PTSD is known as Post-Traumatic Stress Disorder. The disorder has been defined as “a psychiatric disorder…in people who have experienced… a traumatic event…” (Torres). Post Traumatic Stress Disorder can come from various traumatic experiences. Some of the most common causes are “rape, childhood abuse, and intimate partner violence” (Sareen). Other common causes include physical traumas, and exposure to horrific events, such as war.
Who can have PTSD
Anyone can face a number of these traumas. However, Post-Traumatic Stress Disorder in men is more common after exposure to combat-type violence. For women, the disorder develops more commonly from sexual violence. Regardless, PTSD can derive from different causes depending on each experience. The trickiest part is that the disorder can also express itself in its own unique way in each affected person. In this article, we will choose to mainly focus on causes of war, sexual and domestic violence, and child abuse.
World War I
To begin with some history, the soldiers of World War I came back with symptoms of night terrors, flashbacks, aggression, and insomnia. Therefore, this was the first time society was dealing with the aftermath. The affected soldiers often turned to self-medication. Of course, World War I was not the first time people had ever had these symptoms. However, World War I changed how people viewed PTSD when the soldiers came home. They labeled the state the soldiers came home in as “shell-shocked” (Butterworth). After seeing them come back as completely different people, PTSD began to be seen in a new light. Family and loved ones watched these soldiers lose themselves to alcoholism, flashbacks, and feelings of grief, anger, resentment, and numbness.
Over time, PTSD became most associated with war. For example, one study shows that 20% – 30% of veterans developed it (Reisman). However, about 27% of women who have been raped develop it, as well (Mental Health Issues). In the instance of child abuse, 77% to 100% of victims develop symptoms (Mental Heath Issues), Though the statistics show the same to higher rates in all cases, it’s harder to get diagnosed for victims of sexual or child abuse. Society pressures victims of sexual and child abuse to stay quiet. In addition, many victims feel that they will not be believed. Therefore, many victims have suffered alone, leading to a lack of research in how different cases manifest. The general and medical communities may not take other causes of PTSD as seriously as war. But, those who do suffer from the disorder -from any cause- just may feel differently.
I wanted to further delve into some similarities and differences in PTSD symptoms amongst different causes. In addition, I wanted to see if there was truth to the stigma, based on what a couple of people in the PTSD community think. I was curious to see if there are significant differences between causes and PTSD expression.
Note 1: This is not reflective of the opinions of all those with PTSD, Note 2: Interviewees will be anonymous.
I was going to call the following sections “Interview 1” and “Interview 2”, but as they evolved into interesting, truthful, two-sided conversations, I have no choice but to honor them by calling them discussions. Instead of writing them in the traditional Q & A manner, I will be transcribing our conversations.
Discussion 1 – a veteran
Me: Hi! Thanks for agreeing to this discussion.
Veteran: No problem. Actually, I don’t know if you remember, but the first time we connected was when I resonated with one of your art pieces and we talked about some shared experiences with PTSD.
Me: Yes! I do remember that and you sharing some of your experiences with war and the aftermath of coming home. That actually leads in quite well into what we’re discussing today.
Veteran: Yeah, I remember that we talked about how it felt dealing with PTSD. We had some shared symptoms. I remember especially relating to the nightmares and flashbacks.
Me: I remember that. We traded some tips for sleeping better. Your tips were definitely helpful. Would you like to expand or share anything from our discussion?
Sleeping and peace
Veteran: I think some aspects of disturbed sleep we shared were waking up in the middle of the night with terrors and panic attacks. We both shared that activities like yoga and meditation have helped. I’m curious about this, though. When I came home, I felt like reality was different. I felt like I didn’t belong in the realities of normal life anymore. I felt numb and aggravated at times. It was hard to engage and enjoy my old hobbies, which is something I’ve immersed myself in a lot in my later years. Does reality morph after trauma from sexual assault?
Me: I definitely felt numb. I was lucky to have good friends and family to fall back on, but I could not for the life of me feel like I was ever-present. I felt like just a body without a soul, vacantly walking through life, until something would trigger me, shocking me out of numbness, into panic or depression. The brain is interesting. I learned about dissociation when I was first learning about my PTSD. If I remembered something bad or felt anxious, I would kind of just “switch off. I would feel disconnected from everything, including my body, to not feel any external pain or inner turmoil.
Veteran: It’s interesting to me that people don’t see the PTSD that comes from war and sexual assault or domestic violence similarly. Honestly, it seems narrow-sighted.
Me: Why do you say that?
Veteran: I’ve never been a victim of domestic violence, but just from reading things and helping some women friends through bad situations, I would say that being in the midst of a sexually abusive relationship is barely different from being in the “fog of war,” as they say.
Me: *laughter* Well, I’ve never had to face bombs and weapons of mass destruction.
Manipulation and gaslighting
Veteran: *laughs as well* Well, think about it. In war, we face manipulation from our side, to get us to stay in line. We face manipulation from the enemy side. We don’t know who to trust, so we must trust those around us, helping us survive. Manipulation and feeling of reliance may resonate with victims of domestic abuse. Then, there’s of course, the physical violence. I wouldn’t know how to compare. I’ve seen horrors in war, but I’ve also read of husbands doing unspeakable things to their wives. We’re both stuck in a dangerous situation that leads us to be dependent, changes our mindsets about what’s right and wrong, and ultimately, makes it difficult to adjust back to real life.
