PTSD Re-traumatization and Self Isolation

PTSD is a term most people have heard, but often they do not really know what it means.

If you tell someone you have PTSD, it may be hard for them to know what you mean by that, unless they have it themselves or maybe they have a close friend or family member with it.

People with PTSD have trouble with relationships, but not for the reasons people think.

Once you have been traumatized, and then re-traumatized by triggering situations, you feel generally unsafe and there is a natural tendency to want to retreat…back up your steps and run for cover.

People with PTSD can be re-traumatized by people who do not understand, and by people who are more concerned with their own agenda than really understanding.

When someone with PTSD has certain triggers, and explains those triggers to someone, it is important that they are validated and respected. If someone wants to care about a loved one with PTSD, they need to really listen to that person, when they talk about what triggers them. 

*A person that intentionally uses your triggers against you is dangerous to your mental well being. 

But then there are people who just don’t want to listen to or respect your boundaries. Your perceptions are not of an significance to them. 

Everyone has personal boundaries, but people with post traumatic stress disorder can suffer severe re-traumatization when a loved one does not honor their trigger boundaries.

Some triggers cannot be avoided, such as loud noises that may occur independently from either person. However, talking someone into going to a loud dance club, or guilting them into going to fireworks, when it has been made clear that loud noises are triggers, is abusive.

People who have PTSD from the military, and people who have PTSD from domestic abuse have different causes for their symptoms, but some things are the same.

The fight-or-flight mode is activated by the amygdala. If the brain perceives a threat, even if that threat is not real, the amygdala will send chemicals into the body like adrenaline and cortisol.

 The feeling in the body of a “perceived threat” and a real threat is exactly the same. The same physiological responses occur, including blood pressure elevation, and feeling of extreme fear and the feeling that you have to act right away.

Someone who had their jaw fractured by an abusive boyfriend, who suddenly stormed towards them in a fit of anger, may be triggered by someone coming quickly into their personal space, especially if that person is angry.

Once you have asked someone not to do certain things which trigger you, it is a terrible feeling when they still continue to do them. It feels very violating, and only serves to break the trust bond.

Relationships need to be based in trust. Intimate relationships, as well as friendships and family relationships have to feel safe. If one person does not feel safe, then there is a lack of understanding and a lack of trust.

Without both parties feeling safe, the relationship will break down. People with PTSD can find it difficult to trust again, after others have invalidated them about their symptoms.

Sometimes someone will disbelieve you, minimize your trauma, or accuse you of trying to manipulate them with your explanations about your trauma and your triggers. This is very painful and re-traumatizing.

People who have PTSD or C-PTSD from abuse were invalidated as part of the abuse process. Their emotions were minimized, disregarded and made fun of.

To have someone close to you minimize your PTSD, or disbelieve you is re-traumatizing. It gives  the victim into an emotional flashbacks or actual sensory flashbacks.

You can only tolerate being traumatized and re-traumatized so many times.

Soldiers that come back from war only to be disrespected by civilians, or invalidated and ignored by the Veterans Administration, are being re-traumatized.

It is a way of invalidating a person’s reality. This has negative effects on the person’s mental and emotional state.

People with PTSD can be perfectly good and caring partners and friends. They just need validation, respect and understanding.

But after repeated re-traumatization, a person feels isolated and too vulnerable to take a chance on trusting another person again. This leads to self isolation, depression, and often suicidal thoughts.

Evolutionary psychology tells us that our subconscious brain feels threatened by the potential that we would be completely isolated, shunned or thrown out of the social circle.

A Little Evolutionary Psychology

In the past, humans lived in social survival groups called tribes.  Being accepted and included by the tribe was critical for survival. Being shunned would have meant death !

Our primal brain  (called the reptilian brain) perceives rejection by the tribe to be potentially life threatening.  When we are feeling a similar kind of threat, it triggers the fight or flight response in our limbic system of the brain. The amygdala becomes active and send all kinds of alerts and chemicals into the body.

Technically, we could survive living alone and isolated these days, but we were not meant to live in isolation… especially isolation due to “mobbing” or “scapegoating” by the tribe.

