The literature talks about PTSD as “a normal reaction to an abnormal event.” This is the thing, we need to run off the generator, off instinct from time to time. But problems arise when the fuse stays blown and we live accordingly, in a constant state of active terror, surviving by using up all our back-up resources.
Coming back from that kind of fear is a process, and for very good reason. If you suddenly flooded a survivor’s mind with the full awareness of the trauma they’ve been protected from it would do a lot of damage. So my first tip is, take it easy. The simplest and most effective thing you can do is to support their best efforts to create a sense of safety and stability in their own life.
Be present. Listen.
Show them you’re sure that the world contains safety, security and hope. Many survivors have never known these things.
Trauma deeply violates a person’s trust in the sanctity of life, across about as many different wavelengths as you can imagine. And what can make recovery so difficult for those living with PTSD is that often, when a survivor goes to start living off normal power, their mental safety switch gets blown. It happens again and again and again in response to current environmental triggers which unconsciously remind them of the original trauma. These triggers set off what are known as flashbacks, which embed the fear that drives the generator, renewing the traumatised state in the present moment.
When a flashback happens it can make both you, as an outsider, and the person experiencing it feel absolutely helpless. Sometimes they’re hard to recognise but if you’ve ever had anything like a panic attack then you’ll have a bit of an idea. You can watch for similar sorts of physiological changes in the survivor, and if you spot them it’s a fair bet that the person is having a flashback/traumatic stress response.
The person may:-
get a very distant look in their eyes, as if removed from the present moment;
be more easily startled and/or stop moving entirely, not even blinking;
appear particularly emotionally detached/numb, stop speaking, miss normal social cues;
seem unusually nervous/apprehensive/tense;
experience symptoms of physiological arousal which would not normally be expected given the context (eg. trembling/shaking, dry mouth, trouble speaking, heart palpitations, sweating, shortness of breath, nausea/vomiting/stomach pain, difficulty swallowing, dizziness, chest pain etc.);
speak differently, often in a monotone or in a voice that sounds younger than you’d expect;
go through dramatic changes in body language, withdrawing or looking like they’re about to flee.
These and similar changes occur in response to particular present environmental cues, which the survivor may or may not be aware of. As opposed to the case of a panic attack, there isn’t any build-up. There’s no such thing as a prelude to a flashback, though many fear the fact that they cannot anticipate them.
(More on flashbacks/triggers shortly.)
This is a great article. Though I don’t suffer from PTSD exactly, I have experienced some of what you’re talking about. It seems like PTSD can result from any painful or harrowing experience, not necessarily just from war, rape, being attacked and so forth. In a sense, I probably have suffered some PTSD because some of what you describe, I have felt.
Thx! Yeah, Bobby, I totally believe there are a lot more ‘walking wounded’ out there who don’t quite fit the DSM-IV criteria but could still do with an awful lot of TLC and support around these issues.
Traumatic stress works on a bit of a spectrum. Sure, severe cases will always require greater degrees of intervention so of course we call it a ‘disorder’ and arrange appropriate treatments options for people. But that’s mostly ‘the system’ where, down here on the ground, a lot of folks can relate…have been there, more or less.
Yeah, this is all so familiar. Tho I’d add that one of my own responses was to have that panic attack-like experience and then simply burst into uncontrollable tears. The out-take was that I felt very much as though my insides had been ripped from my body, torn to shreds and put back in, just in a great big mess.
,,,There’s no such thing as a prelude to a flashback, though many fear the fact that they cannot anticipate them. ..
No warning, but then when they’re happening, how could you not know? And yes, the dread, feeling as though you’ve taken a beating and wondering when/where the next one is coming from. Its okay if you know *most* of your triggers, but there’s always ones you don’t know.
And that’s sort of what trips me up now, that most of my more intense/insane PTSD is over. Like, a recent time where I was out with a friend. We were having a good time and then all of the sudden I wasn’t. It was getting ugly for me very quickly and I couldn’t explain why. Luckily she saw what was happening and walked me out so we could both go home.
It is alienating for your friends though, when they experience this sort of thing. If I think its confusing, it must be worse for someone else who has no idea what’s going on!
“If I think its confusing, it must be worse for someone else who has no idea what’s going on!” -Svasti
Which is exactly why this series is so great :) I have looked into PTSD before, as well as talking to a few PTSD sufferers and obviously reading blogs, but even with all that I feel that there’s a heck of a lot I don’t know! This post has taught me a few things and filled in a few blanks :)
“speak differently, often in a monotone or in a voice that sounds younger than you’d expect;” -CK
That in particular caught my eye, I didn’t know about the change in voice. I guess I’d probably have guessed the monotone since that kinda goes with emotional detachment, but the young voice? Can anyone elaborate on that / explain the reasons?
CK, will you be writing more on what “spectators” can do to help?
As always, brilliant post!
~Shiv
The shrinks don’t actually know why, Shiv. It’s merely one possible indicator. They reckon it’s something to do with dissociation, which is helpfully abstruse.
Yep, will post more on what spectators can do to help. This series is getting longer by the minute. I keep thinking of info to add and hating my self-enforced daily blog word limit.
