Case History of PTSD and Trauma
These case-histories are mostly from people I have worked with over the years with some fictitious elements added or parts omitted, simply to highlight the mechanisms and dissociation processes of trauma.
– Car Accident
– Falling Accident
I’d consider surgery to be one of the medical wonders of this day and age. Unfortunately, as with many things, it has become big business. Rather than being carefully skeptical and hesitant about surgery, it has become the norm to undergo it, in some countries at least, even for minor issues that can easily be treated by non-invasive therapies.
John is a middle-aged man who has recently gone through an open-heart bypass surgical procedure. Full anesthetics has been administered and the operation itself has gone well. From John’s perspective however it is a different story. Towards the end of the operation John’s anesthetics has started to wear off. Although he doesn’t come round physically he has become conscious. The last 20 minutes of the operation, where they clean and stitch him up, he goes through agony. John doesn’t experience pain but is overwhelmed by feelings of helplessness as he is unable to move or let the medical staff know that he has become conscious. The experience leaves him traumatized. His sleep is, subsequently severely disturbed with repeated flashbacks of the alarming ‘wake up’ during surgery. His blood pressure remains high. He is very quickly snappy, agitated and irritated. When asked about it he admits that he is very angry with the medical staff for not acknowledging that something like this could happen, and for not administering the right dose of anesthetics. His wife says that sadly, John is not the same man that he used to be.
Ella is in her thirties, ambitious and active in life. On a wintry evening, while driving back home from work; she loses control of her car, while negotiating a bend in the road. The car spins and comes to a halt after it crashes into a tree. She’s taken to the hospital, unconscious, with fractured ribs, a torn spleen and concussion. Ella has no memory of the event after losing control of the car. However, months after the accident and her release from the hospital, she suffers from anxiety and fatigue accompanied by chronic pain. She manages to work only part-time but has forced herself to drive again.
Jane is married and has 2 children. Outwardly they seem to be a happy normal family. She seeks treatment as she has frequent outbursts of anger, often for little things and against her children. She also has difficulties with intimate contact with her husband and always needs some kind of background noise, like music or television, or some kind of occupation. As we progress our work it comes to light that Jane has been raped by a friend of the family at a young age. Her shame and pain about what happened is covered up by anger which expresses itself in her family surroundings.
Doug has fallen in the basement after having had a verbal fight with his partner. Though he hasn’t hurt his head too much he’d hurt his back and the stiffness and dull pain doesn’t go away even though it has been there for some time now. He continues to take prescription drugs for pain and inflammation which upset his digestion and makes him feel nausea from time to time. He blames himself angrily for having lost his footing. This is a clear case where the anger of an argument is coupled and projected onto the falling and is then internalized through self-reproach. The persistence of back-pain turns out to be the psycho-somatic holding on to anger. Although Doug doesn’t suffer the usual ptsd symptoms – still this is a post-traumatic stress condition!
Karen has lost her son in a motorcycle accident. She’s retired, widowed and lives on her own. She smokes heavily, suffers insomnia and admits that she is overcome by grief, feels often lonely and depressed. She is able to positively identify that her condition is related to the death of her son but is not able to let go of her attachment to him.
Kelly initially visits me to let me have a look at her little girl who is just a few weeks old. She is very concerned as the baby cries herself to exhaustion before succumbing to sleep. Doing the routine intake/checklist questions I discover that the birth has been anything but normal, as she had so wished for, and had turned into an emergency cesarean. The pregnancy had gone very well with the baby in the right position. She’d been brought to the hospital once the contractions had started. After some hours of labor, with very little cervix dilation, the doctor opts for emergency cesarean surgery, as the baby has descended and it has been stuck for too long with the head in the base of the mother’s pelvic. Kelly and her husband have no time to take in and consider the situation and went along with the decision of the doctor. Looking back she’d felt out of control and overwhelmed by the suddenness of the changed circumstances. She is severely frustrated with how things turned out and feels angry with the medical staff. Rationally she understands that the doctor did the right thing. Emotionally she feels a sense of helplessness for having had to give in to the ‘grilling rules’ of surgery and medical practice. Finally what emerges is that she has trouble accepting her child due to her desire for a natural birth and the outcome of a cesarean. Again the anger and resentment towards the medical intervention is masking her sense of helplessness and her frustration is coupled with and projected onto her non-acceptance of the child which results in the crying and misery of the little one.