PTSD as an Outcome of Childhood Abuse
Originally, Post Traumatic Stress Disorder was recognized and diagnosed in returning war veterans. Now, it is recognized as an outcome from a traumatic situation. In fact, new research postulates that PTSD can result from events that may not seem too severe.
Diagnostic and Statistical Manual of the American Psychiatric Association V5, has refined the diagnostic criteria of PTSD, but it now lists two sets of criteria – one for anyone over six and another for children under 6. This confirms that PTSD can occur in very young children and results in symptoms strong enough to be observed and measured. If you have time to spare, feel free to read about the new criteria here.
For all of us, a traumatic event has some natural repurcussions. When our sense of safety is shattered, it’s normal to feel numb, or disconnected, depressed or ‘out of control’. Bad dreams, obsessive thoughts about the experience and overwhelming fear are all normal reactions to events that are beyond our normal life. For most people, these feelings are short-lived and gradually dissipate. With PTSD, the feelings don’t lift and get worse with time. And since you feel ‘crazy’ you are not likely to talk to anyone about the event or your emotional reactions.
Children who experience trauma may lack the vocabulary to express what happened, may not be believed if they speak out or may have been told it’s their fault. Latest research shows that abuse and/or trauma affect brain development, causing structural abnormalities in the frontal lobe, home to our emotions. Over time, these changes in the brain may result in personality deficits if not recognized and treated. (See http://www.upliftprogram.com/article_ptsd.html)
To diagnose PTSD there must be the presence or threat of a traumatic event, experienced or observed. It can also occur from hearing about a friend’s experience or observation. It is common in those who are exposed to the details of such events (police officers, firemen and paramedics reading reports).
While everyone experiences PTSD differently (and the DSM – V has more detailed criteria), there are three main symptoms:
1. Flashbacks (re-experiencing the traumatic event): The re-living of traumatic events in the moment. They can be precipitated by an external event (the sound of footsteps in the hall) or a jogged memory. They feel ‘crazy’ and disorienting because of ‘feeling’ back in that moment in time. To work thru them, remind yourself that you are an adult and are safe now. Breathe slowly but naturally. Consciously slow down your alarm response. Sometimes wrapping yourself in a blanket or holding a pillow can help. If you’re in public, grab hold of something, (a chair or a desk) plant your feet firmly on the ground and take a couple of deep breaths, and remind yourself that you are an adult, you are in a safe place and that all is well.
Bad memories can also occur as bad dreams. If they occur regularly, remind yourself before you go to sleep, that should a bad dream occur, you will wake up immediately. (This will take practice but can be learned.) Then follow the suggestions above to soothe and calm yourself.
2. Avoiding reminders of the trauma – At its simplest, PTSD is the ‘storing away’ of bad memories which are too difficult to assimilate, integrate and release. Because we need to deal with them, they pop up, usually at inopportune times. From the desire (Conscious or sub-conscious) to keep the memories at bay sufferers may try to avoid reminders of the trauma. So they won’t go near a specific house, or will avoid certain types of people. Or will only sleep in locked rooms or high windows. Making love in certain positions may cause panic attacks. Ditto for the shower hitting your face.
The list is endless and applies to the person’s need to feel safe and avoid the memories. Ironically, often there is no knowledge of why I can only sleep in a room with a locked door, but that’s my truth and so I live that way.
Most of us have seen TV programs where a car backfiring throws a veteran into a flashback. But this is not necessarily the only type of trigger. For abuse survivors, triggers are often more personal and less obvious. I regularly hear from clients who can’t sleep in their parents’ home or at grandma’s house. The smell of a barn or a new vehicle can be triggers. As they try to avoid any stimulus that might trigger their memories, the risk is that their world becomes smaller and smaller. And they get more and more stuck in the drive to keep the memories at bay. And worst of all, along with this symptom is the inability to remember the original trauma.
3. Increased anxiety and emotional arousal: Over time, clients with PTSD often have trouble falling asleep, or once asleep, they can’t stay asleep. Or if they do sleep, it is a light, shallow sleep that is not restorative. Sufferers are usually hyper vigilant – they know where everyone is around them, all the time. I had a client who could empty a handful of change from his pocket, along with all the other paraphernalia men carry, and seemingly drop it on the nightstand. He could always tell if any of it had been moved – even 24 hours later! This kind of vigilance consumes lots of energy and is exhausting. It exacerbates the lack of sleep.
Many people with PTSD have an exaggerated startle effect, so a slamming door will be much more jarring to them. Usually they are more sensitive to noise (banging plates as the table is set) and loud voices. And because of their heightened state of awareness, they may have trouble concentrating. Often misdiagnosed as ADHD, PTSD clients do not find relief with the drugs or therapies for that syndrome because the cause is different.
If you consider a person who isn’t getting enough sleep, who is easily startled and who is always aware of what is going on around them (by the way, they often have amazing peripheral vision), what would be the expected outcome? You got it! Irritability and a bad temper are common in PTSD sufferers. But when considered in the context of PTSD, anger and irritability are perfectly logical outcomes.
Not everyone who is sexually abused gets PTSD, but it is very common. It begins from a need to put the originating trauma at a distance, but ironically creates many problems. It is treatable with therapy and occasionally, medication.
Remember the rules of this blog: No diagnosis. But if some of these symptoms match your experience, contact a mental health professional who can help you determine what’s going on and start you on the road to healing.
Additional information came from: http://www.upliftprogram.com/article_ptsd.html and
Questions? Comments? Did this raise the hair on the back of your head? Let me know and I’ll repond.