We live in a world of relative safety most of the time – but it is a world in which people often lack support for dealing with calamities. In these times we may not have the extended families, long-term friendships, sense of neighborhood, feeling of community or the support from religion that have historically helped people endure times of crisis. We usually get along without difficulty as long as things go smoothly. But when a crisis occurs, we sometimes simply do not know what to do or where to turn.

Traumatic events can leave us stranded. We may lack not only social support when a crisis occurs, but also the language for understanding the place of tragedy in our lives. We may not know how to conceptualize it – how to use words that can describe a disaster and make it real. We may not know how to react emotionally when crisis comes into our lives – these are feelings that we may have never experienced before and they may frighten us. So we refuse to accept the crisis or to deal with it. We think we are strong and able to endure anything. Denial comes easily. Refusing or not knowing how to deal with the thoughts and feelings that accompany a major catastrophe, unfortunately, sets us up for PTSD. And it is not our fault.

PTSD is highly treatable, especially if it is caught early. The idea behind the treatment is to process or work through the traumatic event, as well as to manage the immediate troublesome symptoms the person is experiencing. A trained therapist can help the PTSD sufferer to find the words, in a safe and gentle way, to talk about the event and to confront the feelings that accompany the experience. This is not an easy step, but it is a necessary one. While it might seem natural to avoid reliving a painful memory, it is important to face the memories, feel the emotions and try to work through them. When this happens, the trauma no longer controls the person – the person is now in control of the memory of the trauma to the extent that he or she can approach it objectively and flexibly.

A person who has survived a traumatic event will probably never feel as if the event never happened, but the distressing and disruptive effects of PTSD can be alleviated. In therapy, a person can learn to describe a coherent account of his or her life. People who are able to do this are much less susceptible to the effects of trauma. Therapists use a number of techniques to help a person work through traumatic events, some involving talking and some involving more physical interventions. Sometimes medication can help to lessen the anxiety, depression and sleep difficulties, as well as the physical symptoms, which go along with PTSD. Social agencies now use highly effective techniques, such as critical incident debriefing, to help people process their way through a trauma immediately after a disaster occurs in a community. Victims of violence are often now given support to talk about the event soon after it has occurred.

The old way of thinking was that the strongest people were those who could hold in their emotions and face tragedy stoically. Unfortunately, this is precisely the pattern which leads to PTSD. Real strength comes from knowing oneself and expressing that sense of self in the world with openness, honesty, integrity – and courage.

Baya Mebarek, Psy.D., LMFT
www.sandiegofamilytherapy.net