Trauma and Relationships: Exploring the Effect of Post-Traumatic Stress Disorder on Relationships
Center for Marriage and Family Studies
John Brown University, Siloam Springs, Arkansas
This article will examine the characteristics of Post-Traumatic Stress Disorder (PTSD) and how it can be detrimental to the survivor’s relationships. It will discuss the physiological response trauma produces in the autonomic and somatic nervous systems and how these chemical responses can affect the trauma survivor’s emotions, spirituality, and ability to function in relationships. It will also explore how these chemical responses can occur after a trauma through memory “triggers.” The author concludes with a discussion of treatment options, especially in regard to helping the survivor and the survivor’s significant others.
Post-Traumatic Stress Disorder (PTSD) has received much attention in the past 18 months due, in particular, to the September 11, 2001, tragedy. It is spoken about often in the media, but few lay people grasp PTSD’s effects on those suffering with the disorder in regard to their personal symptoms and struggles in inter-personal relationships. For the professional and pastoral community, it is imperative to understand what is occurring physiologically and psychologically in order to help those who have survived a traumatic experience. For survivors of the traumatic experience, learning how to ride the wave of their trauma-induced symptoms is incredibly important for healing and restoration in all aspects of their lives. This wave has a particular strength and intensity for those that suffer from PTSD and for those who love them. In this article, I hope to promote understanding of the physiological and psychological changes that occur in trauma survivors and the impact these changes can have on survivors’ relationships.
Trauma Survivor Symptoms
Traumatic experiences include, but are not limited, to, child abuse, domestic violence, rape, violent crime, war, terrorist acts, vehicular accidents, terminal illness, unexpected loss of loved ones, and natural disasters. Trauma is unexpected and is out of the scope of what is considered normal living. It can lead to a variety of physical, emotional, spiritual and relational problems. Those that experience a traumatic event often feel powerless and disoriented when it comes to making sense of their former ways of viewing life. Survivors are challenged in the vital areas of security and belief. Trauma makes the survivor question all endeavors and obliterates what he or she once thought of self, God, and others. It penetrates to the very core of one’s foundations by questioning what one has always believed to be true. Furthermore, it can be deeply implicated in various psychological disorders such as eating disorders, addiction, attention deficit disorders, sexual dysfunctions, and many other spiritual and relational difficulties.
Post-Traumatic Stress Disorder (PTSD) presumes that the person has experienced a traumatic event involving actual or threatened death or injury to himself or others during which he or she felt fear, helplessness, or horror. Three symptom clusters, if they persist for more than a month after the traumatic event and cause clinically significant distress or impairment, make up the diagnostic criteria. The three main symptom clusters in PTSD are: (1) intrusions, mental flashbacks or nightmares, where the traumatic event is reexperienced; (2) avoidance, attempting to reduce exposure to people or things that might bring on intrusive symptoms; and (3) hyperarousal, physiologic signs of increased arousal, such as hypervigilance, or increased startle response.
Trauma symptoms are probably adaptive, helping us to recognize and avoid other dangerous situations quickly—before it is too late. Sometimes these symptoms resolve within days or weeks of a disturbing experience. While PTSD is the “prototypical” traumatic disorder, some people—or some stressors—present variations on this theme. Depression, anxiety, and dissociation are three other disorders that commonly arise after traumatic experiences. In addition, somatoform disorders are also seen in some populations. The differences in the symptoms of survivors may result from how the particular individual interprets, manages, and expresses his or her stress. Individual differences affect both the severity and the type of symptoms experienced (American Psychiatric Association, 1994).
Not all individuals who have experienced a traumatic event develop PTSD. The American Psychiatric Association (2000) discusses risk factors that affect the likelihood of developing PTSD:
The severity, duration, and proximity of an individual’s exposure to the traumatic event are the most important factors affecting the likelihood of developing this disorder. There is some evidence that social supports, family history, childhood experiences, personality variables, and preexisting mental disorders may influence the development of Post-Traumatic Stress Disorder. This disorder can develop in individual without any predisposing conditions, particularly if the stressor is especially extreme (p. 466).
