Post-traumatic stress disorder (PTSD) and its variant, Complex PTSD (C-PTSD), present significant challenges in mental health due to the complex interplay between memory, perception, and emotional responses. These disorders impact not only the individuals experiencing them but also those around them.
C-PTSD often arises from severe and repeated trauma, potentially leading to dissociation—a form of extreme avoidance where individuals may disconnect from reality, ranging from brief moments of zoning out to more severe disengagement, unaware of their surroundings.
The core symptoms of PTSD are categorized into hyperarousal, which is a state of constant alertness in the absence of danger; avoidance, which involves steering clear of trauma reminders; and intrusion, where involuntary recall of traumatic events disrupts daily life.
Triggers are diverse and unpredictable stimuli that reactivate traumatic memories. These can be sensory cues linked to any of the five senses that suddenly bring past traumas to the forefront. For example, the smell of wet leaves or the sound of thunderstorms might unexpectedly trigger traumatic memories. Other potential triggers include specific foods, places, or even the sight of someone who resembles a person from the past.
Individuals with PTSD may attempt to avoid known triggers, yet unexpected ones can still occur and are difficult to manage. This unpredictability makes living with PTSD particularly challenging, as triggers can provoke severe responses like flashbacks or panic attacks, severely disrupting daily functioning.
Managing PTSD involves more than avoiding triggers; it requires dealing with the intense reactions they provoke. This constant vigilance can be exhausting for those affected, emphasizing the need for tailored therapeutic approaches to effectively treat and manage the disorder. Such experiences highlight the complexities of PTSD, which involves not only overt symptoms but also subtle, deeply ingrained psychological elements.
It is essential to approach conversations with trauma survivors with care and sensitivity, whether as clients in therapy or in educating those supporting them in their recovery. Here are some statements to avoid, as they can be unhelpful or even re-traumatizing:
- “Time will heal.”
- “That was months ago, shouldn’t you be back to your usual self?”
- “You just need to let it go and move on”.
- “Just learn to forgive.”
- “Block it out and focus on what’s good in your life now.”:
These kinds of comments, while often well-meaning, may not recognize the complexities of trauma and its long-term effects. Most survivors of traumatic experiences have been trying to do just these things, but finding them impossible to do. And advice that works for one person’s experiences, such as a veteran’s coping mechanisms for war-time trauma, might not be applicable or helpful for someone who has endured domestic violence and continues to face threats or reminders in their daily life.
The impact of trauma can be profound and lasting, with the process of healing significantly varying significantly from one person to another. The loss of a spouse can lead to a prolonged period of mourning, which is a normal part of grieving but may be misunderstood by others. It’s important to understand that grief can take years to navigate, and what might appear as an inability to move on may actually be a natural part of the grieving process.
It is more beneficial to listen to a survivor, allowing them to share their experiences at their own pace, rather than making assumptions about their feelings or recovery process. Offering gentle understanding and support without unsolicited advice is usually appreciated and more helpful.
If advice is sought or seems welcome, it should be given cautiously and with sensitivity to the survivor’s readiness to receive it. Telling the survivor that we understand can be particularly offensive to someone who feels very alone, even discounted, in their traumatic events. Whether we do or not, it’s rarely helpful to announce such understanding. Educating oneself about the normal processes of grief and trauma recovery can provide a better framework for supporting survivors effectively.
Bonnie Mikelson LISW
