Post-Traumatic Stress Disorder

"We have met the enemy and he is us."

. . .Walt Kelly, Pogo, 1950

* * *Raymond had survived a small house fire in which he had been badly burned. He worked for a trucking company and upon seeing an overturned tanker on fire on the nightly news, he began to have nightmares and flashbacks of his own experience two years previously. Raymond began to isolate from his friends and family and began missing work because of headaches and an inability to concentrate.

* * *Sheila became aggressively angry when she believed her boyfriend was looking at women who were provocatively dressed. She was unable to keep a relationship because of her irrational jealousy. Sheila did not make the conscious connection that she was reacting to visual triggers that subconsciously evoked images of a pornographic video that her uncle watched while molesting her when she was ten years old. She had never expressed her anger to her uncle and had never told anyone of the experience.

* * *Janet was in an automobile accident in which she miraculously escaped death. She became unable to drive six months later because she "freaked out" at the sound of tires screeching or horns blowing or even at the sight of cars coming toward her at intersections. Even if someone else was driving, she became nauseated upon smelling gasoline when filling up at a station.

Raymond, Sheila and Janet were experiencing the after-effects of severe trauma, Post-Traumatic Stress Disorder. Time, alone, does not heal all wounds. If we do not resolve emotionally traumatic events, we construct damaging defenses and time merely reinforces these and prevents healing. Symptoms of Post-Traumatic Stress Disorder do not necessarily develop immediately following the precipitating event and sometimes a person doesn’t even make the connection. It is thought that PTSD will affect seven to eight percent of Americans. This is certainly not a large percentage, but for those who experience symptoms such as jumpiness, difficulty sleeping, irritability, poor concentration, exaggerated startle response, recurrent frightening thoughts and images there is significant distress or impairment in social, occupational, or other important areas of functioning. Critical Incident Debriefing is the most effective form of therapy and can be done in either individual or group settings. Medication is sometimes necessary to address the nightmares and insomnia.

Raymond was in therapy for about six months. Critical Incident Debriefing, Cognitive-Behavioral therapy and medication were all used in his treatment. Raymond was able to return to work within the first few weeks of therapy and gradually was able to resume his previous level of functioning. He may always get a "glitch" in his stomach at the sight of an out-of-control fire, but he is now able to quickly refocus and bring himself back to a safe reality.Sheila was not able to bring herself to address her uncle or her family directly with what had happened to her, but with Critical Incident Debriefing she was able to cope with the visual, auditory, and sensual triggers to which she had so painfully reacted for so many years. With Cognitive-Behavioral therapy she was able to put some resolution and closure on the anger and emotional anguish she had experienced. Sheila did not require medication and after eight months of therapy, she was able to maintain a healthier relationship with her boyfriend.Janet was able to resume driving two weeks after beginning therapy, which consisted of Critical Incident Debriefing and a brief medication regimen. After two months, she once again felt comfortable driving, although probably remained a more cautious and aware driver!

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