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PTSD Questions & Answers
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Joyce Boaz & Dr. Frank Ochberg, M.D.

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Recovery: Life After Trauma.

Q: Dear Dr. Nader: Thank you for being a guest clinician. I've been asked this question many times by support pals and other trauma survivors with PTSD. Survivors want to know if they have a chance of "living a normal life" with PTSD.

A: Dear Joyce, To help answer your question about "living a normal life," I would like to tell you about two people (their names have been changed):

Case Examples

Anna was molested by her babysitter as a toddler, almost died from injuries as a preschooler because of her mother's neglect, had a variety of scarring but less life threatening experiences in elementary school, was raped as an adolescent, and was assaulted as an adult. She finally found a therapist after a group of men tried to burglarize her house, pointed a gun at her, and fired missing her. Fortunately they were scared away by sirens. She had numerous symptoms. For example, she was constantly afraid, plagued by images such as the barrel of the gun pointed at her, the fire in the barrel, and the huge foot of the huge man trying to kick in the glass door. She had extreme difficulty functioning normally and was completely unable to work. Stomach and skin problems flared up repeatedly...

Robert seemed to grow attached to each of his stepfathers just as they left never to be seen again. He was molested once as a young boy. He was in school when two boys walked in shooting, killed more than 20 students and teachers, and injured others. His best friend and his favorite teacher were killed. He and another person were shot and badly injured when he dropped his lunch tray drawing attention to his side of the room. He hid in terror with other students for more than an hour before someone they trusted gave them the "all clear"...

Anna (an adult) and Robert (an adolescent) (no they do not know each other) each went first to a therapist who was successful with people their age but had no real understanding of trauma. Their symptoms had worsened by the time they found the right clinician to assist them. By that time, Anna was suicidal and Robert frequently provoked and engaged in violent fights as well as taking addictive and numbing drugs. Even though these initial bad experiences and problematic delays complicated their recovery efforts, Anna and Robert now are among the friends most valued in their peer groups. They serve as valued support to others when needed.

About 6 to 8 months after her therapy started, Anna began to work part time. Several months later, she had returned to her original work schedule. She was enjoying parts of her life with intermittent setbacks. Sometimes there were setbacks because of life-stress; sometimes because she regressed when aspects of old traumas emerged for processing. After two years of facing and conquering her traumatic experiences and memories in treatment, she was functioning well. She was more often content than discontent. Anna had not completed processing all of her experiences when she moved away and discontinued treatment. Nevertheless, when an earthquake happened in her area some years later, Anna did better than her husband and her friends. She knew to protect herself from the frightening sounds and sights. She knew to make herself as safe as possible... She called to ask for a referral to a therapist in her area for her friend.

Robert has a family of his own now. He is very good at helping others through their difficult times. He became a little unhinged when the September 11 terrorist attacks happened. For the first time in years, he had the strong desire to use drugs again to numb himself. But a phone call to his old therapist and a good support system soon put him back on track. He likes his life.

A "NORMAL LIFE"

These examples are my way of saying that people can overcome horrible traumas and lead desirable and productive lives. Sometimes, after therapy, patients' friends comment on how much better they are doing-even better than before the trauma. After successful treatment, specific life events can cause set-backs but can be overcome. How long it takes to get to that better place depends on many factors such as the intensity and duration of the traumatization, the level of support following traumas, personality factors, coping style, personal and family history... How well the therapist and the therapy method fit the help-seeker's needs is also important to recovery. Finding a therapist who is skilled in treating trauma and whom you can trust and feel comfortable with is essential.

There are very many different versions of "a normal life." Life experiences affect and help to shape our lives. That can be true with simple or complex experiences. For most of us, life is a process of evolving. No one needs to tell you how intensely and profoundly the details or merged images of traumatic experiences can imprint themselves on a mind or how dramatically traumas can disrupt the body, its neurochemistry and functioning. The important thing is to face those effects of trauma, find healthy ways to relieve the focus on trauma for reasonable periods of time, process the aspects of traumatization that need processing, and do it at a pace that works for you with the assistance that matches your needs.

Recovery from trauma work (including some reasonable amount of avoidance or healthful self-soothing in between efforts) is different for different people. It is important to be prepared for the likelihood that good trauma work will be unpleasant and uncomfortable at least some of the time (maybe most of the time in the beginning of a new method). It usually requires remembering portions of the traumatic experience. Meanwhile, developing a good support system, improving coping skills and judgment, and making yourself safe without relinquishing living can be helpful. It usually is okay to err toward caution until good judgment (about safety and decision making) has been restored or gained.

One of the most wonderful things about human beings is their individual uniqueness. Although there are similarities in traumatic reactions, no two people have exactly the same experience or response. There are many different trauma methods that work. Many combinations of methods that are successful depending on individual needs. Whether you need to intersperse processing the trauma with coping techniques such as anxiety management or medication or you respond best to other methods depends on your beautiful uniqueness.

Dr. Kathleen Nader is a member of Gift From Within's Professional Advisory Board. Dr. Nader is a consultant who has worked for over 20 years in the field of Trauma, Violence and Bereavement. Dr. Nader is a humanitarian and scholar whose work with children suffering from the traumatic effects of school violence has been documented in our videotape called "PTSD in Children: Move in the Rhythm of the Child."

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