This is one of the reasons that scapegoated family members, suffer such severe mental and emotional trauma.

People with PTSD need to feel that they will still be accepted by the Tribe (family, community…whatever applies to the situation…).

They need to know that their personal reality will be validated, even though it may be very different from that of other people. The experiences someone with PTSD has endured may seem strange to people that have not ever had that kind of trauma in their reality.

Isolation can cause death by suicide or “failure to thrive.”

Self isolation will almost always cause severe depression. But being re-traumatized is just as bad, and the brain will try to lead people away from that pain.

Our primal brains are designed to take us away from danger, or perceived danger….and towards pleasure. But the “away from danger” is the priority.

Re-exeriencing the feelings of danger, fight or flight chemicals and physiological responses, is not something that anyone could tolerate on a regular basis.

We were not built to feel in danger all the time. Being in a state of hyper-arousal all the time depleats the immune system and causes mental disorders.

People with PTSD need understanding and validation.

They need their loved ones to be sensitive to their triggers, and to pay attention to what the person asks and needs. 

Otherwise. the relationships cannot continue in a way that is safe for the PTSD sufferer. The person with PTSD will shut down and crawl inside of themselves. No healthy relationship can be sustained without safety for both people. 

 

When Someone with Mental Illness Reaches Out to You / Scenario 2 – Post Traumatic Stress

This is my second scenario and a Do’s and Don’t list for helping someone with mental suffering.
To read my introduction to this series and Scenario 1 , please see older posts at this blog.

Scenario 2 –

Sarah calls you and is in Post Traumatic Stress. Something at work triggered her. She tells you she is in a state of terrible fear. She feels like her job is in danger. She feels like there is an imminent threat to her financial stability. Then she tells you that feels like she will die soon. The walls of her house are closing in on her. She feels like an animal trapped in a cage ready to be eaten.
She cries and says she wants to kill herself. She would rather kill herself than be eaten.

Don’t Say – You are being really dramatic and unrealistic.
(Sarah is not being a drama queen. In the post traumatic stress state, her perception of immediate danger is very real. The amygdala part of the brain goes into hyper alert state and tells the person to choose fight or flight. When someone is in post traumatic stress, fight or flight state, they tend to have an overwhelming urge to run. They want to run but there is no where to run to. This is a terrifying place to be.)

Don’t Say – You are acting like a child. You need to grow up and act like an adult.
(It is not uncommon for someone to regress into a child state during a ptsd attack.It is the brain’s way of protecting itself. The person has no control over it.

Even if you were to force them out of the regression too early, it would be dangerous for their mind. There is always the possibility of a person’s brain becoming disorganized permanently)

Don’t Say – Did you take your meds today?
( Unless they specifically asked you to be in charge of whether or not they take their medication, this comment is condescending. What meds they have taken today is not the point. It is not what they are asking you for help with

They are asking for help with their fear. Bringing up the meds feels like an accusation and like you are saying it is their fault for not taking their meds properly. It takes the focus off of what they are saying to you. They need to be heard, not have you change the subject.)

Don’t Say – Just think positive thoughts.

(If they were able to think positive thoughts they would. The fear part of the brain is sending intrusive terrifying thoughts to their mind. They want it to stop.)

Do Say – You are in a post traumatic stress state. I understand that you feel very threatened. You are not in any immediate danger. Your brain is sending signals to make you feel that way.

Do Say – You are in a state of post traumatic stress.
Is there anything I can do to help you to reduce the level of fear and anxiety ?

Do Say – Something has triggered you to flashback to your original trauma

You feel like your danger level is the same as that situation. That was a horrible thing that happened to you. But your current situation is not the same. It feels that way because it has a similarity to the original trauma.

Do Say – I know you feel afraid and threatened

You had a terrible trauma and something has triggered you to feel the same way you did then. You are safe right now. You are not in danger. Your feelings are an attack of your brain on you. You are safe. Nothing terrible is going to happen. You are safe now.

Do Say – You are safe. I am here for you. You are safe.