June is PTSD (Post Traumatic Stress Disorder) awareness month, and for this I took the time to reflect on my experience on how misunderstood post traumatic stress is, and how misusing the terminology minimizes the experience of those who actually do have diagnosable PTSD. PTSD is “a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury” (What Is Posttraumatic Stress Disorder?).
Symptoms of PTSD are as listed below:
It is common for people to feel immediate distress after a traumatic event, this however is NOT PTSD, rather it is Acute Stress Disorder. Post Traumatic Stress occurs when someone displays symptoms for 3 months or longer after the trauma. Complex-PTSD appears when someone has pro-longed trauma (most often in childhood). This may appear in childhood or may not even appear for years later in adulthood. In my case, as a child I showed no symptoms of PTSD until adulthood and it developed due to the trauma of my burn injury and the endless medical treatment and the inability to process what was happening to me at such a young age.
Note, someone can show trauma symptoms, however that doesn’t mean that they have PTSD. This however does not invalidate their pain and trauma. PTSD does not make someone weak, it is simply develops due to the way their brain and body processes their experiences. It is simply that - a processing disorder. Healing from trauma is about learning healthy coping skills and then going back in a safe way to process how your trauma affected you and reprocessing what happened so the trauma no longer has control and grips over you.
As someone that didn’t get support sooner due to stigma and appearing ‘fine.’ I can recognize I had PTSD long before getting formally diagnosed and only recently got diagnosed due to the severity of the symptoms and it starting to impact my day-to-day life. Even with the social pressures not to get diagnosed, getting the diagnosis was empowering for me because I was finally able to address the hidden pain my body and mind were trying to release for so long and get support. Fear of stigma should never be a reason for someone to not get help.
Throughout this journey I have learned that there isn’t a lot of general knowledge about how to support someone healing from trauma or experiencing PTSD symptoms.
Here are somethings you may not know about PTSD and Trauma recovery:
If the survivor doesn’t want to talk about it it is not a reflection of you but how they feel in the moment. Some people want to talk about it, some do not. Respect their timeline and wishes.
Somethings that bother someone one day, might not the next.
Healing isn’t linear, don’t rush or push us to move through the trauma.
Sometimes someone knows their triggers, sometimes they don’t OR what triggers someone one day might not another.
It can make someone hyper-sensitive or can cause one to get over stimulated easily as they are constantly on the look out for threats.
At its worst it can lead to self-destructive or suicidal thoughts or behaviors. Please create a safe space for a survivor to share this with you and encourage the survivor to get support before it leads to this.
It isn’t just all in ones head. Symptoms are also very physical and very exhausting. It can lead to fatigue, poor concentration, nausea, gut problems and more.
Telling a survivor their greatest fears aren’t real or aren’t going to happen doesn’t help because they already did happen.
Those with trauma can sometimes struggle with dissociation. During this time one can shut down, feel out of their body or even like they are someone else. An example of this is I appear as though I have a high pain tolerance (I don’t), rather I am not present and feel physically and emotionally numb during this time.
It makes someone feel alienated and alone.
It is not an excuse for abusive or disrespectful behavior. (I have quite a few friends who are trauma survivors or have PTSD and are the most kind hearted people I know.)
It is possible to live a healthy, productive and meaningful life with PTSD and after trauma. In fact, I do and I have several friends who have PTSD who do as well!
Here are ways to not and how to support someone during their recovery:
DON’T:
Invalidate us!
Everyone’s experiences are valid to them. PTSD most often occurs from an avoidance factor, avoiding feelings, the moment. Invalidating can confuse the person and cause them to avoid the feelings that are necessary for them to heal and move forward from the trauma.
Try to “fix” me.
PTSD isn’t ‘fixable,’ it is treatable but we are not a project simply to be fixed and move onto the next.
Tell me to “just get over it” or to “be fine” or “just move on”
The trauma has literally re-wired our brains and our body out of survival and greatly impacted us as a person, we are not able to simply ‘just get over it.’ Rather we can move through it and heal.
Toxic positivity or tell us how to feel.
This is invalidating to our emotions. For example if one got a large wound that hurt and then you immediately tell them to ‘be happy,’ it is going to either a.) cause them to avoid the emotion furthering the suppression that causes PTSD or b.) feel very unsupported and invalidated. The wound is going to hurt until it heals! This is healthy and normal! The same applies to our mental and emotional wounds - it is going to hurt until it heals.
Don’t push us to process trauma.
One way to ‘heal’ through PTSD is to do trauma processing therapy, however this is very brutal and hard. Pushing someone to process trauma before they are ready can push them out of their window of tolerance and cause them to not be able to cope.
