By Kent A. Corso.
Those struggling with the lasting effects of trauma don’t need the month of June to keep them aware of how significant trauma is. They know trauma’s impact first-hand. In fact, the mention of “PTSD Awareness Month” may be an uncomfortable reminder some wish to avoid. Still, others may find themselves reveling the success they’ve achieved despite their trauma.
Whether you meet one of these descriptions or lie somewhere in between, consider taking this month as an opportunity to increase awareness about PTSD in a different way.
Two years ago the diagnostic criteria for PTSD were revised for the first time in 15 years. Fortunately, these criteria were developed after careful analysis of all of the new research in an effort to improve how we identify and treat people with PTSD. Meanwhile, some organizations including the government have made significant efforts to refer to PTSD as PTS – removing the word “disorder. Those who prefer the term PTS are hoping this will decrease the stigma around this subject. Yet, medical experts also explain how the difference between PTSD and PTS is not just about stigma.
For most struggling with PTSD no matter how much the diagnostic criteria change, and whether we call it PTSD or PTS, life remains different than how it was before the trauma.
Those who have endured trauma feel differently, think differently, and interact with others in ways that may not resemble their prior personal and professional relationships. Life is just not what it used to be and there is really no way to return it to exactly how it used to be.
If we can agree that the brain plays a vital role in our lives, then looking at the brain can help us understand why things are so different after trauma. Studies have shown that there are significant changes to the brain structure and the way it operates as a result of exposure to a traumatic event. The pre-trauma brain looks and acts different from the post-trauma brain. The way in which trauma changes the brain is so interesting is because of learning.
Yes, learning. Let me explain. PTSD is like a phobia of memories. We encountered some sort of actual or perceived threat to our life. Our brain clicked into survival mode (fight or flight) and activated our body, making it do everything it could to carry us through the event – to persist. In some cases, it is this high gear that actually helped us live through an experience that would have otherwise led to our death. But then we begin identifying situations and memories that resemble the trauma so that we can persist through these too. The result is that we are constantly “on edge” and in survival mode. If those memories of the trauma creep into our minds, our survival mode kicks in again.
This is how PTSD is like a phobia of memories. Instead of getting scared when we see or hear about a spider (arachnophobia) we become anxious when we have a memory of the trauma, or when we see, feel, hear, smell, taste something that brings back a memory of the trauma.
So let’s say this another way: learning has occurred. Different parts of our brain have started to communicate with and connect with other parts of our brain for a specific purpose: survival. Previously, we encountered something horrific and now we have the ability to keenly see any similarities between that situation and similar threats (or memories) that resemble that situation. From my perspective, this speaks volumes about the human capacity to learn and thrive. Some would call this a very valuable skill. I would call this resilience: the ability to thrive in the face of extreme adversity.
To me, PTSD is evidence that the brain has learned how to help us survive something very dangerous. Might this learning that people unintentionally do following trauma be the same exact skill that can be used to help them overcome all of the problematic effects of that trauma?
If our brains learned how to survive in the face of trauma and mostly in an auto-pilot mode, where we didn’t know we were on edge or avoiding things until someone pointed it out…imagine how we could facilitate our own post-traumatic learning if we deliberately focused on learning new skills. This sounds like a whole new type of survival: intentionally doing specific behaviors and attending to experiences to “re-wire” my trauma brain.
So what is a doable way to start recovering from the trauma? Well, we know that developing some new habits of thinking and doing our part of what re-wires the brain. So here are some suggestions:
- First, maybe it’s not about recovery at all. If trauma = learning to survive and thrive, then “re-wiring” also entails learning to survive and thrive…but we are just setting out to learn from a different place than before. Consider the following thought process: I am not sick or broken, I have developed habits that get in the way of my goals – of what’s important to me. I just need to tweak my habits of thinking, feeling, acting, and interacting so that they work for me. I need them to work for me in ways that bring health, happiness, and achievement…so that I meet my goals.
- Considering this: if I unintentionally learned to survive trauma, I can intentionally learn anything. I have learned to operate at high levels of intensity. Therefore, I can gradually learn how to operate at every level of intensity that is lower – step-by-step, level-by-level.
- Some of what’s involved in tweaking how I think, feel, and interact involves how I approach life. There are new skills I can use to help me recover from PTSD (mindfulness, activity scheduling, accepting what can and cannot be changed, re-visiting my priorities and values so that I can LIVE them). There are even apps (click on portfolio and then any of the mobile apps) that can help me practice and track these new habits.
- When learning new skills, it might be helpful if I practice how to work, play, or interact at the level of intensity the situation requires. This means a combination of putting myself out there and paying attention to HOW I am responding to whatever comes at me. When I find I am not performing the way I’d like to or I am not reaching my goals, I need to step back, consider #1, #2 and #3 above, say whatever prayer or mantra that re-motivates me, and then try again.
- Considering how I communicate in my relationships: Is what I am about to say helpful? Unhelpful? What do I intend to accomplish with what I am about to say. Are things moving so quickly or with such intensity that what is being said and what is being heard are two very different things?
- Remember that I did persist and I will persist. I thrive; it’s just what I do. I didn’t accept defeat when I endured the trauma. I am neither perfect nor broken. But I am working hard to be the person I can be proud of.
- I won’t blame myself for any of my shortcomings or get down on myself when things aren’t going well. But I WILL focus on solutions that help me overcome these so that I can reach my goals.
When we keep these things in mind, we can leave all of the other issues of PTSD stigma, diagnostic criteria, and treatment to the experts.
This is really PTSD awareness. We focus on what we are experts at – ourselves.
Investing time and energy in the pursuit of what we care about is worthwhile. Plus, only we can focus on the obstacles (e.g., PTSD symptoms) that are in the way of our goals and priorities. When we work to overcome these, no one reaps the benefits of this success more than we do ourselves. This is how awareness drives recovery. This is how we re-wire the trauma brain.
Kent A. Corso, Psy.D., BCBA-D, is a clinical health psychologist and board certified behavior analyst. He is a prior U.S. Air Force officer and an OEF veteran. Over the last 15 years his clinical practice and research has been conducted on primary care models of behavioral health which involve behavioral solutions for suicide, post-traumatic stress disorder, and problematic health behaviors. Dr. Corso is an international consultant and speaker on these matters, as well as an expert in the area of military cultural competency. He maintains an adjunct assistant professor appointment in the Department of Family Medicine at the Uniformed Services University of Health Sciences’ F. Edward Hebert School of Medicine. Dr. Corso has published over twenty-five peer reviewed works and delivered over three-dozen invited workshops, lectures, and presentations including interviews on regional and national radio. Dr. Corso has been the president of NCR Behavioral Health, LLC since 2009 and assists Raven Drum Foundation with clinical components, implementation, and program outcome evaluation of Project Resiliency.