After Manual of Mental Disorders (DSM-III) in the

After experiencing a traumatic event, the mind has been known to horde away thedetails and memories and then send them back at unexpected times and places,sometimes after years have passed.

It does so in a haunting way that makes therecall just as disturbing as the original event. Post Traumatic Stress Disorderis the name for the acquired mental condition that follows a psychologicallydistressing event “outside the range of usual human experience”(Bernstein, et al). There are five diagnostic criteria for this disorder andthere are no cures for this affliction, only therapies which lessen the burdenof the symptoms. The root of the disorder is a traumatic event which implantsitself so firmly in the mind that the person may be shackled by the pain anddistress of the event indeinately, experiencing it again and again as the mindstays connected with the past rather than the present, making it difficult tothink of the future. The research on this topic is all rather recent as thedisorder was only added to the Diagnostic and Statistical Manual of MentalDisorders (DSM-III) in the last twenty years. Yet, the disorder is quite common,threatening to control and damage the lives of approximately eight percent ofthe American population 5% of men and 10% of women.

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Any person is a potentialcandidate for developing PTSD if subject to enough stress. There is no predictoror determining factor as to who will develop PTSD and who will not. Although allpeople who suffer from it have experienced a traumatic event, not all people whoexperience a traumatic event will develop PTSD. Each persons individual capacityfor coping with catastrophic events determines their risk of acquiring PTSD. Andnot everyone will experience the same symptoms; some may suffer only a few mildsymptoms for a short period of time, others may be completely absorbed, stillothers who experience great trauma may never develop any symptoms at all(Friedman). More than any other psychological problem, symptoms are a reactionto an overwhelming external event, or series of events. From a historicalperspective, the concept of PTSD made a significant change in the usualstipulation that the cause of a disorder could be outside of the self, ratherthan some inherent individual weakness (Friedman).

There are many situationsthat may lead to developing PTSD, including: “serious threats to one’s lifeor well being, or to children, spouse or close friends/relatives; suddendestruction of home or community; and witnessing the accidental or violent deathor injury of another” (Bernstein, et al). Characteristic symptoms includere-experiencing the event, avoidance of stimuli associated with the event ornumbing of general responsiveness, increased arousal not present before theevent, and duration of the disturbance for at least one month (Johnson). When abomb exploded the Oklahoma Federal building in 1996, hundreds of lives wereaffected. Not only are the people who were in the explosion in danger ofre-experiencing it over and over, but so are the people who witnessed theaftermath, from bystanders to the rescue workers on scene. The survivingemployees not only were physically injured in the blast, but saw the deaths oftheir coworkers and children. Surviving a horrific trauma that many others didnot is enough to cause serious emotional harm. For the rescue workers whoarrived, many of them saw death and people who they could not help; feelinghelpless and guilty may manifest into intrusive recollection and nightmares. Toexplain further, the first criteria is that the person was at one time exposedto a traumatic event involving actual or threatened death or injury, where theresponse was marked by intense fear, horror or helplessness (Pfefferbaum).

Thisevent may have taken place only weeks ago, or as far back in memory as fortyyears. The disorder is most commonly found among survivors of war, abuse andrape. It also occurs after assorted crime and car accidents, as well as aftercommunity disasters such as hurricanes and floods. Workers of rescue missionsare subjected to situations of severe stress frequently. Many emergency responseworkers (police, nurses, and medics) may become overwhelmed by the trauma theysee so many people go through and end up with intrusive recollectionsthemselves. Secondly, the trauma is re-experienced in the form of nightmares,flashbacks, intrusive memories and/or unrest in situations that are similar tothe traumatic experience by an associated stimuli (Pfefferbaum). Auditory orvisual stimuli can evoke panic, terror, dread, grief or despair.

Commonly, inthe case of war veterans, the patient may be mentally “sent back” tothe time and location of the original traumatic experience. A veteran who hearsa startling noise like a car backfiring may “hear” gunfire and it willtrigger flashbacks. These flashbacks can last a little as a few seconds,minutes, or up to days where the person behaves and reacts to everything as ifthey are in that original traumatizing setting. Thirdly, there is a numbing ofthe emotions and reduced interests in others and the outside world. The personis attempting to reduce the likelihood that they will either expose themselvesto traumatic stimuli or if exposed will minimize the intensity of theirpsychological response (Pfefferbaum). For this reason, it is extremely difficultfor people with PTSD to participate in meaningful interpersonal relationships.

Forth, there are random associated symptoms including insomnia, irritability,hypervigilance and outbursts of rage. The natural startle inhibitor may bedulled and the patient is easily surprised or upset by unexpected stimuli.Lastly, symptoms of each category must show significant affect on the person’ssocial/vocational abilities or other important areas of life.

