Post-traumatic stress disorder is found under the large dark umbrella known as anxiety. Earlier in the Angst and Anxiety Blog we spoke about the types of problems that exist under the heading of anxiety.
Post-traumatic stress disorder is a particularly painful disorder that is best seen as a problem owned by someone who has witnessed, experienced, or heard about a trauma. The concept of death is intrinsically involved in PTSD. In order to qualify for this diagnosis the person needed to have feared for her life or believed his life or the life of another was being threatened.
There is considerable information out there on PTSD and this is a good thing. It is my belief that PTSD is much more common than previously thought. We know about combat PTSD and other types of PTSD created by rape, sexual abuse of children and survivors of genocide or other human-made atrocities. Nature can create a situation where death is central to the equation through hurricanes, tornadoes, monsoons, earthquakes, wild fires and blizzards. When traumas originate from human beings it is a different scenario for many reasons.
When human beings harm human beings it sets into motion a problem with human relationships that will last a lifetime for the person who was harmed. Of course, it depends on the severity of the trauma, the age of the person who was harmed, and the re-occurence of trauma afterwards. It also depends on whether help was available and utilized by the person who experienced the trauma.
We want to talk here about the phenomenon of trauma occurring over and over again. This is known as repetition compulsion or returning to the scene of the crime. I believe all traumas are crime scenes. Crime scenes are terrible places that involved terrible events.
Sigmund Freud was the first person to describe what would come to be known as repetition compulsion. He noticed that some people seemed to place themselves in positions of potential harm. These people had a history of surviving trauma and then seemed to thrust themselves into harms way time and again. He referred to this tendency as the “death wish or death instinct.”
In time this observation would become known as repetition compulsion or the tendency to compulsively repeat behaviors. For example, a woman who was once raped in a park at night still jogs in parks at night. Another example would be a man who who was sexually violated as a young teen would then drink as an adult and go out prowling the streets hoping to find a confrontation with someone, anyone.
If trauma is not resolved our unconscious minds will place us at the crime scene or one that closely resembles it. This is not because people are masochistic and want to be harmed again. It is because the person who was harmed is looking for a different outcome than the one that happened in the first place. Sometimes people feel, if given another chance, it will turn out differently.
It seldom turns out differently until the person who experienced the trauma has come to terms with the trauma and the numerous ways the trauma infiltrates every aspect of their life. This takes time, this takes counseling, and this takes trying to create a consciously working awareness of what is safe and what is unsafe. It is the Safe versus UnSafe part that became altered or damaged when the trauma took place initially. Things became confused.
People who have PTSD often have difficulty discerning between safe and unsafe. They return to old crime scenes looking for a different outcome. The same outcome is typically waiting.
How do you change repetition compulsion as it applies to PTSD and trauma?
Identify your trauma. What, when, who and how are all very important.
Detail The Crime Scene and Perpetrator: Make a list of what, when, who, and how in as much detail as possible. Include: Time of day, season of the year, do a physical description of the person including facial and physical features and any identifying marks. Imagine you are working for CSI: Your Town and do a forensic evaluation of the crime scene.
List of Triggers: from your crime scene list as many triggers as you can. Remember that a trigger is something that activates a memory and emotional response; a trigger is not the cause of the emotional response. It is simply a trigger to old memories. Triggers can be a tone of voice, a mannerism, certain words, or anything that starts a landslide to a feeling of being powerless or trapped.
Memory Game: When you have an emotional flashback or feel compulsively inclined to act in a way that would potentially place you in danger STOP. You have to do the memory game first.
The memory game involves matching what you are about to do, triggers and the past trauma. An example would be: You had an argument with a friend. You want to go drink. You know your wife doesn’t want you to drink. You decide to make up an excuse about needing to go somewhere. You are planning to go buy alcohol to numb your feelings. You also want to confront your friend. You know that Carl works at the liquor store and he reminds you of Joe who sexually abused you when you were 12. Wow, this is going to end up with a repetition compulsion or putting yourself in a situation to be harmed somehow again.
This is just a short list of things to keep in mind when looking at PTSD and repetition compulsion. There are many fine books out there and experienced psychotherapists, counselors,and psychologists can help with this aspect of PTSD.
Treat yourself as the special person you are and be careful with yourself. PTSD is not caused by something you did, but by something done to you or someone you care about.