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PTSD - The Normal Reaction to Real Life Horror - Part I -

            It’s October again. We return to the month of frights, where every other movie on the TV is a horror movie.  It’s a time of haunting – haunted houses, where we can go to get scared silly; haunted hay rides and haunted costume parties, where we hide our identities behind scary masks and costumes – all culminating in Halloween. Though it’s not a fully-observed holiday, it is also an event that has been stretched out over a course of weeks by the commercial interests in the name of giving us a good time.   

            The most logical conclusion is that many of us like to be scared.  It’s quite fun, if we can maintain the awareness on some level that it’s not for real.  That’s not always easy. This brings to mind the occasion when we first took our young daughters to a Halloween haunted house, at their insistence.  No matter how thoroughly we briefed them that it was all make-believe, short of taking her out of the situation, we could not relieve our younger daughter of her horrified crying.  (I felt like such a jerk!)  On another occasion, I was sitting on the front steps at an employees’ family party, with the same daughter in my lap.  My supervisor secretly lit a string of firecrackers and tossed them in the grass beside me; prompting me to dive for cover with my surprised daughter in my arms. She was only confused; I was scraping my heart up off the grass. (Jerk got his karma!) “Sorry,” my boss said, “I forgot you were a Vietnam vet.”  (Note to self: Do not hit boss.) 

When the Scary Stuff is Real 

 But what if what’s scaring us is for real?  What if we cannot make the threat go away by closing our eyes, turning off a switch, or leaving the scene?   

            Those of us who survive real threats from situations like armed combat, disasters, crimes like rape and assault, and serious accidents typically find that we did not enjoy the real-life fear of the ordeal, and unlike Halloween, we prefer not to repeat the experience!  In fact, for some of us, the traumatic event – or events – were so intense, protracted, repetitive and/or overwhelming that our perceptions and responses to life were permanently changed.   

            The emotional and mental scars are as real as if we had lost an appendage.  Additional circumstances, like the limits of our ability to control the situation, our feeling abandoned or unsupported in the threat situation, our inability to understand the threat situation due to immaturity or lack of experience, and the lack of opportunity to talk about or “process” the experience – all of these contribute to increase the likelihood of the development of Post-Traumatic Stress Disorder, or PTSD. 

PTSD has been described as a normal response to extreme trauma that fall outside the normal range of human experience.   It may develop in persons who survive catastrophic events and even develop to some degree as a result of  vicarious traumatization  – or exposure to somebody else who experienced the trauma.  Examples of PTSD-inducing trauma include: a car accident involving the loss of loved ones;  a wife beaten by her husband; a natural disaster destroying the family house; a violent mugging or home invasion. For me, it was my experience in Vietnam.  Intensity and repetition of the traumatic experience increase the likelihood of developing PTSD. 

A Normal Response to a Terrifyingly Abnormal Situation 

Contrary to what some believe, PTSD is not an indication of weakness or moral failure.  Nobody is immune to the possibility of contracting PTSD, given enough trauma.  Military research has indicated that – given a certain intensity and duration of combat experience – PTSD is inevitable even in the bravest.  What does this mean?  “Them good ol’ boys” who fancy themselves fearless and invulnerable . . . well, they have not yet been through enough to meet their limits. 

Having seen more horrible carnage than any movie special effects can deliver, while flying as a helicopter ambulance pilot in ‘Nam, I now find all those scary movies to be quite boring.  Authentic war movies are another story. I remember, each time Halloween season rolled around again, how my daughters’ thoughts would turn to monsters – and I remember explaining that the only real monsters are people who do horrible things to other human beings.  Natural disasters, we can all understand.  It’s the horrible things we do to each other that make us even more vulnerable to developing PTSD than natural disasters. 

One my motivations for writing about the truly scary stuff this month is my reaction to seeing “crazy Iraq war veteran” themes in three separate fictional TV broadcasts over the course of last week.  To be sure, many of those new returning vets are suffering from combat-related PTSD, but we are not supporting the troops by stereotyping them in the same way the media stereotyped “crazy Vietnam war veterans.”  PTSD is a very real condition that requires treatment, but very few of us have exhibited the degree of extreme behavior portrayed in the media. Providing a caring and responsive social support system is the most critical thing we can do for those who made the sacrifice. 

The Statistics . . . 

But PTSD doesn’t just occur in war veterans.  It is not uncommon in the general population. Current estimates indicate that as many as 70% of Americans have experienced at least one traumatic event in their lives.  Given the right circumstances, as many as 20% of those go on to develop diagnosable PTSD.  About 8% of all adults will have developed PTSD at some point in their lifetime and an estimated 5% of the American population have PTSD at any given time.   

Persons victimized by physical or sexual assault are most at risk of developing PTSD – especially women, since they are more likely to experience interpersonal violence, including rape, domestic violence and childhood abuse. 

It is commonly believed that symptoms of PTSD develop right after the experience of trauma, but that is not always true.  Symptoms may appear months, or even many years after the initial trauma – the emergence of symptoms resulting from early childhood abuse being one example.   

Next, in Part II: What is it like to have PTSD? How do we recover from the real scary stuff? 

Granville Angell   © 10/2006 

Granville Angell, EdS, LPC, NCC, invites you to submit questions for his column. (Your identity will be kept confidential.) Email him:  angell(at)transitions-counseling.com, call his private practice, TRANSITIONS Personal & Family Counseling Services at 704-276-1164; visit his web site: www.transitions-counseling.com, where you can read prior articles.