Which appears tobe an unavoidable effect if a person is in fact experiencing the symptomslisted. All of these symptoms must persist for at least one month An examplefrom the textbook Psychology introduces a 33-year-old nurse named Mary whosuffered severe trauma in the weeks following an attack in her apartment by anintruder who raped her at knife point (Criterion one). In the weeks after theattack Mary suffered from an immense fear of being alone in her apartment (thesecond criterion), and preoccupied with attack, she feared it could happenagain. Her worry developed in to an obsession with protection and she installednumerous locks on all her windows and doors, eventually Mary became so overlypreoccupied with the attack that she could no longer go out socially or evenreturn to work (Criterion three and five). She became repelled by the idea ofsex. Her associated behaviors encompass criterion four.

In the seven years sincethe Gulf War, three percent of United States Soldiers have so far been diagnosedas having Posttraumatic Stress Syndrome. Those with greatest exposure to combatare the most likely sufferers, which lends to the idea that the more severe atraumatic event are more difficult it is to overcome. Additionally it developspredominantly in soldiers who were categorized as having the least “stressresistant personalities” coupled with low levels of social support.Essential to recovery of any stressful event is the knowledge that the suffereris not alone or unique in the grief and that others care about his or herrecovery. Those soldiers who returned from war with no one to share theirexperiences with are likely to re experience warfare in the form of nightmaresand flashbacks. After witnessing the deaths of both enemies and comrades thosewithout social support are likely to internalize their pain which have a goodchance of escaping out of the body in the symptoms listed (Bernstein).”Acute” PTSD occurs within six months of the traumatic event, while”Delayed On-set” PTSD occurs anytime afterwards.

In some instances,patients have developed symptoms decades later. Holocaust survivors,experiencing terrifying nightmares of events they thought they had buried solong ago, have been diagnosed forty and fifty years after the attempted genocideof the Jews with PTSD. PTSD can become a chronic psychiatric disorder that canpersist for decades and sometimes a lifetime. Chronic patients go throughperiods of remission and relapse like many diseases. Some problems associatedwith leaving PTSD untreated are clinical depression and addictions, such asalcoholism, drug abuse, and compulsive gambling. Addictions are a common way of”self-medicating.” There are instances when a person suffers frominvoluntary recall of events that they cant quite place or understand. Sometimesadults who were abused in some form as children do not fully know what istormenting them but still struggle with similar symptoms.

For these peoplehypnosis in a controlled environment is beneficial. After hypnosis the patientand doctor will discuss what has come out and together deal with what has beenlearned. Drugs in general are not a cure for Post Traumatic Stress Disorder, butthey can calm the patient long enough to rationally discuss what is torturingthem. Also it is possible that children who survived the Oklahoma bomb blast maynot be told for some time what they lived through.

Their first recollections maybe hazy pictures that only hint as to what happened. Hypnosis may bring out thedetails that the mind isn’t willingly sharing. When the details are known thepatient then has the opportunity to accept them and develop an understanding andan acceptance (if they are lucky enough to get that far) of what they havesurvived (Foy). Therapy is the only known method of treatment, but there havenot been substantial gains in this field for recovery of patients.

After fourmonths of intensive treatment, Vietnam veterans showed no long term effects oftheir therapy in a study conducted by the “National Center forPost-Traumatic Stress Disorder” in New Haven. The men received individualand group psychotherapy and behavior therapy as well as family therapy andvocational guidance. Although they left reporting increased hope andself-esteem, a year and a half later their psychiatric symptoms had actuallyworsened.

They had made more suicide attempts and their substance abuse wasdramatically increased (Johnson). The Harvard Mental Health Letter publishedFebruary/March of 1991 asserts the important result of therapy (of any kind) isthe enabling of the patient to think about the trauma without it taking over andbeing able to control their feelings without systematically avoiding ordiverting their attention. People who are afflicted with PTSD never feel safebecause they are controlled by their fears; nightmares and flashbacks onlyconfirm their perceived helplessness and remind them of how they were unable toprotect themselves from the event. Healing has taken place only when the personcan invoke and dismiss the memories at will, instead of suffering the intrusiveinvoluntary recall (Johnson).BibliographyBernstein, Douglas A., Alison Clarke-Stewart, Edward Roy, Christopher D.Wickens. Psychology.

Boston: Houghton Mifflin Company, 1997 Bower, Bruce.”Exploring trauma’s cerebral side.” Science News. 149.20 (1996) : 315Foy, David W., ed.

Treating PTSD : cognitive-behavioral strategies. New York:Guilford Press, 1992. Friedman, Matthew J. “Post Traumatic Stress Disorder:An Overview.

” National Center for PTSD. Dartmouth Medical School, 1997.Johnson, David R., Robert Rosenheck, Alan Fontana.

“Post-traumatictreatment failure.” Harvard Mental Health Letter. 13.9 (1997) : 7 Matsakis,Aphrodite. I Can’t Get Over It : a handbook for trauma survivors. Oakland.: NewHarbinger Publications, Inc.

, 1996. Pfefferbaum, Betty. “Posttraumaticstress disorder in children: a review of the past ten years.” Journal ofthe American Academy of Child and Adolescent Psychiatry. 36.11 (1997) : 1503-12″The Harvard Mental Health Letter.” Feb.

/Mar. 1991. Online. Internet.14 Oct 1998. Available.


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