Trauma and PTSD

Trauma and Post-traumatic Stress Disorder (PTSD) is too often miss-understood.  In many ways, PTSD is another specific type of anxiety reaction. With a phobia, a person is afraid of something specific, like a snake.  The phobia is maintained over time as the person avoids the snake, making the body’s fight or flight reaction stronger over time, until avoidance becomes an unavoidable trap, and requires professional help to very slowly and gradually reverse this avoidance process so that a person can build up their confidence, can expand their coping resources, and can reduce the bodily distress that comes with facing the snake.  In the case of OCD, the source of the phobic avoidance is some nasty and unwanted thought. Well, similarly, with PTSD, rather than a snake, the process of avoidance and overwhelming fight or flight reactions centers around a person’s traumatic memories. PTSD is like an overwhelming fear of one’s memories. Just like thoughts with OCD, memories are nearly impossible to avoid. And so what happens is that a good deal of a person’s mental and emotional resources get spent working to keep the memories at bay, while every now and then, the memories get triggered, and the body’s fear reaction is made stronger rather than weaker over time.  

Because people often live with PTSD symptoms for many years, and because trauma’s early in life often involve people who we trust the most, treatment for PTSD can sometimes be a bit more complicated and lengthy than treatment for OCD.  But this is not a hard and fast rule. Most people with PTSD can benefit from psychotherapy within a 12 to 20 session time-span. One bit of helpful clinical wisdom I’ve picked up over decades of working with people who have survived significant trauma is the inherent wisdom of people when they seek treatment, especially for childhood traumas.  When someone comes to see me for some old traumas, they almost always do so because they are at a place in life where they are strong enough and courageous enough to do the work.