Post Traumatic Stress Disorder carries with it some very real consequences. Any discussion of PTSd and combat trauma that tries to make coping nothing more than “try harder and get over it” can be extremely discouraging to the person who is struggling with trauma and its effects. Hope can be removed when we are unwilling to acknowledge that the brain and the systems that support it, as well as the individual emotional makeup of a person, can be profoundly impacted by traumatic events. Some of these things will never be fully repaired and the pre-trauma “normal” may not ever be the post-trauma “normal.” In all of this, though, two things need to be understood.
First, it’s OK to be different after experiencing trauma. Our fixation with getting back to a pre-trauma state or forgetting the traumatic event altogether is not practical or helpful. When medication is given to cause a patient to forget or to become numb to the memories, the emotional and psychological healing that can take place through normal processes has been stopped. This is the reason so many people will spend the rest of their lives treating the symptoms of their PTSd with medication. They have never given their bodies the time or opportunity to heal, and so they never will.
This is probably a good time to take a quick aside and talk about medication. Even though medication can numb a person to the point that healing cannot take place, at the right time and in the right quantity, medication is not necessarily bad. There are many who struggle so profoundly with anxiety and depression that they are not in a clear enough state of mind to make the decisions needed to get well. In these cases, the right dosage of medication can be helpful. It can be a tool used to get to the right place. Medication becomes harmful when it gets in the way of the body’s natural healing process. In our Mighty Oaks programs, it is not uncommon to have students who are prescribed twenty or more daily medications! These medications are not intended to treat the problem, only to mask it. Our recommendation to anyone who sincerely seeks to get well is to actively work with his or her physician to understand what he or she is taking, why it’s being taken, and the plan to get to the minimum dosage possible. While we would never advise someone to stop taking doctor prescribed medication, there needs to be a plan in place to get to the point where it is no longer needed or at least needed at minimum levels. We need to focus on getting well instead of focusing on merely stopping or numbing the pain.
A traumatic event is not something that can be forgotten or simply moved past. It can, however, be a catalyst for growth as well as an opportunity to help others who are also struggling with trauma. Growth in any area of life often requires pain, but if we are willing to grow through the pain, we will become people we never could have been otherwise. The goal is not to get back to where we were before the trauma; the goal is to grow through it and become more fully equipped to fulfill our God given purpose.
Second, we must understand PTSd just as we do everything else, from the perspective of Creation. One of the interesting things about this discussion is that it is typically framed in the language of the victim. Even calling it a disorder implies that the one with the diagnosis is somehow broken. The person who has endured trauma is not broken—they are human! In our program working with the military and veterans, we never include the “D” in PTSd because we do not want to precipitate the idea that hardship in life is somehow uncommon. A disordered life is a life WITHOUT trauma. And when we approach this topic and look for ways to move forward, we must grasp the truth that not only are we not broken when we deal with traumatic life events, but we are functioning exactly as our Creator, God, intended. If this is the case, then trauma, even severe trauma, does not have the ability to keep us from moving forward in our lives and relationships unless we allow it to. We are not broken. There is hope.
So, what does PTSd look like? I have spoken previously about the limbic system of the brain and how it works. There is of course much more to brain function than a post like this will allow us to cover, but even with the overview provided we can see how the functions of this brain system are in place to protect us. As discussed, this system can store information one of three ways:
- It stores historical information so that we can respond to similar future situations in the right way.
- It stores situation-specific responses. These first two are similar and fall into the “fight or flight” category. This really is amazing when we understand that we were created with a mechanism designed to keep us safe. This is what allows us to learn, often without conscious thought, how to respond to dangerous situations so that when encountered at some point in the future, we will respond appropriately without thinking. We have all experienced this to one extent or another. If you have reflexively pulled your hand away from an electric stove without thinking because at some point in the past you burned yourself, you have experienced this principle at work. You may not have known the first time you touched those electric stove coils that they were hot, but your brain recorded that information so that there would not be a next time. Consequently, even when the stove is off, your mind prevents you from putting your hand on it. For those in combat, the principle is the same. After observing a catastrophic event or suffering some degree of trauma personally, your brain stores everything that happened at the moment you were hurt or saw someone else get hurt and automatically responds when one of those elements is present again. It may be a sound or smell or the shape of a house—anything can cause your mind and body to respond as if the threat were right in front of you once again. This is why someone who has experienced trauma will have many of the same physiological responses to a “trigger” even though they are not in danger. The body, in conjunction with the brain, is working to mitigate danger. What we call instinct or a “gut feeling” that we use to tell us when things just aren’t right is often the limbic system alerting us of danger based on something that has happened in the past. An incredible mechanism that can keep us out of danger we may not even know exists.
- It stores trained responses. This third category is equally as amazing and familiar to anyone who has done multiple repetitions of anything so that he or she could eventually do them without thinking. A quote often attributed to Martial Artist Bruce Lee is, “You need to train it until you forget it.” This is the premise of running football plays until you can’t get them wrong or drilling Jiu Jitsu moves until they become second nature. The limbic system is being trained so that these movements that take place in fractions of a second can happen with precision and speed, without the obstacle of conscious thought.
This process is especially familiar to anyone who has been through U.S. Marine Corps Boot Camp. Until I learned about this process of unconscious thought, I believed, as I am sure many Marines do, the constant yelling and moving as quickly as possible at all times while going through basic training was nothing more than a form of harassment. The Drill Instructors were harassed by other Drill Instructors who had been harassed themselves, and this process had probably been taking place since 1775. It was now our turn. I thought that it was to make the recruit hard or to somehow weed out the bad. Contrary to the opinion of any recruit getting off the bus at Marine Corps Recruit Depot, the entire process is designed to train the limbic system, so that when that recruit becomes a Marine responsible for his own life and the lives of others in combat, he will move and respond instinctively. When every second may be the difference between life and death, the trained responses in the limbic system carry that Marine forward without being slowed down by having to observe, orient, decide, act. This is the same process that police officers go through. They fire thousands of rounds through their service weapon, pulling it from the holster and replacing it each time, so that in the confusion and chaos of an armed conflict, they can instinctively draw their weapon and effectively employ it as necessary. It is extremely rare to hear of a police officer accidentally hitting an unarmed bystander or drawing the wrong weapon on their belt. They train to the point that they no longer need to think to do their job.
The fact that we can learn subconscious responses to thousands of situations is strong evidence for a Creator who knew what He was doing! Of course, just as we can step back and marvel at the design intended to keep us from harm, we must also acknowledge that the same responses at the wrong time or without the right context can be harmful and, in many cases, devastating. This does not mean that we are broken or that our design failed; it just requires that we understand what can happen as well as the harmful thoughts and behaviors that can potentially overwhelm us if we are not diligent.
When are these responses bad?
- Many of the responses associated with PTS and combat trauma can be personally and relationally damaging if they happen when you are not in danger. People who have been diagnosed with PTS are often described as “angry” or “having a short fuse.” It is interesting because what can be helpful in one scenario is just obnoxious in another.
- We have already stated that once you have experienced trauma it is very unlikely that you will forget that event and may even remember it with most of the details intact. This is fine if you grow through the trauma and allow the memory of what happened to equip you to better serve others and more fully do what you were created to do. Some people, though, allow the memory of what happened to absolutely enslave them to a specific moment in time. They will not move forward because the memory of the past occupies every unguarded moment. They need to fill those moments diligently and deliberately with positive thoughts and actions instead of allowing an event to define their lives. Many will never find freedom from those memories.
- If there is one thing that we consistently deal with on the PTS side of our Mighty Oaks Programs, it is bad behavior. For some, trauma and difficulty are an excuse to behave poorly. There is never a good excuse to make a decision you know is harmful, but many think that because they were hurt, abusing drugs and alcohol, chasing illicit relationships, and generally being a jerk are acceptable. They blame a PTSd diagnosis for their problems when really it is the bad decisions that they made following the trauma that have caused most of their difficulties. Bad behavior, with or without trauma, will always lead to destruction.
- As odd as it sounds, there are many who have found an identity in their PTSd diagnosis and are unwilling to heal because they don’t want to lose that identity. This is much more common in the veteran community than in others, but often those who have been diagnosed with PTSd wear that diagnosis as a badge of honor or as proof that they did something important and got hurt. I have a hard time understanding this and have found it to be extremely damaging to any attempt to get better. Outside of the veteran world, those who suffer trauma do their best to find some sense of normalcy as quickly as possible, but many times veterans act like the kid with the broken arm who wants to leave his cast on because of the attention it gets him. This is by no means everyone, but those to whom it applies will have a difficult time finding a larger sense of purpose.
- While this next group is probably smaller than the others, there are those who hold on to their PTSd diagnosis because of the benefits that come along with it. We have almost incentivized those struggling with trauma by putting them in a situation where they are getting paid for their diagnosis and will lose the pay if they get better. While I believe everyone, who served is entitled to whatever they are promised, mental and relational well-being should never be replaced by a paycheck. Some will, unfortunately, decide that a monthly check is more important than figuring out how to move forward.
- Another harmful response to PTSd is the persistent belief among many who have been diagnosed that any counselor who is not also a combat veteran cannot possibly offer any helpful advice—unless someone has been hurt the way that I have been hurt, they have no right to tell me what I should do.
Interestingly, we don’t carry this thinking over to any other area of our lives. We do not believe that a doctor needs to have had cancer to know how to treat it. We trust that he has studied and helped other patients with cancer and so, even if he has not suffered from it himself, he can prescribe the right course of treatment. While not all counselors have personally dealt with PTSd, many of them have spent years both studying and helping hundreds of individuals who have. The “you don’t know what I have been through” excuse becomes a wall behind which many hide so that they are not held accountable for their behavior. This thinking takes away much of the helpful insight and advice that is available when counseling is approached with an open mind.
- This last group has learned how to get everyone in their world—spouse, kids, and friends—to cater to their needs because of what happened to them. There is little motivation to get well because they have created an environment that has selfishly turned everyone else into their caregiver. Only you can know if you need a caregiver, but never be content to stunt your own growth and healing because those around you are willing to take care of you.
God has built within us an incredible mechanism to provide safety and a high level of proficiency as we do the things that He has designed us to do. He does not intend to hurt us; rather, He equips us to be the very best that we can be, to have the freedom to accomplish everything that He sets in front of us. When we allow the events of our lives to dictate how we think, act and live, we have given that freedom away. Many will say that the freedom to grow, produce, and live a life of meaning was taken from them. They accept that they are disordered and embrace all that goes along with that brokenness. The only thing disordered is a definition of PTS that says we are. There are memories, feelings and emotional struggles that may never go away. However, we must understand that we never lose the power to choose how to respond to them.
*This post is an excerpt from the book, “The Truth About PTSd” which can be found on the Mighty Oaks Foundation Website: http://www.mightyoaksprograms.org