Saturday, January 28, 2012

Shattered Optimism Grows into Failure to Self-Protect in PTSD

In an ongoing discussion of trauma, our original objective involved an attempt to understand why the survivors of Hephzibah House (HH) experience a failure to protect themselves, especially after immediately leaving the home.  Some survivors also experience long-term problems with self-care and self-protection problems, even into adulthood. Though this information pertains directly to them, it also pertains to anyone who has experienced significant trauma.

We've examined the childhood roots of victimization that certainly contribute to lack of this particular lack of self-care, but we've yet to consider this feature directly related to PTSD. When people develop Post Traumatic Stress Disorder (PTSD), a condition that quite often results when the affected person has been unable to avoid painful circumstances, it creates a pervasive sense of pessimism which arises from the physical response of survival which fails to shut down after the trauma threat has resolved. One of the ways a person lives out that pessimism comes through the idea that self-protection will be futile. Just as developmental factors contribute to a person's failure to self-protect, so does their sense of pessimism.

Beliefs About Self

Before Trauma. Prior to significant trauma, most people experience a type of optimism that suggests to a person that they are generally safe and can expect certain predictable, positive things from their environment. If healthy and not strongly affected by the pitfalls immature parenting in their original family while growing up, most people tend to see themselves in positive terms – as good, capable, and talented. They tend to assume that their futures will be positive.

Following Trauma. PTSD shatters and transforms most of those optimistic assumptions. As a matter of survival, the person no longer feels safe but anticipated continued threat, giving substance to the cliché, “waiting for the other shoe to drop.” The traumatized person becomes well acquainted with helplessness and vulnerability, and in some sense, they become subconsciously preoccupied with it.

This pessimism also turns inward and creates the feeling in a person's sense of self that they should be ashamed, but it reaches beyond the circumstances that prevented them from favorably avoiding harm resulting from the trauma. Traumatized people struggle with shame and guilt (beyond the experience of survivor guilt), regardless if such feelings are deserved or not, and they bleed over into other areas of life that have nothing to do with the trauma. Traumatized people question their own worth, tend to feel overly responsible within other situations, and can compulsively self-recriminate.

Beliefs About How The Traumatized Person Fits Into the World

Before Trauma. Prior to trauma the world seems to most people as a fairly predictable and orderly environment with fairly sensible institutions and basic rules that, when followed, result in predictable outcomes. The world seems, by and in large, a reasonably fair place, wherein responsible behavior results in safety and self-benefit. Other people are generally believed to be good and reliable, and reaching out to others is a worthwhile and beneficial process.

Following Trauma. After trauma, the rules that used to apply which made the world seem like a place that made sense seem to disintegrate for those suffering from PSTD. The world's rules left them without recourse, and their beliefs and efforts failed to protect them from harm. For all their good planning and good effort, the system failed them. A person must face the idea that life is not always fair, and as it was likely in their own experience, the system of the world and it's predictable nature fell apart for them.

In terms of people and as a matter of survival, people become untrustworthy and hurtful. Social interaction becomes a tiring and threatening process. This tends to create the sense of isolation and alienation. As we've noted before, certain areas of the brain shift from a focus on self to a focus on survival and threat. Physiologically, it becomes very difficult to concentrate on the perspective that life is a safe place and that people (and God) can again be safe for them.

Special Considerations Regarding the Survivors of Hephzibah House

Survivors of HH would most definitely experience the pervasive sense of pessimism after leaving their traumatic environment, particularly after immediate exit Some young women report report that they were raped soon after exiting HH. In response to this particular kind of threat, they experience what is known as “freezing,” a response of immobility wherein they “freeze up” in panic and seem to submit to their attacker. In error people like Ron Williams and Bill Gothard teach that such immobilization amounts to a sinful warranting of rape, and the girl's own actions essentially warrant the violation in some sense.

This feature of trauma contributes to the host of factors that promote the response of freezing which we will discuss in an upcoming post which is enhanced by the component of dissociation experienced by those who experienced chronic trauma. Reasearch indicates that it is also associated with chronic trauma and panic and has little to do with planned action, character, or human will. Again, it is another response that results primarily due to a physiologic response. The lamenting and guilt that follows such a type of revictimization is also a very common experience.

More to come.