The Impact of Post Traumatic Stress Disorder (PTSD)

Jun 27

Throughout my many years of working in the mental health field as a therapist, I have worked with many individuals who experienced symptoms of Post Traumatic Stress Disorder (PTSD). Whether it be from military service, childhood trauma, a physical or sexual assault, an accident, being a witness to a death or trauma, or a multitude of other causes, PTSD can have significant impacts on an individual’s ability to function. I have had many clients whose ability to trust had been shattered, which then impacted their ability to form meaningful and deep relationships. Clients who melted down in tears in the middle of a shopping center because somebody walked by with the same cologne their abuser wore, or had on a similar t-shirt on that their attacker was wearing during an assault, veterans who reacted to loud noises, people who had flashbacks, nightmares, hypersensitivity, etc.

Many clients’ self perception and inner dialogue was severely affected by the abuse/trauma. I would go so far as to say that, in my experience (I am a practitioner not a researcher so please do not take my observations as research data) one of the predictors of severity of impact was what an individual told themselves, or their belief about themselves, as a result of the incident. For example, one individual who was raped might lay the blame on their attacker and not internalize it. This response helped them to not see themselves as damaged or changed because of the event–or at least not to such a great degree. Another individual who experienced a similar event might internalize it, blaming themselves, and come away from the experience believing that they are now somehow less–that they are damaged goods. That nobody will want them, that they are dirty, that they can never have a normal intimate relationship again, or any number of other horrible and untrue messages that they might tell themselves.

The cognitive distortions (negative beliefs or messages we tell ourselves) following a traumatic event, whether that be a singular event, a series of events, or abuse over a period of time, can be devastating on the health and mental wellness of the individual who experienced the event(s). With my clients, I would call it “shoulding” on oneself. The “I should not have gone there”, “I should have fought back harder”, “I should have done something”, etc. The reality is that the attacker/perpetrator should not have done what they did. Helping my clients understand that the actions of their attacker/perpetrator does not dictate their future worth or value was an important focus; that those actions were only an indicator of who the perpetrator is and does not define their victim. I had one young adult client tell me once, in tears, that she had been saving herself for marriage and now, after being raped, she was no longer a virgin. I worked with her over time to understand that the virginity that she was saving for marriage was still intact. Her virginity was something that was hers to give, not something that somebody could forcibly take. I worked diligently to help her to understand that she was not now defective or broken. That she was still the same beautiful individual that she was prior to the assault. Nobody had the power to take that away from her. People can act on us, which can cause us to feel powerless, but taking that power back is a huge step in the healing process.

Don’t get me wrong. It is important not to minimize the event or the real impact that it can have on an individual. When I worked with individuals having PTSD, I would work to help move them to the point that they could see themselves as having worth and value, which allowed them to take power back into their life. The messages we tell ourselves can have disastrous impact on us. Such negative “self-talk” is not much different than someone who experiences years of verbal and emotional abuse, leading them to start to take on the belief that they really are like what the abusive person is telling them they are. Whether that false message be that they are worthless, that they are broken, they will never amount to anything, or any other negative message. When we hear something often enough we can start to believe it and this holds true for the messages we tell ourselves. Most of us, whether or not we have been through severe trauma or life threatening experiences, tend to be our own worst enemies. Thus, whether we suffer from PTSD or not, we need to work to regulate the messages we tell ourselves.

