A syndrome called post-traumatic stress disorder (PTSD) can affect victims of sociopaths. The trauma of losing love, friends, family, possessions and of enduring psychological/physical abuse is the cause of this disorder. To fight the symptoms of PTSD, it is helpful to understand the symptoms and how they relate to loss and trauma.
As I read through the current literature on PTSD, I quickly discovered that there is a fair amount of controversy regarding this disorder. We can actually learn about the disorder by listening to the arguments. The first question on which there is much disagreement is, “What trauma is severe enough to cause PTSD?” There were several editorials by experts disparaging the fact that everything from giving birth to a healthy baby to a boss yelling at an employee is now said to cause PTSD. Most experts are in favor of reserving this diagnosis for people who have suffered truly unusual life experiences, like kidnapping, rape, war, 911, etc.
The problem is that many people do experience severe stress reactions to difficult life circumstances. It remains to be determined what we should call these reactions.
Those of us healing from our relationship with a sociopath often vacillate between accepting the trauma and minimizing it. Thus, the argument about what kinds of trauma are severe enough to cause PTSD has a direct effect on us. The argument can leave us feeling weak, like we should be able to get over this. After all it wasn’t as bad as 911, Iraq or Katrina—or was it?
The second question is “what symptoms constitute PTSD?” The following table shows the most common symptoms seen in a group of 103 British men and women diagnosed by psychiatrists with PTSD (Current Medical Research Opinion, 2003):
|Anxiety at reminder cues||96 (93%)|
|Intrusive thoughts, images, sounds, sensations||94 (91%)|
|Poor concentration||93 (91%)|
|Diminished interest in significant activities||88 (85%)|
|Recurrent dreams of trauma||86 (83%)|
|Avoidance of activities or places associated with the trauma||85 (83%)|
|Foreshortening of expectations about the future||80 (78%)|
|Detachment from others||78 (76%)|
|Avoidance of thinking or conversing about the trauma||75 (73%)|
|Poor appetite||69 (67%)|
|Startle reactions||46 (45%)|
|Acting or feeling as if the event was recurring||37 (31%)|
|Inability to recall parts of trauma (amnesia)||19 (18%)|
I put up this table because I thought that a number of you would also endorse these symptoms. Notice that “acting or feeling as if the event was recurring” was really not that common. But similar symptoms, like “Intrusive thoughts, images sounds and sensations,” were very common. Amnesia was also uncommon. Startle reactions were only seen in half of the subjects.
A feeling of a foreshortened future is a particularly debilitating symptom because it impairs a person’s ability to plan for the future and leads to a sense of hopelessness. I will expand on this further, but I strongly believe this feeling of a foreshortened future has to do less with our thoughts about our past, and more with our thoughts about our present.
As I look at this list of symptoms, I am struck by the fact that many, many of those writing into Lovefraud complain of these symptoms, particularly nightmares. There is something special about having had emotional involvement with an aggressor that seems to produce nightmares. Since so many have all of the most common symptoms, I think it has to be that the trauma of life with a sociopath is severe enough to cause this disorder in many people.
Here’s where defining exactly what trauma is gets sticky. Rachael Yehuda, Ph.D., said in a recent article published on MedScape, “One of the things that biology has taught us is that PTSD represents a type of a response to trauma, but not the only type of response. It is a response that seems to be about the failure to consolidate a memory in such a way as to be able to be recalled without distress.” Well, this is precisely the definition that is too broad. I personally have a lot of memories that I experience or re-experience with distress. Yet these memories are not accompanied by the list of symptoms in the table above.
For me what made the experience traumatic was the truly life course-changing nature of the trauma. The answer to the question, “Will I ever be the same?” for me defines trauma significant enough to cause PTSD. The trauma that causes this disorder redefines us in a way that is different from other emotionally significant experiences. This trauma strikes at the core of our identity.
The final controversy surrounds the treatment of PTSD. Interestingly, there is no question that medications (SSRIs, particularly Zoloft) are very helpful. The problem is though that when a person goes to a physician and receives a medication, he/she is by definition “sick.” Assumption of a “sick role” or “victim identity” is one of the many factors that slow recovery from PTSD.
Many therapists are of the belief that “debriefing” or retelling the story is necessary for recovery. One group of researchers reviewed the studies on debriefing and concluded that there is no scientific evidence that it prevents PTSD. Instead, the evidence points to post-trauma factors like social support and “additional life stress” being most important.
How can we put this all together? Considering last week’s post, those who experience trauma serious enough to have stress hormone overdose as manifested by dissociation, are likely to also develop PTSD. An examination of the symptoms of PTSD reveals that at the core of the disorder is the fact that the person really doesn’t believe in his/her heart that the trauma has ended. PTSD is about ONGOING, not past, trauma. For those of us whose lives were assaulted by a sociopath, there is ongoing stress. The stress is the social isolation, financial ruin, and threatened further losses long after the relationship has ended. Those who recover from this without PTSD work hard to put the trauma behind them in every way.
Putting the trauma behind you does not mean you can’t take medication to help with the process. It does mean facing those bills, former friends, and other personal issues you want to avoid. Remember AVOIDANCE STRENGTHENS FEAR.
Above all, stop the ongoing trauma by ending contact with the sociopath. Do not assume a sick role, instead, work to stay healthy. Fight to be the person you want to be. Don’t allow this single experience to define you. Make living for today the place you love to be. As Louise Gallagher says in her recent post, “This is, in many ways, the greatest challenge of recovery — to accept the past is simply the route I took to get to where I am today, a place I love to be. The past cannot be changed. It cannot be altered. It cannot be made ‘better.’ It can only be accepted so that it, and I, may rest in peace with what was, eager to accept what is true in my life today.”