Trauma does not equal PTSD

I have read articles where the author said that PTSD is a normal reaction to trauma, or a normal reaction to an abnormal event.  But it’s not true.  Usually the people that say that are people that have suffered with PTSD.  However science doesn’t support that view.

George Bonnano a leading resilience researcher from Columbia University wrote in 2011 that the single most common outcome after a traumatic event is recovery without intervention.  Research shows that most people recover after trauma without any kind of treatment.  In other words, most people are naturally resilient.

It is normal to have some type of stress reaction after trauma, but those reactions in the vast majority of cases are temporary.  Most people will experience some type of physiological or emotional reaction after severe stress, at the very least due to the adrenaline dump.  You may have feelings of shock, horror or disbelief and may experience hyperarousal, emotional numbing or have trouble sleeping.  These various reactions are reasonable to expect and usually subside within a few weeks, and do not turn into full blown PTSD.  Most research shows that PTSD rates are in the neighbourhood of 15 percent after a traumatic event.  That means that 85 percent of people do not develop PTSD after experiencing trauma.  That is good news.

The other positive news is that PTSD is preventable in many cases.  Prevention can be accomplished through resiliency training pre-incident, and also through post-incident support.  In a study (Brewin et al, 2000) researchers found that the severity of the trauma had less to do with the outcome than the support the victim received after the event.  A lack of support after trauma will be a major factor in increasing the chances of PTSD, but the reverse is also true.  A strong support system can prevent PTSD onset.

Sometimes people diagnosed with PTSD, and people that work with victims balk at the idea that PTSD is not a normal reaction and that it is preventable.  They feel it is insensitive to the victims.  Like saying they are weak, or mentally inferior in some way.   That’s not what the scientific research is saying though.  It’s research, it’s not a personal attack.  And of course the purpose of the research is to help people in the future.

Let’s compare it to cancer research.  If there was a study that found a method of preventing cancer that was effective 50 percent of the time, it would be celebrated and promoted.  No one would assume that it’s being insensitive to people that already have cancer.  It would just be great to know that much of the suffering could be prevented.

Those victim’s advocates or critical incident stress responders who, because of their sensitivity to victims, don’t want to discuss the fact that PTSD is not the normal response and preventable, really don’t help future victims.

I know that PTSD can’t be prevented in all cases, but that should not stop us from working towards that goal.  There should be a greater focus on resiliency training, not just treatment for those with trouble coping.  Is it not better to prevent somebody from falling, instead of afterwards trying to put all the pieces back together again?

We will all face some significant trauma in our life and will have stress reactions to that event.  It is good to seek treatment and a have a support system.  And it is good to know that those reactions are usually temporary and that over the next weeks we will regain a sense of normalcy.  It’s good to know that odds are strongly in our favour that we won’t develop PTSD.  This positive assumption will help us. 

If people assume they will develop PTSD because they experienced trauma, because they believe that is the most common reaction, it can create a self-fulfilling prophesy.  The placebo effect is well documented, and it shows that beliefs can help or hinder healing.

We need to have a healthy perspective about the natural resiliency of the human mind and our ability to effectively cope with trauma and bounce back.

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