Teresa Jacobson, DBH, LPCC-S, NCC
11/15/2023
Have you ever been called "too sensitive" or have been told "you have an emotional problem"? Perhaps it's time to clear the air.
Traumatic things that happen to an individual deeply impacts not only how one sees themselves and the world around them, but causes extensive neurological, physiological and psychological changes. Each time a traumatic event is triggered thereafter, this exact cycle of changes is relived, and experienced by the individual all over again.
Post-Traumatic Stress Disorder (PTSD) is a pervasive and intense condition that can feel and look chaotic and feel utterly powerless to the one experiencing it. It is not something I would wish on a fellow human being due to the anguish, malignancy of thought, damage to one's health, self-image, confidence, and potentially one's life.
Difficulty "regulating emotions" has long been linked to anxiety and depression; and evidence is abundantly clear a strong link of emotion intensity and PTSD also exists (Shepherd and Wild, 2014). Studies have shown those exposed to early-onset chronic interpersonal trauma may have higher levels of emotion-related difficulties. However, this is not a character flaw. It is the result of trauma.
"Among trauma survivors, emotion regulation difficulties are strongly related to PTSD symptoms" (Barlow, Turow, & Gerhart, 2017). The challenge to regulating emotions in trauma-exposed people with PTSD is complicated.
Many people misunderstand trauma and the impact it can have on an individual. With willingness and compassionate curiosity, perhaps a more thorough understanding can help.
Misnomers about Trauma and PTSD
Myth: "I went through a similar experience. It wasn't traumatic for me."
Fact: We don't get to decide if something was traumatic for someone else.
Myth: "He/She/They are just too sensitive (fill in the blank, "over-reactive, emotional").
Fact: The amygdala (our built-in safety radar) hijacks the prefrontal cortex (or logic center) when triggered from a traumatic experience. When the pre-frontal cortex goes off-line, we can only experience the emotions we feel. Literally, we have zero access to logic until we ground to present and safety.
Myth: "It is all in your head."
Fact: Nothing here is imagined. PTSD is very real and causes extreme anguish.
Myth: "It was in the past, you should just get over it" ("let it go", "pick up your bootstraps", "put your big girl panties on", "just move on").
Fact: Everyday memories are filed away in the brain's memory center, where files can be retrieved when needed. Unprocessed and "stuck" traumatic memories are like files that remain open, where images, thoughts, emotions, and body sensations can be summoned by the brain when the amygdala perceives a threat. So the person in the trauma trigger is experiencing all of the same emotions, thoughts, images, and physiological changes immediately, brought on by the release of adrenalin and cortisol, as the "fight, flight, or freeze" response takes over. This is intense, horrifying,, and completely draining and can look like many things to the outsider and cause the one experiencing the symptoms to "feel like I'm going crazy." But they are absolutely not. They are suffering, deeply.
Myth: "Only those in the military experience true PTSD."
Fact: Post Traumatic Stress Syndrome is not exclusive to experience, gender, culture, socioeconomic status, age, level of education, or any other variable. No one is immune to the experience of trauma, or development of PTSD. Adaptability and resilience can help someone after trauma, and we'll go into that in a later article.
Myth: "Women are more prone to PTSD"
Fact: Every human being can experience PTSD. Regardless of the traumatic experience, PTSD causes the same spiral of distress and neurological, physiological, and psychological changes despite gender. or experience of trauma.
Myth: "PTSD causes people to drink or use substances."
Fact: PTSD causes extreme anguish and some people have tried to "numb" or "lessen" the feelings associated with PTSD by using other chemicals to escape. But what transpires is worsening symptoms, potential addiction, and a domino impact on other parts of one's body, well-being, relationships, and life (not to mention possibly more traumatic things).
Myth: "I will never be able to get over my trauma."
Fact: Though the memories won't be erased, evidence based treatment like Eye Movement Desensitization Reprocessing (EMDR) can stimulate the natural healing process of the brain and allow the "open file" to be stored in the long-term memory center, lowering the "charge" of the trauma. It is an efficient therapeutic modality that can help someone heal from within, and help a person feel more in control of their own body and mind, feel more confident, and more centered. It is a powerful therapy.
It is important to identify symptoms of PTSD in trauma-exposed individuals and to know that it is very treatable. These painful wounds can truly heal.
Post-Traumatic Stress Disorder
A person exposed to a traumatic event may experience symptoms indicative of PTSD. If the below symptoms last for over one month and are intrusive, avoidant, cause negative alterations in one's mood, and cause changes in arousal and reactivity, it is likely PTSD. The severity of symptoms cause "significant functional impairment or distress in various areas of life, such as social or occupational" (DSM-5-TR, 2022). One caveat is the distress experienced is not a result from the use of a substance.
