Friday, October 24, 2008
Post Traumatic Stress Disorder (PTSD)
The concept of PTSD came out of the study of war veterans but unlike shell shock or battle fatigue, which tended to be obvious and directly related to combat, PTSD is usually felt after the veteran comes home. Prior to Vietnam very little attention was focused on what happened to soldiers after they came home from war. The media attention and self-examination that the Vietnam fiasco brought about focused many people on the long-term psychological effects of traumatic experiences.
Conservative military estimates showed that 30% (or more) of soldiers experienced major psychological problems after the war, sometimes years after. As these people had been relatively normal functioning people before the war the old mental health models, which tended to see everyone as at least partially dysfunctional no longer were applicable. A new paradigm or viewpoint was needed to explain why normal people were breaking down after the traumatic events. Hence the term Post Traumatic Stress Disorder was born.
Other psychologists and counselors were quick to realize that the same process of breakdown was occurring in civilians after they had experienced major trauma or a series of traumas. Forward thinking clinicians began to abandon old concepts of mental illness because the old paradigms couldn’t explain why mentally healthy and stable people where breaking down after experiencing major traumas. These traumas could be varied such as the unexpected death of loved one, victims of rapes, assaults or other unexpected traumas, both mental and physical.
For the first time large numbers of clinicians began to abandon old models and study the effects of trauma on normal, sane, stable people. Now large numbers of clinicians began to see people, as normally healthy people who sometimes “broke down” or became over whelmed by life events to the point were their normal coping mechanisms were unable to stand up to the pressures of traumatic events. The paradigm of mental illness had changed.
This new paradigm of people as basically healthy until their coping mechanism became over whelmed could not, of course explain all mental health problems. There are still many other forms of mental or emotional dysfunction with numerous causes and treatments. The PTSD model only attempted to explain what happens to normally functioning people who experienced serious and overwhelming and unexpected traumas. People who had time to prepare for life changing events did not tend to experience the same kind of reactions. The element of surprise was central to the result of PTSD. For instance, if your mate died after a period of illness, you have time to prepare, but if your mate was suddenly killed the result could be more overwhelming.
The traumas that could produce PTSD were unexpected and severe. The traumas could be emotional or physical. The trauma could be one major trauma or a series of traumas, the important point was that the traumas were unexpected and life changing, without the necessary time and resources to adapt.
The importance of this model lay in the fact that the effects of trauma could be reversed. People could come out of the “breakdown” stronger and more resilient than they were before. The beauty of the concept was that if people were mentally healthy before the overwhelming experiences then they could return to that health. PTSD practioners could effect positive change in the person by helping them find their own inner strengths, assets and resources to rebuild their methods and strategies for coping with stress. People could regain their stability and they could do so in a relatively short period of time. This approach didn’t necessitate years of psychotherapy and or the use of drugs for long periods of time.
The drawbacks of this approach were that like any other approach it couldn’t be applied to everyone and in all situations. The other drawbacks were ones shared by most approaches. The person had to recognize that they had a problem, they had to be willing to develop insight into themselves, and above all, they had to be ready to accept the responsibility to change. This approach (like others) couldn’t fix the problem; it could only help those who were really ready to “fix” themselves. Like other approaches it was limited by the clients willingness and readiness to change. It involved support, insight development, and most importantly, constructive action on the part of the person suffering. Like all other approaches it was limited by the old adage “You can lead a horse to water but you can’t make them drink
Conservative military estimates showed that 30% (or more) of soldiers experienced major psychological problems after the war, sometimes years after. As these people had been relatively normal functioning people before the war the old mental health models, which tended to see everyone as at least partially dysfunctional no longer were applicable. A new paradigm or viewpoint was needed to explain why normal people were breaking down after the traumatic events. Hence the term Post Traumatic Stress Disorder was born.
Other psychologists and counselors were quick to realize that the same process of breakdown was occurring in civilians after they had experienced major trauma or a series of traumas. Forward thinking clinicians began to abandon old concepts of mental illness because the old paradigms couldn’t explain why mentally healthy and stable people where breaking down after experiencing major traumas. These traumas could be varied such as the unexpected death of loved one, victims of rapes, assaults or other unexpected traumas, both mental and physical.
For the first time large numbers of clinicians began to abandon old models and study the effects of trauma on normal, sane, stable people. Now large numbers of clinicians began to see people, as normally healthy people who sometimes “broke down” or became over whelmed by life events to the point were their normal coping mechanisms were unable to stand up to the pressures of traumatic events. The paradigm of mental illness had changed.
This new paradigm of people as basically healthy until their coping mechanism became over whelmed could not, of course explain all mental health problems. There are still many other forms of mental or emotional dysfunction with numerous causes and treatments. The PTSD model only attempted to explain what happens to normally functioning people who experienced serious and overwhelming and unexpected traumas. People who had time to prepare for life changing events did not tend to experience the same kind of reactions. The element of surprise was central to the result of PTSD. For instance, if your mate died after a period of illness, you have time to prepare, but if your mate was suddenly killed the result could be more overwhelming.
The traumas that could produce PTSD were unexpected and severe. The traumas could be emotional or physical. The trauma could be one major trauma or a series of traumas, the important point was that the traumas were unexpected and life changing, without the necessary time and resources to adapt.
The importance of this model lay in the fact that the effects of trauma could be reversed. People could come out of the “breakdown” stronger and more resilient than they were before. The beauty of the concept was that if people were mentally healthy before the overwhelming experiences then they could return to that health. PTSD practioners could effect positive change in the person by helping them find their own inner strengths, assets and resources to rebuild their methods and strategies for coping with stress. People could regain their stability and they could do so in a relatively short period of time. This approach didn’t necessitate years of psychotherapy and or the use of drugs for long periods of time.
The drawbacks of this approach were that like any other approach it couldn’t be applied to everyone and in all situations. The other drawbacks were ones shared by most approaches. The person had to recognize that they had a problem, they had to be willing to develop insight into themselves, and above all, they had to be ready to accept the responsibility to change. This approach (like others) couldn’t fix the problem; it could only help those who were really ready to “fix” themselves. Like other approaches it was limited by the clients willingness and readiness to change. It involved support, insight development, and most importantly, constructive action on the part of the person suffering. Like all other approaches it was limited by the old adage “You can lead a horse to water but you can’t make them drink
