Root Causes and Treatment

[Tapery]

I have been reading posts here and many of the links and have a few questions lingering. I wonder what differences it makes in the resulting PTSD if the stress was caused by a single critical event or a series of (minor to serious) related events over a limited period of time. I have, also, been wondering about the use of carefully selected acts intended to cause stress that would lead to PTSD. This latter came from the story in one of the links about the police man who hid behind his uniform to harass the woman with the dogs who had the audacity to challenge his “power”. Doesn’t this underlie much of Psychological Warfar? Or, perhaps, work place stress? Terrorism? The bottom line is that I wonder if the treatment of PTSD is different depending on the type of events that caused it, and or if the events are ongoing. I am sure I have not expressed this well but it would be helpful if anyone has any information or ideas.

I'm no expert on these things.

I just think it is different for each person and I think adult trauma is a little different than childhood trauma. I think the blocked memories of children are much harder to access. I think this because children don't usually remember any of it so they have to recall something they didn't even know existed in the first place.

I also think it depends on what level our trauma hits us and what level of our emotional structure is affected.

There are some traumas that may put a crack in our emotional structure and others rip out the very foundation.

Sometimes we just need to develop new coping methods and sometimes we need to restructure our entire concept of reality.

Lets say I build my whole foundation on the love and security of my family and sisters and brothers. Then as an adult I find out I was the only child in the family that was adopted. That new truth might break my foundation and topple my structure. I may have some rebuilding to do.

Lets say I don't ever find out I'm adopted and have a good secure life and come home one day to find out I've been robbed. That's more like a crack in my structure. I'll have to repair, but I may not have to rebuild.

Now a child who has blocked out abuse and trauma may suddenly erupt like a volcano when something happens that puts a crack in the structure. Once a little bit of false reality cracks the rest of the false reality doesn't work anymore and the whole structure begins to crumble.

Prolonged stress can either be healed by raising our coping methods or separating ourselves from the situation. I just went through a stressful situation at work where the police kept coming to the facility and drawing their guns on employees. After a few times of this I was having a harder time calming down and starting feeling anxiety. Separating myself from the situation solved my problem. I also noticed that this bothered me much more than the other staff members because of my past trauma.

Going through prolonged trauma wreaks havoc on our nervous systems and I'm not sure if that can be healed yet. After many years away from trauma I still have a startle reaction to noise and my nervous system is not normal. I take medication to help me with this.

Single incidents can put us in shock. It may take us a long time to finally accept all that has happened. It can also be complex. Not only did we have a traumatic event, but we may have also lost a loved one at the same time. Then we are dealing with the shock and grief of death and maybe the shock and horror of an accident we may have witnessed.

Some traumatic events carry shame and guilt with it. These are two additional emotions to deal with. We may have to work through survivor's guilt.

I think the answer is as complicated as we are.

Is this what you were asking?

[Tapery]

Originally Posted by Morning Glory

I'm no expert on these things.
...Is this what you were asking?

Thank you MG for you response. Yes, this is the beginnings of what I am interested in and you look like an expert to me.

What I hear you saying is that whether the trauma is caused by a single incident or longer term stress or trauma (there can be an overlap?) its effect is primarily determined by how many facets of the emotional structure are involved and how many healthy facets remain intact and ready to be activated for emotional healing. Coping mechanisms, including withdrawing from a situation, are the underpinnings, the first level of defense, for our emotional structures. I am not sure how that emotional structure corresponds to what we call our personality or character. (Sorry for not using all the standard vocabulary. This is a bit new to me.)

I know that in the brain there is built in redundancy for many functions. I assume that after a trauma some facets of the emotional structure that remain in tact can be called upon to support new functions. Reason to live comes to mind. Family, altruism, revenge…or are these not part of the emotional structure? I realize I am also uncertain about how the nervous system relates to our emotional structure. They are not quite the same?

Shame and guilt sound like they are in a different category. Aren’t they culturally imposed “coping mechanisms” that server in a very general sense to protect society rather than the individual? Aren’t they often imprinted in the place that has the least resistance, children vs. adult; women vs. men, weak vs. strong, poor vs. rich, etc. That feels more expedient than healthy. Sorry, just me rambling but I am really trying to understand.