According to the National Comorbidity Survey Report, it is estimated that the prevalence of PTSD among adult Americans is 7.8%, with women (10.4%) twice as likely as men (5%) to have PTSD at some point in their lives (www.ncptsd.org/facts). According to this survey, this estimate represents a small portion of those who have experienced at least one traumatic event. It is reported that up to 60.7% of men and 51.2% of women have experienced at least one traumatic event in their lifetimes. At the time of the survey (pre-September 11, 2001), the most commonly experienced traumas were:
• Witnessing someone being killed or severely injured
• Being involved in a life-threatening accident such as a motor vehicle accident
• Being involved in a natural disaster
• Exposure to combat
Memories After a Personal Trauma
August 28, 2000, was a day like any other except for the fact that I was taking my friend of over 20 years back to the airport. She and I had had a wonderful visit full of laughter, intimate chats, and fun. Beth was headed to Denver to be with her two sons and her husband. It was early in the morning, and the sun was starting to rise. The warmth of the day provided a soothing balm in the dusk of the morning. I was saddened that my friend was leaving but delighted with the time we had been able to spend together. She and I set off at 5:30 a.m., enjoying our drive. Then there was darkness.
I heard the smash of metal but never saw the truck that hit us. Somehow I had not seen the other vehicle as I merged into the highway, and he missed seeing me since there were no brake marks where we collided. He was traveling 55-65 miles per hour and hit the side of the car exactly where my friend was sitting.
There was no light and no sound until I awoke to a feeling of dread that has followed me for more than a year and a half now. I didn’t know what had happened, but I did know from the earthquake in my stomach that it wasn’t good.
I yelled to God, Oh, Lord, help! as I looked at my friend. Her eye was deviated to the right, and she was beginning to have a seizure. Being a nurse I quickly knew my dear friend had brain damage, and I feared the person who hit me was dead. Later, I discovered my initial fears were true.
I lay there with a concussion, broken ribs, and collarbone, but in the midst of the physical pain, it was the emotional pain that I couldn’t bear. I cried and pleaded with God.
Help my friend, help the person who hit us, and help me. After I spoke, I clearly recognized that the process I was entering into was going to be a long and painful one, and I needed all the help I could get. I then asked God, How am I going to make it through this? After that, I just wanted to disappear.
Post-Traumatic Stress Disorder has been called a disorder of memory (van der Kolk, 1994b) primarily because, in its symptoms, it crests in the reexperiencing of traumatic memories through nightmares, flashbacks, and intrusive thoughts. Since the day of that accident, I have been a casualty to traumatic memories.
“Researchers repeatedly have found that it is not simply the traumatic event, but the frequent recall of that event and of the emotions and physical responses associated with it, that cases major problems in everyday life—especially relationships” (Matsakis, 1998, p. 84). These memories destabilize the trauma survivor because they come without warning and elicit fear. In moments, the resulting distress will likely interfere with the survivor’s personal and work relationships. These memories are triggered by a sophisticated process of the central nervous system, which will be discussed in the next segments of this article.
The Autonomic Nervous System and Trauma
To understand the aftermath of trauma, one must first understand the physiological responses of the central nervous system. The survival center of the brain is called the limbic system. The limbic system’s primary goal is to sense that a real threat is near and thus release hormones that serve to protect the body. These hormones tell the body to be on the defense when something ominous is near. After the threat is noted by the limbic center, the sympathetic branch of the autonomic nervous system is activated. This activation brings about a heightening of the fight-or-fight response due to the release of epinephrine and norepinephrine. The well-known fight-or-flight mechanism elicits many body responses that prepare the body to protect itself. These include increased respiration and heart rate. Also the skin pales as the blood flows away from its surface and focuses in on the muscles to prepare the body to move quickly if needed.
