Sunset Star 7 by Brian Sapere

 

Post Trauma

Posttraumatic Stress

Combat veterans, hostages, and victims of rape, child abuse, assault, or natural disasters frequently suffer long-lasting symptoms, referred to as posttraumatic stress disorder (PTSD)

 

People with PTSD are hyperreactive to the world around them. Minor startling events can trigger reexperiences of the trauma, such as hallucinations of being back in the combat zone. Victims frequently explode in aggressive outbursts and cannot keep thoughts of danger out of their minds. They have recurring nightmares. PTSD sufferers retreat from social and emotional commitments, become irresponsible at work, show little emotional expression outside of outbursts, may find themselves in legal troubles, and experience little life pleasure. These difficulties can last for decades. One Vietnam veteran, quoted in the 1985 report of a study by Bessel van der Kolk and colleagues, described his state:

 

After a certain moment you just keep running the 100-yard dash. I spend all my energy on holding it back. I have to isolate myself to keep myself from exploding. It all comes back all the time. The nightmares come two, three times a week for a while…. You can never get angry, because there is no way of controlling it. You can never feel just a little bit. It is all or nothing. I am constantly and totally preoccupied with not getting out of control.

 

PTSD patients live in a constant state of preparedness to defend themselves against the danger that originally caused the problem. For this lasting damage to occur, a person must experience a truly terrifying event with the sense of having no control over it. Scientists studying anxiety disorders have induced in laboratory animals a condition similar to PTSD by subjecting them to painful shocks from which they cannot escape. Drugs that deplete certain brain messenger chemicals produce animal behaviors like those evoked by the inescapable shocks . Clues like this have led researchers to look for unusual features in the brain chemistry of people with PTSD. The chemicals the brain uses to initiate the “fight-or-flight” response to danger are chronically present at high levels in PTSD patients. One of these chemicals, norepinephrine, has far-ranging influences: it diminishes the ability to sleep, increases alertness, elevates heart rate and blood pressure, promotes the release of hormones that mediate the body-wide response to stress, and possibly causes “flashbacks” and nightmares duplicating the traumatic events.

 

Some parts of the brain and body adapt to the high levels of hormones by reducing sensitivity to them, while others do not, causing disorder in the nervous system, tipping it toward constant anxiety and overreaction. The outpouring of these chemicals may lead to their absence in some parts of the brain following periods of anxiety, and this absence can lead to such behavioral symptoms as low emotional reactivity, shaky hands, jerky movement, exaggerated startle responses, and speaking difficulties.

Another brain system linked to stress and disrupted in PTSD is the endogenous opiate pain-reducing circuit. Intense fear or pain releases floods of substances, including opiates, in the brain and body to reduce unpleasant sensations, presumably to permit the person or animal to function and fight in order to escape harm. One study found that combat veterans with PTSD had reduced sensitivity to pain after they watched a segment of the movie Platoon (about the Vietnam war), which simulated combat. The PTSD patients reported that viewing the film was extremely unpleasant. Participants in this study who did not have PTSD found the scene distressing but showed no subsequent increase in their pain thresholds. The pain sensitivity of those with PTSD was reduced as much as if they had received an injection of eight milligrams of morphine.

 

Essentially, the combat veterans with PTSD responded to the clip as if they were in a life-threatening situation. PTSD researcher Bessel van der Kolk suggested that because PTSD sufferers pour so much natural pain-killer into their systems at so little provocation, the victims become addicted to their own internal narcotics. There’s a similarity between the systems of opiate (such as heroin) withdrawal and PTSD; both are characterized by anxiety, irritability, unpredictable rage, insomnia, and hyperalertness. Also, the opioid system in the brain is closely linked to the norepinephrine (adrenaline) system, both of which participate in responding to danger. These two systems, disordered in PTSD, probably act together to produce the unpleasant symptoms.

 

Some people exposed to catastrophes spend the rest of their lives seeking out further traumatic events, bringing themselves into emergency situations or taking up dangerous careers as soldiers, firefighters, or police officers. These people may be addicted to the flow of internal opiates, requiring frequent fear to prevent the occurrence of withdrawal symptoms. They may need to seek continuous excitement through horror movies, dangerous sports like white-water rafting, or fast driving. These sensation seekers need the stimulation required to produce their own internal opiates, not the RAS stimulation sought by extroverts.

