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Trauma: how a person lives it will determine how much they suffer


Post-Traumatic Stress Disorder (PTSD) is a term banded about but DR VASILIOS SILIVISTRIS looks at what it really means

It is not the event that determines whether something is traumatic to someone, but the individual’s experience.


What does Trauma mean?

Trauma is the Greek word meaning to pierce, or to wound. It is a severe emotional shock caused by an extremely upsetting experience that affects the body’s physiology and the central nervous system.


Why do people get traumatised?

To successfully negotiate a traumatic event, we must respond in one of two ways: either resist and overcome the threat (Fight) or avoid and get away from the threat (Flight).

Furthermore, if we are unable to exercise either of these two options, we enter a third state, common to all animals, we Freeze. Unlike our animal friends, this frozen state of heightened autonomic arousal may become chronic over time. Animals in the wild literally ‘shake off’ the threat, but we humans, with our complex brains, get stuck in frozen patterns of distress.

In PTSD and Panic Disorder, for example, we see automatic and persistent symptoms of hypervigilance, fatigue, anxiety, sleep disturbance, social withdrawal, addictive behaviour, depression and numbing.


What is Post-Traumatic Stress Disorder (PTSD)?

In our everyday lives any of us can have an experience that is overwhelming, frightening and beyond our control. We could find ourselves in a car crash, the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences, they often have to deal with horrifying scenes.

Soldiers may be shot or see friends killed or injured.

Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years.

This is called Post-Traumatic Stress Disorder or PTSD for short.


How does PTSD start?

PTSD can start after any traumatic event. A traumatic event is one where we can see that we are in danger, our life is threatened, or where we see other people dying or being injured.


Some typical traumatic events would be:

  • Serious road accidents
  • Military combat
  • Violent personal assault (sexual assault, physical attack, abuse, robbery, mugging)
  • Being taken hostage
  • Terrorist attack
  • Being a prisoner of war
  • Natural or man-made disasters
  • Being diagnosed with a life-threatening illness
  • Even hearing about the unexpected injury or violent death of a family member or close friend can start (vicarious) PTSD.

What are the symptoms of PTSD?

There are four main types of PTSD symptoms. A diagnosis of PTSD requires the presence of all categories of symptomatic responses:

Re-experiencing the trauma: Flashbacks, nightmares, intrusive memories and exaggerated emotional and physical reactions to triggers that remind the person of the trauma.

Emotional numbing: Feeling detached, lack of emotions (especially positive ones), and loss of interest in activities.

Avoidance: Avoiding activities, people, or places that remind the person of the trauma.

Increased arousal: Difficulty sleeping and concentrating, irritability, hypervigilance (being on guard), and exaggerated startle response.


How is PTSD commonly treated?

If symptoms persist for longer than four weeks, a diagnosis of PTSD is made.

Symptoms of PTSD are commonly treated by Psychotherapy.

Because PTSD has so strongly affected the brain itself, treatment often takes longer and progresses more slowly than with other types of anxiety disorders, and is most effective with a specialist in trauma recovery.

It is most important to feel comfortable and safe with the therapist, so there is no other fear or anxiety about the treatment itself.

Psychotherapy may include relaxation techniques deep breathing, muscle relaxation, positive imagery, meditation, et cetera.


In conclusion.

Working with clients who have experienced a traumatic event, the sooner we are able to process what the client is experiencing in the ‘here and now’ the more favourable the outcome will be.

On average, however, clients who have developed PTSD following a traumatic event, sometimes require only six to eight sessions. However, in some severe cases, clients might need more sessions to process their experiences and, depending on the extent of their symptoms, it may be more effective to see the therapist as often as required.


Dr Vasilios Silivistris (Vasos) is a psychotherapist, counselling practitioner

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