Beginning Treatment of PTSD and Related Anxiety Disorders
Taking care of yourself as treatment begins
Posttraumatic stress management
Posttraumatic Stress Disorder, or PTSD (described below), is a serious, disabling psychological condition whose successful treatment takes time, care, and experience. Latest research on treatment effectiveness indicates that, while a single treatment session can produce excellent results, complete treatment may take a number of weeks. With complex PTSD cases, involving chronic trauma or multiple traumatic events, the disorder can take significantly longer to resolve, and complete resolution may be difficult.
While you are waiting for your treatment to finish, what can you do to help yourself return to a normal life as quickly as possible? Suggested here are several answers to this important question, answers that have been found to be helpful to many people. It is likely that you will get the same results that they have, if you apply these ideas and procedures thoughtfully and diligently.
Why does PTSD happen?
When something traumatic happens to us, we are, by definition, overwhelmed by the amount of negative feeling that the event provokes. Our normal capacity to function is lost, for a time. We are traumatized.
Immediately after the event is over, all that remains is a memory. Our brains have the capacity to heal naturally from the effects of traumatic events, by converting traumatic memory into ordinary memory. The result is that the memory no longer functionally disturbs us, although we may always be uncomfortable about what happened to us.
However, if our brain has not been able to recover from an extremely distressing, painful, fearful, or shameful experience that occurred in the past, posttraumatic stress symptoms (described in the next section) will result. Whether or not these symptoms constitute formal PTSD, they will still produce a serious anxiety disorder, with complex and disabling consequences.
Failure to heal from a psychological trauma will result in continuing hypersensitivity to certain stimuli, resulting in one form or another of emotional over-stimulation of the brain. Memory of the trauma will simply continue to overwhelm the brain, with the result that one is stuck with the traumatic memory and its effects.
What does PTSD do to us?
The person with enduring posttraumatic stress experiences symptoms that seriously disrupt their peace of mind, their relationships, their work, or their recreational activities. This situation can easily continue for years. With active PTSD, there are four results of an unhealed psychological trauma. Described as psychological symptoms, they are these:
Memories of the trauma keep coming back to us, repeatedly;
We try hard, over and over, to avoid anything (including memories) associated with the trauma;
We experience a general loss of ability to respond positively to the important things and people in our life;
We experience chronic increased responsiveness to stimulating things in life, so that we may be inappropriately irritable, suffer from insomnia, have trouble with anxiety and lack of concentration, be "jumpy", and so on.
Recovery from PTSD
Recovery from PTSD initially involves teaching your brain new ways of dealing with your distressing and disruptive memories and symptoms. Do not mistake this learning of symptom management methods for treatment. Symptom management is similar to first aid. Its purpose is to assist you in achieving some comfort, and adequate function, while you are transitioning to full treatment.
This learning of new ways of managing symptoms will often occur automatically if you will simply allow your brain to notice the effects of certain new behaviors. In the beginning of your treatment, practicing some rather simple things will get you started with the essential learning you will need to accomplish promote you healing:
Check in with yourself from time to time. Notice where your main attention is focused at the moment. Practice distinguishing between "inside stuff" and "outside stuff" - internal versus external stimuli, and memories and the imaginary world inside your head as contrasted with the real world physically around you. Work at learning to become good at choosing to attend to the outside stuff as a way of stopping unpleasant internal experiences. You can do this by spending a little time carefully noting the details of your present environment - objects, shapes, colors, textures, and so on. Allow your attention to shift and to become absorbed in what is real, immediate, and safe.
Practice choosing to calm yourself. Let go of muscle tension, slow your breathing and bodily movements, become quiet outside and inside. Practice allowing your mind to become blank, then keep it blank and calm for a little while. Practice allowing yourself to come to a resting place from time to time. If this is hard for you (and it can be particularly difficult before your PTSD has received much treatment), then practice calming yourself using slow walking, noticing carefully every little movement you make. Pretend you are stalking an animal that is very close to you, and you are seeking to move up to it and just touch it, unseen. Walk very, very slowly, noticing every little movement you make. This will require a great deal of concentration. Do this exercise for several minutes - the longer the better. This active calming exercise is often very helpful for individuals with PTSD.
Practice correcting your time perspective. Bring your attention to present reality here and now. Notice the day of the week, and how old you are, and remind yourself that right now you are not being confronted by an emergency. It may be helpful when doing this to say these things out loud to yourself (if you're alone!).
Practice correcting your thinking errors. Remind yourself frequently (and particularly when you are upset or anxious), that with PTSD you will tend to have a distorted view of the world. Work at correcting this view by reminding yourself that:
Problems are much more common than crises. Only the latter requires a rapid response.
Feelings will often mislead you. Most of the time your house is NOT on fire, the world is not in crisis, and you are safe right where you are.
Over-reaction (excess feelings), and its opposite (numbness), can be managed, while your treatment is focusing on resolving their causes. Let excess negative feeling be a signal for you to choose to use active calming and relaxation skills, such as the slow walking exercise described above. Practice this choice often, for practice will much improve your ability to respond effectively.
Practice caring for yourself. Self-care activities of the most basic sort ARE very important for victims of psychological trauma. Give particular attention to: sleep (or resting, if sleep isn't possible), exercise (a very good idea!), proper nutrition and medical care, and engaging supportive social contacts. These are all critical aspects of your personal self-support program.
Recovery from PTSD requires action
Help yourself to recover and to grow into a positive relationship to your life by noting and using that which is naturally healing for you. This may well include contact with special people, places, activities, thoughts, feelings, or objects. All of these will be things which in the past have tended to calm you, to help you feel whole and comfortable and at peace, and have led you to feel wonder and gratitude for being alive.
Seek out these things often, to anchor yourself in the real world as an antidote to the experience you have when encountering active posttraumatic stress. Invite yourself to return as often as you can to this healing, real world.
Remember the healing wonder of laughter, and how it tends to put everything into correct and comfortable perspective. Laughter truly is the language of the gods. Speak it often!
FINALLY, do remember that just as the body, if healthy and properly supported, will naturally heal from wounds, so will the mind heal from psychological trauma, under the right conditions. Flowers know how to grow, and our mind knows how to heal. We only need to give it the right kind of support, and the healing will occur. Many, many other people have done accomplished this healing. You surely can as well.
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