PTSD: A Mini-Primer
Post-Traumatic Stress Disorder, or PTSD, has become a familiar term now because of its prevalence among men and women returning from war. We’ve seen it portrayed in movies and on TV: a returning soldier has intrusive flashbacks of a horrific war-related event, exhibits moodiness, and consumes excessive amounts of alcohol.
While such portrayals are not entirely inaccurate, they’re simplistic and lead to a stereotypical understanding of what is actually a complex disorder in the general population. Childhood abuse of any kind, sexual assault, racism, housing instability, chronic food insecurity, a terrifying car accident, being raised by a mentally ill or extremely volatile parent, being bullied, losing a parent early in life, and other traumatic experiences that happen to regular people every day can fundamentally re-organize the brain/nervous system and permanently alter its perceptions of risk and safety.
…trauma increases the risk of misinterpreting whether a particular situation is dangerous or safe… Faulty alarm systems lead to blowups or shutdowns in response to innocuous comments or facial expressions… the inhibitory capacities of the frontal lobe break down, and people ‘take leave of their senses’: They may startle in response to any loud sound, become enraged by small frustrations, or freeze when somebody touches them. 1
My Story (A Small Part of It, Anyway)
I was 36 years old when my daughter was born. My 23-hour-long labor had been punctuated by many scary moments that culminated in an emergency C-section. Although relieved by her safe arrival, when my husband and I brought her home, I was in a state of hyper-arousal that I seemed unable to turn off. Every time my daughter cried, my stomach would erupt with butterflies, my heart would start racing, and I would be flooded with feelings of panic.
When I told my obstetrician I was “struggling with a little anxiety,” he reassured me that it was a normal response for an older, career-established, first-time mom adjusting to the new constraints and demands of motherhood. What I had failed to tell him was that the feelings I was struggling with were far more than “a little anxiety;” they were more akin to terror. But I didn’t know how to admit that – even to myself – because it seemed nuts. It didn’t make sense that I felt powerless and frantic whenever my baby cried, that my body responded to those cries as if I were about to face lions in the Roman Colosseum. Not only did I have everything I could need or want, including a loving and involved husband, but I had years of medical practice under my belt.
So I did what I thought I had to do: I sucked it up and took care of my baby. Oh, and I cried. I cried when I nursed her; I cried when I changed her diaper; I cried as I tried in vain to take the popular advice, “Sleep when your baby sleeps.”
After about 8 weeks, my state of hyper-arousal gradually subsided, and I concluded that those nightmarish 2 months had simply been a really rough adjustment period.
That is, until I experienced a nearly debilitating relapse a few months ago when circumstances beyond my control brought about a radical rearrangement of my life. I felt trapped, powerless, and panicked again, and this time, those feelings were accompanied by intrusive flashbacks of traumatic experiences I had accumulated over four decades. My startle response was off the charts. When my daughter, now almost 7 years old, snuck up behind me and playfully poked me in the ribs, I reacted as if I had been punched in the face by a malicious assailant. When I experienced a minor disagreement with 2 of my family members, I shut down and withdrew into my bedroom like a wounded animal, refusing to eat, drink, or interact for 8 hours.
I’ve had a good bit of helpful counseling over the years, but I’m now working with a therapist who has in-depth knowledge about and experience with trauma and trauma recovery. He’s helping me process traumatic memories through a procedure called eye movement desensitization and reprocessing (EMDR). It’s enabling me to make revelatory connections between my past and present that I’ve never made before and, as a result, is making a measurable difference in the way I respond to situations that usually trigger a reflexive release of adrenaline and cortisol. The physiologic response hasn’t gone away, but it has definitely dampened, and I now have more capacity to respond appropriately.
I’d like to conclude by saying that even in my suffering, I remain keenly aware of the privilege I enjoy in the form of financial resources, a strong educational background, and robust social connections. There are millions of trauma survivors in the United States alone who don’t have access to trauma counselors and continue to live within unbroken cycles of trauma. Many of them live together in beleaguered and impoverished communities. Poverty, systemic injustice, and regular exposure to violence literally shape the brains and even the DNA of entire communities and their offspring.2 It’s a serious public health crisis that includes but cannot be reduced to the poor choices of individuals.
I’ve chosen to write about my own journey because I want knowledge about the impact of trauma to become household knowledge. My sincere hope is that once we begin to comprehend at a societal level how many of us have been shaped and broken by traumatic experiences, we’ll abandon our seats at the table of scoffers (Psalm 1:1), begin to build bridges, and become agents of healing and transformation for one another.
- Van Der Kolk, Bessel (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY: Penguin Group. 61-63.
- Yehuda, Rachel et al. “Holocaust Exposure Induced Intergenerational effects on FKBP5 Methylation.” Biological Psychiatry Journal, August 12, 2015. http://www.biologicalpsychiatryjournal.com/article/S0006-3223(15)00652-6/abstract