Today I was reading the DSM IV definition of PTSD, which is:
The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior).
OK, that's all very nice and clinical, but I'm wondering - how do YOU define PTSD?
Please leave a comment with your description. On the Heal My PTSD, LLC, web site I want to include a description of PTSD that makes sense to us, from the perspective of those who struggle with PTSD, not those who study us and make assumptions. Let me hear from you!
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10 comments:
PTSD: "I am unable to accept and process what has happenned".
I think that's the heart of it. All the rest are symptoms arising from that.
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For me, having PTSD is all about being STUCK. Stuck in the moment of horror, unable to move past it. The feeling is very much like being trapped in a nightmare, unable to wake up; or like a computer that's "frozen" and incapable of functioning.
I also feel as though my adrenal glands have been seriously depleted by my traumas, leaving me with minimal energy, just barely enough to stay alive. I'm exhausted most of the time, yet getting a good, solid night sleep almost never happens.
I have all the classic symptoms, too, such as recurring nightmares, flashbacks, and a strong startle reflex...even my poor little dog will startle me if I don't hear her coming into the room. I've actually startled myself, when I unexpectedly catch a glimpse of myself in a mirror!
I find myself doing a lot of "guarding" behavior, meaning I avoid situations, places, people, and things that could hurt or trigger me. This has severely limited my life, and hampered my ability to do and accomplish all the many things I would like to do.
Unbearable emotional pain has been a prominent feature of my PTSD for many years, too. Usually this pain takes the form of unrelenting, utterly debilitating depression, and overwhelming anxiety. But sometimes it comes out in the form of RAGE, which scares me--I don't ever want to be like the abuser! I tried drinking, and pot, to self-medicate, but found that only made everything much worse, both the depression and the rage, so I quit that right away.
For years I kept searching for a White Knight or Prince Charming to rescue me from my misery, as well as support me financially, since I was usually too screwed up to hold down a job...but no mere human being could possibly be my Savior! I was far too needy ~ and rightfully so, like someone who has been run over by a train, I needed a lot more help than most non-professionals can possibly give.
For the past few years, instead of drinking or drugging or running around desperately seeking the next Mr. Wrong, I've been spending most of my time reading. Suspense Novels ~ Bubble Gum for the brain ~ are my Great Escape. Our house is FILLED with books.
I also do a lot of designing on my computer, which is as close to art as I can get, not being able to draw a straight line. I design and decorate virtual dream homes of various styles, which I find very relaxing and a lot of FUN.
Finally, PTSD has caused me to have a very inaccurate self-image for almost 50 years of my life. Coming from a very verbally, and sometimes physically, abusive childhood, I reached adulthood with less than zero self-esteem. I tried so hard to be perfectly good and please my mother, but just about all she did was put me down. The "kindest" thing she would tell me, was that she loved me--but then she would follow that up with, "I just don't like you." When I asked her why she didn't like me, she would say, "It's just you, it's just the way you are." How do you fix THAT about yourself?
With all my (understandable) neediness, my lack of self-esteem, and, of course, lack of relationship skills, when I went out into the world seeking a husband to solve all my problems, I all but had "Easy Victim" tattooed on my forehead. No truly healthy man was interested, of course! So it's really no wonder that I went from one abusive relationship to another abusive relationship, which reaffirmed both my skewed definitions of "love" I had learned as a child, and my equally skewed image of myself. Each failed relationship left me with even more scars and brokenness, and an even more warped perception of myself.
Advised by a therapist to journal, I found I was far too emotional for the arduous task of sitting still and writing, so I started pouring out my heart into a tape recorder, instead. Later, I went back and listened to my recordings, fully expecting to hear a CRAZY, totally messed-up woman on those recordings, since I had been told all my life that that was who/what I am.