Me: It’s important to understand how to feel safe and deserving again.
Flashbacks and panic
Veteran: That’s why I resonate with your art. I see similar emotions of haunted thoughts, self-blame, and how it can feel unbearable at times. I also see the insomnia! You make your art late.
Me: *laughter* That’s very true. So then, speaking of haunted thoughts, how would you say your PTSD took shape in your mind after returning home? Did you experience flashbacks? Nightmares? Or was it more of a feeling of dullness and frustration?
Veteran: I had a lot of trouble sleeping. I’ve woken from bad dreams drenched in sweat. I struggled to get certain memories out of my head and I would be completely in my head. The flashbacks would come at random times. I couldn’t predict them, which made me fear them more. I didn’t want to feel the memory, but I was anxious about when or where it would happen.
Me: For me, it was mostly flashbacks and nightmares. I would have flashbacks that sent me into bad panic attacks, or if I woke up from a PTSD nightmare, I could be shaking and crying. Probably my worst PTSD nightmare was one where I woke up startled and disoriented, screaming. I went to the hospital and was calmed down, but for a bit, I lost where I was and my orientation.
Veteran: Yeah, those are symptoms I’ve seen in myself and guys I knew too.
Me: PTSD therapy in cases of sexual, domestic, or child abuse or often focused on relationship healing and forming stronger future relationships. Would you say that that’s an important part of your healing?
Veteran: I think it’s important for anyone to have a good support group, but I think I had the opposite problems regarding relationships than people who experience sexual or child abuse. I’ve noticed that victims of those struggle to trust partners because of their previous hurt. It wasn’t really like that for me. It was more than I hoped I wouldn’t have too much baggage for my partner and that I would treat them well after seeing what I have.
Me: Ahh, that makes sense. Well, I think there’s more of an intersection than we thought! I think a lot of survivors of abuse also worry that they may be unlovable or have too many problems for people to deal with. I know personally that victims of domestic abuse worry about how they will treat their future partners as well. We don’t want to pick up the bad behaviors of our old abusive partners, but sometimes it’s inevitable, especially when you lived in that reality where those behaviors were once considered “normal.”
Veteran: I think that’s normal considering. I know some buddies of mine had problems with sex and intimacy, so I think it can happen. I don’t drink much and I’ve never done drugs, so I luckily avoided too many vices during my healing.
Me: That’s a good point. I think so many people struggling with PTSD do turn to substance abuse and other vices to cope.
Veteran: Fortunately, I’ve learned to sleep peacefully. Keeping a busy day, exercising, and getting any bad memories out through art and the other types of sculpting and building I do have helped keep a positive mindset. It is possible to overcome negative aspects of life by creating positive ones.
Me: That’s great! I think that’s a very good note to end on. Thank you so much for your time!
Discussion 2 – a survivor of child abuse
*Note: The interviewee’s name has been changed to “Jane” in the following discussion for the purpose of anonymity.
Jane: Thank you for interviewing me for this! I love Women’s Republic and am excited to be part of this.
Me: We’re so glad you like it and I’m happy to meet you!
Jane: I’m bad at segues, so I guess I’ll just start with some background.
Jane: Basically what happened was that by the time I was 4, my older brother was already 15. We have a large age gap. He was the first person who molested me. I obviously didn’t know he was doing anything wrong. When it became more painful, I told my mom. She either didn’t believe me or didn’t want to. I didn’t know what to do after that because my brother and dad were really close. I felt like if my mom didn’t believe me, my dad definitely wouldn’t. My dad was physically abusive with me, but almost never with my brother. He didn’t know what was going on with my brother until he walked in on it happening one day. Instead of getting mad at my brother and stopping it, he began molesting me from that day too.
By the time I was about 13, I had had sex with a few of my brother’s friends and my dad’s brother. At that point, my mom knew fully what was going on, but I think she was scared of my dad. I didn’t know what to do except wait until college to leave. I wasn’t allowed to work or do much with friends from school, so I didn’t have many confidantes.
When I was 15, my brother’s friend convinced me that my home life wasn’t normal. He acted like he didn’t like my brother and we started dating. We mostly just got wasted and did drugs. After a while, he convinced me to drop out and move away with him. It’s not like I was doing great in school or anything, but I was still iffy to drop out entirely. He told me he’d be able to take care of everything, and since my home life was intolerable, I left with him. He definitely did not take care of me. All he did got deeper in the drug game and wanted to use me to get his fix or get more money. After that, I pretty much jumped from guy to guy to have a place to live.
Me: I’m sorry all of that happened to you. You’re truly a brave woman.
Jane: Thank you so much, that means a lot. I definitely made a lot of bad decisions though.
Me: Haven’t we all, especially in stressful situations…
Jane: *laughter* You know, I’m just really lucky I didn’t end up a junkie or something.
