Going Back by Gary McKay Read Free Book Online Page B

traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person.
    The person’s response to the event must involve intense fear, helplessness, or horror. The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event, persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness and persistent symptoms of increased arousal. The full symptom picture must be present for more than 1 month and the disturbance must cause clinically significant distress or impairments in social, occupational, or other important areas of functioning.
    It is accepted that soldiers in combat will be exposed at some time to stressors that can lead to PTSD. It is not an automatic given that every soldier will be impaired with PTSD. It is not only those in the front line—the ‘bayonets’ of a military unit—that will be affected in war. What are referred to as ‘witnessed events’ can include, but are not limited to, observing the serious injury or unnatural death of another person owing to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. The disorder may be especially severe or long lasting when the stressor is of human design (e.g. torture, rape). The likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.
    Recurring dreams and flashbacks
    The traumatic event can be re-experienced in various ways. Commonly the person has recurrent and intrusive recollections of the event or recurrent or distressing dreams during which the event can be replayed or otherwise represented. In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment. These episodes, often referred to as ‘flashbacks’, are typically brief but can be associated with prolonged distress and heightened arousal.
    Distress
    Intense psychological distress or physiological reactivity [crying, over-reaction and non-reaction to events around them] often occurs when the person is exposed to triggering events that resemble or symbolise an aspect of the traumatic event [e.g. anniversaries of the traumatic event; hot, humid weather for combat veterans from Viet Nam; movies depicting events similar to those witnessed].
    Avoidance of stimuli
    Sufferers of PTSD will go to extremes to avoid the stimuli that has brought about their disorder and make efforts to persistently avoid thoughts, feelings, or conversations about the traumatic event and to avoid activities, situations, or people who arouse recollections of it. This avoidance of reminders may include amnesia for an important aspect of the traumatic event. This is often referred to as ‘psychic numbing’ or ‘emotional anaesthesia’ and usually begins soon after the traumatic event. Veterans may complain of having markedly diminished interest or participation in previously enjoyed activities, of feeling detached or estranged from other people, or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality). The individual may have a sense of a foreshortened future (e.g. not expecting to have a career, marriage, children, or a normal life span).
    Symptoms
    Those with PTSD have persistent symptoms of anxiety or increased arousal that were not present before the trauma. The symptoms may include difficulty falling or staying asleep that may be owing to recurrent nightmares during which the traumatic event is relived, hypervigilance