Every person can have experiences in everyday life that overwhelm him and frighten him beyond all measure. He can get into a car accident, become a victim of an attack or watch a loved one die. Such drastic experiences can deeply impress a person and also hurt him psychologically. Such an injury is called “trauma”.
What is posttraumatic stress disorder (PTSD)?
Everyday life continues after the event and most people learn to cope with it without having received help. After a few weeks, the violent feelings and symptoms slowly subside. In some people, however, such a traumatic event causes a reaction that lasts for months and years. The reaction to the trauma is called posttraumatic stress disorder (PTSD).
What causes trauma and PTSD?
Shock traumas cause PTSD, e.g. triggered by
- Car accidents, accidents, falls from great heights (experienced or witnessed!)
- Military deployment, torture, catastrophes
- Loss of limbs, mutilation
- Fistfight, rape, abuse, assault
- Diagnosis of a life-threatening disease
- Surgery (also dental surgery), injury, birth stress
- Loss of a loved one
What is only a massive thrill for one person can have a traumatising effect on another. In general, the more violent and threatening the event, the greater the likelihood that the body will no longer be able to cope with the energy and respond with symptoms.
Symptoms of PTSD
Many people have feelings of deep sadness, depression or guilt and anger after a traumatic experience. In addition to these very understandable emotions, there are three symptoms that often occur and can last for years:
- Flashbacks and nightmares
You experience the event again and again. These flashbacks can be extremely realistic with all the emotions, sweats and noises from back then. Minor things in everyday life can cause a flashback. If, for example, you had a car accident in the rain, a rainy day can trigger a flashback.
- Avoidance behaviour and deafness
The experience may have been so painful or stirring that you avoid any memory of it. You try to distract yourself, perhaps through a hobby, through too much work, or by spending your time crosswording. You avoid places, situations and people who remind you of them. You try to cope with your feelings by not feeling anything anymore. You become emotionally deaf. You communicate less with people. They then find living together or working together with you exhausting.
You are constantly on your guard. You cannot relax, you do not sleep well and your fellow human beings perceive you as erratic, quick to react and easily irritable. You yourself do not know why this is the case.
Other PTSD symptoms include
- Tension, muscle pain
- Feelings of panic and anxiety
- Irregular heartbeat (palpitations)
- Excessive drinking
- Drug and painkiller use
How can I tell if I have PTSD?
You have had a corresponding experience.
- You have flashbacks, vivid memories or nightmares.
- You avoid anything that reminds you of it.
- You feel emotionally dull or deaf.
- You are constantly on the go, quickly irritable, but don’t know why.
- You distract yourself to deal with it.
- You are depressed and exhausted.
- You find it difficult to deal with others.
- You eat more, drink more alcohol, take drugs or sedatives.
- Your emotions shoot up uncontrollably.
If the event was less than six weeks ago and the symptoms are slowly diminishing, this is part of the normal adjustment process.
If the event occurred more than six weeks ago without the symptoms improving, you should talk to a doctor.
„Some traumas – loss, death, accidents, disease or abuse are explicit. Others, like the emotional deprivation of an unloved child, are more subtle. And some, like my own feelings of estrangement, seemed to come from nowhere. But it’s hard to imagine the scope of an individual life without envisioning some kind of trauma. And its hard for most people to know what to do about it. . . It’s rare for someone to get through life without experiencing trauma. . . (My father) did his best to keep it out of his consciousness as long as he could.“
Mark Epstein, The Trauma of Everyday Life
Why is PTSD often not recognized?
- You don’t like to talk about things that upset you, worry you, or frighten you deeply. (This is the case with most people.)
- People close to you and even doctors feel uncomfortable when you try to talk about cruel events. Then why should you reveal yourself to these people?
- You don’t want to admit that you have one symptom or another because you don’t want others to judge you as weak or mentally unstable.
- You notice a few symptoms, but you don’t see their connection or cause.
- It is much easier for you to talk about accompanying problems (such as headaches, sleep problems, tension, problems with alcohol or work) than about the cause itself.
- You hope that at some point the symptoms will stop by themselves.
What are complex traumas (complex PTSD) ?
