“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma.” By Judith Lewis Herman
The DSM-5 states acute stress disorder and post traumatic stress disorder (PTSD) are complex psychological disorders resulting from a direct or indirect experience of one or more traumatic events, whereby, an individual directly or indirectly, witnessing a traumatic event directly or indirectly, learning of a traumatic event, and or repeated or extreme exposure to trauma and or negative details of a traumatic event. The hallmark symptoms for PTSD are psychological distress, avoidant behavioral tendencies, heightened startle responses, hypervigilance, sleep impairment, nightmares, dissociation, involuntary and intrusive distressing thoughts, memories or flashbacks. It is important to note that acute stress disorder precedes post traumatic stress disorder. The symptoms for acute stress disorder can last anywhere from three (3) days to one (1) month. The symptoms for post traumatic stress disorder can last anywhere from one (1) month and can be pervasive for many years. Individuals with chronic post traumatic stress have symptoms longer than three (3) years. Characterizations of acute stress and post traumatic stress disorder include adverse changes in cognition, mood and situation reactivity.
Trauma, regardless of degree, causes a tear in the human psyche. Many individuals may have acute stress disorder but symptoms dissipate within thirty (30) days. A relatively small portion of individuals experience symptoms beyond 30 days resulting in a posttraumatic stress disorder diagnosis. It is important to note individuals who receive treatment can fully recover. Individuals with chronic symptoms can last years and even the duration of one’s lifetime. Additionally, extensive stress and multiple traumatic experiences may lead to ongoing posttraumatic stress symptoms. Posttraumatic stress and acute stress disorders have debilitating effects often cause an individual to feel off balance, out of control and insecure about present and future events. Maladaptive coping further complicates a person’s ability to recover after a traumatic event. Individuals with posttraumatic stress disorder find it difficult to resume life normally after a traumatic event causing an incongruence between the self and the ideal self. The incongruence between the self and ideal self can cause significant psychological distress. An individual’s attention and focus may be on returning to the self before the traumatic event occurred and to a place of perceived normalcy. There may be difficulty in embracing and accepting a new self with new norms.
Posttraumatic stress and acute stress disorders can be extremely debilitating and can have lasting negative consequences on a person’s life. Individuals who display chronic symptoms posttraumatic stress and acute stress symptoms may experience significant sleep impairments, poor executive and cognitive functioning, and impaired emotion regulation that may manifest in the lack of focus, increased irritability, disruptive or destructive behavioral tendencies, frequent mood changes, poor self-esteem, depression, helplessness, addictive tendencies that may cause poor personal and interpersonal relationships, reduced productivity, poor employment performance, job loss, financial instability, homeless and even suicide.
Posttraumatic Stress Disorder (PTSD) can be likened to the Incredible Hulk disorder. In a nutshell, the brain’s sole purpose isn’t just to keep signal the body to work, store information, or retrieve information and ensure species survival. This means, that in order to ensure a person survives after something traumatic, the brain will bypass the executive center in the brain (planning) and create shortcuts. Much like a computer when you use hot keys to bypass normal computer program functions to create a quicker and more efficient operating system. The problem with PTSD is that it bypasses a person’s ability to think clearly, plan appropriately and make sound decisions.
The Incredible Hulk’s behavior when triggered serves as a reminder that an individual can demonstrate destructive behavior but, when channeled appropriately, exhibit above normal survival mechanisms. The above normal survival mechanisms enable the brain to develop and enhance fight or flight responses, enabling a person to assess a threat, develop a plan for flight or fight, and cause a person to act on the plan. This can happen very quickly if the person has rehearsed these events long enough. Things like flashbacks, triggers, and associations are critical in reinforcing the fight or flight responses. Dissociation removes the emotional responses associated with trauma that induces a numbing state which enables them to exist without having emotional responses to triggering events.