Me: Did you stop doing drugs after some point? What do you do now?
Jane: When I was moving around, I was still using. I was dependent at that point and mostly dated guys who could hook it up for me. I don’t use it like that anymore and I go to community college.
Me: That’s great, congrats! That makes sense though, especially with you having to find a place to live.
Jane: Exactly. After I moved out, no matter how bad the new living situations were – and some of them were bad – I never went back.
Me: So have you ever seen your family since?
Jane: I never went back to that house, but my mom has tried to contact me and my dad used to try to show up at places to threaten me to come back home. Maybe I will talk to my mom one day. I want to know why she didn’t stand up for me, but I’m still too mad to have that conversation.
Me: Yeah, losing that sense of security at such a young age, it’s understandable to take some time. Do you think your relationships are better these days?
Jane: I am not dating at the moment. I’m still kind of in it, you know?
Me: What do you mean?
Jane: A lot of the guys I dated after moving out were abusive, pimps and addicts and whatever. I don’t have a whole lot of trust in guys right now *laughter*.
Me: Makes sense for sure.
Jane: That’s not the only thing, though. I guess I just need to grow up more. I’ve only been with guys who treated me bad so sometimes I feel like I don’t even know how to treat myself good. I feel like if I started dating right now, I would choose the wrong guy again.
Me: I think knowing that you feel like you should treat yourself better is really good!
Jane: Yeah. I’ve been trying hard to be healthy physically and whatnot. It’s hard not to feel the fear though.
Me: Do you think you would feel unsafe with intimacy or friendship right now?
Jane: I have some good friends, thank God. But yeah, I’m pretty distrusting of people and once I like them, I’m a total people pleaser because I don’t want them to leave. I think I wouldn’t feel safe in a dating situation right now.
Me: You told me in our preliminary conversation that you were diagnosed with PTSD. If you feel comfortable answering, do you still go to therapy or is there anything else you do that you find helpful?
Jane: I still go to therapy and it’s really been such a lifesaver. I know I have trust and commitment issues because of the guys in the part and my family, but it’s not just yet. I guess I never thought about getting to know myself and what makes me feel happy and safe before I went to therapy.
That’s why I’m still figuring those things out. It’s like I’ve lived for other men my whole life, and now I’m finally meeting myself. Like sometimes I wonder if I even ever liked some of the stuff I said I liked as a teen or if I just said it to make someone happy? Therapy has also helped with other things. I have a pretty bad temper. Makes sense, right? I’m still dealing with it, but I have some good methods to calm down. And therapy has helped me decrease self-harm and keep the substances at bay like I couldn’t sleep because of anxiety and bad memories, so I’d pop a benny or whatever.
I don’t do that now. And it helped me not have meaningless sex for immediate gratification. I learned I need a lot of validation because I used to hate myself. Maybe I still do, but less. My therapist says it’s because I never had respect and people who instilled confidence in me, so I didn’t really learn what it means to me to respect myself. So I’m trying to do that for myself and surround myself with good people. I feel bad about myself a lot and my first thought is that I could find a guy, but I try to distract myself in better ways because I know the feeling won’t last. I’m still in the process of not blaming myself for what happened and not letting it define my future.
It’s hard since I don’t know who the future me is or what I want, but my therapist says it’s ok to take this time to figure it out. A few things I try to do are yoga and meditation before bed. I also love to sing and read, so I try to do that every day. I have been prescribed medication now for sleep and I think I’ve been feeling better overall.
Me: Days are definitely easier when you’re refreshed and didn’t have horrible dreams all night. It sounds like you’ve highlighted all the issues you want to tackle and you’re well on your way to doing so! Good luck and congrats on all your progress.
First, I’d like to thank my two interviewees for their amazing contributions. I hope, reader, that they peeled a few extra layers off the complex disorder, PTSD. PTSD occurs after traumatic incidents or experiences. Though most cases of PTSD are thought to have come from war, PTSD also is a frequent outcome of other traumas, such as sexual, domestic, and child abuse. In the public community and the medical community, PTSD from incidents that are not related to war is not taken as seriously.
After conducting two discussions with people with PTSD for different reasons than I, we concluded that though all individuals and their experiences are unique, there are several ways PTSD symptoms overlap, despite the cause. Hopefully, the medical community begins to take treatment for all PTSD more seriously. But this is good news because those of us with PTSD have a large community of those with whom we can resonate.
Butterworth, B. R. (2021, January 25). What World War I taught us about PTSD. Retrieved from https://theconversation.com/what-world-war-i-taught-us-about-ptsd-105613#:~:text=Though much has changed, many, identified during World War I.
Mental Health Issues. (n.d.). Retrieved from https://www.ncjrs.gov/ovc_archives/ncvrw/2005/pg5n.html
Reisman, M. (2016, October). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/#:~:text=In one major study of,as 20% to 30%.&text=As many as 500,000 U.S., have been diagnosed with PTSD.
Torres, F. (2020, August). What Is Posttraumatic Stress Disorder? Retrieved from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
Sareen, J. (2014, September). Posttraumatic stress disorder in adults: Impact, comorbidity, risk factors, and treatment. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168808/