But to my amazement, I heard the voice of a woman who didn't sound crazy at all! I heard a woman who had been through a lot of hurt, and who was therefore in a lot of pain, which was only to be expected, considering.... and I also heard a woman with a big, kind heart, a lot of compassion, a lot of love, and a lot of hard-earned wisdom. I heard the voice and words of a woman whom I actually LIKED!
Growing up to HATE the person in the mirror was the cruelest thing that my abusers/traumas did to me. A person may have all the wealth, beauty, intelligence, talent, and popularity in the world.... but if you don't like yourself, you are going to be MISERABLE inside. I was almost 50 years old when I finally began to know myself through listening to my taped journal, and it was a wonderful, LIFE-SAVING eye-opener.
Then at the age of 52, I decided to join a church, and be baptized. The church is very large, so to help the congregation feel that they know the new member, their policy is to videotape each prospective member being interviewed and telling some things about themselves. Then the tape is professionally edited, and shown on the huge overhead screen for all the church to see, just before you are baptized.
There I was, standing in the water, waiting my turn to be baptized, when suddenly I saw ME up on the big screen, and I heard my voice echoing throughout the large building, and, once again, I was pleasantly amazed. "That's ME?" I thought. "That's what I look like, and sound like to other people? Is that really who I am?"
Like the audiotapes had partially done for me, now this video of myself, introduced the real me to me. And, once again, I found myself really liking the woman I was seeing and hearing on the screen, very much! She was someone I would like to be friends with, if I met her somewhere. She was kind and gentle and charming and even sort of funny, in a pleasant.... and she was NOTHING AT ALL like the "Crazy, Worthless, Unworthy of love and respect" kind of person that my abusers had taught me from the cradle up, that I was!
I now know, from the many psychological books I've since read on the subject, that abusers will typically "Project" their own hateful, crazy, selfish traits, onto the person they are abusing. O How Wonderfully Freeing it has been, even at this late stage in my life, to finally learn that I am NOT AT ALL the kind of person that my abusers made me believe I was.
This tremendously healing insight has led me, and my therapist, to a new, experimental type of PTSD treatment that I am now trying... and that I'm also writing about in my blog, and in a book. I call this new treatment, "Comprehensive Reintegration." To see my blog and read more about it, go to: www.myspace.com/ptsdcure.
Thank you, Michele, for all this great, encouraging, HEALING work you are doing for Survivors. You are a Beautiful Gift!
In Truth and Love,
Lynda
Michele, I know you are looking for a much more concise personal definition of PTSD than the long rambling essay I just posted, so here are twelve points I’ve distilled from my prior post:
1. A sense of being STUCK in the trauma, like being in a nightmare and unable to wake up
2. Feeling physically and emotionally exhausted, depleted by the trauma
3. Easily overwhelmed by life, often unable to function, even at performing simple tasks, like a bogged-down or “frozen” computer
4. A seriously curtailed life due to instinctive “guarding” behavior, through avoiding situations/people that could cause further trauma or a trigger
5. Unbearable emotional pain, i.e.: debilitating depression, overwhelming, paralyzing anxiety, and terrifying rages that may induce fear of “becoming like the abuser.”
6. Attempts to alleviate emotional pain with drinking, drugging, affairs, and/or other addictive, reality-escaping behaviors; possibly including thoughts and/or attempts at suicide as a way to permanently stop the pain
7. Feeling physically and emotionally unequipped to survive and cope alone, driven to desperately seeking someone to “rescue” and provide support
8. Having a skewed, unhealthy idea about the meaning and expression of “love”
9. Possessing little or no relationship skills
10. Having a skewed, extremely negative self-image, or a sense of having no personal identity
11. Vulnerable to repeated abusive relationships, due to the lack of self-esteem, poor relationship skills, skewed understanding of what it means to love, and the need to be rescued/supported
12. Psychological and Physical symptoms, such as an extreme Startle Reflex, Recurring Nightmares, Flashbacks, Phobias, and Disturbed Sleep Patterns
One final thought: My personal definition of PTSD may only apply to what some call "Complex PTSD," which is caused by long-term, repeated traumas/abuse, particularly in captivity or after years of child abuse. People who have developed PTSD due to a single severe trauma which occurred after they were adult, probably do not have their basic sense of Self so strongly affected.
