I last posted about community violence and its impact. Perhaps the most significant impact of community violence is the lasting damage in the minds and hearts of the community members. Post Traumatic Stress Disorder, PTSD, is a reaction to trauma — either a single, significant threat to life or personhood, or a series of (possibly smaller) threats. It is important to understand PTSD. We are continually affected by it, whether we realize it or not, and we need to act corporately to prevent it.
Please read on.
We are made to survive where we are. When we experience a threat to ourselves, our loved ones, or the people around us, we adjust. Our entire selves – bodies, brains, souls – adjust. The adjustment helps us survive danger, but if the danger has passed or if it is sustained over too long a period, our coping itself starts to harm us. PTSD is a state of adjustment to a world which we have found to be extremely dangerous; it is a state of high alert in which we never feel it is safe to let our guard down.
There are four overarching categories of symptoms in PTSD: intrusive symptoms, avoidance symptoms, cognitive and affective symptoms, and arousal (alert-ness) symptoms.
What exactly PTSD is, neurologically, is not crystal-clear. What we do know is that trauma can affect the brain’s alert system. Scans show that the upper parts of the brain that can sooth our amygdala (part of our danger-sensing system) are less active in PTSD patients in high emotional states. Symptoms of this change in arousal and reactivity include feeling irritable, being hyper-vigilant, having an extreme startle response, problems concentrating, or sleep disturbance.
Trauma also alters our experience of the present: the dangers of the past continually intrudes on us. Unrecovered victims experience traumatic memories as fundamentally different from typical memories. Rather than a scene or fact they call up in their mind, they may re-experience their trauma in episodes called “flashbacks.” Other intrusive symptoms include recurrent distressing dreams and intense thoughts or physical reactions to reminders of the trauma.
To survive the new and horrible world into which they have been plunged, many trauma survivors begin avoiding “triggers” for their fear and panic symptoms, since it is difficult, even impossible, to control the symptoms once the have been set off. Their avoidance symptoms may include avoidance of external places, people, things, or events, or they may invade internal experiences: memories and emotions.
As you might expect (or perhaps know), trauma also affects emotions and thoughts. Experiencing a trauma may change how a person perceive herself, others, or the world. It may become difficult to trust herself or others. Her beliefs about the trauma and why it occurred may be distorted. She may constantly feel sad, angry, or irritable. She may feel distant from others, as if she is in another world, and uninterested in her previous activities. She may not be able to feel curious, connected, cared-for, and content.
I have witnessed clients and friends experiencing the effects of trauma over, and over again. At points, this witnessing has produced some of these symptoms in me. I have had weeks of insomnia, where I had difficulty controlling my anxiety for people I knew to be in danger. I have had nightmares based on details of other people’s trauma. I have been overwhelmed by my emotions, in deep fear because I seemed to have lost control over them. Perhaps you have felt or witnessed these things too. If you have not, please believe me when I say these changes are crushing; like the pressure of deep-sea diving. They pour in to submerge the lives of the victim and everyone who cares for them.
Trauma is pervasive, and its effects, destructive. These traumas and their victims are here, in Jackson. They are everywhere. For every shooting, assault, and rape. For every case of abuse, for every accident, for every disaster. For every threat to health and personhood, know that each leaves a wake.
All of us experience fear, stress, and grief; we all, therefore, have waded into the shallows of PTSD’s dark pool. The majority of Americans have experienced at least one trauma in their lives. Of those who experience a trauma, approximately 20% will have symptoms severe enough to be diagnosed with PTSD. To quote Dr. Bessel Van Der Kolk, trauma is a “hidden epidemic.” As he writes:
“…trauma remains a much larger public health issue, arguably the greatest threat to our national well-being… In today’s world your ZIP code, even more than your genetic code, determines whether you will lead a safe and healthy life. People’s income, family structure, housing, employment, and educational opportunities affect not only their risk of developing traumatic stress but also their access to effective help to address it.”
There are things we can and should do at the individual level to heal from trauma. However, trauma is a burden on our society perpetuated by poverty and other systemic factors. As long as our neighborhood, race, or gender continues to predict the likelihood we will suffer a trauma, changes need to take place at the community level, at the systemic level.
I’ll write more about this next week. But, in case you did not know, one way you can address this issue is by supporting non-profits seeking to provide better access to mental health resources. I am a therapist with just such an organization; you can read more on my About page or by visiting thenetms.org.
To read more about these topics, see:
The Archaeology of Mind, by Jaak Panksepp and Lucy Biven
The Body Keeps the Score, by Bessel Van Der Kolk