PTSD is a constellation of psychological conditions and physiological reactions to either experiencing or witnessing traumatic events. In its acute phase, the PTSD sufferer is generally dealing with chaotic internal dialogue, nervous exhaustion and an overly stimulated nervous system with possible associated internal organ issues, and a general failure of coping mechanisms.
Immediately following the removal of the person suffering from PTSD from the situation which caused it, it is essential that in order for them to become functional again, Maslow’s hierarchy of needs must be applied. This however is complicated in what we might refer to as the “warrior class” or “caregiver personality” as these individuals generally have a habit of sacrificing their own needs for others, and have no idea what they might actually need and/or how or where to go about receiving help from others.
Since oftentimes, pride is the only thing that kept these survivors alive, coming to terms with it enough to allow anyone to help them is difficult enough. And since PTSD is often incurred through interpersonal relationships – or severely aggravated by them – trusting anyone enough to let them help is a long hard road.
Maslow’s hierarchy of needs states that before emotional healing can occur, physical safety must be assured. In context with today’s society, that means having the bills paid on time, taxes filed, rent and groceries covered, etc. Because of the way that the current social net is set up, this requires that an individual who is temporarily too overwhelmed by life has to essentially become a prisoner to the system via being mandated financially to someone else as a trustee. And since most of the time, PTSD is incurred through social relationships, very few who are suffering from debilitating PTSD related symptoms are going to be willing to allow that last vestige of their freedom/pride to be taken from them.
The social net at present is basically set up so that authorities come along and say “hey, we’re from the establishment and we’re here to help”. Which isn’t exactly something that is going to make anyone who is living in an overwhelmed state feel safe or willing to work towards resolution. To treat the symptoms of paranoia, anxiety, and inner tension, the first response the system has is to further exacerbate the situation, by putting the person in an institutional setting and using medications to sedate them. What little possessions or relationships the individual has left at this point by which they define themselves as a person are either stripped away by the system or else destroyed through the sense of social shame we associate with “mental illness”.
There is no shame in being too overwhelmed by life to deal with bills, and there should be no shame in the fact that you jump out of your skin at loud unexpected signs or that when people move by you rapidly that you react in a defensive manner. And it is true… for most people immediately leaving a situation with the acute symptoms of PTSD, there does need to be some sort of way of resolving this set up without taking advantage of the vulnerable. ? perhaps through community based clinics for debt resolution and non-government or church related social workers? Sanctuary trauma — the retraumatizing of someone who has already reached their capacity to function in the world via harrassing telephone calls or letters about debts, with escalating threats, being treated like a moron because you are too stressed to properly process information, etc., is a very real and profoundly harmful phenomena which leads more than a few people to commit suicide. In fact… I would hazard a guess that the effect of feeling useless and incompetent as a functional human being contributes more to the rash of suicides in the modern world than any other feeling. Particularly when you are dealing with people from backgrounds like the military, police, physicians, etc., who pride themselves of their competance.
Our modern society has developed a very unempathic habit – taking our pre-existing Schadenfreude and need for entertainment – and applied a gruesome twist to it. Wherein when we see someone – anyone really – behaving in a manner which we find to be outside of our limited understanding, the first reaction should be one based out of compassion and empathetic understanding.
Within front line crisis workers and military, I would suggest that the most difficult part of PTSD is the fear of losing self control and being regarded as incompetent by others due to physical characteristics related to PTSD, such as hand shaking, the propensity to burst into tears when overwhelmed, and the personal burden developed by the “suck it up buttercup” attitude that prevails in these fields. Every individual has a different stress tolerance level which is known only to them, and the internal sense of shame associated with feeling incompetent to the tasks set for them by life is perhaps more difficult to deal with than the stressors that brought them to that breaking point.
Caregiver/service oriented personality types often neglect themselves for the good of others, which I believe is a characteristic which can be used to benefit both the person being treated for PTSD and the community, through volunteer programs such as walking dogs at the SPCA, working with disadvantaged kids, at a local soup kitchen, etc., according to the person’s tolerance level. This too builds community and bridges the growing divide between civilians and the people in uniform.
Cognitive therapy, EMDR and biofeedback, movement based and art therapy, as well as teaching these warriors how to relax and just enjoy life – or find outlets such as entrepreneurship – would be a benefit. As would matching them up with a dog (which provides a focus, stability, talking point, and monitors their handler’s moods) or engaging them in working with horses or in programs that get them back in touch with nature.