The official diagnosing criterion for the diagnosis of PTSD (DSM-5-TR, 2022) is outlined below.
The presence of one or more intrusive symptoms beginning after the traumatic event occurred:
Experiencing recurring, involuntary, and intrusive distressing memories after the traumatic event.
Having recurrent dreams or nightmares related to the traumatic event.
Dissociating or having flashbacks.
Being triggered of the traumatic event which causes intense or prolonged psychological distress.
Experiencing physiological reactions when reminded of or triggered of the traumatic event.
The presence of one or both avoidant behaviors:
Avoiding or making efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the trauma.
Making efforts to avoid external reminders or triggers (such as people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts or feelings associated with the traumatic event.
The presence of two or more negative alterations in cognitions and mood after the traumatic event:
Being unable to remember an important aspect of the event due to dissociation.
Believing negative core beliefs or expectations about oneself, others or the world.
Blaming oneself for the trauma's occurrence or consequences of the trauma.
Experiencing persistent negative emotions like fear, horror, anger, shame, or guilt (to name a few).
Decreasing interest in participating in significant activities.
Detaching or feeling estranged from others.
Feeling unable to experience positive emotions.
The presence of two or more alterations in arousal and reactivity associated with the traumatic event:
Exhibiting irritable behavior and angry outbursts.
Participating in reckless or self-destructive behavior.
Experiencing hypervigilance.
Displaying an exaggerated startle response.
Having difficulty with concentration.
Finding it difficult to fall or stay asleep, or restlessness while sleeping.
PTSD is unfortunately more common than people seem to realize. Thankfully, there is an efficient therapeutic path to feeling better.
Enhancing The Healing Power Within
Eye Movement Desensitization Reprocessing (EMDR) "is a structured therapy that encourages the patient to focus briefly on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories" (EMDRIA, 2023). This therapy is extensively researched, effective and efficient, and is proven to not only help people recover from trauma and PTSD symptoms, but is also helpful for other conditions and distressing life experiences.
EMDR therapy does not require delving into the details of distressing events. Once the client and therapist together decide EMDR therapy is a good fit, the early sessions will involve identifying what the client would like to work on and strategies for managing distress.
When ready, the next phases of EMDR therapy involves having the client focus on a specific event while paying attention to an image, negative belief, emotion, and body sensation that arises stemming from the event, while working towards a positive belief the client would prefer to have.
"While the client focuses on the upsetting event, the therapist will begin sets of side-to-side eye movements, sounds, or taps" (EMDRIA, 2023). The client remains grounded with the therapist who checks in frequently. "The client will be guided to notice what comes to mind after each set. They may experience shifts in insight or changes in images, feelings, or beliefs regarding the event.
The client has complete control to stop the therapist at any point if needed. The sets of eye movements, sounds, or taps are repeated until the event becomes less disturbing."
The memory will still exist, EMDR is not hypnosis. EMDR promotes a decrease in the intensity of the "charge" from the triggers of the trauma, and an end to the fight, flight, or freeze response from the traumas targeted.
As a survivor of trauma who was diagnosed with PTSD, and now an EMDR clinician, I have experienced and witnessed the anguish of trauma and the healing power of EMDR. It is a powerful therapy that has the potential to heal even the most complex cases of PTSD.
Should the above symptoms of PTSD resonate with you, know that the pain you experience can lessen tremendously. I hope you find the willingness and self-compassion to seek your own EMDR therapist, so you too can heal.
Teresa Jacobson is a Doctor of Behavioral Health and Licensed Professional Clinical Counselor Supervisor who provides therapy using evidence-based practices to counsel Ohio and Kentucky adults of all ages and life experiences via secure Telehealth visits. An empathetic, strength-based, person-centered multi-cultural counselor with an existential philosophy, Teresa can be reached by emailing steppingtowardserentiy@proton.me
calling (513) 206-3026, or visiting
References
Barlow, M.R., Turow, R.E. and Gerhart, J. (2017). Trauma appraisals, emotion regulation difficulties, and
self-compassion predict post traumatic stress symptoms following childhood abuse. Child
Abuse & Neglect 65, 37-47. Retrieved from http://dx.doi.org/10.1016/j.chiabu.2017.01.006
DSM-5-TR (2022). Posttraumatic stress disorder, Diagnostic Statistical Manual. American Psychiatric
Association, Washington, DC. 123-127.
EMDRIA (2023). What is EMDR therapy? EMDR International Association. Retrieved from
Shepherd, L. and Wild, J. (2014). Emotion regulation, physiological arousal and PTSD symptoms in
trauma-exposed individuals. J. Behav. Ther. & Exp. Psychiat. 45, 360-367
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