Early Treatment Readiness
Following overwhelming experiences, a substantial minority of people understandably develop mental conditions that are serious enough to require professional help. Resilient individuals are masters at rebounding from stress. They are also wise enough to know that no one is immune to PTSD and other stress-related mental disorders and to know when they need help to rebound. Rather than worrying about appearing strong, they are concerned with healing (becoming whole again) so that they can be 100 percent there again for themselves, their friends, and their families. Resilient people actively seek needed help, rather than waiting and hoping that time will heal emotional wounds.
Why Is Early Treatment Important?
Recall that PTSD is the most complex of the stress-related mental disorders, and that understanding it helps us better understand the other stress-related mental conditions. So in this chapter we’ll focus on the early treatment of PTSD. It is critical to understand that:
- Many people do not spontaneously recover with time and needlessly suffer decades after the crisis has passed. For some, symptoms might appear months or years after the traumatic event.
- PTSD is a highly comorbid disorder. Most of the time, a range of medical and psychological conditions co-occur with PTSD, such as depression, anxiety, substance abuse, anger, hostility, cardiovascular disease, cancer, diabetes, gastrointestinal problems, headaches, chronic pain, skin problems, autoimmune diseases, suicidal ideation, accidents, poorer lipid profiles, greater unhappiness, and greater overall mortality, to name a few. Those with PTSD typically use more medical care. They also tend to cause strain on family members, who feel like they are walking on eggshells and who may exhibit similar symptoms.
- PTSD treatments are highly effective. Early treatment can often prevent post-traumatic stress symptoms from becoming PTSD. However, even skillfully combined treatments provided decades after exposure to traumatic events have been shown to be highly effective (Creamer et al. 2006). There is no need to suffer needlessly for decades when there are scores of effective treatment strategies. A skilled trauma therapist can help survivors find the right treatment or combination of treatment modalities.
- When you are healed, you are better prepared for the next crisis. Treatment can bring you back to full capacity. Conversely, unresolved trauma can make you more prone to problems when future crises occur. The treatment process will likely teach you new coping skills that will benefit you in the future. When you have confidence in the healing process, you can urge others who need help to get it.
Regarding treatment, be flexible. You might have survived a crisis by thinking things like Press on, Suck it up, Don’t quit, or Deny pain. Once the crisis has passed, be ready to shift to the healing mode. Stop and admit needs; unburden and heal emotional wounds; replace the water in the well so you can carry on better. Effective treatment will help you function at your best again. Some people will respect the fact that you sought help. There is no shame in this.
The treatment of PTSD usually involves helping the survivor to stabilize and manage symptoms; confront, neutralize, and properly store traumatic memories; and restore balance in life. It is helpful to think of the trauma specialist with whom you might choose to work as a coach. He or she will help you improve your coping skills, much like a golf coach would help you improve your game. Become an expert by reading about PTSD—its nature and treatment options. This will help you gain more from the treatment process and will help you be a more effective resource to others who also experience PTSD.
How Will I Know When I Have Recovered?
There are a number of indications of recovery. These are adapted from Dr. Mary Harvey (1992):
- You’ll be able to recall or dismiss the traumatic memory consciously (with minimal intrusions, nightmares, or flashbacks).
- You can name and tolerate the feelings associated with the memory.
- You tolerate other symptoms (such as depression, anxiety, grief, or sexual dysfunction) well, or they diminish.
- A sense of self-worth, enjoyment, and meaning in life is restored.
- You are comfortable with all feelings—positive, negative, and neutral.
- You are committed to your future.
The Myths and Distortions that Complicate Recovery
If you are suffering from PTSD, you might feel shattered, and that nothing will ever put you back together again. This is normal and quite common. Fortunately, healing and recovery are quite likely when you find the right treatment. Sadly, most people with PTSD do not get proper treatment and thus suffer needlessly for years. Many others whose symptoms do not rise to the level of a formal PTSD diagnosis nevertheless suffer from troubling PTSD symptoms. They, too, could benefit from treatment.
So many people don’t obtain critically needed treatment for several reasons. Some don’t know where to find it. Others fear that treatment might jeopardize their career or reputation. And others are blocked from seeking help by common myths and distortions, which are listed here—along with counterarguments:
- Those who seek treatment are weak and dependent. It is strength to recognize areas in which help would benefit us. An intelligent treatment plan encourages greater self-reliance, and healing helps us reach this. Healing PTSD also helps to improve the comorbid psychological conditions that block progress and enjoyment.
