The policeman and the barking dog behind PTSD

What is Post-Traumatic Stress Disorder (PTSD)?

Post-Traumatic Stress Disorder (PTSD) can occur after you have been through a traumatic event where you may have felt that your life or someone else’s life was in danger or under serious threat. The main feeling that characterises PTSD is that of intense fear and helplessness.

Symptoms – How do i know i have PTSD?

Symptoms of PTSD can be terrifying, disrupting your daily activities and even making it hard to get through the day. In order to be diagnosed with PTSD, and in line with DSM-IV criteria, symptoms must be present for over a month and involve all or some of the following:

♦️ Re-experiencing (need 1 or more): flashbacks (reliving the trauma as if it was happening now); nightmares of the traumatic event; intense distress when faced with reminders of the event; and/or physiological reaction at reminders      

♦️ Avoidance (need 3 or more): avoidance of thoughts and talking about the traumatic event; avoidance of the place where the trauma took place or people who were associated with the event; disinterest in activities; memory loss; detached feeling; hopelessness / futility; loss of emotions. 

♦️ Hyperarousal (need 2 or more): sleep disruption; lack of concentration; hypervigilance; being on edge; irritability.

If you have any of the above symptoms this is NOT YOUR FAULT, but your brain’s way of dealing with traumatic events.

Why do I have PTSD?

I often find that when I see clients with PTSD symptoms one of the first things they ask is “why do I have this?”. Other than reassuring them that this is a normal reaction to something that was very traumatic, I always find that offering an explanation of how our brain works in such cases in a simple – understandable – manner is always the most successful way in truly answering that question. So here it goes.

Our brain has two parts that play a significant role in the development of PTSD:

 ♦️ The Hippocampus OR “the policeman” as I like to describe it, who likes to keep the order 👮‍♂️ This is the part of our brain which is responsible for organising and recalling our memories in chronological order. Under normal circumstances, our “policeman” lets us know when and where everything took place and can identify each memory as something in the past. However, when under severe stress – such as experiencing a significant trauma – the policeman can be described as “asleep” / not working and so he is not able to store those memories in any order at all, thus storing them in the wrong place, the amygdala.

♦️ The Amygdala OR “the barking dog” for our purposes. This is part of our alarm system that aims to keep us safe and prepares us for action through “fight or flight”. It is very sensitive and picks up on ‘real danger’ as well as memories about danger. It has no sense of time so is unable to separate the two. Therefore, when we are confronted with a reminder of our trauma, that dog will start barking and set off the alarm bell making us feel that the traumatic event is happening again.⠀

How can i get over PTSD?

In essence what we aim to do through therapy is help the policeman “wake up” again so he can respond to the alarm set off by the barking dog and place the memory of the trauma where it belongs, in the past. CBT has been proven to be the most effective course of treatment for PTSD, enabling the sufferer to process the traumatic event in detail and thus promoting a good partnership between the “policeman” and the “barking dog” 👮‍♂️❤️🦮. 

Once the brain is able to set the traumatic experience in the past where it belongs, it is also able to realise that the threat is over and that there is no need to be constantly on guard, by being hypervigilant or avoiding specific places/people/conversations. The CBT treatment for PTSD is a very demanding process (as are the treatments for most disorders!) but one that has been proven the most effective in helping sufferers break free from their trauma and regain a sense of control over their lives. 

‘Always remember, if you have been diagnosed with PTSD, it is not a sign of weakness but a sign of your strength, because you have survived’