Another response to trauma is what is known as the freeze factor. This is demonstrated in the research lab when a mouse, knowing it cannot escape a threatening situation with a predator cat, assumes a frozen stance and appears dead. Some victims of rape have also experienced this inability to fight or flee. They find that their bodies go into a numb state. This response is the result of the limbic system automatically commanding a heightened arousal of the parasympathetic branch of the autonomic nervous system when fight or flight is not perceived as possible. The arousal of the parasympathetic branch causes the body to freeze instead of going into fight or flight.
Within every human being, the mind, body, and emotions are inseparable from each other. Cognitive therapy rests largely on the belief that the way we think affects the way we feel and vice versa. Trauma thoroughly demonstrates this pathway of mind/body/response. The mind/body response effects one’s emotions as well. In the case of trauma, many of the psychological and emotional symptoms are not only present in one’s cognitive processes but in the body’s physiological processes as well.
The biochemistry of PTSD has been research extensively in recent years, yet there is currently no single definitive theory as to how trauma affects the body. One theory states that trauma changes body chemistry so the individual is more prone to anxiety and depression; another hypothesizes that trauma disrupts specific biochemical balances (Murburg, 1994, 1996; van der Kolk, 1996a).
An alternate theory proposes that the organism coordinates mental, physical, and emotional efforts to illicit a self-protective response, as seen in the fight-or-flight mechanism. After the trauma and with the onset of PTSD, some systems may not return to previous levels and daily functioning and may remain in a state of heightened arousal. This heightened arousal may continue for months or years after the traumatic experience occurs (Giller, 1994). Survivors of a traumatic experience secrete more neurohormones of epinephrine or norepinephrine than nontraumatized people. It has been found that persons who suffer from PTSD excrete more neurohormones than do those diagnosed with major psychiatric disorders, such a clinical depression or even schizophrenia (van der Kolk, 1994a, 1994b, 1996b). Not all studies of trauma survivors demonstrate these results, but vast majorities do (Murgurg, 1996).
Though there is no comprehensive explanation for these biological changes in those who have endured a trauma, it has been validated that for many trauma survivors the damage has both physical and emotional components. These central nervous functions and responses are known to affect memory, sexuality, physical health, cognitive processes, and emotions, but not all agree how they are affected. Though much has been discovered in recent years about biological changes due to trauma, this area of research continues to be explored. What understanding we do have is vital to the understanding of the healing process for the trauma survivor and for the understanding of how the trauma has affected them personally, emotionally, spiritually, and relationally.
The Role of the Somatic Nervous System in Trauma Survivors
In contrast to the autonomic nervous system, which is responsible for involuntary hormone and chemical release, voluntary movements of muscles characterize the somatic nervous system. Understanding the role of the somatic nervous system is primary in being able to grapple with how traumatic events are remembered implicitly through the encoding of posture and movement. The somatic nervous system receives impulses from the autonomic nervous system, and the skeletal muscles contract. Contraction continues as long as the muscle continues to receive neural impulses (Rothschild, 2000). This type of continual muscle contraction sustains the tension of stress and prevents relaxation.
The somatic nervous system is responsible for many of the body’s reactions to the trauma including the fight, flight, or freeze reaction of simple and complex muscular movements. These movements cause specific positions and behaviors that encode the traumatic experience into the brain. “Somatic memory recall can occur when those same positions, movements, and behaviors are replicated either purposefully or inadvertently” (Rothschild, 2000, p. 56). Experience changes the brain (Kandel, 1989). In traumatic experience, the brain changes by storing some element of what is recalled into both cognitive and affective memory.
In Post-Traumatic Stress Disorder, the physiological hyperarousal of the autonomic nervous center is largely due to cue-evoked memory. The brain’s neuronal activation pattern that was previously associated with fear will not overgeneralize and respond to false signals (Perry, 1999). This recall of the traumatic state underlies many abnormally consistent traits of the once-adaptive response of threat (Perry, 1993, 1994). These associations between nonthreatening cues and a full-blown threat response are related to somatic memory. The brain appears to generalize, especially in regard to fearful stimuli, making a person who has survived a traumatic event vulnerable to the development of “false” associations from a one-time threatening situation to other nonthreatening situations. This is a very important piece of information for both the therapist and the trauma survivor to understand in the process of healing and restoration. The trauma survivor must gain the ability to interpret stimulus correctly.
