Of all the weighty-sounding diagnoses in the DSM-IV, perhaps Post-traumatic Stress Disorder (commonly referred to as PTSD) is the most weighty. In short, PTSD is an anxiety disorder resulting from exposure to an intensely dramatic event or events. Following exposure to trauma, individuals suffering from PTSD can experience recurrent painful thoughts or dreams, flashbacks, difficulty with sleep and anger, and other intense feelings including anxiety and hopelessness.
The term PTSD came into usage following the Vietnam War as thousands of veterans returned from Vietnam experiencing symptoms clearly related to their exposure to trauma. The diagnosis loosely correlates to the term Shell Shock, which was first used under similar circumstances following World War I. PTSD is quite common among soldiers who served in both Iraq wars and in Afghanistan.
Yet it is not only trauma associated with war that is sufficient to cause the kind of suffering captured by the term PTSD. Rape, abuse, assault, natural disasters and various other types of trauma, physical and otherwise, can all cause serious, prolonged suffering. In fact, many psychotherapists are rethinking symptoms formerly described as indicative of personality disorders instead as being better classified as part of PTSD.
While I do not commonly diagnose as part of my practice, I find an understanding of trauma and its consequences to be essential. We unfortunately live in a world where trauma and abuse are commonplace, and the suffering that results is profound. I choose to define trauma broadly, recognizing that everyone experiences difficult events differently.
Consistent with my non-diagnostic approach, there is no set formula which I follow in working with patients who are experience suffering related to trauma. Frequently, talking in therapy about the traumatic events, once an environment is created to do so, is tremendously helpful. But not always. Revisiting suffering can also create significant disturbance that results in unnecessary pain. Navigating this is an art. I do not believe in revisiting trauma solely for the sake of revisiting trauma, as an end-in-itself. As with many challenges, I think the most growth often comes from finding ways of building with pain, rather than merely expressing it.
PTSD typically comes with difficult, day-to-day symptoms. While addressing these doesn’t define the long-term plan, I offer patients with these difficulties a host of tools for managing the anxiety, painful thoughts, and physical symptoms that interfere with their lives.
Group therapy as an option for PTSD
For many, a therapy group offers tremendous support for those struggling with PTSD. By creating an instant treatement team, groups are intensely supportive. But groups can also do more than support; as with all suffering, growth is dependent not just on alleviating symptoms but on creating your life. Those with PTSD often isolate themselves, or keep their pain and trauma private, exacerbating its impact. A therapy group provides an opportunity to break out of this limiting way of dealing with trauma.
While it may sound trite, traumatic events, in addition to causing genuine suffering, are also opportunities for growth. When we’ve experienced trauma and are suffering, we are more likely to reach out to others and ask for (and offer) help. We discover who’s available to get closer to us. We discover strengths we didn’t know we had. We examine the ways we’ve lived our lives prior to the trauma, offering an opportunity to make profound changes in areas we might have otherwise left unexamined and untouched.