What goes around...
I’ve been thinking a lot about pts (post-traumatic stress) lately. Especially in conjunction with traumatic brain injury, which I’ve said a number of times is an ongoing traumatic experience, and not only at the time of the initial injury.
Anyway, I’ve been thinking about the effect my TBIs have had on the people around me, and I can definitely see how my own trauma led to their trauma, too. The jumpiness that people who love and/or care for someone who has experienced TBI, is a common thing — and I think it’s directly related to their own traumatic stress.
‘Cause traumatic stress is, in fact, contagious. (And so I’ve answered my question.)
From the ever-handy Wikipedia:
(PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one’s own or someone else’s physical, sexual, or psychological integrity, overwhelming the individual’s ability to cope.
Think about it… Someone sees someone they love and care for experiencing this traumatic experience, and they themselves are traumatized. And when the person who experiences TBI is a close part of that person’s life, then their injury can in fact represent a threat to their “physical, sexual, or psychological integrity, overwhelming the individual’s ability to cope.”
When you’re in the midst of your post-injury haze, and things are starting to fall apart — whether or not you know why it is or what to possibly do about it — you can say and do things that seriously threaten the people around you. It can threaten them on physical levels — like when your temper becomes violent and unpredictable. It can threaten them sexually — like if you lose all desire to have sex, or you become more sexually assertive. It can threaten them psychologically — like when you’re not acting like the person they know, and your behavior is so bizarre and unpredictable that they start to feel like they’re losing their mind and they doubt their own sanity.
Yes, post-traumatic stress — especially with TBI — is definitely contagious.
And that seems to me to be one of the missed pieces in TBI recovery — addressing the PTS of caretakers and partners of TBI survivors. It doesn’t even need to be moderate or severe TBI. I think mild TBI makes for an even likelier candidate for PTS, because it’s so insidious and can sneak up on you in subtle ways that make you — more than anything — feel like your psychological state is threatened.
Everybody feels like they’re going crazy, and when you don’t understand the underlying causes of it, well then, you’re totally screwed.
Until you get help.
This is where I can see some trauma therapy really helping — for the caregivers and partners and family members of TBI survivors. You get a really good trauma therapist who can work with those “TBI satellite participants”, and you help them sort things out, help them come to terms with their own individual trauma, and you get them on their feet, realizing that they are safe, that they are okay, and that they can deal with everything that comes up.
It’s one way that therapists can occupy themselves — while acknowledging that talk therapy probably isn’t the best thing for someone who is neurologically compromised. Everybody gets their place, but talk therapy and TBI can be a recipe for disaster, which can create even more trauma after the fact.
The more I think about it, the more surprised/dismayed I am that more sensible approaches to TBI and PTS haven’t been developed. There seems to be a sort of territorial overlap between the two, that doesn’t need to exist. Traumatic Brain Injury comes with a full compliment of neurological issues that can be as physiological as psychological. And those issues can — and often do — lead to traumatic stress. That traumatic stress then compromises the cognitive processes of TBI survivors, thus short-circuiting their recovery in the period after the initial injury… which then compromises their long-term prospects for restoration of their quality of life. I really believe the trauma piece is why TBI survivors — especially “mild” traumatic brain injury survivors — have poor long-term outcome prognoses.
There’s the trauma overlap that biochemically shorts out the adaptive nature of the brain, so the brain doesn’t get a chance to adapt in the ways it needs to, in order to effect actual recovery.
And countless people are suffering needlessly, because psychotherapists and neuropsychologists and neurologists are all battling over their respective territories, causing needless pain and suffering as a result.
But if people could put their own individual needs and wants aside and collaborate in a meaningful and respectful and productive way, who knows how many people could be helped?
Who knows? It’s maddening to think about all the suffering that’s taking place, because therapists are saying “You don’t have TBI/brain damage, you’re experiencing trauma,” and neurology folks are saying, “You don’t have trauma, you’ve had a TBI.” The two are inextricably interconnected, but nobody seems to have either the courage or the insight or the will to team up and come up with a common-sense approach that can mitigate both.
- TBI leads to disrupted neurological function
- Disrupted neurological function leads unanticipated changes in thought and behavior
- Unanticipated changes in thought and behavior leads to trauma
- Trauma biochemically prevents neurological adaptiveness.
- Lack of adaptiveness feeds into yet more trauma.
- And the cycle continues.
Each “arm” of the therapeutic/rehab community could easily find a complimentary place where they could constructively collaborate with each other.
But they’re so accustomed to marking off and defending their territory, that they fail to live up to their full potential. And countless people suffer as a result. AND they decide that it’s “impossible to recover” from TBI. What a terrible, inhumane thing to tell people. That they are irreparably damaged and have no hope of true recovery. Please.
The solution? Well, our “experts” could start talking to each other and start collaborating on a win-win situation for everyone.
Or those of us who have been neglected and abandoned and misguided by the therapy/rehab establishment can take matters into our own hands and address the most fundamental underlying basis for our ongoing issues — constant fight-flight sympathetic activity in our autonomic nervous system, which feeds the traumatic stress dysfunction and short-circuits our ability to recover and rehabilitate.
In a way it might just be possible for TBI survivors to take their recovery into their own hands — especially mild TBI sufferers. And the therapists and neuro people might be put out of a job. Because I suspect that countless people who have been sitting in therapy for years and years actually have underlying neurological issues that no amount of talking will fix — it only makes it worse and perpetuates the therapeutic relationship — and ongoing billing for the therapist and the insurance companies.
If we just got some exercise and learned to balance our nervous systems with slow, steady breathing, and we ate decent food at regular intervals, how much less “therapy” would we need? (There are always those who need to have someone to talk to just to check in regularly, but I’m talking critically about psychotherapists who insist on digging around and raking up all the muck inside you to “release it for healing”. All that stirring up will do a neurologically compromised individual more harm than good, trust me.)
Anyway, it’s a beautiful day and I’ve got a lot on my plate before the weekend is up. If only the weekends were three days instead of two. I feel like I’m just getting started, but I’ve got less than 12 hours till I start working again.
Oh, well. I guess the main thing is that we see where there are opportunities for positive change — stemming from seeing where things are not working as well as they could. If we can piece things together and understand the origins of post-traumatic stress and how it affects the people around us, we might be able to do something about it.
But as long as we keep separate and alienated and territorial, the suffering will continue.
And that’s a damn’ shame.