PTSD is often associated with war veterans, especially those who were in combat. Not to take anything away from those individuals who have been in combat, as far as the subject of PTSD goes--that is only one, singular aspect, one route one can be on, to acquire this condition.
I bring this up because of the discussion about whether or not there should be trigger warnings on pieces online or on books or in college syllabi.
There are stereotypes about PTSD that are not flattering or even truthful. Many imagine the veteran hiding under a car or bed, armed, ready to fend off enemy soldiers that exist only in his mind.
While I am sure that can happen, most often PTSD is more subtle than that. So subtle in fact, that there are people in your world who have it, or have suffered from it, and you probably don't even know.
That doesn't make this condition any less destructive to those who suffer from it, and the family members who help that person cope with it. Subtly should never be confused with a lack of potency.
So lets do some vocabulary work. It always helps if one has the right words to describe what they see or experience.
Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Mayo ClinicNot everyone who experiences a traumatic even goes on to develop PTSD. But for those who do, it can take time to figure it out. I know that one would think that it would be obvious, but not always. Sometimes the realization can come months after the original trauma. And without proper diagnosis, it might take the person suffering years, before they can put a name to their cluster of symptoms.
The first aspect of PTSD is the Anniversary. An Anniversary is the time leading up to, during and after the time of the event on the calendar (after the fact) where certain psychological factors emerge causing one to relive aspects of the trauma or traumas.
This can manifest as intense anger, sadness or a host of negative emotional states, this can also bring on binge drinking or substance abuse, that can lead to fights with loved ones or the sufferer behaving in an erratic manner, or even pulling away completely. This can also culminate in suicidal ideations or attempts. This will happen every year. How it ultimately manifests will differ with each person. The effects can be mitigated over time, if the sufferer figures it out or receives a diagnosis and support.
So an Anniversary is a predictable, episodic event wherein the survivor relives some or many aspects of a trauma.
A Trigger is far more subtle than an Anniversary. A trigger doesn't have to be anything obvious to you or me. To use the favored Combat scenario--a trigger can be loud noises like fire crackers or gun fire, or cars or motorcycles backfiring. It can be large crowds, parades even with lots of people in uniform in one area.
It can be anything that reminds a combat vet, of combat. In general it can be anything that reminds the person of their trauma.
It can also be anything that elicits a startle response and puts a person into a hyper-vigilant mode.
Hyper-vigilance: A state of extreme watchfulness. You have tuned into every aspect of your surroundings, as if a threat were immanent, even though there may be NO threat at all. Being in this state will disrupt sleep patterns or even stop sleep from occuring, and can lead to insomnia, irritability, anger, and anxiety. You can be in this state indefinitely or at least until one runs out of adrenaline.But that's just the really obvious things. It goes far deeper than that. An anniversary happens once a year, but a trigger can be anything at any time that elicits a strong association with that traumatic event.
It can be obvious things like crowds of people marching in uniform, or sounds that mimic gunfire. But it can also be something like a smell. The smell of gunpowder or anything burnt. It can be a word or phrase that you associate with the event, or the name of a person you associate with that event.
It can be the angle of the shadows at a certain time of day. It can be a color or a song, or the smell of cologne, or a pattern on wallpaper-- literally anything that causes your brain to go back to those memories of that event.
And it can be a word, or pictures as well. And that's where we get into trigger warnings discussed online.
What this means:
Well you know that once a year for weeks you are going to be dysfunctional because of that Anniversary. That annual event, that you remember vividly that past trauma and that happens around the same time every year, like the opposite of Christmas or your Birthday.
And you think--Cool, this really sucks but I can live with this once a year thing, I have 11 other months that I can really live life.
But then you discover the "Trigger" which can be anything, and can turn your entire world upside down at any time, for weeks or even months at a time. You can be triggered once in a while or you can be set off, by situations that happen in series or in parallel. It really isn't up to you at first. It's what is in the world directly around you.
One of those surprise triggers I dealt with a long time ago: I went to see The General's Daughter. It was a movie about a rape and murder in the Army. And it set me off like a Roman Candle. I stayed pissed off about that for weeks. I don't think I slept more than a couple hours a night for a week, and when I woke up I would have fingernail marks in my hands and my jaw hurt from gritting my teeth.
If you will recall, there were PTSD hotlines set up for veterans who went to see Band of Brothers, which is a movie about D-Day and taking Normandy. Because many WWII vets and probably any combat vet who saw that movie, would have been affected and might have needed a sympathetic ear.
Let that sink in for a moment. A mere movie can set someone's condition off. Or a startling car horn or alarm bell, or a graphic story in a book or on a blog.
No matter what, if a person is triggered, it really sucks. But for some people, it is important for the rest of us to understand that, that trigger can be a prelude to suicide or a drinking binge or other seriously destructive and potentially dangerous behaviors. People who may or may not even understand what is happening to them, who may or may not have a diagnosis.
It serves us well to learn to be gentle with others and ourselves. Because if we make this world too harsh and too ugly, then it becomes very difficult for people to realize where normalcy ends and begins. And if you have PTSD, those lines are blurry already.
People with PTSD need the loving care of their friends and family, because this condition forces them out of their bodies and the world around them, to be trapped in their minds, in memories that are so powerful that those memories drown out reality in the now. Time stops for us. We are ghosts caught in the past, unable to return to now or respond to now. We have for a moment, lost our way back into this corporeal existence where you are, where food is, where the love is, and the acceptance is.
We haven't died, and yet are already in a hell. We lose our grasp on all the good things NOW, and relive those hellish vignettes over and over and over--the memories and trauma become a sick feedback loop. In our dreams, in our nightmares, in our memories, in a really bad case, it can be everywhere whether one is awake or asleep.
We may even still be somewhat functional when this happens. It may be hard to detect if you don't live under the same roof with that person.
PTSD isn't just for veterans. It isn't just for combat veterans. It's for police officers, and other First Responders, it's for medical personnel, it's for people who have survived domestic abuse, or car or motorcycle accidents, it's for people who survive rape and sexual assault, stalking, and molestation, it's for lots of different kinds of trauma, it can also affect children and keep affecting them into adulthood. It's any kind of trauma that makes a person feel absolutely helpless and threatened simultaneously.
So putting that trigger warning on a paper or book or blog or website is a kindness for some.
There are a few times when I have seen that warning and thought--today is not a good day to look at that sort of material. And I skipped it. And it was good. Because the author gave me permission to live in the now, they gave me the ability to choose now over the bad old times and I am grateful for it.
And for some who don't have a diagnosis. If they notice changes in their mental state, every time they read or watch something with a trigger warning, it just might help them find a diagnosis or at least cope with their own troubles in a more productive manner.
Our culture has become mean. And it's all contrived. Somehow we have confused meanness with strength and that is an erroneous association. It takes great strength and control to be gentle. It takes great discipline to be mindful. Anyone can be a brute without even having to think or try that hard.
Putting that trigger warning out is a mindful step, that tells the world we are intelligent enough to comprehend the depths of trauma, and strong enough to care for those who have been affected by it. Over time we just might also learn as a culture, to acknowledge the depth of harm that violence does in theory, before we set off to inflict it upon others.
What kind of world would that be like?
You can see things that hurt you so much in your soul (with or without this condition) that you cannot make yourself watch or read the material. This is an example of being gentle with one's self. Putting a trigger warning on material is an example of being gentle with others.