From your explanation I can easily see how important it is for a child to receive help soon after a trauma.

I know you used your recent work experience as an example but I am very sorry to hear that you had to go through that. I am glad you have support. I am assuming that because among other things you say you have medication for that. I hope you are in a better place for you now.

Thank you again for the explanation. It is a help.

Wow! I wish I could write like you do.

That's what I meant to say, lol.

I think our nervous system is different from our mental and emotional makeup, but I can't be sure of that.

There was a book out about sensitive people and it explained how we process a lot more information than most people. When we walk into a room of people and we are aware of everyone's moods. We can see that someone might be sitting alone and feel uncomfortable. We can hear many noises that other people can ignore. We are concerned with the child's safety and help keep an eye out on them. We're looking out for the little old lady that is looking for the restroom. We don't filter information well. So that's what keeps the nervous system fired up all the time. My surroundings need to be quieter than most and I isolate more to protect myself from all the stimulation that most people don't even notice. I might find myself day dreaming a lot to escape. This is what effects my nervous system. So I guess it's mental first before it becomes a nervous system issue.

I don't know if there is a way to add filters when you don't have them. The anti-depressants seem to help with that so it just might be a chemical problem.

I can only speak for myself and my experience with my PTSD. My entire makeup was based on a lie. All I needed was a little bit of truth to hold myself together. As I went forward in my recovery I gained more truth to stand on. Accepting truth was the hard part for me. Letting go of the lie brought a lot of grief. This all caused panic attacks and a greater need for safety and security. I think as children we create our own reality and block out what we can't handle at that age. Then we build on that so we're building on a lie. When we find out the truth the whole thing starts to crumble. The quicker it crumbles the worse off we are at first. This has put many people in mental hospitals with a break down. Medication has helped a lot to lesson the symptoms and give some relief to allow room for recovery.

I don't know how to place it all into separate categories. I had it drawn out, but lost the thread when the boards crashed. I think I still have the pictures and could post them again. I'll look for them.

Hugs

[Tapery]

Thanks MG but for me sometimes words flow and other times I don’t seem to be able to spell or even remember my name. I am interested and you are making sense. I am sure that is it.

I am trying to put together bits and pieces of things I have learned over the years that seem to relate. I think there are three things at work here where you talk about sensitive people (the book sounds interesting). I see first of all the observable event or condition, then the interpretation, and finally acting upon the chosen action or inaction. I guess you could have filtering at each step and I can see how PTSD could alter how we progress through each step.

There is another book out now that I have thought about getting (but didn’t think about it being related to this) called “Blink.” It is about intuition. It talks about the subconscious recognizing and accurately interpreting event and or conditions (my words) and presenting the conscious mind with relevant truth (interpretations?). I think this involves being observant but what you are talking about feels like it has more to do with what course of action is chosen. I will have to think about this.

I wonder about this thing we call truth but I believe I know what you are talking about. It is our belief systems, what we believe to be true. If we are forced to change what we believe …isn’t that only a problem when it touches on things we have either been taught or come to accept as being important. If a person had been conversing with someone called “Red” on the internet and believed them to be redheaded but when they met them the person actually had gray hair that may or may not cause that person a problem. I guess if the wrong information was the result of a lie that would mean that the person who told the lie was also saying that it made a difference to them one way or the other …or they preferred the other person believe one way vs. the other. I am wondering now how much of the emotional structure has to do with values rather than truth. I am sorry, I don’t mean to be insensitive. Please don’t’ take it that way. I know you are going through this and it isn’t easy. I appreciate your sharing. I can understand why you do better where things are quiet and why feeling safe is important. Falsehoods corrupt just about everything.

If you find the pictures I would be interested in seeing them. I will try not to make it a habit to ramble on like this. Thank you.

Hugs to you too.

I am really enjoying this conversation. You are helping me sort this out.

I guess I had two things going on at the same time. My spiritual beliefs were being restructured at the same time my mental and emotional beliefs were being restructured. It worked hand in hand for me. I'll separate it and talk about the mental and emotional.