Lynda
I just thought of a big #13 to add to my list of what PTSD means to me. This last one is far too pervasive and debilitating to be left out…but it’s not easy to put into words. I know this one is too long and rambling, but it’s the best I can do at the moment, with a topic that hits so painfully close to where I’ve been hurt the most:
13. There is a strong tendency for medical professionals and lay people alike to “Blame the Victim” of multiple traumas, due to their ignorance of what long-term, extreme abuse will do to a person’s sense of self, and how crippling it is to one’s ability to exercise sound judgment, or form healthy relationships. Accusations of Masochism, of “Setting Yourself Up For Failure,” and of “Provoking” their abusers into mistreating them, are all too common; along with outright refusal to believe their story of abuse (denial being the normal first human reaction to any horror). When a severely traumatized person with zero self-esteem has been in a string of abusive relationships, she is commonly told: “Lightning doesn’t strike the same place twice,” or “The whole world can’t be wrong and you right,” or “The common denominator in all those failed relationships is YOU.” All of which further injures the trauma victim’s self-esteem and sense of justice.
Everything that Mike & Lynda wrote, I can relate to.
Definitely, up until I had EMDR, it was literally a never-ending nightmare. Something that would recede a little, then come back with a vengence.
How I define PTSD now (as opposed to before when I felt very out of control) is this:
A 'fracture' in your experience of life, caused by a traumatic event. This fracture is caused in your mind, by you (and no one else). Its a response for attempting to cope with what happened. But unfortunately, its an ill-informed response. And its one that makes you feel like something is being done 'to you' instead of what's really going on, which is that your own mind is causing you to re-live your trauma over and over again.
Because we are terrified, we feel helpless and it is difficult to break the cycle. The longer it is left, the worse it becomes. I wrote about this in a post called 'Never-ending nightmare'. It is certainly tough to accept that our own mind is the cause of the terror we're experiencing over and over.
Anyway, the key is reaching out, as uncomfortable as it feels. Then, getting the help you need. Because it is entirely possible to treat and recover from PTSD, as you well know. :)
Lynda:
I can relate to a lot of what you've written and so I've taken your bullet points and reworked the ones that I ued to be able to relate to. I guess my PTSD was complex too.
1. Endlessly reliving the nightmare, unable to wake up
2. Exhausted
4. Shrunken Life
5. Unbearabel Emotional Pain
6. Attempts to escape reality
10. Very innaccurate self image. Self-image badly damaged
12. Psychological and Physical symptoms, such as an extreme Startle Reflex, Recurring Nightmares, Flashbacks, Phobias, and Disturbed Sleep Patterns.
13. Pro's blame the victim - in an unhealthy way based on hindsight and wishful thinking based on projection from "It could never happen to me therefore ...."
Just to be clear about the difference between PTSD and Complex PTSD:
First referred to by Judith Herman in her book, Trauma and Recovery, Complex PTSD (C-PTSD) is a psychological injury that results from protracted, prolonged or repeated exposure to traumatic events and circumstances.
Complex PTSD is a variation of PTSD and is delineated by:
1. emotional dysregulation
2. pathological dissociation
3. stress related breakdowns in bodily health
So, do nightmares, flashbacks, numbing and startle response go under complex PTSD? I was going to "ditto" those.
I can also relate to Lynda's adrenal stress problems. Here's a good article: http://www.womentowomen.com/adrenalfatigue/adrenalglandnutrition.aspx
Also, I just started taking Enzymatic Therapy's "Adrenal Stress End" supplement. It could be just a placebo effect, but I swear I've noticed some changes already after taking it for about two weeks.
@Marj - No, those symptoms are present in all forms of PTSD. The difference lies mostly in the way trauma was experienced, i.e. over a prolonged period of time.
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