This week’s posting focuses on four key issues a person needs to know at the beginning of PTSD treatment. These are elaborated in more detail in Chapter 3 of The Recovery Guide. The first issue is that despite all of the confusing and bewildering symptoms that can feel as if you are losing your mind, the fact is that PTSD is not the same as crazy. Many people with PTSD question their own sanity, and that is expectable when no answers have been found to explain what can at times seem like you are losing control over your own memories and thoughts. There are reasonable answers for what you are experiencing.
The second issue to understand up front is that the normal thoughts and actions that we use to deal with stresses everyday (i.e., called coping skills) got overwhelmed in the traumatic event. As a result, the person thereafter becomes overwhelmed by small events or perceived dangers quickly and easily. This is why many treatment approaches focus on rebuilding and strengthening a person’s coping skills.
The third issue is the fact that a person loses the ability to feel safe. This is a product of both changes in brain functioning and also psychological factors. It is normal for people to want to feel generally safe and secure in their environment on a regular basis. When that is taken away, the natural reaction is to try and feel safe by anticipating danger and changing your behaviors to ensure your own safety and the safety of those you care about. These behaviors might be labeled as “paranoid” by someone who is uninformed about what is really happening.
The fourth issue a person needs to be told about at the beginning of PTSD treatment is the tendency to feel worse before you start to feel better. Some people quit treatment because there is the expectation that treatment will help them feel better immediately, but in the first several weeks (or months) the opposite seems to occur. The reason for feeling worse initially, is that the absolute worst experiences of the person’s life are being brought to mind frequently in the treatment process, even if the details of the trauma are not being discussed specifically. Remember that the person has been trying to keep these thoughts out of their awareness, and now here we are thinking about those very things quite often. This is very much like opening up and cleaning an infected wound so that it can begin to heal correctly.
Encouragement – It is very important to stick with the treatment process early on. If you feel worse initially and quit (like many people do) then you have not given treatment an adequate chance to work. Most people who stick with treatment and figure it out, build their coping skills, and resolve the emotional damage of the trauma find significant levels of healing.
I put an explanation of these issues near the beginning of The Recovery Guide in order to help individuals just starting treatment have a head start in understanding what is most likely happening to them early on. By knowing up front how these four issues work, a person can better know why it seems so difficult in the beginning and hopefully take courage as they “tough it out” and stick with the process of recovery. Thousands of other people have made it through this very painful part of the journey of healing. I encourage you to persist in this investment in your own healing. For those who have done so, I have seen huge benefits in their lives, and also in the lives of people close to them.
Take heart – it does get better.
