured or killed. These were derived from reality: real nurses and body-baggers had terrible PTSD, just like combat vets, rape and incest survivors, people who lost their homes in fires or floods, or lost their kids on Flight 103 over Lockerbie or in the World Trade Center. Interestingly enough, DSM IV basically contains a legalese mumbo-jumbo numbing ritual which enables professionals to not think about the reality.
As a person is traumatized, at least for the first time,* the sense of personal safety is shattered. Two things start to happen immediately. The person will strive to survive using three available systems: fight, flight or freeze. What they called the reptile brain in high school biology seems to take over and choose. Military training is designed to get soldiers to always choose fight, but they wouldn’t have to train us to do that if we were natural born killers. Culture and religion often train women to freeze, to take it and endure. In nature, flight is most common.
Simultaneously, while survival is at stake, feelings will shut down and information taken in and processed will become focused so the person can do whatever it takes to survive.
Whatever it takes! This is not a polite, well-behaved part of us. It pisses and shits in its fear. It scratches and bites and goes berserk, beating people to death with the rifle-butt when the bullets are gone. It kicks and gouges. It runs out on its friends, trampling whoever gets in its way. It cowers, unable to get up or to fight, unable to protect those it loves. It may freeze or follow orders that are against all the survivor personally believes in. Survivors may feel shock or shame over what this part of them did.
Let me emphasize something: this ability to do whatever it takes to survive is God-given or evolution-given, depending on your point of view, but we all have it, and in traumatic enough situations, it will come out or we die. Extreme situations which trigger this reaction again and again may cause survivors to do things in order to survive which can be hard to look back on later.
This survivor part of us is not able to listen to reason either. It does not speak English, nor can it tell time. It is going to be looking for danger from now on whether or not others think it is reasonable.
Real physiological changes occur in the brains of survivors which make them quick to react. In order to live through the trauma, survivors may develop the capacity to go from fine into a killing rage in seconds. That helps them live. They may stop sleeping soundly. Sleep can get you killed. Survivors may be uncannily able to read the moods of those around them because the moods of their abusers defined their lives. They become hypervigilant, searching for physical danger all around and all the time. Due to hypervigilance and lack of sleep, it is hard for them to concentrate on everyday things, although they are concentrating on survival information. They may do poorly in school and believe they are stupid when what they have is a symptom of PTSD. Survivors react faster and more completely to sudden noises (startle response). These are lifesaving skills as long as the survivor is still at risk, still in combat, still living with the batterer or the molester, still living in the bad neighborhood, the bombed-out city. These are reality based, effective survival skills. They keep you alive.
They don’t go away by themselves.
Similarly, shutting down feelings in order to do whatever it takes to survive, or do your job and help others survive, is a reality based survival skill. If you sit down and cry in combat, you will get killed. If you keep screaming while Daddy hurts you, he may kill you. If you cry in the aid station or emergency room, you won’t be able to save as many lives. Numbness is the answer. It is effective. It will help you live. It will help you keep others alive. And your brain’s inborn capacity to rapidly adapt means that what horrifies you the first time becomes nothing much by the third time it happens. But, if you didn’t care, you wouldn’t have to get numb. Being numb is evidence that you do care.
From The Post-Traumatic Gazette #1, copyright Patience Mason 1995, 2005, What are Post Truamatic Stress Reactions?

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