People with complex trauma have a history in which they have been subjected to long-term totalitarian control. These include
- Sexual abuse
- Child sexual abuse
- Neglect in early and earliest youth
- Physical abuse
- Emotional abuse
- Domestic violence
- Torture, concentration camps – and all those forms of trauma in which the victim cannot flee or does not think he can flee, for example when he is buried under an avalanche and does not know if help will come.
“In all of us there is a force that spontaneously strives for contact, health and vitality. As much as we have retreated and isolated ourselves, or as serious as the trauma we have experienced may be, at the deepest level there is an impulse in each and every one of us towards being connected and healing, comparable to the way the plant grows towards the sunlight.”
Laurence Heller/Aline LaPierre, Healing Developmental Trauma
Symptoms of complex PTSD
Complex traumas occur weeks or months after the event, but it can take years for them to be detected. The loss of trust in people – and in the world in general – is a central part of complex PTSD. Some children respond by being defensive or aggressive. Other children disconnect from what is happening and grow up with a sense of shame and guilt. They feel uncomfortable in their skin and have no confidence.
In addition to the classic symptoms of PTSD, complex PTSD also has the following symptoms:
- Feeling of deep shame and guilt, lack of self-esteem, negative self-image.
- Feeling light-headed or numb.
- Feeling of alienation (depersonalization).
- Feeling of helplessness, defencelessness and helplessness.
- Feeling of subliminal threat.
- Lack of body awareness up to the blackout of body areas.
- You can’t trust anyone and would prefer to always stay in control.
- You cannot rejoice, do not react to the joy of others, lack of empathy.
- You control your feelings through drugs or alcohol.
- You disconnect yourself internally from what is happening in your environment (dissociated).
- You cannot express your feelings in words.
- You very often deal with thoughts of suicide.
- You spontaneously take risks, do things spontaneously, have problems with aggression and impulse control.
- You have problems with contact to other people. You have the feeling that you don’t belong anywhere and feel like a burden.
- You have problems setting limits and saying no bluntly.
- You feel constantly stressed and under pressure.
- You discover a lot of flaws in yourself and react very vulnerable to rejection.
- You simply don’t know what you need and feel that your needs don’t deserve to be met.
Worsening factors in complex PTSD are:
- The younger the person, the worse the trauma.
- The trauma is caused by the primary caregiver (e.g. the mother).
- The trauma lasts for a long time.
- You are isolated.
- You still have contact with the person or situation that threatens or abuses you.
Worth reading books on the subject are:
Judith Lewis Herman, Trauma and Recovery: The Aftermath of Violence–From Domestic Abuse to Political Terror) 304 pages, $30,58, Basic Books, ISBN-13: 978-0465087303,
J. L. Herman is a professor at Harvard University and has introduced the term “complex PTSD”. In her book, she describes the effects and parallels of domestic violence, private terror such as rape, and public terror as experienced by veterans and victims of political terror. The book provides an understanding of problems that have so far been dismissed as “personal problems” and relates them to a broader socio-political framework. Published in 1992, the book has changed the way people think about trauma and how trauma is treated.
Susan Hart, The Impact of Attachment: Developmental Neuroaffective Psychology, 427 pages, 40,95 €, W. W. Norton & Company, ISBN 978-0393706628
Susan Hart, Brain, Attachment, Personality: An Introduction to Neuroaffective Development, 400 pages, 54,40 €, Karnac Books , ISBN 978-1855755888
Susan Hart combines the findings of neurobiology with those of interpersonal relationships and shows the effects on early childhood bonding patterns. With many examples from daily life and from her practice, she explains how a healthy mother-child relationship develops and what can go wrong.
Laurence Heller/Aline LaPierre, Healing Developmental Trauma 320 pages, 19,31 €, North Atlantic Books, ISBN 978-1583944899
This book explores the deepest human needs. It leads to a profound understanding of the fundamental conflicts between oneness and separateness, these two seemingly irreconcilable opposites, and shows a path to personal growth and maturity. It describes how early childhood trauma undermines the ability to relate to oneself and others. The resulting diminished liveliness is the hidden dimension behind many psychological and physiological problems.
If you have any questions, please feel free to contact me in my practice in Berlin or Munich. Here you will find the contact page.