I’ve got this idea that the young voice stems from that inner child we all have – that little version of us is where we store a lot of our pain. It doesn’t seem to matter if your trauma happened when you were young or not – still, the young voice comes out. Maybe because that really vulnerable part of you doesn’t know how to be a grown up?
All just ideas I guess, but its good to consider.
In my own experience, spectators mostly miss what’s happening. Its not like there’s an obvious change and people will often mistake the symptoms for some other kind of weirdness, even when they know you deal with PTSD. Why? Because its not easy to make the connection between someone being suddenly very weird and PTSD.
Actually, I think spectators can do more to help once they’ve seen it play out once or twice, and have then had an honest conversation with their PTSD friend. Not everyone wants to have that conversation, though!
You speak great wisdom, Yoda ;)
I’ve been tripped out like that a few times recently. Really gets me to still have so much trouble identifying why even having come so far towards awareness.
And the torn to shreds part, ugh. I so get that, unfortunately.
So, CK, will you touch on ways to work through PTSD or to prevent flashbacks in your series?
Love always,
Me
I will, dear Ash :) Cheers for introducing Beth to the blog/me, btw.
This is a really good explanation Kid. For me, that feeling of numbness and then being absolutely unable to function socially struck home. And it does feel as if I’m in an altered state – drawing off of the ‘emergency generator’.
I’ve never been able to explain this to anyone else who was not a therapist though. Not even to other people with ‘problems’. More power to you for trying to do so.
Cheers. Yeah, I’ve never been able to explain it to folks either but having been asked to I’m giving it a shot. We’ll see how it goes :)
I love to see these posts written. I’ve had a lot of comments from people when I write about my seizures and how they’d be really freaked out if they had to go through what I go through and they’d never know what to do with someone etc…
For me, it’s all second nature now. Hell, maybe people are getting sick and tired of me talking about all the damn things!
Though to me, you can never talk enough about educating people. So, I won’t stop talking. Shove the biggest gag in my mouth, tie my hands behind my back and I’ll still find a way to express what is important.
Obviously, I’m with you here.
Also, dissociation is so odd, isn’t it? It’s like this weird, “cross-functional” (dys-functional) brain thing that can occur in so many places. Trauma, seizures…
I mentioned to you how I basically felt completely DP/DR’d out and then realized later, I now have a viral infection. My brain was telling me to lie the hell down and get some rest, get safe or this “thing” is going to hurt you? No, you might pass out at any moment!
The seizures? The same. SPs can be auras/warnings to get to safer places to ward off injury from more serious seizures to come.
I don’t know. I just find it interesting that some of these ways our brains react and manifest themselves are the same all over.
OMG, I wrote this without any tea and while still viral! W00t!
Now, time for tea. *PA toddles off to make tea*
It is pretty amazing – all these connections all over the place. Similar neurological fireworks showing up in different ways.
And oath, yeah, dissociation is seriously weird. I’m not sure I’ll ever entirely get it but it remains intriguing so I’m cool with that.
Yes, go make tea. Get better already! ;)
As I study my own family members and clients and myself I’ve learned that one of the common signs that someone is close to jumping the track is that they disconnect in their language–i.e. jump from one topic to another, suddenly change the subject in a way that doesn’t make sense. This usually happens before the person starts to experience the entire triggering process and I’ve learned to watch for that in clients, friends, family, myself. It’s like our system almost knows something is coming and our words suddenly get garbled. I’ve found that sometimes if this can be caught early enough a full on episode can be averted or considerably lessened, though not every time.
“The Body Remembers” by Babette Rothschild is a boring and hard read, but a good read on the early physiological signs of triggering/PTSD and how to “bring the system down” a bit. Peter Levine’s Somatic Experiencing work is all about this as well–actual techniques for lessening and defusing the triggering reaction.
I’d never paid much attention to it but thinking back on it, absolutely. I get little gaps – bigger than usual though i’m not exactly a ‘talker’ to begin with ;) And i’ve heard it with other people. Nice call, wily! Thanks!
My dad suffered from PTSD (they called it shell shock back then), as do I. He, from his stint in the war (WWII) and me from fighting my own war known as childhood.
I can relate to each of the symptoms you listed. I think though that I don’t always notice some of my symptoms simply because I’m too busy trying to stay in the survival mode.
Sometimes something will affect me a certain way, very strongly. It panics me, I don’t know where it’s coming from. I don’t think it must be a trigger to my PTSD–well, unless I read something like your article. Then I remember: oh yeah, I have PTSD.
For me the younger sounding voice would be one of my parts, as I have Dissociative Identity Disorder.
I’m looking forward to Part 3 of this article!
Heh yeah, feels like i end up almost having to re-learn everything each day… and those are the good days, when you’re with it enough to remember to pay attention in the first place!
i think that’s it. Like Svasti said- the younger voice is our inner child, which is one level of dissociation. It’s well short of DID parts but it’s the same principle at work, i reckon. the same basic underlying mechanism giving rise to the symptom in a more or less distinct fashion.
I think you are doing a great job at explaining mental health issues in simple terms. I’ve never suffered from PTSD but I’ve worked with individuals who have. I am adding your blog to my blogroll and hoping to understand more about you. Keep up the great work!
Danke :) I shall mosey along and check out your blog, too.