Emotional Changes in Trauma Survivors
PTSD sufferers tend either to overreact or under act to everyday situations, creating anxiety and shame within themselves and chaos in their relationships. “Trauma can give rise to at least four overwhelming emotions: Fear, grief, rage, and anxiety. These feelings can be so powerful that to experience them in full force at the time of the trauma would be personally disorganizing and might endanger survival. Therefore these emotions tend to be suppressed, to some degree” (Matsakis, 1998, p. 89). These four emotional responses to trauma correspond to the physiological arousal associated with the release of norephinephrine and epinephrine, which cause the fight, flight or freeze response. The unbearable affect of these overwhelming emotions are buffered by the stress induced analgesia response (Van der Kolk, 1996a), which releases endogenous opioids and causes a numbing effect. These opioids are released in response to the hyperarousal of the autonomic nervous center during intense trauma. The hyper-arousal/numbing cycle can also be found in trauma survivors who are victims of external or internal triggers.
How can the wounded heart mend
When it doesn’t know
When the memories will come again?
--an old Greek folk song about trauma
“Traumatized people relive the event as though it were continually recurring in the present. They cannot resume the normal course of their lives, for the trauma repeatedly interrupts . . . Even normally safe environments may come to feel dangerous, for the survivor can never be assured that she will not encounter some reminder of the trauma” (Herman, 1997, p. 37).
A trigger can be anything that reminds the trauma survivor of the traumatic event and elicits a stress-related emotion or physical symptom. Sixteen months after my car wreck, walking with a friend, I saw skid marks on the street. I wasn’t thinking about my car wreck; in fact, I was enjoying my day. After seeing the marks, I instantly heard the sound or crunching metal. I was haunted by the sounds from the auditory flashback—my heart started to pound quickly, and feelings of vicarious fear arose. The skid marks were an external trigger I had never encountered before and have not encountered since. The auditory flashback caused a hyperarousal response of my autonomic nervous system producing a sequel of psychological and physiological responses. Triggers can be external such as the skid mark I saw or they can be internal such as hunger, sexual arousal, or even extreme emotional states such as sadness or happiness. Wherever they arise, triggers can create memories of trauma that elicit psychological states of terror and anxiety and/or the physiological states of numbness and withdrawal.
The prolonged stress that trauma survivors experience can affect the secretion of neurotransmitters. These transmitters are the chemical substances that enable messages to travel from one nerve call to another (Bourne, 1990). “Neurotransmitters help regulate the intensity of emotions and moods and they are . . . involved in memory functions” (Matsakis, 1998, p. 97). “Over time, a thought—recalling the trauma—may activate limbic, basal ganglia and brain-stem areas—resulting in emotional, motor and arousal/state changes which are the functional residuals associated with the stored patters of neuronal activation present in the original event” (Greenwald, Draine, & Abrams, 1996). Conversely, a state—arousal—may lead to activation of aired neuronal activity in the amygdale—resulting in an emotional change which may or may not be sufficient to activate associated cognitive memories (LeDoux, Iwata, Cicchetti, & Reis, 1988). Indeed, in many cases, the individual is complete unaware of “why” he or she feels so fearful or depressed. The external or internal triggers may not be something of which the person is aware. It is the nature of the human brain to store experience (Perry, 1999).
Prolonged stress can cause arousal of the autonomic nervous system (flashbacks, panic attacks, abnormal startle responses, and hypersensitivity to noise, temperature and pain); depletion of serotonin (causing all-or-nothing responses, overreactivity to new stimuli or touch and pain, and emotional over-sensitivity; depletion of catecholamine (prone to aggressive outbursts, increased sensitivity to stress, nightmares, and aggression toward oneself and others); and deregulation of endogenous opioid system (blunting of emotional and physical pain, poor memory, symptoms similar to clinical depression, and emotional deadness).
