Post-Traumatic Stress Disorder (PTSD) can occur following a severely traumatic incident, or a series of less severe incidents. Complex PTSD can be experienced as a result of repeated childhood traumas or multiple traumas. It is normal to experience stress after a trauma, but the symptoms normally diminish after several weeks. If the symptoms persist, then trauma-focused CBT or EMDR (Eye Movement Desensitisation and Reprocessing) are currently recommended as the treatments of choice.
Symptoms include flashbacks (traumatic re-living of the event, including images, sounds, emotions and physical sensations) and nightmares, resulting in severe anxiety and/or angry reactions or avoidance of any triggers that may remind the individual of the incident in some way.
PTSD develops because the trauma experience was so distressing that we want to avoid any reminder of it. Our brains don’t process the experience into a memory, so the experience stays as a current problem instead of becoming a memory of a past event. Each time we are reminded of the event, the ‘flashbacks’ mean we experience the trauma again, as though it is happening again, right now. That is very distressing, so we do our utmost to stop the flashback, and avoid any further reminder of the event, so the event remains un-processed.
Cognitive Behaviour Therapy, and EMDR, helps our brain to process the traumatic event into a memory, filing it away in the appropriate filing cabinet of our mind, so that it becomes a past event, rather than constantly reliving the trauma as happening right now. Therapy will help us to think about or imagine the traumatic event in a safe environment, and we can gradually expose ourselves to those situations that remind us of the event. Inevitably, thinking and talking about the trauma may be upsetting at the time, but it will reduce the overall distress and resolve the problem.
Overcoming Avoidance & Facing Your Fears. We try to avoid all the situations, people, places and even thoughts, which are likely to distress us. This avoidance helps prevent us becoming distressed in the short-term, but it is one of the main factors which keeps the problem going over a long time. Avoidance also interferes greatly with our everyday lives as our lives become very restricted.
Dealing with the memory. We normally avoid thinking about the traumatic event and so our brain never processes it in the normal way. It is therefore helpful to deliberately think about and remember the event.
Find out as much as you can about the event, which may include asking other people involved about what they remember from their perspective, including perhaps emergency personnel.
Try to piece the story of the event together.
Write it down, even if only using bullet points.
Talk about the event with other people who perhaps weren’t there, but can listen and be supportive and offer a helpful perspective.
Coping with flashbacks & Nightmares. Because we become upset and avoid thinking about the trauma, the brain has not been able to process and file the memory away, so any trigger tricks the brain into thinking the event is happening again, right now, and we re-experience all the feelings and sensations as though it really was happening right now.
Use these coping strategies and grounding techniques during a flashback: Grounding Techniques & Coping with Flashbacks. https://www.getselfhelp.co.uk/flashbacks-grounding-techniques/
Set aside some time every day, maybe 15-20 minutes, to think about the traumatic event and write down some notes. Try to make it the same time each day, which might be evening time if you have nightmares. Finish this time by writing down a positive coping statement such as “I survived”, “I’m taking back control of my life”, “I have …… who/which supports me”.
Develop Coping Strategies for dealing with stress and anger, e.g.
