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PTSD: A Primer, part 2
by Peter Goetz, MFT

In the first installment of my Primer on PTSD, I laid out some of the perimeters of PTSD from a diagnostic framework along with some of the forms it takes, how trauma actually impacts people's lives. Here I'll focus in on a few examples, painting with a broader stroke some emotional and mental problems that people live with when trauma impacts them. These are human dilemmas, ones we acclimate ourselves to and normalize; they aren't often associated with traumatic experience. They become the wallpaper of our lives, conditions we take for granted.

Trauma narrows our field of awareness, keeps us from wide angled views of life. Trauma that's been lodged in our nervous systems can result in our getting caught in just carrying on. People survive and don't know the energy they expend in just doing that alone. Here's a few examples from people I've worked with over the years. I've nipped and tucked these examples to provide a protective screen of identity but they stand as examples of everyday life problems that thread back to traumatic experience still having impact now.

* A preoccupation with the past. That could be memories of what was, fantasies of what might have been or sometimes just a preoccupied sort of mental drift. Trauma hijacks us from being in present time. This makes living and working in our daily lives challenging, sometimes impossible with dissociative mind wanderings and distractions. Joe was a mid-30s man who had been working in therapy to deal with vague but persistent memories of childhood abuse, the nature of which were unclear to him. It seemed his system was trying to organize and bring something into awareness. His uneasiness and agitation, his difficulty with focus was mixed with a determination to clarify his mind, to carry on with what had once been his full capacities. These had been formidable earlier in his life, both with career and artistic pursuits. It frustrated him enormously that he couldn't seem to organize his hopes into plans and those into action.

Trauma often brings with it a dissociative splitting of experience. This makes sense from the perspective of a psyche whose adaptive capacities were overwhelmed in dealing with stress at a young age. Intrusive force is dealt with by fragmenting the experience itself. Whereas Joe had gained myriad personal and professional skills and tackled many developmental markers in his life, he waxed and waned through dissociative states. He'd find himself staring off into space, having strong emotions well up with no mental content. Thoughts would be disconnected from emotion. Dissociation had once provided a protective shield of quelling overwhelm for him. Now, in present time, it dampened and dragged the full energies he needed in his life to carry forward his goals with clarity and purpose.

* Persistent fear that grabs our attention and doesn't seem to let go. There's no discernible reason why given what life is presenting us with right now, but fear seems to permeate us nonetheless. It can seem less that we're experiencing the fear and more like fear is running us. An example I'm thinking of in this regard is a young man who I'll call Zach. He was assaulted in the public restaurant he managed. The assault had come out of the blue, not random as he later learned, but from his being mistaken for someone else. After his initial shock dissipated and his bruising healed, he was left with a pervasive fear and sense of vigilance that wouldn't go away. It seemed his body-mind system was locked in fear mode that would not let go. Zach couldn't sleep, lost his interest in motorcycling, in all the usual things that he loved doing (and the people he loved doing them with) and blamed himself for not being able to shake it, to just get over it. Whereas he wanted to move on his nervous system had gone into survival mode and hadn't been given the opportunity to unwind from that position. A nervous system under stress is designed for one thing: survival. That alone will consume vast amounts of energy until other resources become available to unwind what has been held tight.

* Hopelessness or other negative feelings that can color the whole of an individual's view of life. An example of this can be taken from growing up in a family with the depression and unpredictability coming from alcoholism. Annie, an intelligent woman in her early 40s described a family history with this kind of inconsistent foundation that was geared for just getting by. There were few stable boundaries between adults and children. Annie never knew where adult protection would come from; the atmosphere in which she lived was despairing. She found it hard to trust in herself, her decisions, her desires. This fed a chronic hopelessness, an emotional poverty that became her normal. This kind of constriction keeps young people like Annie from feeling the space, freedom and potential to explore their world and to naturally invest trust and hope in themselves. Hope, as a human capacity, becomes diminished.

Looking at our life experience through the lens of trauma offers a perspective where our unproductive actions or painful cyclical patterns make sense. A trauma perspective suggests that our difficulties may stem from something that actually happened to us. That alone can be liberating, not to mention clarifying. Any step back from shame or self recrimination is worthy of attention and becomes a possible resource. Knowing the impact that severe stress and trauma holds in shaping the experience of our lives offers us breathing room, information that can only expand our field of vision.

this article was published in condensed form in psyched magazine at psychedinsanfrancisco.com

 

(c) 2014 Peter Goetz

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