Posttraumatic stress. The Case of Mary

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Posttraumatic stress is a disorder caused by emotions and it is categorized as an anxiety disorder. Posttraumatic stress disorder develops after an individual has experienced a frightening, highly unsafe or life-threatening experience (American Psychiatric Association, 1994).

Individuals with posttraumatic disorder experience the traumatic event again and again, and because of re-experiences, they tend to retrain from visiting places that might remind them of the event, people who might reignite memories of traumatic experiences or things associated with the traumatic event.

This disorder can affect individuals who experienced the traumatic event personally, witnessed the event or those who collect the pieces at the site the event occurred; this include legal officers and emergency workers (American Psychiatric Association, 1994).

Sometimes the trauma event can affect those close to an individual who experienced the event, they include friends and relatives. Some of the traumatic events include a terrorist attack, when an individual is diagnosed with an illness that is life threatening, natural disaster, being kidnapped, being a war prisoner, military combat, serious accidents, and violent assaults such as robbery, sexual harassment, abuse and physical attack.

In the case of Mary, who is a police officer, she experienced a traumatic event when she was travelling in a police car; the police car was driven at a high speed at a roundabout and because of the failure of brakes, the car crashed into a wall. Following the crash, she suffered injuries and could not walk for five weeks.

For Mary, this was just one of the serious accidents she had experienced, although this was the most serious. She has experienced repeated car accidents, and this has exposed her to the development of complex posttraumatic stress disorder.

Individual with complex posttraumatic disorder present symptoms that include intrusive thoughts; these individuals might experience intrusive thoughts through flashbacks where they re-experience the traumatic events or sometimes feel the pain experienced during the event reoccurring (Smyth et al, 2002). Some patients manifest intrusive thoughts through dreaming about the traumatic events experienced, and this leads to sleep disturbance or insomnia.

These individuals mostly avoid smells, touch, taste and any other sensation, which reminds them of the experienced traumatic event; they tend to avoid people such as friends, workmates and family members, and places such as home and work place, which will revive the traumatic memories (Smyth et al, 2002).

When they do this, they lose interest in their favorite activities and feel totally detached from people close to them. They always fear of the future and always feel unsafe. When people suffering from complex posttraumatic stress disorder engage in avoidance behavior, they experience emotional numbness.

These people are also faced with challenges of hyper-arousal; they experience panic attacks more often and this can make them feel angry and irritated. Prolonged attacks and stress can lead to memory lose and low concentration levels (Newman et al, 1996). The sufferer sometimes feels jumpy, and he or she is easily startled, the sufferer can also be hyper-vigilant, couscous and alert because he or she thinks that the event will happen again.

In extreme cases, the sufferer feels depressed and hopeless, and because of this, the sufferer experiences suicidal feelings and thoughts. They also feel alone and alienated from the other people, physical pains and aching of the body. If the case is not handled during its early stages, it might lead to substance abuse or criminal activities.

Symptoms of complex posttraumatic stress disorder vary from one individual to another, and this depends on the traumatic event; whether it is an accident, a sexual arousal, military combat, among others (Newman et al, 1996). It also depends on the exposure of the sufferer to similar traumatic events and how intense the exposure was.

Considering the case of Mary, she was exposed to three serious car accidents, and after some months, she started experiencing fear of the similar accidents happening again. She avoided any situation where she was driven by another person; this is seen in her reaction when her husband speeds the car after realizing that they were late for a social engagement function. According to Mary, over-speeding would lead to an accident that is similar to the ones she had experienced in the past; she even brakes down in tears.

She has lost trust in people around her; she fears that they would cause an accident if they drove her, even if they promise to drive her slowly and carefully. She can only trust herself; therefore, she could drive herself without too much distress. She tries to avoid police cars as much as possible; this is because the traumatic accidents she had experienced happened when she was being driven in a police car. When she is told to move from her desk job to street policing, she feels that they are putting her back to the place where she experienced her traumatic accidents; this makes her to panic and feels stressed by the change her job location.

Mary experiences intrusive thoughts, which are manifested in her flashbacks of the accident; she could see potential accidents all over. This makes her break in tears as her husband her at a high speed, and when other people offer to drive her carefully and slowly.

Mary is always hyper-vigilant when driving or being driven; when her husband over-speeds, she feels that the speed is too much and can cause a serious accident. This makes her watch over her husband’s way of driving to prevent him from causing an accident.

It is not a guarantee that each individual who experiences traumatic events would develop posttraumatic stress disorder. This is because each person has a different way of reacting to traumatic events (Smyth et al, 2002). Also, people have different abilities and ways in which they manage their stress and fear.

After a traumatic experience, the support offered by people close to the person such as friends, professionals and family members determine the development of posttraumatic stress disorder (Newman et al, 1996).

In Mary’s case, she has already developed posttraumatic stress disorder; this is because she has registered symptoms of posttraumatic stress, which are evident several months after the traumatic events. Therefore, Mary requires to seek help from professionals; there are several treatments available for posttraumatic stress disorder patients.

