If you experience a trauma, is it possible in the aftermath to prevent your response from turning into PTSD? Not exactly. But that isn’t the end of the story.
Post-traumatic stress disorder (PTSD) has a long and winding history. Previously labeled shell shock, so-called because of its prevalence in veterans coming back from war, the condition has grown to be better understood. It is characterized by symptoms where a person is routinely reliving and re-experiencing a trauma that they initially were subjected to, which can be incredibly disruptive.
While PTSD and a related condition known as complex PTSD (C-PTSD) are commonly associated with seeing time in combat, it can also arise from a wide variety of trauma-inducing situations, including assault or other experiences of violence.
One of the key indicators is whether someone experienced or witnessed an event where their life was in danger, or at least felt like it was. Repeated or extreme exposure to aversive details of a traumatic event is also a major risk factor.
However, just because we’ve only labeled PTSD as a medical diagnosis since 1980, despite its symptoms first being understood during the American Civil War, doesn’t mean that we currently fully understand the how and the why of PTSD. In this article, we’ll look at steps you can take to mitigate PTSD, unpack the role of different forms of trauma, and provide information for those who have already been diagnosed with the condition.
There is hope, even if it can sometimes take work to find it.
Can You Prevent PTSD After Trauma?
When discussing the prevention or mitigation of the condition, it’s important to understand the barriers victims are facing when they are confronting not just the symptoms, but the trauma that inherently goes along with it. Saba Harouni Lurie, LMFT, owner and founder of Take Root Therapy, says it’s key to think about the treatment of PTSD through a lens that doesn’t put the pressure on the victim of the traumatic experience to prove their validity.
I think that if we frame it as though you can prevent developing PTSD, then we are at risk of further blaming the person who then has PTSD for not doing what they needed to do to prevent themselves from developing this—to some degree—natural reaction to unnatural things happening to them.
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SABA HAROUNI LURIE, LMFT
There are a variety of strategies that have been purported to significantly reduce symptoms present in those who have undergone a traumatic experience that can lead to PTSD. Some of those symptoms can include panic attacks, disassociation, and hypervigilance. The hallmark of PTSD is the patient reliving their traumatic experience through emotional or visual flashbacks.
Some surprising methods have been researched as possible treatments include playing the video game Tetris and the use of psychedelics. Many of these modalities are not approved by the US Food and Drug Administration (FDA) for the treatment of PTSD, however, and should not be pursued without consulting a doctor.
Robert Cuyler, PhD, the chief clinical officer of digital therapeutic company Freespira and a licensed clinical psychologist in the state of Texas, said that it’s important—when we are talking about the trauma that can lead to the development of PTSD—to differentiate between little t trauma and big T Trauma.
“We’re going to mostly be talking about big T Trauma,” he says. “And so as it’s defined, you are in a situation, either personally involved, affecting somebody close to you, or witnessing a major event that is perceived as life changing, life threatening… [It was] thought to be a combat related condition, and then slowly, we have become to realize how pervasive trauma exposure is in the general population.”
Cuyler is keen to point out that just because you experience a significant traumatic event does not automatically mean you are going to develop PTSD. Research in this area has found that there are a wide variety of reasons why you might develop PTSD, including a genetic predisposition, childhood trauma, and previously existing psychiatric illness.
Of the strategies available to those who have experienced a trauma consistent with the development of PTSD is mindfulness, specifically grounding. Helene Zupanc, LPC, a therapist in Arizona, said that this strategy is helpful in the face of, as the saying goes, the body keeping the score.
You’re telling your brain the trauma’s past. I’m safe. I’m in the present moment. Look around, look for things you can see here, taste, touch, smell, get yourself in the moment. And it’s kind of like a safety and stabilization technique, understanding that you went through this but you’re not in it.
Past research in this area looked at a wide variety of treatments—including cognitive behavioral therapy and various medications—concluding that more research needs to be done and that this area of mental health was under-researched. A more recent analysis found that CBT that was keyed in on acute stress showed the most promise for PTSD prevention, though more information gathering needs to be done to confirm this.
Lurie said that, regardless of the treatments you explore, it’s important to remember that there is never a one size fits all approach.
“I work with some clients that really respond well to the safe, calm place exercise, where they’re able to visualize being in a safe place, and that helps them regulate,” Lurie says. “And for some clients, that’s really activating, and they hate it…I think, in part, understanding what coping skills help me regulate and what works best for me is so important in trying to manage these symptoms.”
How to Get Help After Experiencing a Trauma
Experts agree that finding safe people and spaces to discuss your experiences is vital to anyone after experiencing trauma with the goal of regaining a sense of physical safety. It’s also important to seek help from a professional who can teach you techniques to manager flashbacks and nightmares
“Gravitate towards those who are accepting, understanding, not critical, not shaming, not blaming,” Cuyler says. “Often, there’s going to be one or two people in that person’s life that are in that category…steer away from the people who are going to tell you exactly what to do.”
The National Institutes of Health suggest a number of strategies, including trying to maintain a healthy diet and sleep routine. Experiencing, or re-experiencing trauma, is also risk factor for the development of or relapse into substance use and abuse.
While the first step should be to ensure you are as safe as possible—such as in cases of abuse—Zupanc says that negative self-talk is something to watch out for as well as you figure out how to navigate the world after your traumatic experience.
“You may be telling yourself, I am bad this happened to me, or I’m not valuable, I’m not worthy, and sometimes we make those conclusions unconsciously,” she says.
If You’ve Already Been Diagnosed
While having a PTSD diagnosis can be daunting, the diagnosis itself can open doors for you. Service dogs are increasingly being used to mitigate PTSD symptoms, and to expand out a person’s circle of trust. The service dog that lives in my house to support my wife is a perfect example of that. Cuyler said that finding people—and, possibly, furry companions—that can help you expand that circle is key to recovery.
“Your service dog loves you, and that’s wonderful. How are you going to expand that circle to those people who are trusted and accepting and open? Because one of the things that can get people stuck is that they sort of lock in,” he says. “‘I need x in order to be okay. And I get scared anytime I go outside that bubble.’”
Cuyler adds that it is often key for those with PTSD to be connected to safe and trusted people who can help them re-establish trust with the world.
He says it is helpful to “go outside your little bubble, out of your little zone of safety and to re-participate in the world gradually, so that that sense of safety begins to incrementally grow. And if you can’t get there, that’s when the professional help is the meaningful next step.”
Another possible path forward is to find the type of therapy that isn’t re-activating for you. Lurie, who is a board certified art therapist, said that using a form of expression like art, can help people reframe the way they see themselves in relationship to their traumatic experience and all that has come since.
“The art can allow us to both create this concrete representation of the experience, but also of yourself as a survivor,” she says. “And having that visual can offer something to connect, with and relate to, and hold to help you cement this new narrative that is going to be beneficial for you.”
Takeaways
Post traumatic stress disorder is debilitating and yet its prevention is understudied. While there are strategies you can use to mitigate its effects, it’s important to understand that you are not at fault for the trauma that happened to you.
PTSD is a condition that affects far more people than just those who have come back from war. Whether it’s through the lens of self care, a variety of therapies, or the support of family and friends, help is available.
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