Trauma

Post-traumatic stress disorder (PTSD) was first used as a diagnosis by veterans from the Vietnam War, but such symptoms have existed for much longer. The disorder has had many names, including:

Post-traumatic stress disorder isn’t only associated with war-related scenarios however. Traumatic events such as natural disasters, abuse, a terror attack, bereavements and accidents can also cause symptoms.

It is understandable for people to feel distressed and upset after a traumatic event. For many, these feelings gradually subside and they are able to carry on with their lives as normal. For others however, distress and anxiety following a trauma may be ongoing. It can be so severe that their everyday lives and ability to live normally suffer. The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness or horror in response to the threat of injury or death.

Your exposure to traumatic events can happen in one or more ways:

1. You witnessed something first hand
2. You experienced the traumatic event
3. You are repeatedly exposed to graphic details of events e.g. first response on the scene
4. You learnt someone close to you experienced or was threatened by a traumatic event

At the time someone is being exposed to this intensely fearful situation, their mind suspends normal operations and copes as well as it can in order to survive. This might involve different reactions such as, ‘freezing on the spot’ or the opposite ‘flight away’ from the danger. Until the danger passes the mind does not produce a memory for this traumatic event in a normal way. Unfortunately when the mind presents the memory for filing it can be very distressing and can revoke the emotions associated with the trauma and the sensations such as touch, taste, sound and vision, smell, all of which can present as nightmares, flashbacks or intrusive unwanted memories. This process of filing the memory away can re-traumatise the individual.

As the mind continues to try to process the memory, the individual finds that their levels of awareness change. People can find it difficult to control their emotions and suffer intense symptoms of anxiety both physically and emotionally.

Many PTSD sufferers also feel emotionally numb and have trouble communicating with others about what they feel. As feelings and symptoms of PTSD become so unmanageable, the sufferer starts to avoid anything linked to the original trauma, which impacts their daily life activities.

The brain is programmed to process memories, so the more the individual avoids thinking about the trauma, the less likely any memory processing will occur, and the more likely it is that further attempts at filing a memory will occur automatically. This leads to further nightmares, flashbacks and intrusive memories which lead to further hyper-arousal and emotional numbing, which in turn leads to more avoidance and so on. This cycle is why some PTSD sufferers manage for such a long time without seeking support, but eventually the symptoms become unmanageable. Following a trauma, the majority of people’s psychological reactions subside. Yet in 20% the reactions stick and become chronic.

Most patients presenting with PTSD have had the problem for many months, if not years. The interventions outlined below are effective in treating such individuals and duration of the disorder does not itself seem an impediment to benefiting from effective treatment provided by competent healthcare professionals.

Psychological interventions

The duration of treatment can extend beyond 12 sessions if several problems need to be addressed in the treatment of PTSD sufferers, particularly after multiple traumatic events, traumatic bereavement, or where chronic disability resulting from the trauma, significant comorbid disorders or social problems are present. Trauma-focused treatment needs to be integrated into an overall plan of care.

For some PTSD sufferers, it may initially be very difficult and overwhelming to disclose details of their traumatic events therefore I would devote several sessions to establishing a trusting therapeutic relationship and emotional stabilisation before addressing the traumatic event.

To schedule a confidential consultation to discuss how I can assist with your current PTSD condition, simply call on 0207 205 2868 or complete the online enquiry form.