The trauma I went through as a child created a belief and an emotion. The belief was usually faulty and negatively aimed toward myself. The emotions from the trauma could have been fear, anxiety, panic, pain, guilt, shame, need etc..

Since I was too young to process the trauma I blocked out the memory. That was my coping method at that age. It was automatic and I didn't even realize I did it. I was then left with the free floating emotions. Since I didn't have a memory to associate with the emotions I projected them onto other persons, places and things, which influenced all of my choices and actions. All I knew is that I was afraid. I was in pain. I was guilty and had shame. All my choices were dysfunctional because of this. My emotions were dictating how I had to live to survive.

Slowly but surely I started taking responsibility for my emotions. I tried everything to fix me. I couldn't do it. I wasn't aware that it was hidden memories causing the problem. Then one day I had a huge miracle. A huge ball of emotional pain connected to a memory. It instantly felt like 2000 pounds of emotional pain was lifted right out of my chest. It was unbelievable.

For the next 5 years I had memories come to the surface and connect with one of my emotions. Each time there was a connection there was freedom from the emotion and the dysfunctional action that went with that emotion. This is what I meant by believing the lie. I did not know that all this was hidden from me. Each memory was terrifying, but only took a few days to get completely out. I think since I knew what was happening I was able to let it happen even though it was so hard to look at. When the emotion connected to the memory it was the same as reliving it over again. Most of the memories were not that hard for an adult, but the intensity of the emotion was from a child's point of view. So piece by piece my entire belief system fell apart and was put back together again with the facts of what really happened. The hardest emotions have been guilt and shame. It's much harder to look at and face the things that we feel guilty about or are ashamed of. Even if the guilt and shame are not our fault.

In my case my spiritual beliefs also fell apart. I had to start from scratch.

I would imagine that trauma as an adult could be the same way. We go into shock and our minds process things slowly. We accept things slowly and it can cause the same kind of free floating emotions until we face the facts of what we've been through.

I don't know where values fit in to all of this. I always had very strong values, but could rarely live up to them. I was too busy trying to survive. When I went through all of this there was no treatment that I knew of and I didn't even have a word for anxiety or panic or PTSD. I just thought I was always losing my mind. I called it brain leak. That just about summed it up for me.

I went through all my memories without knowing that their was a word for it called flashbacks. In fact it was only about 3 years ago that I discovered all these terms. I was amazed that there were other people out here who knew about this. I thought I was the only one.

[mateo]

Wow. Boy can i relate to some of the stuff in this thread. Thanks.

[Tapery]

Hi, mateo. MG is a wealth of information, isn’t she? Please jump in if you have anything to add or ask.

MG, I think my use of the word “value” was not very precise. It can be used many ways but I was thinking in terms of importance vs. unimportance rather than good vs. bad.

Thank you for sharing. It does help to see the sequence in how things played out. It is wonderful that you have managed to free yourself of so much pain. I know what you mean about doing much of the healing work first and then finding out that you have not been alone or at least not the only one to go through it.

In my town recently there was an event that generated a level of anger (hatred?) that felt like free floating unattached emotion. I recognized in the local paper’s editorials an effort to direct it and attach it to one small facet of the event, not total responsibility just the anger. I found myself bristling at what felt like the injustice of it. I almost wrote a letter to the editor about it. I am a bit ashamed of the “almost” part of that. I hesitated, taking the time to think about it and how it related to other things I have seen happen. Perhaps the projection of emotions onto other than the source event sometimes has help from outside.

I grew up in a very conservative church but conservative in a different way than we think of it today. Much of the church teachings had to do with our personal actions and beliefs not other’s. I was obligated to do my personal best and give everyone else the benefit of the doubt. The effect of this was a distorted reality. Some years ago I took part in an in depth theological group study. The material and discussions were approached in both a sensitive and candid way. I was part of the first real group after the pilot study. The course was edited (read that muzzled) later to offend less people. I was blessed to be a part of that group. It was there that I first seriously looked at what was behind my religious beliefs. I came out of it with my belief structure stronger but more open. I am less willing now to simply accept what other people say I should believe and realize even well intentioned people are products of our culture and that I can be wrong, too.