- I should be able to “soldier on” alone. Why? Is it written somewhere that one must never get assistance from others? If help ultimately strengthens us, is it weakness to ask for it, or is it strength and wisdom?
- If I show that I have feelings, I will lose control. Actually, people are more likely to lose control by bottling up feelings in an unhealthy way. It is liberating to realize that we can show human emotions such as grief, fear, and pain, and even shed tears—as we might at a funeral—and then return to full functioning. With emotional flexibility, we are less likely to snap. It is only by acknowledging vulnerability in certain areas that we can strengthen those areas. As the saying goes, we have to feel it to heal it.
- I should only be tough and mean. Many strong people are also tenderhearted. Most people would prefer to serve beside and be around strong individuals who also have a heart. It is okay to show and ask for warmth and affection.
- I must always be on guard and never relax. A rubber band that is constantly stretched will break. Be vigilant when needed, then take a breather when it’s safe so that you can function better.
- These symptoms will go away with time. They might, but if they are severe they likely won’t.
- I’ll lose it and never recover if I start talking about the trauma. I couldn’t stand the pain of talking about the trauma. Verbalizing helps to integrate and neutralize traumatic memories. Talking about trauma might be uncomfortable initially, but usually it becomes easier with repetition—especially when we choose the proper setting. A skilled trauma specialist will help you do this only when you are ready, and then at a pace that is acceptable to you.
- Talking about the trauma makes it worse. See the comments above.
- Denying my feelings will make the pain go away. Distancing or drinking will get me through. Ignored pain tends to accumulate until it erupts, often destructively.
- I shouldn’t have to suffer. I shouldn’t have to work at healing. Why would that be the case when everyone suffers? Perhaps you could adopt a softer, more accepting response to suffering as you work to solve your problems. Consider reading item 13 of the online resources (available at http://www.newharbinger.com/39409); it’s about resilient suffering.
- I should not request time to recover. When time is needed to recover, have the courage to ask for it.
- I must appear strong so that no one thinks I’m weak. I should be ashamed for having symptoms. This keeps many from getting help and causes many to self-medicate to disguise symptoms. Would you rather look strong, or invest the effort to be and feel strong inside?
- I should be over this by now. Recovery takes time—as long as it takes. Often, the slower you go in treatment, the faster the recovery.
- All problems can be resolved with willpower and getting back to work. Obviously this doesn’t work well in many cases of PTSD, since many symptoms can persist for decades until new approaches are tried.
- Mental health professionals are useless, touchy-feely incompetents who can’t relate to what I’ve been through. As with any profession, some trauma specialists are effective and some are not (Artwohl and Christensen 1997). Some have experienced what you have, and some who have not have tried hard to understand experiences like yours. Some have a capacity to care and help even though they have not experienced what you have. Nevertheless, shop around until you find one you can respect, relate to, and work with.
- I’m irrevocably bad for what I did. I’ll never get over it. Would a truly bad person feel the remorse that you do? Humans are able to listen to guilt, make needed changes, and then release it. Eventually, the guilt subsides.
Finding Needed Help
Fortunately there are many useful resources available for those with PTSD (see the recommended resources). The Sidran Institute, for example, helps people locate a trauma specialist in their geographic area. (Because the complexities of treating PTSD require an exceptional degree of expertise in PTSD, when looking for a mental health professional, it is best to find a trauma specialist.) The Post-Traumatic Stress Disorder Sourcebook (Schiraldi 2016a) explores the nature of PTSD and its treatment options in a clear and comprehensive way. This book also contains an extensive list of additional resources.
If symptoms have persisted or are disrupting any area of your life, and self-management strategies are insufficient, consider finding a trauma specialist. Be a good consumer. Prepare for your search by reading as much as you can about PTSD. Know beforehand which treatment modalities seem right for you. Discuss with a potential provider which treatment (or treatments) she or he uses, and be reasonably certain that you will be comfortable working with the provider.
Conclusion
Most people would not choose to suffer from the effects of trauma or other stress-related conditions. However, you can minimize suffering when you take the steps needed to recover and heal. In the recovery process, you’ll likely learn new coping skills that will help you throughout your life. Through this process, suffering can ultimately make you more resilient.