How to prevent post-traumatic stress disorder following a traumatic event

In my last article, I discussed the difference between someone experiencing a traumatic event and being diagnosed with post-traumatic stress disorder (PTSD). During this discussion, I pointed to research indicating that over 90 per cent of people who experience traumatic events recover without eventually developing PTSD.

I closed the article by stating that there are steps a person can take after a traumatic event which can make it even less likely that they will eventually develop PTSD. I will discuss these steps in the following sections.

Facilitating natural healing: Cognitive and behavioural steps

When a person has experienced a traumatic event, the goal to focus on is taking steps which facilitate natural healing. Doing so entails allowing the disturbing reactions which the person experiences in the aftermath of the event to gradually diminish in intensity so that they eventually run their course.

In doing so, the person will have averted the onset of PTSD. PTSD entails the reactions not diminishing in intensity so that the person experiences them long after the time of the traumatic event.

The steps to facilitate natural healing are twofold:  Thinking (cognitive) steps and action (behavioural) steps.

Cognitive steps: Normalize reactions following the traumatic event

The reactions a person experiences following a traumatic event can feel very disturbing. These include memories of the event intruding on your consciousness, difficulties in concentrating and functioning, and getting ‘triggered’ with a rush of anxiety when you think of the traumatic event or encounter reminders of it as you go about your day.

It is very easy at these times to conclude that the reactions you are experiencing are symptoms of lasting damage as well as evidence that you have PTSD. This conclusion affects your mood negatively, leading you to become depressed on top of the anxiety you have already been experiencing.

It also affects your behaviour by leading you to withdraw from social and work/academic activities both because of your depressed state and to avoid situations with reminders of the traumatic event which trigger anxiety.

This negative way of thinking about your reactions following the traumatic event, while understandable, interferes with natural healing. A more positive and accurate way of thinking about your reactions following the traumatic event is to normalize them.

That is, it is expected that in the immediate aftermath of a traumatic event you will have various reactions including those which I mentioned: Memories of the event intruding on your consciousness, difficulties in concentrating and in functioning, and getting ‘triggered’ with a rush of anxiety when you think of the traumatic event or encounter reminders of it as you go about your day.

And although normalizing these reactions doesn’t change the fact that they are unpleasant, disruptive, and even scary at times, it makes it easier to experience them when you realize that they will diminish in intensity over time. It also helps to understand that these reactions will eventually run their course rather than being signs of permanent damage or symptoms of PTSD. And they will indeed diminish in intensity and eventually run their course if you behave in ways which allows them to do so.

Behavioural steps: Gradually return to routines while overcoming avoidance

Your routines for work/school and social life necessarily will be disrupted temporarily after you have experienced a traumatic event. Having said that, gradually returning to these routines is an important behavioural step which will facilitate natural healing and decrease the chance of your eventually being diagnosed with PTSD.

Restoring your routines will typically expose you to situations in which reminders of the traumatic event are present and in which opportunities to think and talk about the event occur. As such, it is tempting to avoid returning to your routines so that you can avoid the anxiety from being triggered by these reminders of the event.

Although it may seem counterintuitive, overcoming the urge to avoid and allowing yourself to experience the anxiety is ultimately beneficial to your healing from the traumatic event. The reason is that the anxiety triggered by reminders and memories of the event is a conditioned emotional response.

That is, there is nothing inherently fearful about the reminders and the memories. Rather, they elicit anxiety because they are associated with the traumatic event. The more you elicit the conditioned emotional response of anxiety after the traumatic event by exposing yourself to the reminders and memories, the more the strength of this response will decrease as the connection between these innocuous stimuli and the traumatic event is broken.

In contrast, avoiding memories and reminders of the traumatic event interferes with the natural healing process by not allowing the conditioned emotional response of anxiety to be elicited enough for it to decrease in intensity. As a result, having anxiety when you are exposed to memories and reminders of the traumatic event is more likely to be prolonged the more you avoid returning to routines.

Short-term pain does not have to lead to long-term pain

Traumatic events obviously entail experiencing intense emotional pain–sometimes accompanied by physical pain–at the time they occur and in the short-term which follows. Although this short-term suffering can be challenging to endure, taking the cognitive and behavioural steps in this article following the traumatic event facilitates healing so that you do not have to endure emotional pain on a long-term or permanent basis.

If you have experienced a traumatic event recently, you may find it helpful to work with a psychologist trained in trauma therapy who can help you to take the steps discussed in this article which facilitate healing to head off the development of PTSD. If you experienced one or more traumatic events some time ago and are still experiencing symptoms stemming from the event, you may be experiencing PTSD. In this case, a psychologist trained in trauma therapy can help you take the steps to heal from this disorder.

May you take the steps following a traumatic event to avert the onset of post-traumatic stress disorder,

Dr. Pat