Can I Go Back There?: Understanding Post-Traumatic Stress Disorder

I hosted our annual Mini-Psych lectures again in 2012. The first three lectures are posted on our website (Mini-Psych 2012) and the last two should be ready in the next week or two.

As part of the series, I gave a talk entitled Can I go Back There?: Understanding Post-Traumatic Stress Disorder, in which I discuss some general anxiety principles and then review the effects of trauma on a person’s sense of security. I also discuss some of the differences between “normal” responses to trauma and PTSD.

You can also watch this class directly on the Douglas Website.


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Posted in Anxiety.

Posted on 04 Jun 2013

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7 comments to Can I Go Back There?: Understanding Post-Traumatic Stress Disorder

  1. Teresa Salera
    On Jun 5th 2013 at 00:48
    Reply

    Thank you very much for your video on PTSD.

  2. Susan
    On Jul 18th 2013 at 18:48
    Reply

    Hello Dr. Z.

    I watched your lecture on PTSD, on the Savoir channel (14) Videotron.

    I enjoyed it a great deal and was very impressed on how you presented and spoke on this subject and I also found it very
    educational for myself and others that I know who have and still are suffering from PTSD. I myself have suffered this disorder for the past seven years, maybe more and probably still do, and will for the rest of my life. I was thrilled to find out by watching your mini class, what I was suffering from though somehow I knew something was wrong but not knowing what it is and not being able to put a name to it is worst, I gained some relief from my suffering when I was able to identify what it was.

    My question to you is this, I have a sister who unfortunately, got involved with drug trafficers, and they groomed her to transport drugs and she ended up doing time in another country, what is so sad about her situation is that, she had a good job and a good reputation before she got involved with these people, and since her return back to canada, she has never been able to get her life back together ist been 25 years and from my stand point it looks like she is trying to destroy herself and she is doing a fine job of it, as you mentionned in your class she too had other truamatic experiences happen to her when she got back from doing time in jail and I believe these events put her over the edge. What I would like to know is, is there any legal measures I or my mother can take to get her evaluated so she can start living again and stop hiding from the world.She was in the educaton field before these events took place. Also could you please give me any information on how to detect if PTSD is only part of the problem, we do suspect continued drug or alcohal abuse. Any advice you can give would surely help us help her and it would probably help me as well.

    Thank you,

    I appreciate your time and consideration.

    • Camillo Zacchia
      On Jul 19th 2013 at 14:20
      Reply

      Hi,
      Thank you for your comment. I’m sorry to hear about your sister.
      As far as the question of getting your sister evaluated goes, there are really only two options. (I don’t know if you are writing from Quebec but the laws are generally similar everywhere). Legally, we cannot force someone to be evaluated or treated against her will unless there is an imminent threat to her life or to someone else’s. This is obviously a last resort but necessary in many cases. To do so, the simplest thing to do is go to the courthouse and ask for guidance (A CLSC should also be able to help you). They will help you with the necessary forms. If a judge agrees that there is a threat, an order will be given to pick her up for an evaluation. The order at that point is simply to force an evaluation. If a psychiatrist feel she needs to be kept for treatment and your sister doesn’t want to, the Dr. will get another order.
      Sometimes the person threatens a neighbour or the police. In such cases he or she is taken to emergency for an evaluation without the family having to get involved.
      Needless to say, this is not what anyone wants. A far simpler solution (second option) would be to maintain lines of communication with your sister. At some point she might acknowledge that things aren’t going well. This is when you can offer to bring her to emergency (any hospital). If she goes on her own accord she is far more likely to comply with treatment.

      As far as the question of diagnosis goes, don’t focus too much on specific diagnoses. Human beings react to events past and current. These may cause struggles with varying emotions (depression, anxiety, anger, etc). In order to deal with these emotions, a person will sometimes turn to substances, or resort to impulsive acts, or manipulate, or almost anything. The result is often a mixed clinical portrait. For example, a person may abuse substances as a result of trauma (this would be considered a secondary condition caused by the first). But the abuse may lead to an entirely new set of problems (financial, legal, interpersonal, etc). Sometimes these conditions need separate (or simultaneous) treatment and sometimes they go away by themselves if the cause is eliminated. It is hard to say.
      Psychiatric diagnoses are not precise. They are an attempt to define certain common clusters of symptoms but people do not always fit into such categories. As a result, we often see “co-morbid” conditions (where a person has multiple problems). In fact, the common denominator is the person’s emotional turmoil. (How do you precisely define the boundaries of a turmoil?). Dealing with images of traumatic experiences may be part of the issue for your sister but there are many other aspects of her experiences and her biological make-up that are affecting her.

