“An abnormal reaction to an abnormal situation is normal.” –Victor Frankl
Post-traumatic Stress Disorder (PTSD) is a psychological condition which emerges following the exposure of a traumatic event, which may be actual or threatened death, serious injury, or sexual violence. Diagnostic and Statistical Manual of Mental Disorders has recognized it as a Trauma and Stress-related Disorder.
People with PTSD shows Intrusion symptoms like re-experiencing the trauma in the form of nightmares, flashbacks, unwanted upsetting memories, emotional distress and physical reactivity to the reminders to the traumatic event. Avoidance of people or places which remind them the trauma and emotional numbing are very apparent. Negative alterations in cognition and mood, which get reflected in the feeling of isolation, difficulty in experiencing positive emotions, exaggerated blame of self or others for causing the trauma, inability to recall key elements of the trauma are easily noticeable.
Life gets even more difficult with the de- personalization which is an experience of being detached from oneself as if this is not happening to me and de- realization as if the things outside are not real. Simultaneously the alterations in arousal and reactivity also take place. Thus the person becomes more irritable or aggressive, hyper-vigilant, has difficulty in concentration and sleeping, shows heightened startled reaction and may also get engaged in risky or destructive behaviours.
Now the question arises that: Is every person having an exposure to a traumatic event is going to have Post-traumatic stress disorder?
No, not exactly. Lower socioeconomic status, lower education level, prior exposure to trauma, family dysfunction, separation of parents, the death of a parent or a loved one, self-blaming coping strategies, female gender and younger age at the time of trauma exposure are considered the basic risk factors which make a person more prone to it. This provides a clear understanding of how much vulnerable we Indians are.
Interestingly, people with PTSD are 80% more likely to have either depression, bipolar, anxiety or substance abuse disorder and also in 48% of cases, traumatic brain injury could also be found.
These all factors for sure complicate the picture, but it doesn’t mean that there is no hope.
To understand how to help people going through PTSD, we need to understand how human mind works. Basically, we are emotional beings, so when we are emotionally troubled, we start lacking in healthy coping strategies, so, first of all, it is very important to clear the layer of negative unhealthy emotions. The deeply rooted terror or intense fear of the horrifying event needs to be released first. Emotional Release (like terror, anxiety and maybe guilt in few of the cases) becomes the first and foremost step. Thus, the professional assistance is a must.
Various techniques like Jacobson’s Progressive Relaxation Technique could really bring down the heightened level of anxiety and terror by relaxing the mind and the body.
Eye Movement Desensitization Reprocessing has also given the good results in most of the cases by just not only managing the emotions but also replacing the negative unhealthy cognition (e.g. “I could have stopped it” or “I am responsible for the event” ) with the healthy positive cognition (“I did the best I could do in that situation”). So, it works not just at the emotional level but also changes the way of thinking, which brings greater changes in the long run.
And of course, we can’t skip the role of Cognitive Behavior Therapy and Rational Emotive Behaviour Therapy which mainly focus on Cognitive Restructuring and developing healthy stress coping strategies.
Cognitive restructuring incorporates the change in the perception and interpretation of the event, by changing the way of thinking. In cognitive restructuring, negative thought-patterns are disputed and replaced by new effective healthy ways of thinking. Thus, the event is not taken as the punishment or the curse but as a reason to grow spiritually or becoming stronger emotionally or may be a reason to help others going through a similar situation. As goes the saying:
“God does not give the hardest battles to his toughest soldiers, he creates the toughest soldiers through life’s hardest battles”
In several cases, Clinical Hypnotherapy has proven its effectiveness in releasing the pain and trauma and also leading to insight, providing meaning to the suffering.
A very eminent Austrian Psychiatrist and Founder of Logotherapy, Dr Vicktor Frankl, who himself was a Holocaust survivor demonstrated in his book “Man’s search for Meaning” that if we can provide meaning to our suffering, we can actually grow out of it. It leads to spiritual growth.
Richard G. Tedeschi and Lawrence G. Calhoun have given the concept of “Growth After Trauma”, which basically encompasses a renewed appreciation of life, improved relationships with others, finding new possibilities in life, increased personal strength and spiritual growth.
Exposure to a traumatic event might make people realise that there are so many things which they previously were taking for granted are actually simple blessings of life. Social support plays an impeccable role in surviving the worst, which sometimes results in improved relationships. And as it is said until or unless we are placed in a difficult situation, we are not aware of our mental toughness. And finally, when we grow spiritually we transcend the trauma.
Apart from all the professional/ therapeutic assistance, there are few simple steps that can be taken in a day to day life to make the transition from the emotional trauma to emotional strength and spiritual growth more smooth.
It starts with ‘unconditional self-acceptance’ which is anyhow easy to quote, but difficult to practice. But a small step against self –criticism can go a long way.
Life can always take unexpected turns. When something good happens we all feel this is what we actually deserve, we are such a good soul/human being but what about the situations when something really bad happens unexpectedly, something that could never be thought of, something completely life-changing, first we go into denial, it seems like a bad dream and then comes the anger with the question “Why Me.” Then we keep grudges against ourselves, people and destiny, we regret or we feel being punished for some known or unknown mistakes committed during this lifetime or past…the so-called “ Karma.”
But what we don’t think maybe it is just an Event and “Events don’t define people”.
Also, ‘Practicing Forgiveness’ might seem a bit more difficult and controversial too. As the people feel justified in their anger. But what we need to understand that forgiveness does not mean justifying the wrong deed, but it actually means not punishing oneself for the mistake/ blunder/ crime committed by somebody else. The feeling being victimized will persist, till the moment we carry the pain/ grudges/ regrets inside.
And lastly, ‘Practicing Gratitude’ by simply creating a Gratitude Journal or writing a Gratitude Letter to somebody and reading it to him or her, can actually reorient the complete perspective towards life.
It can be concluded that with the understanding of the fact that it is quite normal (read as probable) to not to have a normal childhood or not to have a normal life and rather, at times it may seem easy to quit than to fight back, but we always have a choice either to carry the emotional baggage, have regrets/ grudges or to set an example for others, by not just being resilient but also transcending the trauma as very rightly quoted:
“Pain is inevitale, suffering is optional”