Trauma and Relationships
Traumatized people often oscillate between rampant emotionality and numbness. The inconsistency in mood of the survivor can weak havoc on relationships. As Judith Herman explains:
Similar oscillations occur in the regulation of intimacy. Trauma impels people both to withdraw from close relationships and to seek them desperately. The profound disruptions in trust, the common feelings of shame, guilt, and inferiority, and the need to avoid . . . all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments. The traumatized person . . . alternates between isolation and anxious clinging to others. The dialectic of trauma operates not only in the survivor’s inner life but also in her close relationships. It results in the formation of intense, unstable relationships that fluctuate between extremes . . . Traumatized people suffer damage to the basic structures of the self. They lose their trust in themselves, in other people, and in God. Their self esteem is assaulted by experiences of humiliation, guilt, and helplessness. Their capacity for intimacy is compromised by intense and contradictory feelings of need and fear. The identity they have formed prior to the trauma is irrevocably destroyed (Herman, 1997, p. 56).
One can see the impact that traumatic stress has on psychological and relational health. Trauma survivors with PTSD often experience problems in their intimate relationships with family and close friends.
The entire family is profoundly affected when any individual member experiences psychological trauma and post-traumatic stress. Even when only one family member directly experiences a traumatic event, the other family members may experience shock, fear, anger, and pain in their own unique ways because of their affection for and connection to the survivor. Living with an individual who has PTSD does not directly cause PTSD, but it can produce “vicarious” or “secondary” traumatization. Whether family members live together or apart, are in contact often or rarely, and feel emotionally close or distant, PTSD affects each member of the family.
Spouses, family members, and friends may feel hurt, alienated frustrated, or discouraged if the survivor loses interest in group or intimate activities and becomes easily angered or emotionally isolated. These secondary victims often end up feeling angry or distant toward the survivor, especially if he or she seems unable to relax and live in the relationship without being irritable, tense, anxious, distractible, or controlling, overprotective, and demanding. Areas that cause acute distress for family members of trauma survivors include communication, parenting, sleep problems, rage episodes (with verbal or physical violence)l, addictive behaviors, conflict resolution, remainders and flashbacks, suicide threats, and sexual intimacy with a spouse.
Damage is seen in the internal processes of trauma survivors. PTSC involves symptoms that interfere with elements necessary in health relationships:
• Loss of interest in social or sexual activities leaves the survivor feeling distant from others and emotionally numb.
• Feeling irritable, on guard, easily startled, worried, or anxious leads to the inability to relax, socialize, or be intimate without being tense or demanding.
• Difficulty falling or staying asleep and severe nightmares prevent both the survivor and partner from sleeping restfully, and may make sleeping together difficult.
• Reliving trauma memories, avoiding trauma reminders, and struggling with fear and anger greatly interferes with the survivor’s ability to concentrate, listen carefully, and make cooperative decisions—so problems often go unresolved for a long time.
• Significant others may come to feel that dialogue and teamwork are impossible.
• Feeling close, trusting, and emotionally or sexually intimate may seem a dangerous “letting down of the guard” because of past traumas—although the survivor often actually feels a strong bond of love or friendship in current health relationships.
• Having been victimized and exposed to rage and violence, survivors often struggle with intense anger and impulses that usually are suppressed by avoiding closeness or by adopting an attitude of criticism or dissatisfaction with loved ones and friends.
• Survivors may be overly dependent on or overprotective of partners, family members, friends, or support persons (such as healthcare providers or therapists).
• Alcohol abuse and substance addiction—as attempts to cope with PTSD-can destroy intimacy or friendships (National Center for PTSD).
