Sometimes, fear, loss, and guilt are so intense that they manifest in unpredictable panic, insomnia, and nightmares, intrusive and disturbing thoughts during the day, near amnesic repression of memories, increased isolation due to avoidance of triggering situations, physical tension and health problems, substance abuse or addiction, and a moderate to severe inability to maintain personal and professional relationships. Treatment of such intense symptoms requires regular time spent in a quiet, safe, calm environment with a nonjudgmental, gentle-yet-confident clinician who is trauma-trained, up to and including the study of conventional and alternative treatment protocols.
The humiliation felt by an embarrassed or endangered kid, the pain and terror felt by a victim of crime or abuse, the aggression and shame felt by a perpetrator of crime or abuse, the nightmare experiences of carnage and killing that military service members have witnessed or committed all can be approached and integrated. Traumatic events can be worked into a bearable if not meaningful part of one's story, catalyze profound insight and altruism, and become part of a life well lived. Without support, however, PTSD sufferers can fall into a counterproductive, even dissociative and dangerous, re-hashing and re-experiencing of their traumas. When this happens, the client feels as if a past trauma is inevitably recurring on some level in some measure, and such perseverance leads to further repression of difficult material and perpetuation of PTSD symptoms going forward.
The mechanism by which treatment protocols for PTSD succeed is in supporting the client’s ability to self-regulate and be present, and with reasonable physical calm, recall and thereby recast memories of a prior traumatic event. This isn’t as easy as it sounds. Current references to past horrific or humiliating events are overwhelming, obviously. And because the daily environment can trigger trauma memories without warning, the PTSD sufferer has become hypervigilant and skilled at avoiding any and all situations that might stir up that material. All this has likely led to extreme isolation and despair for the sufferer as well as the sufferer’s family, and it requires help to sort through.
Choosing to presently and calmly experience traumatic memories in therapy is a very difficult yet necessary step if trauma resolution is to occur -- it requires courage in a greater and different direction than most clients can imagine at first. And it's possible, even natural in the right conditions. Just as a serious unexpected/unwanted physical infection heals when obstacles to healing are removed and careful treatment is sought and accepted by brave patients from qualified health care providers, serious unexpected/unwanted psychological impairment following trauma will resolve once obstacles to healing are removed via the careful combined attention of a brave client and qualified therapist.