Post-Traumatic Stress Disorder: Symptoms and Solutions from a Christian Counselor

After Trauma

One of the most distinguishing features of Posttraumatic Stress Disorder (PTSD) is the word “post,” meaning that the symptoms appear after the traumatic event has occurred. This is important to note because there can be confusion for the person suffering and also for those who witness the symptoms experienced; after all, the event is in the past.

An unhelpful impulse that people sometimes have is to tell the person suffering, “It’s over. It isn’t happening anymore.” The trouble is that the body, mind, and spirit are remembering the traumatic event. And by remembering, I mean reliving the event. It is not simply brought to mind; it is brought back to the body and spirit of that person.

The physiological systems in the body are signaling that it is happening again. Often, while a traumatic event is still occurring, the body and mind seek survival, and part of that survival is to not allow the senses to fully take in what is currently taking place. It isn’t until after the person is in safety that the body and mind begin to allow the senses to take in what happened. This is when PTSD symptoms can begin to occur.

Remembering Through Reliving

An important aspect of the reliving that takes place with the body and mind is the interplay of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The PNS is the nervous system responsible for rest and digest; it operates when safety is experienced. The PNS allows us to sleep and connect with others.

The SNS is responsible for keeping the body safe through alerting the body to danger. The SNS is the system responsible for fight, flight, freeze, or fawn responses to danger. Think of the rabbit that rapidly switches from eating in the grass to darting quickly away when you approach it. The eating is when the PNS is operating, and the darting away is when the SNS kicks in as the rabbit interprets danger approaching.

Origins and evolution of PTSD

The term and cluster of symptoms currently recognized as PTSD originated in behaviors that were noticed in men who had experienced combat. The symptoms that we now recognize today as PTSD were first called “shell shock.” In other words, these men were stuck in the SNS after the traumatic experience had already taken place.

Interestingly, many veterans of our armed forces prefer to talk about these symptoms as PTS. The thought is that using the term “disorder” pathologizes a reaction that is natural and is to be expected in one who has experienced trauma. Many professionals in the mental health community agree with this as well. The term PTSD originated in the medical model that can sometimes pathologize normal, natural responses.

The wellness model, which I lean toward and was trained in, instead chooses to recognize and normalize symptoms that are naturally occurring, while at the same time working to decrease the difficulties surrounding the symptoms in order to allow the person some relief. Now, we have come to recognize that combat is just one possible example of trauma that people can experience. Any stressful event that overwhelms a person’s system can be recognized as trauma.

Trauma is personal and complex. Two different people could experience the same event, and one could be traumatized while the other one is not. It depends on how the event is received and perceived through one’s physiological, psychological, and emotional systems. We do not choose trauma. That can be the most difficult part of healing: acknowledging that what occurred was traumatic for you.

According to the DSM-5

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), five main criteria must be met for a person to be formally diagnosed with Posttraumatic Stress Disorder. The first criterion is “exposure to actual or threatened death, serious injury, or sexual violence in one of the following ways.” (APA, 2013). There are various ways in which a person could be exposed to the above for it to be considered trauma.

It could be 1) directly experiencing it, 2) witnessing other people experiencing it, 3) receiving information about this happening to someone close, or 4) repeated or extreme exposure to details of the event. (APA, 2013). The other criteria for a formal diagnosis can be clustered into four types of symptoms: changes in arousal and reactivity, intrusive symptoms, negative changes in mood and thoughts, and avoidance symptoms

Changes In Arousal And Reactivity

These symptoms have to do with what it looks like when a person’s SNS is continuing to be active, even when the situation would not typically bring this forth. The SNS is aroused, and the person responds by reacting. For many people, this marked stress response might not be limited to the time and place of the traumatic event.

It could be seemingly random times, or it might feel as though this is a constant state of being. The great thing about the functioning of the SNS is that we were created with it in order to survive. It is a gift that is meant to keep us from death and danger. However, when an event occurs that overwhelms this system, our bodies and minds don’t get the memo to turn it off.

Because the stress response symptoms continue to communicate danger and threat, symptoms also might look like people having nightmares, being easily startled and upset, or having trouble concentrating. When the body is in natural states of relaxation, sleep or quietness, it finds ways to continue to alert the person to the perceived danger.

Solutions For Relief

Find ways to experience rest, even if it is only for a short period of time. Think about encouraging your PNS to start activating. Here are some ways that your body naturally responds by switching the PNS on. Activities that produce endorphins can signal to your body that you can relax. Here are some ways to do this:

Deep Breathing This might sound strange, but when you breathe in through your nose and out through your mouth, you naturally stimulate the PNS.

Play Even a simple game of War or Uno, played with someone whose company you enjoy, can start those endorphins firing. Shooting hoops, kicking a soccer ball around, gardening, board games, a crossword puzzle, completing a puzzle, etc.

A Simple, Achievable Challenge reading a chapter in a book, running a mile, going on a hike, baking something new, lifting weights, doing ten pushups every day, etc.