      Good luck and let me know if I can be of any assistance.

  3. Maurice
    On Aug 12th 2013 at 15:40
    Reply

    Thank you so much about this lecture.

    You described everything that I’ve been going through.

    Except for one. I haven’t been to a trauma, or maybe I just don’t aknowlege it.

    I was raised in a very dysfunctional family. Caretakers were much older (50+). One had serious alcohol issue, the other, more present, had serious anger issue. I wasn’t abused physically or sexually by them. But I was often yelled at, humiliated and nothing I ever did was good enough.

    Then, outside the home, bullying started. Insulted, humiliated, often beaten up (two guys would often grab each of my arms and made a contest of which one could hit to make it turn blue the fastest. I was forced feed insects and dog food. Neighbors would be hostile to me, and the situation was treated at home as if I deserved it.

    At six years old I was sent to another city in a hospital for a month because of an unexplainable tumor. I was alone most of the time, unaware of what was going on. I got surgery and was sent back home. Still no explanation. I went through a house fire, without harm, but almost got trapped inside. My “father” became very ill because of his drinking and I was sent in aSummer camp away. I got attacked by every kid in the cabin once because I was sad all the time.

    I became a very rebellious teen. Every feeling was turned into anger. From 16 to 30, that is how I lived.
    I started therapy, because of the confusion, and the binge drinking and eating.

    And the anger left, to go back to pain and sadness, and the certainty that the world is a very hostile place.

    I have flashbacks, i had nightmares. But never of one specific event. But all of them, smaller but over years.

    I know Deveopmental trauma and c-ptsd aren’t official diagnosis, but I feel like an impostor saying I have PTSD.

    I’m 49. People are often worried that I will kill myself, i ‘m so withdrawn. The thing they don’t know is, I don’t want to die, I want to live. But I feel like I don’t know how.

    • Camillo Zacchia
      On Aug 14th 2013 at 02:50
      Reply

      I’m sorry to hear about everything you’ve been through. It underscores how lucky some of us are to have lived a relatively uneventful life.

      I didn’t talk about it much but I did mention that childhood trauma is different. It can often have more broadly based consequences It can affect a person’s ability to love, to feel safe in any type of relationship, to feel any measure of self-confidence, etc.

      In PTSD, a specific trauma creates a fear related to the event. In childhood trauma (or more accurately, a childhood filled with abusive experiences), the impact touches not so much on a specific event but on relationships (or how a person feels about himself and others).

      • Maurice
        On Aug 14th 2013 at 03:11
        Reply

        That’s what I think. It’s not like I recall one event, it’s like a cluster of things.

        I want to work on it, but I don’t think I have the codes.

        Do you have suggestions for support groups, programs?

        I’m trying very hard to convince my CSSS to let me come to Douglas, but they seem reluctant.

  4. Claudine
    On Dec 17th 2013 at 15:50
    Reply

    Bonjour,

    Je tiens à vous remercier pour vos précieux articles. Je souffre moi-même d’un ÉSPT chronique et vos articles et capsules vidéos m’aident à mieux comprendre.

    J’aimerais vous proposer d’aborder les troubles concomitants à l’ÉSPT, comme la dépression, le trouble d’anxiété généralisé et l’alcoolisme. Parce qu’honnêtement, ces problèmes peuvent être encore plus difficiles à gérer et être plus invalidants que l’ÉSPT lui-même.

    J’ignore si c’est maintenant reconnu dans le nouveau DSM-V, mais je sais que certains chercheurs font maintenant une différence entre l’ÉSPT simple et l’ÉSPT complexe, j’aimerais en savoir davantage si vous le voulez bien.

    Merci mille fois !

    Claudine

    P.S. Vous pouvez me répondre en anglais, mais je suis plus à l’aise d’écrire en français ! :)