Blame us (aka victim blame us).
Yes one does need to take accountability for their actions BUT blaming the victim will only cause guilt in shame around the bad things that have happened. It isn’t supportive. Trauma isn’t the victims (or survivors) fault.
Tell us to ‘Just change your thoughts.’
PTSD isn’t ‘thoughts,’ it is literally reliving in settle or severe flashes, scanning the room to see who is going to hurt us next so we are prepared.
Don’t touch without permission,
Most people with PTSD developed it from being touched without their consent. Ask the person if it is okay to touch them before you do as touch could be a potential trigger for them.
Try to control us or give us ultimatums.
PTSD develops due to not being in control of the bad things that happen to us, not giving us a choice is very disempowering and could play on our triggers and recovery.
Say you support us, then leave.
Don’t act like you support us then leave. Some people with PTSD have experienced abandonment trauma. Follow through with your word or don’t say it.
Say you understand, when you don’t.
Don’t tell me you understand. No ones two experiences are the same, there is no possible way one could ‘understand’ exactly what one is experiencing. One can empathize with someones experiences but there is no way they can ‘understand’ there exact experience and their exact emotions and state of mind during that time.
Don’t give me unsolicited advice
Unless you are a trained professional, trained peer supporter OR the survivor asked you your opinion do NOT give advice. For example; I have had several people recommend different mindfulness practices, when different mindfulness music can actually trigger me (either to going under anesthesia or make me feel unsafe in my body and cause severe pain due to the pain resurfacing), which is actually more harmful for my recovery than helpful. Yes it may come from a place of trying to be helpful but it isn’t to the survivor.
Don’t ghost them.
Survivors most often have been abandoned when they have needed it the most, if you can’t be there for them, communicate that rather than just disappearing. Disappearing will most likely cause them a lot of anxiety.
DO:
Listen and validate ones experience.
Survivors need to know the pain they went through is valid and that they didn’t deserve to go through it. Validating and acknowledging their pain is the first step in healing.
Help us find more support if we need it.
Finding good mental health support is VERY hard, even if the person you are supporting has a therapist, they may need more support. If they ask or need it, help them find it.
Show up for them when it counts.
Those who have experienced trauma trust has been violated, to build a supportive relationship with them, show up for them when it counts to build trust.
Set your limits, BUT also state what you CAN do.
No one can do everything, however if you only say what you can’t do to the survivor you take away that safe relationship with them and it can also feel controlling. When setting a boundary, also show empathy and tell them the ways you can support them so they feel loved and supported.
Include them in their support planning.
The survivor knows what works and doesn’t work for them, give them a voice in their recovery.
Do casual light-hearted things with them.
Trauma is heavy! But you can support them in light-hearted ways if you can’t bear the weight of the heaviness of them. For me this means going horse back riding with me or maybe having a game night!
Be there accountabilibuddy.
Recovery is hard and not something someone can do on their own, it is easy to fall into unhealthy coping strategies. Offer or if they ask you to be an accountabilibuddy to help them stay on track in their recovery. This creates a safe space for them to come to you when they are struggling.
Make them feel safe.
Trauma and PTSD makes one feel unsafe. In order to heal one needs safe relationships. Safe physically, mentally and emotionally to express their pain and be themselves. Show them through your actions that you are a safe person.
Accept them where they are at.
Rather than trying to understand, accept them for who they are and where they are at.
Earn their trust.
According to David Horsager’s book The Trust Edge trust is built through - clarity, compassion, character, competency, commitment, connection, contribution and consistency (2009). Do these things to build and keep their trust, for once you break it, it is hard to get back.
Help them stay grounded.
Post Traumatic Stress causes you to get very ungrounded, and not live in the present. Helping one stay present can help them cope with symptoms. A great way to do this is the 5-4-3-2-1 method. 5 things you see, 4 things you can touch, 3 things you can hear, 2 things you can smell, 1 thing you can taste. Animals can also be very grounding - my horses and my service dog are excellent at keeping me present in the moment.
Ask them what you can do to accommodate them.
This may be adjusting to certain things so they can avoid triggers, allowing them to have a service animal with them, flexibility in time etc.
There you have it - ways to support someone in trauma recovery! I hope you find this helpful and are able to utilize this in supporting others.
References:
Horsager, D. B. (2009). The Trust Edge: What top leaders have & 8 pillars to build it. Leaf River Publishing.
What Is Posttraumatic Stress Disorder? What Is PTSD? (n.d.). https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd.