Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states
According to the Diagnostic and Statistics Manual IV the type of trauma that cause Post Traumatic Stress Disorder (PTSD) are serious enough to be life threatening. Examples of these types of traumatizing events are being in combat or in a war zone, earthquake, concentration camp, or serious accident. The other possible type of traumatizing event is witnessing the death or injury to another person during one of these types of episodes.
In actuality it is in my opinion and experience and in the opinion of many professionals with whom I have worked over the years it is possible to experience traumatizing events that are less serious than being life threatening but that cause PTSD anyway. In other words there are many smaller traumatizing events that accumulate during a life time that lead to the same devastating result as PTSD.
Let’s review PTSD before we go any further:
Post Traumatic Stress Disorder:
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1. Persistent dreams and nightmares about traumatic types of events that resemble the original trauma.
2. Intense emotional reactions to stress that resemble the original trauma in any way.
3. Avoiding places and people for fear that exposure to people could reawaken bad memories.
4. Loss of hope about a personal future. In other words there is a conviction that marriage, children and career will never occur.
5. Difficulty remembering the actual events of the original traumatizing events.
6. Difficulty falling and staying asleep.
7. Irritability and anger.
8. Difficulty concentrating.
9. Extreme startle response.
10. These symptoms interfere with the ability to function at work or in a personal life.
*All of these are taken from the DSM IV and this is not a complete list of symptoms.
A Perfect Childhood:
I have found that people who experienced lesser but repetitive distressing events tend to dismiss its impact on them. In fact, one of the factors that alert me to the possibility of trauma is when a patient reports to me that they had an ideal or perfect childhood. What is disturbing about this opinion is that there is no such thing as a "perfect childhood." In fact, those who were abused as children are oftentimes the greatest defenders of their parents. Later in therapy, as layers of memory emerge people become better able to admit having experienced childhood trauma and better able to remember the specific events and how they felt during the crisis.
Certainly there are many types of shocking events that happen to people during childhood and later in life in addition to abuse. For instance, the death of one or both parents is a trauma that has to take its emotional toll on a child. In a similar way, the death of a sibling, parental divorce, poverty, alcoholism and drug abuse on the part of parents, constant verbal and physical arguing between parents and victimization by criminals are some of the other types of horrors that affect children.
While these types of disasters may not be as overwhelming as being in an earthquake, hurricane or war they are nevertheless very traumatizing.
If we accept the premise that the "whole is greater than the sum of its parts" then we must realize that smaller traumas accumulate and increase their devastating effects exponentially.
While we not remember a lot of what happened during childhood our bodies do remember everything. The limbic system or primitive part of the brain has stored away all the shocks, traumas, distressing events and horrors that may have occurred while growing up. Ever wonder why you react very emotionally to something that should not bother you but does despite your attempts to dismiss it? The reason is that a present day event has triggered memories of something troubling from the distant past that you cannot put words to. Yet, you find yourself feeling very emotional. Perhaps there was a movie or Television program you were watching that served as the trigger. Stored away in the limbic system the recent event, movie or conversation causes the emotions connected to that distant event to come surging forward.
In fact your emotional reaction to the event may be to "fight or flee," so that your adrenalin is pumping and you are emotional and alert. The problem with this reaction that you cannot help is that if it happens a lot then it takes a heavy toll on your body and your health.
What to Do?
We all know the negative impact of stress on our lives. We also need to be aware that present day stressors connect with those distant stressors of the distant past to cause what seem like irrational reactions. In order to avert heart disease, obesity, diabetes, high blood pressure and other serious illnesses we need to get help. Help comes in at least two forms:
1. Self Help:
d) Deep relaxation using visualizations
e) Plenty of sleep
f) Learn to delay reacting to events instead of getting angry
g) Proper nutrition without drinking or drug abuse
2. Professional Help:
a) Psychotherapy: cognitive behavioral therapy, eye movement desensitization, traditional talking therapy, etc. All of these are excellent.
b) Medications: anti depressant, anti anxiety, sleep medications.
c) Using one of the psychotherapies in conjunction with medication is best.
If you think the psychotherapies are expensive please remember that becoming sick is more expensive.
Your comments are welcome and encouraged.
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