Like you I am working on my mental and emotional beliefs. In my little world openness and candor are not acceptable. One must be polite and conform to certain conventions. It makes being able to accurately pin emotions down to specific events in daily life difficult. To use a metaphor I picked up somewhere along the way, I have come to look less at the rocks and more at the flow between the rocks.

My art mentor once asked me why I wanted to paint and I told him that I wanted to paint my mysteries. He wasn’t totally approving but for me if I were not doing that I would simply be doing illustration. My art takes me to the edge of my understanding and allows me to probe a little beyond.

This conversation is helpful and I truly do appreciate your openness.

Hugs

My daughter paints her flashbacks. It really helps her. She is very creative and that may be why she has such visual flashbacks. Most of her flashbacks do not have much to do with her memories. I think they are more of a creative component that her mind uses as a release. She is very light hearted and has a happy spirit. Her drawings and paintings can be very scary to me anyway. They are not something I would hang on my wall, lol. It helps her a lot to paint them or draw them.

I also learn with pictures, but not the artistic kind. I put everything I learn in a diagram of some sort. I sort out each new piece of information and get it all in a nice little box so I can understand it. I'm not very creative. I really think there is a difference between the way creative people and someone like me handle their PTSD. I think flashbacks can be much worse for people who are very creative and much harder to sort out.

I think it's great that you are painting your mysteries.

[Tapery]

I am glad your daughter is able to express herself through her painting. All paintings are not destined to be hung on a wall. I kind of like the small ones that are meant to be placed in a small portfolio and held in the hand when they are viewed. Art can and does server many purposes. One of the most successful contemporary artists I have met had a stack of small drawings on a table at a private reception. Most of them would sell for $10,000 a piece or more and people were shuffling through them juggling canapés and drinks in their other hand. The artist stood there politely answering questions appearing to be very content. I liked him as an artist and as a person.

I like graphs, charts, and math. I tend to be overly analytical, not one of my most fun characteristics. I’ll share a secret with you, I don’t think I know what creativity really is. So much of what I do is built upon what others who came before me discovered. I feel like I am part of a continuum, only adding my own small mark, one that may be lost as soon as I make it. It doesn’t matter. It doesn’t change anything. I do because I cannot “not” do.

[pedagogue]

Originally Posted by Tapery

I wonder what differences it makes in the resulting PTSD if the stress was caused by a single critical event or a series of (minor to serious) related events over a limited period of time.

Good question.

In both instances, people accept certain ideas (‘lies’) of safety. When trauma happens, the ‘lie’ is shaken, and PTSD can occur. Comparing one incidence of trauma to one that happened over a period of time is hard/impossible because though PTSD is one of the few disorders that actually has a defined cause, it is based on a number of independant factors. Previous experiences of the person, genetics, etc. The two most important factors are the person's proximity to the trauma, and their reaction (typically a feeling of helplessness). If a person experienced the trauma first hand, they are more likely to have PTSD, than someone who witnessed the trauma. An important factor is how threatened the person felt during the trauma. Another factor is how the person reacted ot the trauma. If they reacted helplessly or not at all, they are more likely to experience PTSD, than if they tried and failed to do something.

Originally Posted by Tapery

I have, also, been wondering about the use of carefully selected acts intended to cause stress that would lead to PTSD. I wonder if the treatment of PTSD is different depending on the type of events that caused it, and or if the events are ongoing.

You can do certain things to cause new PTSD and/or instigate an existing case. The most frequent instigator is violence (war, rape, etc).

PTSD can be treated in a variety of ways....depending on the trauma. For instance....a war vet may present differently than someone who was abused throughout their childhood.....or they might have the same symptoms, it really is hard to say.

It is late...so i'm off to bed, I'm going to check back tomorrow maybe. This is a very interesting thread.

-pedagogue

[Tapery]

Hi pedagogue. Thank you for the explanation. With PTSD does it always come down to a connection between the lie that was reveled and the symptoms that resulted? From what you are saying it doesn’t really matter if the lie was revealed in a single incident or a series of incidents but I suppose a single incident would be easier to identify and could make it easier to root out which lie it was that was reveled. But, aren’t our beliefs interconnected and often contradictory? So I suppose there never is a single lie involved. Perhaps our beliefs regarding our helplessness and control are part of that network of “lies” that gets pulled in.

