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POST-TRAUMATIC STRESS DISORDER -- What to Expect and Why
Post-Traumatic Stress Disorder is an emotional and physical reaction to a life-threatening event or trauma. “On the psychological and mental levels, trauma refers to the wounding of the emotions, the spirit, the will to live, beliefs about the self and the world, one’s dignity, and one’s sense of security. The assault on one’s psyche is so great that normal ways of thinking and feeling and the usual ways the individual has handled stress in the past are now inadequate.” PTSD used to be associated specifically with war veterans and a syndrome commonly called shell shock. Through extensive research it was found that a wide variety of people who were exposed to potentially life threatening situations could experience PTSD. Survivors of domestic violence, child abuse, and rape have all been found to suffer from PTSD. The violence and fear created by the trauma (be it rape, emotional or physical abuse, etc.) causes the mind and body to become alert and protect itself. This mental and physical alertness is known as hyperarousal. Following the trauma, the body and mind have difficulty releasing this tension and as a result, survivors of trauma experience certain emotional and physical symptoms. Hyperarousal results in a wise variety of symptoms including insomnia, psychic-numbing, memory impairment, and others. Identifying these symptoms may help in healing by reassuring that these are normal reactions to a life-threatening event. The following is a list of possible symptoms and the cause behind them.
· Why can’t I sleep? Sleeping is a part of a natural and healthy life, but for many survivors of trauma getting a good night’s sleep is an on-going battle. For many survivors, sleeping is difficult because of the body and mind’s hyperarousal. A sleeping person is very vulnerable and the body is reluctant to expose itself to injury. Also, nightmares and flashbacks can make it difficult for the survivor to sleep. For some survivors, nighttime is the most difficult to handle. Daytime activities can keep the mind occupied, but without these distractions the survivor may experience fear and anxiety while recalling the trauma. Sleeping can be particularly difficult for survivors who were attacked while asleep or in bed. The mind associates sleeping with the trauma and causes severe anxiety at bedtime.
· Why do I feel so disconnected? During trauma the body produces a natural anesthesia to allow the person to do what they need to get safe. Stories of people walking miles on a broken leg or living for months on minimal amounts of food and water is proof that the body can numb itself to pain in order to preserve life. For survivors of rape, this natural anesthesia can block out the assault to allow the survivor to plan escape or assess danger. “Shutting down” emotionally serves as a means of reducing the intensity of the trauma and allowing the brain to think more clearly. Like other symptoms, the body holds on to this defense mechanism to ensure safety. · Why do I have difficulty with my memory? Memory impairment is a common symptom of PTSD. Because the incident was so traumatic, the brain needs to repress all or part of the memory in order to maintain the ability to function. In order to survive, the brain is dependent on the body for food, sleep, etc. and will block out memories so that the trauma survivor will remember to take care of their physical needs.
· Why can’t I trust anyone? Rape is a crime of power and control. The survivor has been dehumanized by their perpetrator; made to feel like a vulnerable object that is at the mercy of a stronger or more powerful force. The survivor does not want to be vulnerable again and so will try to eliminate the possibility of being victimized again. By not trusting or relying on anyone, the body can protect itself because it fears everyone. Regaining trust is a difficult part of healing from a trauma.
· Why am I so angry? Anger is a common reaction among survivors with PTSD. Survivors are angry that the rape happened at all, that it happened to them, that they still have to deal with it, that they cannot return to the way that they felt before the assault. This anger can affect every aspect of life. Ordinarily frustrating situations can become enraging. It is important to remember that the stressors of daily life still exist and that changes in daily behavior may be necessary. As a survivor, are you overextending yourself? Are you still trying to take care of everyone in your family when you need to concentrate on yourself? Are stressful situations at work becoming overwhelming? Individual counseling or working with a support group may assist a survivor in making the necessary changes to ensure that the survivor’s emotional needs are being met.
While this article has detailed some of the questions common to survivors of sexual assault and abuse, it does not serve as a substitute for the advice of a therapist or counselor. Talking to someone can help a survivor to begin to heal and regain control. If you are a survivor and unsure about going into counseling, remember that you can always just try it once. If you don't feel comfortable, your counselor or advocate can work with you to find something or someone else that will work for you.
Footnote 1. Matsakis, Aphrodite. Post-Traumatic Stress Disorder: A Complete Treatment Guide, Oakland: New Harbinger Publications, 1994. p. 28.
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