Trauma and PTSD: What's Your Take?

by Chevies Newman | October 18, 2011 9:37 PM EDT

The ways in which PTSD occur are variable. If it occurs within a backdrop of hyper vigilance (combat and persistent stress), there may many layers to unfold. Does the soldier feel guilt over killing and replay this scenario in multiple ways? Survivors guilt? Did they allow themselves to become unnecessarily violent?
Redirecting the thought processes in this scenario will require knowing how to help the patient reframe the experience.
Other scenarios, those in which an immediate unpredicted trauma occur, may also require a debriefing. Some must be converted to feel empowered, others may feel too responsible.
A forced purging, however, seems futile.
Neuroplasticity, which is damaged to some degree, must be restored. If the patient desires, initiation of psychopharmacology centered around improved sleep and Anxiety can lay the framework which will help build pathways around the loop. If you help a person sleep and feel better, much of the self absorption will improve, laying the foundation of more effective therapy. Once a patient understands the relief they can get medically, they generally become much more optimistic about their prospects and more willing to openly share their experience. I think.

by Linda Moon | October 13, 2011 7:41 PM EDT

The traumatized person needs to tell his/her story enough times that the compulsion to tell it tapers off. It is important to remember that PSTD is still present even if the patient is no longer obsessed with it but do not be surprised that the need to tell can crop up even years after the event itself. This is one of the benefits of having people will to listen be there for the wounded whenever help is needed. Like suicide, PSTD is a condition that keeps on "giving" long after the event occurred.

by sharon A | October 13, 2011 6:15 PM EDT

I, too, believe it's wise to "follow a person's lead". I know, personally, I have found it helpful to tell my story at least once through....if that had been discouraged, I don't feel like I could have fully moved through it. However important it can be to tell one's story, though, it is THEN important to stop "living" in it....For others, perhaps, even the re-telling would be too traumatizing.

by Sandra Donahue | October 13, 2011 4:29 PM EDT

Having been married to a combat vet for 40 years, and knowing many of them personally, you need to take your cues from them. If they feel they are in a "safe environment"with no judgment, and are given an "opening" it should be up to them to take the lead. No one who has been through a trauma should be made to go at a pace set by someone else.

by Robert Sands | October 13, 2011 12:53 PM EDT

the decision whether to support or discourage retelling of trauma depends on the "axis II"considerations as well as quality of trauma. In the 80's it was obligatory to invite telling, even if repeated. Lessons were learned via borderlines and MPD patients who became professional storytellers of their trauma and they were "overidentified" with their trauma. It would have been better to help them move on, prohibit retelling and help to "get a life". Now we are much smarter and need to assess the purpose of the telling and watch the results. Talking leading to working through and integration affirms the model. Talking leading to preservation and affective dysregulation suggests it is not smart and that other issues are primary (bipolar, axis II for example).