Intrusive Symptoms

The name itself describes the nature of this symptom: it is unwanted by the person who is experiencing it. These symptoms typically present as involuntary and distressing memories of the traumatic event, nightmares with content connected to the traumatic event, feeling and acting as if the event is taking place again, and physiological reactions to reminders of the event.

Often, when one is experiencing this symptom, their body is operating out of their SNS that employs the stress response. It can be a terrifying experience. The foundational place to begin in addressing how to move through this symptom is the most counterintuitive: don’t attempt to silence these symptoms. The more that one attempts to silence or ignore these symptoms, the more it is reinforced that they are too difficult to face.

And the more that a person believes that they are too difficult to face, the more they attempt to silence them. It can become a vicious cycle that often entraps a person in compulsive behaviors intended to keep them “safe” from these symptoms. To be clear, these intrusive symptoms are extremely difficult to face, and this is often why people seek out counseling or a trusted friend to share them with.

Solutions For Relief

Find a trusted person to share about the memories If these symptoms feel intense and unmanageable, I recommend finding a trained counselor to address them with. If these symptoms feel manageable and not intense, then sharing with a trusted friend can help relieve some of the suffering involved in these symptoms.

Acknowledge what is happening Acknowledging that this is your body’s response to the traumatic event can allow some of the fear to decrease. Putting words to experiences can signal the brain to move out of the SNS.

Ground yourself in the present moment Bring all of your senses online by looking around where you are and stating what you see, hear, touch, smell, and taste. This can remind your body where you are and allow the physiological reaction to the event to decrease in intensity.

Negative Changes In Mood And Thoughts

We typically see this in the form of thinking that the world and people are to be feared and avoided. Another common thought is putting guilt and blame on oneself. We have this basic concept in mental health that we tend to see often. The basic concept is that thoughts impact moods and emotions.

Naturally, when the negative thoughts mentioned above appear, it can lead to a negative mood. These thoughts can serve a protective role for the person. If a traumatic event involves another person’s evil actions, then the victim may seek to avoid revictimization by viewing all people as potentially evil. It does give them the perception that they are protected, but it also will disconnect them from people who can provide safety and comfort as well.

Even feelings of guilt or shame serve to allow the person to believe that they have some control over stopping the traumatic event from happening again. Think of the person in an abusive relationship who thinks, “I shouldn’t have made them so mad at me. If I hadn’t made them mad, they wouldn’t have hurt me.” From the perspective of the mind trying to figure out how to avoid this event in the future, these thoughts make sense.

Solutions For Relief

Identify specific thoughts that you have about the traumatic event Again, this can be difficult to do and is often best suited to being done with a trained counselor.

Ask yourself how truthful the thoughts are Feelings and trauma can lead a person to operate from an idea that is not based on the truth. This can be incredibly difficult, and often it is best to do this with a trained counselor.

Build awareness Identify when these thoughts emerge and develop an awareness that this might impact your mood. You can act accordingly – reach out to trusted friends and those who, naturally, by the way they treat you, confirm that there is still goodness and beauty in the world.

Avoidance Symptoms

These are exactly what they sound like: avoiding things, places, and people that are associated with the traumatic event. Now this is completely understandable from a physiological perspective, as reminders of the event cause intrusive symptoms, arousal and reactivity symptoms, and changes in thoughts and mood.

After reading a description of those symptoms, I think you would agree that it makes sense to want to avoid them. Here is where it can become difficult. Much like the intrusive symptoms, the more that we avoid, the more we reinforce the idea that we are incapable of facing them. The more this is reinforced, the more we are reactive, the more intrusive the memories feel, and the negative thoughts and moods continue to increase in intensity.

Some people use avoidance as protection for their entire lives. It is important to remember that avoidance does give the person a feeling of protection and safety, temporarily. And, at the same time, it reinforces the belief that it is too painful to face.

Solutions For Relief

Acknowledge that your body is attempting to protect itself from something perceived as a threat If you are able to, try to coach and encourage yourself through the moment with minimal avoidance.

Be curious about why you are avoiding certain things Without casting judgment on yourself or being harsh, simply wonder why you might be avoiding.

Seek support Often, it is most helpful to seek support from a counselor who is trained to support someone who has experienced trauma.

Faith-Based Healing and Recovery

Healing and recovery from posttraumatic stress looks different for every person. Old, familiar, involuntary symptoms might emerge again at different seasons or stages of development in life. For others, reliving the past eventually fades into a memory of the past, which can be recalled at will, with no involuntary reactions of the body.

The current clinical understanding of the goal of treatment for PTSD is for the person to find meaning in what took place. What I have found is that there is a certain sense of staleness and emptiness when attempting to make meaning out of trauma, without inviting God into it. I’ve noticed that it can place another burden on the person that is far greater than one’s capacity as a finite being.

After all, the trauma reaction was a result of an event that was too much for the human system to endure. What might God do in your healing journey? Only God knows that. He does give us an open invitation when he tells us, “Come to me all you who labor and are burdened and I will give you rest” (Mt 11:28)