 

These changes in the brains of those exposed to catastrophes can happen through a process known as neural kindling, which has been studied in rats. Electrical stimulation of the amygdala of rats eventually leads to a permanent “heating up” of the responsiveness. If one gives a rat thirty to sixty days of daily one-second repeated stimulation bursts, the animal begins to have spontaneous convulsions that emanate from the limbic system even after the electrical stimulation has ceased. If inhibited children have a more excitable circuit leading from their amygdala to the hypothalamus, a frightening environmental event might function as a similar kindling stimulus. The trauma that causes posttraumatic stress disorder may also have a kindling effect in the brain, ensuring that future activities will pass along an already “warm” pathway. This is what may lead PTSD sufferers to be irritable and extrasensitive to glitches in the world.

 

PTSD shows that if an experience is intense enough, it can change the way the brain works even in adulthood. At the time of World War I, some believed postcombat trauma symptoms to be “shell shock,” caused by physical concussion to the brain. We now know that the actual effect is on the neurons of the brain, but it has an equally overwhelming impact on the life of the trauma survivors, affecting almost every aspect of their ability to function in human society. It is not easy for these people to recover normal functions because of the widespread unbalancing of their nervous systems, which have become programmed to deal only with terrible threats. Behavior therapy and treatment with drugs that restore balance to brain chemicals are now being developed and becoming available to help PTSD patients live normal, productive lives.

 

Our brains are constantly in flux, adapting to serve our lives. Of course, changes in adulthood are not usually as dramatic as those in childhood, when we learn language and the ways of our local world, but change is possible at any time through the selection and deselection of neural pathways. It isn’t that one has to have an experience as dramatic as a major trauma in order to change; it’s simply that right now these dramatic changes are easier to study.

 

There’s no point in life at which we can’t grow and develop, even if that growth is related to one of the roots of the self. We can’t change much about how we amplify the world nor much of our basic mood predispositions, but we can change our experienced mood by doing things that make us happy and concentrating on optimistic interpretations.

 

I know this sounds a little simplistic, yet there is a lot of research that backs it up: even silently repeating things like “Every day in every way I am getting better and better” does have longlasting results, as does learning to interpret the events of our life in a more positive manner, as does cognitive therapy. Optimists live longer, are freer from disease, and recover from surgery faster. Is this just innate? No, for people who obtain training to become more optimistic also increase their immunity to disease! This is why taking up new challenges throughout life is most often associated with increased health; it also indicates that if we make minor changes, the major changes in life will also be possible. In the final chapter, we’ll briefly discuss some of the ways in which we can manage change, taking into account what we now know about our basic nature.

 

Dr. Robert Ornstein, The Roots of the Self: Unraveling the Mystery of Who We Are

(from Chapter 15: “Of Monkey Brains, Fish Hierarchy, Tame and Wild Cats, Missing Limbs, and the Amazing Possibility of Growth in the Brain”)


 

POSTRAUMATIC  STRESS  DISORDER  SYMPTOM  CHECKLIST

 

If you are experiencing these symptoms, please consider consulting a professional if you have not already done so.

  • intrusive and distressing thoughts, images and perceptions about the traumatic event
  • recurrent nightmares
  • a sense of reliving the experience – illusions, flashbacks (including those that occur when intoxicated), hallucinations
  • intense distress (psychological and physiological) upon exposure to “cues”
  • avoidance of anything that may remind you of the trauma, including thoughts, feelings, conversations, places, types of people, foods
  • inability to recall an important aspect of the trauma, not remembering years from your childhood
  • diminished interest in significant activities
  • detachment or estrangement from others, music, books, movies, etc., feeling alien, like a Martian
  • problems with time
  • inability to experience certain feelings – disappointment,  anger, love, sadness…
  • intense and chronic shame and guilt
  • not knowing what you feel
  • feelings of doom, of a foreshortened future
  • irritability, tantrums, rage, angry outbursts
  • insomnia, sleepwalking
  • difficulty concentrating
  • desperate need to control everything
  • easily startled
  • hyper alertness
  • fatigue
  • frequent illness
  • feelings of dread, being tortured, spinning, falling apart, etc., that you can’t explain
  • spaciness, trance states
  • self-harm
  • immaturity
  • forgetfulness, amnesia, blackouts
  • feeling like there are different parts of you that don’t go together
  • emotional and/or physical numbing
  • inner deadness
  • out of body sensations
  • automaton, robotic, automatic behavior; “not knowing what you are doing”
  • finding yourself in strange places, and not knowing how you got there
  • seeing and experiencing relationships in terms of villains, victims and bystanders (including those that rescue or fail to rescue)