With time, many of these intrusive symptoms fade, yet they can be relived even years after the trauma by intrusive reminders such as anniversaries of the ordeal. “As the intrusive symptoms diminish, numbing or constriction symptoms come to predominate . . . She may complain that she is just going through the motions of living, as if she was observing the events of daily life from a great distance” (Herman, 1997, p. 48). These lifeless emotions can lead to depression, anxiety, and other relational issues such as sexual dysfunction.
Physical intimacy presents a particular barrier for survivors of any traumatic event, especially sexual trauma. Arousal and the physiological processes of orgasm may be compromised by intrusive traumatic memories. Reminders of the trauma may similarly invade sexual feelings. Sexual disinterest and dysfunction can be a direct consequence of numbing or an increased opioid response. Reclaiming one’s own capacity for sexual pleasure is a complicated matter ; working it out with a partner is even more complicated but is possible with therapy and time.
Embracing Shame and Disappointment in One’s Self
The emotional sequelae of trauma survivors affect emotional stability and can be a hardship on all interpersonal relationships, especially intimate ones with partners, family, and close friends. One of the most difficult emotions that survivors of trauma have to deal with is shame. Many have heard of survivor’s guilt—the belief that the survivor could (and should) have changed the situation and prevented the outcome of the trauma incident.
In the aftermath of traumatic events, as survivors review and judge their own conduct, feelings of guilt and inferiority are practically universal . . . Guilt may be understood as an attempt to draw some useful lesson from disaster and to regain some sense of power and control. To imagine that one could have done better may be more tolerable than to face the reality of utter helplessness (Herman, 1997, p. 53).
A large amount of shame is evoked simply for surviving a traumatic incident. “Shame is a strong sense of being uniquely and hopelessly different and less than other human beings” (Wilson, 1990, p. 25). Trauma seems to consistently bring up unresolved feelings and thoughts of self-blame. Why couldn’t I have stopped him . . . seen the truck coming . . . know it was a dangerous situation . . . helped the hurt individuals more?
Shame makes one feel separate, different, and alienated. Many traumatized individuals believe on some level that they allowed the traumatic events to occur. The alienating effect of shame can interfere with intimacy in spiritual areas with God, sexual and emotional areas with a spouse, relational areas with family and friends, and personal areas with identity issues.
To overcome share and guilt, the survivor needs the assistance of others in his or her struggle to arrive at an accurate assessment of the trauma event. When those closest to the person recognize psychological harm and accept a prolonged recover process, the survivor begins to feel understood and cared for. A fair and gracious verdict by those closest to the survivor diminishes the feelings of humiliation and guilt produced by the trauma.
Treatment for Trauma Survivors
Professional help may be indicated when many symptoms persist for weeks or months, or if the symptoms are extreme. Therapeutic interventions commonly used to treat PTSD include the traditional approaches such as cognitive-behavioral therapy, relaxation techniqu4es, desensitization, pharmacotherapy, group treatment, brief psychodynamic psychotherapy, as well as such more contemporary approaches such as Eye Movement Desensitization and Reprocessing (EMDR) and body therapies.
It is important for clinicians to remember that trauma robs the victim of a sense of power and control. Thus, one of the overarching goals of recovery is to restore a sense of power and control to the survivor. “One of the results of trauma therapy is the reestablishment of the protective function of fear” (Rothschild, 2000, p. 62). Because residual fear and anxiety becomes generalized to inappropriate stimuli, the delineation of true threat and nonthreatening events becomes handicapped, and the trauma survivor may repeatedly fall prey to dangerous situations. The internal alarm for danger is overloaded due to constant arousal of the autonomic nervous system resulting in protective mechanism of fear to be disabled (National Center for PTSC).
Treatment for PTSD typically begins with a assessment and subsequent development of a treatment plan that meets the needs of the survivor. After addressing crisis issues the treatment may include: educating survivors and their families about PTSD and its possible ramifications on relationships; reexperiencing the traumatic event in a safe environment through imagery or storytelling; examining and resolving feelings such as anger, shame, and guilt; and teaching the survivor to cope with post-traumatic memories, triggers, and feelings without becoming overwhelmed or emotionally numb.
