Post Traumatic Stress Disorder (PTSD)
Steven G. Rise, PhD, LCSW-R
Many of the mental, personality and addictive disorders are based in or reinforced by hyper-vigilant or malfunctioning ego defenses that either overprotect an individual, or deviate his perception, and subsequently his expressions as well. An example used earlier that demonstrates this hyper-vigilance and malfunction most clearly is Post Traumatic Stress Disorder (DSM-IV 309.81), which expresses itself in cognitive, physiological, emotional and behavioral dysfunction, in addition to noticeable shifts in one’s belief systems, and disillusionment in his understanding of God.
One’s core values, including his subjective experiences and objective truth, and all of his self-expressions are impacted by severe trauma. Because of its all- encompassing impact, Post Traumatic Stress Disorder (PTSD) also establishes a potential framework for one’s natural defense mechanisms to engage, which allows the psyche to (over) protect itself.
As one’s prior subjective experiences within his core values structure assists him in defining self and his environment in the present, his expectations and anticipation’s based on those prior experiences are vulnerable to assault at any given moment. PTSD develops because of the overwhelming, sudden and unexpected intensity of an event that causes one to respond with intense fear, helplessness or horror. The force of such a severe psychic blow is beyond the person’s ability to absorb and accept, thus prolific symptoms manifest in every area of his personhood, which may even include permanent changes to personality. PTSD is an Axis I disorder that is categorized under the anxieties.(1) Perhaps because one who bears the manifestations of PTSD seldom views the world in the naivety he once did. Therefore, his expectations and anticipations stay continuously hyper-vigilant awaiting future assaults.
This disorder also serves as a well-defined example to exhibit the interwoven nature of self and one’s expressions as outlined in the Core Values Model, particularly regarding the internal conflict between one’s subjective experiences and objective truth. Because of the suddenness and intensity of the event, one contemplates and often loses his previously sustained belief system. This period of reevaluation has the ability to lead a person into disillusionment or toward objective truth, depending on many variables, including his value system, support network, personality, prior trauma and the extent of his loss.
Some of the characteristic symptoms of PTSD include persistent re- experiencing of the traumatic event, avoidance of triggers or stimuli associated with the event, general numbing or disassociation, and hyper-vigilance, which often has significant ramifications physiologically. One may experience PTSD by being the actual victim of personal assault, disaster, accident or illness, or by being in close proximity to the event as an observer, or by being the recipient of information of such trauma where the victim is a close friend or family member.(2) Individuals with PTSD often express survivor’s guilt, or guilt feelings about surviving while others did not, because of what they had to do to survive, or because of their powerlessness to correct the situation. These individuals are also at higher risk of developing either or a combination of essentially all of the mental disorders, depending upon their perceptions and personality types.
There is an extensive list of conceivable physiological, emotional, cognitive and behavioral symptoms one might experience. The constellation of symptoms is unique to everyone because of the exclusive framework of subjective experiences and core values that defines each person. Some of the symptoms include: Phobic avoidance of situations or activities that symbolize or resemble the original trauma, which may interfere with interpersonal relationships; impaired affect modulation;self-destructive or impulsive behavior, which according to Beck, implies the trauma influences one’s core value system.(3) Other symptoms include: dissociative symptoms; somatic complaints; feelings of ineffectiveness, shame, despair or hopelessness; feeling permanently damaged, which on some levels may be true because trauma impacts how one defines self, the world, and how he interacts within his environment; the loss of previously sustained beliefs; hostility; social withdrawal; paranoia; inability to relate to others; or changes in previous personality characteristics.(4)
Depending on one’s overall core framework and ego strength, one will think, feel, respond and develop situational beliefs unique to self. As these variables, among others, are combined with different personality types, an added dimension of difficulty unfolds.
1 Herman, “Complex PTSD,” 377-391
2 Ibid. 424.
3 Beck, Cognitive Therapy and the Emotional Disorders, 244.
4 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 425.