Cognitive processing therapy is among these treatments, this is a type of treatment that involves counseling with an aim of giving the patient a new way of handling distressing thoughts, and at the same time understands the traumatic events (National Center for TSD, 2006). This type of therapy is also directed to change the way the patient look at herself considering Mary’s case, and the world around her; this is because one’s thoughts and perception have a direct on his or her actions and feelings.

If Mary chooses to use Cognitive Processing therapy, then she will have to go through the following steps. First she will learn about her PTSD symptoms diagnosed by the professional and how therapy can help her. Mary will be given the whole plan for the therapy together with the explanation of the skills involved and their importance.

Secondly, Mary will be made aware of her thoughts and feelings; this is meant to find out why the thoughts and feelings happen, i.e. why Mary re-experiences the thoughts and feelings on the serious accidents she had experienced. She will have a chance to learn how to pay attention to her thoughts and feelings about the traumatic accidents.

Mary will also be given a chance to think about her trauma in different ways and how it has changed her life; this is done through writing or talking to the therapist (Chapman et al, 2005). The third step is that Mary will now learn skills that will help her challenge her thoughts; she will be given worksheets and allowed to decide on how she wants to feel and think about her trauma.

The skills she will have learnt will also help her to deal with the day-to-day life. After using the skills and gone through the trauma, Mary will have to understand changes in her beliefs about her self-esteem, control, safety and trust and her relationships with other people (National Institute of Mental Health, 2006). It is by understanding her beliefs that she will find a balance between her beliefs before and after the trauma.

Another treatment, which can apply to Mary’s case is prolonged exposure therapy; in this type of therapy, Mary will repeatedly be exposed to situations, thoughts and feelings about serious car accidents involving police cars. The exposure is meant to reduce the distress causing the trauma by reducing the power the trauma has to cause distress.

Mary will have to go through four steps to complete this therapy; first, she will attend the briefing of the treatment and learn more about her symptoms; the briefing will help her understand the goals set for the treatment (Chapman et al, 2005). The next step is practicing the skill of restraining her breathe; this skill will help her relax.

During anxious and or scary situations, people tend to breathe fast and if Mary learns to control her breathing, then she can manage her distress in the short-term (Keane and Friedman, 2000). These exposures will also help Mary to deal with real-world situations; she will learn to approach safe situations, which she avoided: she avoided being driven, even when it was done slowly and careful.

This exposure will help her lessen her distress with time, and when the distress reduces, she will have more control over her life. Mary will also be allowed to talk about her trauma over and over in the presence of her therapist; this will help her to have full control over her feelings and thoughts.

Through the exposure, Mary will learn that she does not have to be afraid of memories of traumatic accidents. This type of therapy might be hard at times because she will have to think of stressful things about serious accidents involving police cars but with time she will feel better.

Apart from seeking professional help, Mary can choose to help herself through challenging her sense of helplessness. When Mary experiences trauma, she feels powerless and vulnerable; therefore, she has to pin down the feelings by reminding herself that she is strong and tough; this will help her overcome distress that comes with the trauma (Bell et al, 2008).

Mary also has an option of the Eye Movement Desensitization; this form of treatment will be performed by a therapist when Mary is thinking about the trauma. The therapist will waive his or her hand in front of Mary as she follows the movement of his or her hand with her eyes (National Center for PTSD, 2008). This will help Mary’s brain to process her memories about the accidents reducing negative thoughts about the accidents.

Sometimes in cases of anxiety and depression, she can choose to take medicine such as serotonin reuptake inhibitors or sedatives to help her to relax. There are people who choose to calm themselves down or want to forget traumatic events through taking of alcohol and drug abuse (Bell et al, 2008). This might help them forget for sometimes, but in the long-run it has severe effects; it might cause drug addiction or suicide.

Posttraumatic stress disorder can affect anyone who is subjected to traumatic activities; however, the development of this disorder depends on an individual. Posttraumatic stress disorder development can be prevented by the family members and friends of the sufferer through support and understanding (Callaghan, 2004). If an individual is shows signs PTSD, it is advised to seek medical help to avoid complications such as drug abuse, which might develop in the later stages.

Reference List

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington: American Psychiatric Association.

Bell, P. et al. (2008). Posttraumatic Stress Disorder in Northern Ireland. Acta Psych, 12(2), pp.160-166.

Callaghan, P. (2004). Exercise: a neglected intervention in mental health care? Journal of Psychiatric and Mental Health Nursing, 11(2), pp. 476-483.

Chapman, D. et al. (2005). Is resilience in your future? WELCOA Special Report. New York: Wellness Councils of America.

Keane, T. and Friedman, M. (2000). Effective Treatments for PTSD: Practical Guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.

National Center for PTSD. (2008). U.S. Department of Veterans Affairs. What is posttraumatic stress disorder (PTSD)? Web.

National Center for PTSD. (2006). U.S. Department of Veterans Affairs. Treatment of PTSD. Web.

National Institute of Mental Health. (2006). Anxiety Disorders. Web.

Newman, E. et al. (1996). The effects of overwhelming experience on mind, body and society. Journal of psychiatric, 23(5), pp.242-275.

Smyth, J. et al. (2002). Structured writing about a natural disaster buffers the effect of intrusive thoughts on negative affect and physical symptoms. Web.

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Posttraumatic stress. The Case of Mary

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