Three Elements of PTSD

The diagnosis of PTSD usually focuses on three elements:

The repeated reliving of memories of the traumatic experience in images, smells, sounds, and physical sensations. These are usually accompanied by extreme physiological states, as well as psychological stress that may include trembling, crying, fear, rage, confusion, or paralysis – all of which lead can lead to self-blame.

The avoidance of reminders of the trauma, as well as emotional numbing or detachment. This is associated with an inability to experience pleasure and with a general withdrawal from engagement with life.

A pattern of increased arousal, as expressed by hypervigilance, irritability, memory and concentration problems, sleep disturbances,and an exaggerated startle response. Hyperarousal causes traumatized people to become easily distressed by minor irritations. Their perceptions confuse the present and traumatic past, such that traumatized people react to many ordinary frustrations as if they were traumatic events.

The core issue of PTSD is that certain sensations or emotions related to traumatic experiences are dissociated, keep returning, and do not fade with time. People with PTSD seem unable to put an event behind them and minimize its impact. They may not realize that their present intense feelings are related to the past, so they may blame their present surroundings for the way they feel.

PTSD can be placed on a continuum from minimal traumatic impact to moderate effects, and to high or complex PTSD that includes additional symptoms associated with severe long-term childhood trauma, i.e., sexual and physical abuse, residential school experience.

In general, the more prolonged the trauma and the more interpersonal in nature, the more severe the impact will be.

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