It was on a rainy winter’s day in 2017 when I first heard the term Post Traumatic Stress Disorder (PTSD) in a way that was meaningful to me. I was sitting it a tub chair, feeling totally uneasy, almost wired yet vacant, staring at the uninspiring view of a Co-op supermarket through the raindrop obscured window. My Psychologist was sharing the diagnosis of PTSD and I was keen not to accept it.
‘’Oh no! I’m not having any of that’’ I remember saying internally.
I distinctly recall averting my eye contact as if this meant her words couldn’t penetrate me and I remember a very real fear rising in my chest as I asked myself ‘’What on earth will they think of me at work!’’ Having a disorder was not high up on my list of things to do and certainly not how I wanted my colleagues to perceive me.
The reality was, I had just voiced a debilitating set of symptoms that I’d been experiencing for several weeks, triggered by me finally leaning into the 8 years of sexual abuse I’d been exposed to as a child. Reflecting on the severity of the situation and my subsequent state, it is no wonder the diagnosis followed. I am grateful now that I did accept the diagnosis and went on the receive the help I needed.
I now work with people who are experiencing PTSD and I am also studying the disorder and impact it has. Seeing both the theory and the practical elements through a lens of my own personal experience is fascinating, and the more I learn, the more I am in wonder at the complex genius of the human brain.
PTSD is a condition classified by the Statistical Manual of Mental Disorders in the US and the International Statistical Classification of Diseases (ICD-10) in the UK.
For a diagnosis of PTSD to be made there are several criteria that must be met.
1. A person must have been exposed to a trauma, either by way of an experience or witnessing an event that is deemed to be a threat of or actual death or serious harm OR threat to personal integrity or that of somebody else. This can include being consistently exposed to details of traumatic events such in the cases dealt with by judges, police officers, paramedics etc.
2. There must be at least one intrusion symptom that is linked to the event which starts after the event occurred. This would include elements such as distressing dreams, flashbacks of the events that appear to be as real as the event itself and physiological responses in line with those experienced during the event, when reminded of what happened such as crying, heart racing etc.
3. Avoiding memories, thoughts and feelings about the event which can extend to avoiding situations that may trigger a reminder. If the PTSD was triggered by a car accident on a motorway for example, there may be an avoidance of motorways going forward.
4. Not being able to recall aspects of the initial events in detail and losing interest in social connection and/or experiences. Detaching from the world to protect oneself.
5. An altered state of arousal and reactivity which may lead to unhelpful behaviours such as hyper-vigilance, anger or a propensity to misuse stimulants such as drugs/alcohol etc.
I believe it’s critical to note that many people experience traumatic events during their lifetime. In fact, research conducted by The National Council suggests that 70.4% of adults have experienced some type of traumatic event at least once in their lives.
With these statistics it’s hardly surprising that the number of people being diagnosed with PTSD is rising. I would argue however, that in many cases only some, rather than all the PTSD diagnostic systems are present.
It is very likely that following a traumatic event, a person will experience some of the aspects of PTSD I have mentioned. This would be a normal response to such an incident and the symptoms would dissipate with time. Of course, having a few of the symptoms does not mean a person has the disorder, so importantly one of criteria for PTSD that I haven’t touched on is the duration that the symptoms are experienced over.
My fear, which is being backed by some experience working with clients, is that PTSD is being diagnosed at general practice level for people who are experiencing some of the symptoms short-term. My hope is that people will seek help from a psychologist in determining whether the diagnosis is correct. It’s estimated that only a small percentage of those who experience trauma go on to have chronic PTSD, i.e. the symptoms continue to be experienced over prolonged periods.
I feel grateful that I discovered the Havening Technique® which is a safe and non-intrusive way to work with trauma and symptoms of PTSD. Where PTSD is a chronic condition, I will only do this when working alongside a medical professional, but for the general symptomatic presentation, a client can work with me to change the way they perceive the situation.
For a trauma to be encoded in our brain a few elements need to be present. Firstly, there needs to be the event itself coupled with what is known as a vulnerable landscape in the brain (determined by environmental factors we have been exposed to throughout life). We then need to perceive the event subconsciously as being both threatening and inescapable. Where these conditions are present, the trauma will be encoded and sit on a neuron in the brain waiting to be triggered, almost like a live landmine would wait silently in the field until its disturbed.
One of the challenges with this trauma encoding is the very fact the trauma can be triggered by new sensory information which flows in throughout our daily lives. Anything that we perceive to be linked to the trauma (even the most tedious links can cause a trigger) will activate the body’s fight, flight or freeze response and we are likely to respond in the way that we did at the time of the trauma and then perhaps include an unhelpful habitual numbing response such as drinking, emotional eating or being angry in order to escape the uncomfortable or scary feelings we are experiencing as a result of the trigger.
Having been through several years of talking therapy & some EMDR, I realised that talking about the abuse I’d experienced was eliciting this emotional response and I believed (rightly or wrongly as I have no evidence) that the PTSD symptoms continued as a result. I liken this to having a wound a continually pouring salt into it. I believe some talking therapy is key in order to ensure the buried feelings are accessed but in the case of PTSD it’s often evident that the feelings are being felt.
When I discovered Havening, this started to change. Working through the events and the associated feelings brought about a neutral state which meant I could re-experience the events without feeling the fear, shame or desire to use my unhelpful numbing habits. It wasn’t coming from a place of dissociation because I had absolutely felt the events being activated when I initially thought of them in the therapy session, rather it was a result of a neural process known as depotentiation which I like to think of as the land mines being deactivated by the bomb squad. Once the process occurs, the mine can no longer be harmful. We view it still as something that used to cause harm but doesn’t have the ability to do so now that it’s been neutralised.
The benefit of this technique, which was created by medic, Ronald Ruden, in the US, is that clients don’t need to re-experience the original trauma in detail, unlike with EMDR therapy. It simply must be activated for a few moments before a series of distraction techniques are deployed, alongside the application of touch. This combination allows the process of depotentiation to take place and the client reports a feeling of neutrality, almost as if they are disconnected with the trauma. I love to see clients screwing up their eyes and shaking their heads in disbelief because they can no longer associate the dreadful feelings with the event itself. Once the process has taken place, the event will never be experienced in the same way again.
So, you can see that this way of working is so wonderful for clients experiencing PTSD symptoms around an event. And in my case, with a more chronic case of PTSD which is linked to a prolonged and high number of events, there are ways to work with clients to neutralise the string of events quickly, albeit not always in a single session.
It is wonderful to be able to piece together my academic learning in psychology and neuroscience with my practical work with my clients and I know this will grow from strength to strength, always putting the wellbeing of my clients first.
The work of Dr. Ronald Ruden is in my view an enormous step forward for the treatment of PTSD symptoms and I would love to see this replace the more intrusive EMDR therapy currently deployed by the NHS.
For more information please feel free to email me at firstname.lastname@example.org
Angela Cox is certified practitioner of Havening Techniques. Havening Techniques is a registered trademark of Ronald Ruden, 15 East 91st Street, New York. www.havening.org