Understanding PTSD

This is a very complicated subject but an important one at the same time. For starters, what constitutes a “trauma” is as variable as people themselves. It ranges from exposure to violent sexual or aggressive behaviors in early life settings to the cultural effects of marginalized communities.

Growing up Black in the Deep South or Kurdish in Turkey, or Jewish in Nazi Germany can have life-long negative effects on certain people. We have all heard of children bullied in elementary school who resorted to suicide to express their distress.

My Observation

As a psychoanalyst, I have learned that these experiences often “summate,” meaning that painful and frightening childhood experiences, even when seemingly “over with,” act in the background to make that individual more susceptible to later blows.

We need to be very careful not to write off certain situations because, in our minds, they don’t rise to our appreciation of what constitutes “trauma.”

I had a patient once with a birth defect which, although repaired, left her with the underlying unconscious notion that she shouldn’t have survived and should expect nothing from the life to which she was restored.

The bottom line is:

1. The only person qualified to make this determination is the patient.
2. Traumatized individuals need our care as every other mental disorder, anxiety, low self-esteem, depression, and masochism all have PTSD at the base.
3. Efforts to treat begins here with an open mind and heart.

Treatment Approach to PTSD

1. The central issue is to be aware of its often invisible presence.
2. The patient must lead the way.
3. Provide a safe, uncritical, kindly mental “playground” where the patient can find the wounds, those that he/she is consciously aware of, and those below the surface.
4. It is my experience that in that setting, individuals are ready to let go of the emotional burdens they have carried for their entire lives and live at a new level of freedom and joy.