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PTSD: What not to say and why

Things not to say:
1. It’s ok now, move on.
2. I know someone else who went through the same thing, and they didn’t act this way.
3. Aren’t you just over-reacting?
4. Why don’t you just stop thinking about it?

Let’s address these one at a time. The first one is, it’s ok now. Move on. The reason that we shouldn’t say that is because it isn’t ok now, and the person would clearly move on if they could. When someone has suffered an event which brings on PTSD, it isn’t ok and they can’t move on. They are physically stuck at the point in time when the event took place. They are usually completely oblivious to the amount of time going by since the event, and are unable to ignore the impact that the event is having on their lives. If someone was in a serious accident and had to have their lower arm amputated, no one would even think of telling them that it’s ok now, move on. People would clearly understand that damage has been done and healing needs to take place. They would recognise that counselling therapy as well as physiotherapy would be needed before the person could even begin to “move on”.

With PTSD, the injury isn’t that visible, so people can be fairly callous to the impact that it actually has on the sufferer. It has in recent studies been recognised as a physical brain injury due to the way it changes the brain’s processing of events in life. The brain is unable to process the information of the event, and gets “stuck”. Imagine telling your brain not to recognise the colour blue. I think it safe to say that we all realise that not wanting to see the colour blue any more will not change the fact that the colour exists, and we will see it. We might try to avoid seeing the colour blue by refusing to look up at the sky, but that won’t change the peripheral view of the sky that we will see regardless of our desire not to. Everywhere we look, the colour blue will be noticeable, and any efforts to stop seeing the colour blue will only make that colour that much more noticeable. You can not force your eyes to stop registering the colour blue. In a similar way, the person suffering PTSD can not force their brains to stop remunerating about the event, having nightmares about the event, or having flashbacks when triggered by something that reminds their brain of the event. The brain is in complete control. They are not.

The second one is, “ I know someone else who went through the same thing, and they didn’t act this way”. Just as every person is unique, every experience for every person is unique. It’s also true that we don’t really know what a person is feeling or experiencing if they don’t choose to tell us, and some people might choose to keep it hidden as much as they can so that they can avoid having to talk about it. Some people are numb to an experience until a similar experience happens. In any case, we should never judge anyone for the way they react to any traumatic experience. One thing to remember is that we never truly know how we ourselves would react to the same experience until it happens to us.

The third one is, “aren’t you just over-reacting?”. This question not only diminishes the experience of the person they are asking it of, it also judges. The implication is that the person has chosen this course of behaviour; perhaps as a way to get attention, but certainly for not any legitimate reason. No one who has suffered from PTSD would choose to live like that. Unless you’ve experienced PTSD, you really can not imagine how painful, terrifying, and embarrassing it actually is to live with. It’s an enemy that takes you over, and it can make life so difficult that death can be preferable. This is why so many soldiers commit suicide. There truly are some things worse than death. There are some traumatic events that we can all agree are traumatic, such as a terrorist attack. However, any event that causes a significant impression of being in fear of one’s life will have the same result.

It’s true that you might not consider that the car crash you only just survived was a traumatic event, but it’s just as true that someone else would. I’ve treated people who survived a crash that they shouldn’t have, and the crash itself wasn’t the problem. They could remember every detail of it years later, but it had no impact on them. I knew another person who just had a prang and was so affected that they couldn’t drive again, even years later. They were able to ride in a car reasonably well, but could not drive. Every person, every event, is unique, and no one would choose to have PTSD as an over-reaction. Each person’s experience deserves respect and dignity, not judgement.

Finally, “why don’t you just stop thinking about it?”. This question is based on a lack of information about what PTSD actually is and does. When we ask questions to diagnose the condition, the question addresses intrusive thoughts, or thoughts that are unwanted but persistent. Have you ever had a song in your head that you just could not get rid of, and it drove you potty until it decided to go away? Well, PTSD is similar, but much worse. Just as you couldn’t make that song get out of your head, the person suffering from PTSD can’t just stop thinking about the event. The thoughts are there, unwanted and determined. The person suffering from PTSD can not control their dreams, either, so will wake up with a start thinking they heard the brakes screeching and glass shattering. People can wake up in a cold sweat, or screaming….at no time is “just stop thinking about it” an option.

What not to say is easy enough. What is the right thing to say might be another matter, and many times, people really have no idea what to say or do to help the sufferer. In reality, the reason why soldiers just hold on to each other sometimes is because sometimes, that’s all you can do. Just hold on to each other. I read about one soldier who went into meltdown in public, and his wife went down to the ground with him, just holding onto him tightly the same way another soldier on the field would’ve done. Sometimes, that’s all you can do. Just be there. Get as much information about the condition as you can. Get the advice of a professional, if you want to. One thing to remember is this: If you think you might say the wrong thing, saying nothing at all is a perfectly acceptable option, as long as you just make sure that the person knows you’re there and want to understand.

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