This is interesting and helpful. Thank you for the information and your thoughts.

Marsha

[pedagogue]

Originally Posted by Tapery

Hi pedagogue. Thank you for the explanation. With PTSD does it always come down to a connection between the lie that was reveled and the symptoms that resulted? From what you are saying it doesn’t really matter if the lie was revealed in a single incident or a series of incidents but I suppose a single incident would be easier to identify and could make it easier to root out which lie it was that was reveled. But, aren’t our beliefs interconnected and often contradictory? So I suppose there never is a single lie involved. Perhaps our beliefs regarding our helplessness and control are part of that network of “lies” that gets pulled in.

This is interesting and helpful. Thank you for the information and your thoughts.

Marsha

The 'lie' portion was more of a description of what happens, not really meant in a literal sense, but more of the idea of it. If you think of a rape survivor, their initial idea that the world is generally safe was shattered after the attack. Now they are wary of most everyone, and their sense of safety is gone.

Below is the diagnosis criteria for PTSD. I bolded the appropriate areas:

# The person has been exposed to a traumatic event in which both of the following were present:

1. the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

# The traumatic event is persistently reexperienced in one (or more) of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
2. recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
3. acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

# Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

1. efforts to avoid thoughts, feelings, or conversations associated with the trauma
2. efforts to avoid activities, places, or people that arouse recollections of the trauma
3. inability to recall an important aspect of the trauma
4. markedly diminished interest or participation in significant activities
5. feeling of detachment or estrangement from others
6. restricted range of affect (e.g., unable to have loving feelings)
7. sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

# Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

1. difficulty falling or staying asleep
2. irritability or outbursts of anger
3. difficulty concentrating
4. hypervigilance
5. exaggerated startle response

# Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
# The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

This was pulled from http://www.mentalhealth.com/ (a very useful website) and can also be found in the APA DSM-IV Manual.

-pedagogue

[Tapery]

Originally Posted by pedagogue

The 'lie' portion was more of a description of what happens, not really meant in a literal sense, but more of the idea of it. If you think of a rape survivor, their initial idea that the world is generally safe was shattered after the attack. Now they are wary of most everyone, and their sense of safety is gone.
-pedagogue

Yes, I understood the “lie” was not literal. I understood it to be a misconception of the nature of the world or the way the world worked…or perhaps the way we believe the world should work.

I have someone in my family who had a trauma as a child and has undergone hypnosis to bring it to the surface. I am not comfortable sharing the details because the story is not really mine. Contrary to the way I may have made it appear this is not academic for me but I appreciate the help with understanding the dynamics of this, with what has been going on.

The facts you printed sound very official and I am sure they are but I think there is more that is not there especially in the area of what causes this. I think you for what you have been able to give me.

[pedagogue]

Originally Posted by Tapery

...I think there is more that is not there especially in the area of what causes this.

You are more right than you think. What I posted was the guidelines and criteria...merely something to reference...but is in no way all encompassing. Also, the diagnostic criteria for PTSD might actually get revised because it DOES miss some things that should be in there.

Best of luck with everything!

-pedagogue

[Tapery]

Originally Posted by pedagogue

... the diagnostic criteria for PTSD might actually get revised because it DOES miss some things that should be in there.

Best of luck with everything!

-pedagogue

Ah, yes. That feels right.

Thank you

[mateo]

I dont really know much about this topic (PTSD) but was struck by how much i could relate to (recent breakdown)

Learning about some of the causes & the discussion of how it works has been enlightening but im wondering if you (plural) could comment some more on the treatment for it. I saw the thing about art therapy. Meds? Counseling? How does the hypnosis stuff work? Thanks--matt

Hi Matt,

Here is a link that might help from the National Center for PTSD.

http://www.ncptsd.org/facts/treatmen...king_help.html

[pedagogue]

MG....great link!

-pedagogue

[mateo]

thanks!