Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD)

When in a traumatic situation the brain doesn’t have time to respond in the way it usually processes information, because the situation may be life threatening or challenge fundamental beliefs about ourselves. What the brain does is release a chemical that shuts down communication to the thinking part of the brain, from the instinctive part that controls fight/flight. The part of the brain called the thalamus triggers this as it is like a gate keeper, watching out for threat, problems occur when threats are perceived where none are present. We want this to happen if we are in a life or death situation as we need to just react, not think about what we have to do to react, i.e put one foot in front of the other to run, we just want to do it, in order to save our lives. What that means is the events that happen just get ‘filed’ anywhere and not stored through the usual process of committing something to memory, for example, you can remember that you had lunch yesterday and what you had, because this has been processed with time context and situation context. This doesn’t happen in traumatic situations, it’s like it all just gets thrown in a cupboard and, where an individual suffers with PTSD, is what creates flashbacks and nightmares as if the events are happening in the here and now, so something can trigger the memory and it feels like they are right back there in the life or death situation. An analogy of a factory production line can be used to demonstrate. The trauma memory (the big box) is too big to process in the way that everyday memories (the small boxes) do and it creates a lot of negativity, such as nightmares, flashbacks and intrusive negative thoughts, in trying to process. This difficulty in processing and storing the memory means that it keeps on getting pushed back into current memory, so feels like it’s still happening, as such the individual responds as if the threat is current.

Therapy helps the individual to process this in a conscious way, and has been proven to build new neural pathways. This can be likened to when a lot of people walk a path into a field, that area becomes flat compared to the other overgrown areas, therefore easier to walk. Creating a new path will take a little more effort as it is overgrown at first but, eventually, the new path becomes flattened and easier to walk through. In the same way it is difficult at first to build new ways of responding but, with perseverance, the new ways become automatic. Allowing the events to be processed in a safe environment, and moving the trauma into memory allowing the individual to experience it as having happened in the past. It is a difficult process as it requires exposure to the anxiety feelings around the event, but living with PTSD is not easy, so for many it is the more empowering option! Remembering that fight / flight physiology reduces when there is no threat present, and because the environment is safe, the threat isn’t current so that physiology will reduce.

In each trauma script there will be a number of ‘hot spots’, or bits where the anxiety is worse than at other times, so, for instance, when someone has been attacked the image of the attacker’s face may trigger greater anxiety. The approach used may vary, but the government’s guidelines INICE) recommend either Eye-Movement Desensitisation and Reprocessing (EMDR) or Cognitive Behaviour Therapy (CBT) when working with PTSD. Both approaches work with imagery, CBT being based on exposure and EMDR centring on adaptive information processing of the incident (as opposed to the current maladaptive information processing present in the suffering with PTSD). The important thing to know is that this is the body doing what it needed to do in order to survive during the traumatic time, sometimes it needs a little help in readjusting after the event.