Maintaining intimate and health relationships is key to treatment. These relationships can actually prevent the development of and/or diminish the symptoms of PTSD. Successful intimate relationships require:
• Creating a personal support network to cope with PTSD while maintaining or rebuilding family and friend relationships with perseverance and commitment;
• Sharing feelings honestly and openly with an attitude of respect and compassion;
• Continual practice to strengthen cooperative problem-solving and communication;
• Infusions of playfulness, spontaneity, relaxation and mutual enjoyment.
Because traumatic life events invariably cause damage to relationships, people in the survivor’s social world have the power to influence the eventual outcome of the trauma. A supportive response from other people may alleviate the impact of the event, while a hostile or negative response may compound the damage and aggravate the traumatic syndrome. In the aftermath of traumatic life events, survivors are highly vulnerable. The sense of self has been shattered. That sense can be rebuilt only as it was built initially—in connection with others.
The emotional support that traumatized people seek from spouses, family, and close friends takes many forms, and it changes during the course of resolution of the trauma. In the immediate aftermath of the trauma, rebuilding of some minimal form of trust is the primary task. Assurances of safety and protection are of the greatest importance.
Objective perception of the trauma is possible after the trauma recedes and is no longer a barrier to intimacy. At this point, the survivor is able to turn toward his or her partner and give more attention to the relationship. The survivor may also become aware of the ways in which his or her partner suffered from the survivor’s preoccupation with the trauma. The survivor may then be able to freely express his or her gratitude, forgiving oneself and others, seeking forgiveness when necessary.
Trauma and Spirituality
Trauma also affects the survivor’s spiritual belief system. Traumatic experiences force the survivor to confront psychological and spiritual challenges that are unfamiliar to most. The organizations of self and God are often thrown into question or destroyed by experiences of trauma. The deconstructive power of trauma exposes the lack of cohesiveness that comprises identity and the image of God. Simultaneously, there is a desire to reconcile the realization that one’s former existence in the world before the traumatic experience is lost.
Traumatic events expose victims to aspects of life that they would rather ignore. Trauma challenges their beliefs about security and certainty, and it has the power to throw into question or obliterate any organization of self, God, and humanity. Maintaining both a strong belief system and attachment system can mitigate negative effects of trauma and perhaps prevent the development of PTSD (James, 1994; Matsakis, 1998; Reite & Field, 1985; van der Kolk, 1988, 1996a).
Trauma is overwhelming and can lead to deep spiritual questioning. Many times survivors will go back to the foundation of their faith in God and question his very existence and the meaning of life. Old answers no longer suffice. Questions about evil and cruelty in the world, along with reexamination of their image of God, can cause stress while journeying down this path of recovery.
Trauma causes survivors to confront their beliefs about God and negotiate their views of God’s love in the midst of the ordeal. Trauma, in spite of its horror and the havoc it causes in the survivor’s life, has the power to open survivors to a deeper and more intimate relationship with God and with others. “Most survivors seek the resolution of their traumatic experience within the confines of their personal lives. But a significant minority, as a result of the trauma, feel called upon to engage in a wider world” (Herman, 1997, p. 207).
If healing is to occur, the help of God and others is required. Acknowledging this need is a milestone on the healing path. Traumatic injuries need not become pits of deadness, denial and disease which rob life from survivors and from their loved ones. Rather, with love and understanding, healing can occur. Negotiating the psychological and physiological responses that are innate in PTSD can bridge the passageway for the trauma survivor’s personal and relational healing process.
Nancy Hoffman, R.N., M.A., is a Licensed Professional Counselor with the Center for Marriage and Family Studies at John Brown University in Siloam Springs, Arkansas. She specializes in working with women’s issues, grief and trauma, adolescents, and stepfamily issues.
REPRINTED WITH PERMISSION FROM MARRIAGE & FAMILY: A CHRISTIAN JOURNAL, Vol. 5, Issue 4, 2002. Permission given by George Ohlschlager of the American Association of Christian Counselors.