I also had the opportunity, through the years, to work with many veterans who, for reasons I will not discuss here, chose not to utilize counseling services through the VA system. Of those valiant veterans whom I worked with, at least one was so severely impacted that they needed to, and eventually did, go into a residential PTSD treatment program through the VA system. There is one case that stands out to me for a different reason. This veteran had been in the Middle East for a tour of duty. The individual never experienced combat and their life was never directly placed at risk. They were never shot at, never blown up by an IED, never witnessed a fellow soldier being injured or killed. Really a best case scenario when it comes to serving a tour of duty in a combat zone. So, why did they experience PTSD symptoms? I remember doing a lot of reading and researching on this trying to figure it out. I will note that whatever shortcomings the VA system might have they are a leading expert on PTSD and PTSD treatment and I would often turn to their resources when researching cases like this. What I learned was that individuals who had been in combat zones but never experienced combat were still coming home with PTSD type symptoms. It turns out that even though they never actually experienced combat, that period of time they served in a combat zone required them to be on constant alert. Always watching where they stepped while on patrol, taking care to always step where somebody else had stepped. Constantly wondering about the intentions of the locals: if that woman was really carrying a baby or was it a bomb? Will a shot come from a building? Is this the day my vehicle hits an IED? Etc. This constant state of hypersensitivity and awareness took its toll and veterans could not simply turn it off returning home. In addition to not being able to turn off their heightened awareness, it was found that they exhibited similar trauma effects to those who did experience a situation in which they were in direct threat and/or witnessing others dying.

Information is power in my mind and helping this client understand that, first and foremost, they were not alone, and that what they were experiencing did make sense. They were not weak or somehow broken nor were their symptoms a slight on those who had been involved in direct traumatic experience (I remember them telling me that they did not want the PTSD diagnosis as that took away from those who had directly experienced combat). It was, in fact, a real and lived experience of many who served in such situations and they needed to hear that.

Of great concern relating to PTSD, no matter the cause, is its link to suicidal thoughts, attempted suicide, and completed suicide. The Jed Foundation indicates that “About 14% of trauma survivors and nearly one in three people with PTSD have reported a suicide attempt”. This is in comparison to the general population where, per the American Foundation for Suicide Prevention website which states “Based on the 2022 National Survey of Drug Use and Mental Health it is estimated that 0.6% of the adults aged 18 or older made at least one suicide attempt.” Admittedly the actual rates of suicide attempts can be hard to track as many never tell anybody, or if they do, present at the ER the report an alternate cause to their illness or injury. Even so, the difference between these populations is considerable. The jump from 0.6% of the general population having had at least one suicide attempt to 14% of people who experienced trauma having at least one attempt and then jumping to 33% of those having PTSD having at least one attempt is a significant, and worrisome, difference.

What can we do?

If you are a friend, family member, colleague, mentor, coach, provider, clergy, etc. of somebody who has experienced trauma or who may have PTSD, be aware and be there for them. If you have experienced trauma or have PTSD please know that your symptoms and the impacts you experience are a normal reaction to an abnormal situation. Combat, sexual assault, child abuse, etc., are not supposed to be a part of normal human experiences. Our minds and bodies do their best to make sense of these abnormal experiences and to find ways to protect us from future harm. Oftentimes our minds can be left reeling and working to process and the affected individual may experience nightmares or flashbacks. You may become hyper aware as a means to avoid future trauma which can cause you to be overly anxious or to react to stimuli that may be somehow attached to or reminiscent of the trauma. You may have learned not to trust or a myriad of other things which both serve to protect as well as to deal with the traumatic situation. This does not mean you are broken. It means that your mind is actively trying to process a messed-up situation. Know that you are not alone. There are people who care and who want to help. Whether that be family, friends, counselors, clergy, or others. Reach out and find those who want to and can help. Turning to others who have experienced trauma can be beneficial. Looking for well run and support focused support groups can be beneficial.

If you are experiencing suicidal thoughts please seek help. There are competent professionals who are there to help as well as family members, friends, and others who can help and support you. Other valuable resources are crisis lines such as the 988 Lifeline, a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States, which is as easy to reach as just dialing 988. You are important, you are special, and you are of worth. Don’t allow yourself, or anyone else, to tell you otherwise. I have worked with a lot of people through the years from many different walks of life and have never met a worthless one. If you think you would be the exception to that, you are wrong. None of us, including myself, are perfect, but none of us are worthless either. We all have value and worth, including you!