I’ve been giving a lot of thought to how PTSD and TBI interrelate with one another. With so many soldiers coming back from Iraq and Afghanistan with serious issues related to TBI and PTSD… and considering how ill-informed and ill-equipped our society is in dealing with these very serious issues, I do want to try to explore some of the aspects of each.
I do this as someone with a history of TBI and PTSD. My injuries started when I was a kid, and children (and women) are more susceptible to developing PTSD, so that old habit I have of saying, “Oh, that was so long ago… I must be over it by now!” doesn’t hold water anymore. The fact of the matter is, I lived in very violent conditions as a kid, and it affected me. A lot. It was traumatic. It was distressful. I had a very disordered childhood. And the other fact of the matter is, I sustained several mild traumatic brain injuries as a kid, which did not help.
I’m going to be using Belleruth Naparstek’s book Invisible Heroes: Survivors of Trauma and How they Heal as a guideline. I’m not recommending that everyone run out and buy it — tho’ I won’t stop you if you want to. Be forewarned: I personally found a lot of the stories of trauma it recounted to be, well, traumatizing. If you’re squeamish about stories of violence and sexual abuse and terrorist attacks, you may not want to read it. I’ve read it — and struggled through it — so the damage is done with me. But you won’t necessarily have to go there, as I walk through the PTSD stuff I’ll be covering here and in later posts. I’ll also be drawing from other online sources about PTSD, and I’ll add links to other things you can read. I’ll try to avoid posting links to really awful stories. I don’t want to discount anyone’s experience, but some things I have a terrible time dealing with, and I’m guessing I’m not alone in that.
Note: This nasty habit of revealing horrible accounts to make a point about trauma is a common problem I find in current PTSD literature — it’s often written by psychotherapists who are accustomed to hearing people recount horrific events, so they can work through it. But I’m not a trained and objective psychotherapist, and I can’t stand hearing about awful crap other people went through. It makes me feel awful and wretched; there’s nothing I can do for them, which is deeply frustrating. It’s also sometimes vicariously traumatizing, which is no fun. If some therapists or researchers can find a way to recount trauma without needing to go into all the disturbing personal details, they’d be doing us all a big favor. I try to do it, here, but I’m not sure I do such a great job of it.
Anyway, back to my discussion…
Let’s start with the factors in and contributors to the development of PTSD from trauma (from Chapter 4 – “Who Suffers: How, When, Where, and Why”). They are (follow the links to see what I’ve written about each one – I’ll be updating these over time):
The Nature of the Traumatic Event
- proximity (follow this link to see more discussion)
- duration (follow this link to see more discussion)
- extent of brutality (follow this link to see more discussion)
- betrayal (follow this link to see more discussion)
- threat of dying (follow this link to see more discussion)
- perpetrating violence (follow this link to see more discussion)
- societal context (follow this link to see more discussion)
- being trapped
- psychological history
- social support
Reactions Around the Trauma
- panic and acute stress
- biochemical anomalies
- drinking and intoxication
- sense of control during the event
- self-blame and negative beliefs
- subsequent health problems
Many of these elements of PTSD tie in with experience of traumatic brain injury — even if it’s “mild” — in what I consider significant ways. TBI has a way of exacerbating a lot of problems, to begin with, but when it heightens the impact of something like PTSD, things can get really interesting.
In the past, I’ve talked about how PTSD can lead to TBI. In the future, I’m going to talk about how TBI can contribute to the development of PTSD.
But for now, it’s a beautiful day and I need to go outside.