Case Studies PTSD and Post-Traumatic Stress Disorder

These case studies of PTSD 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.

- Surgery
- Car accident
- Rape
- Falling accident
- Grief/Bereavement
- Birth/cesarean

Case Study PTSD #1: Surgery

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 recently went through an open-heart bypass procedure. Full anesthetic was administered, and the operation itself went well. From John’s perspective, however, it is a different story. Towards the end of the operation, John’s anesthetic started to wear off. Although he wasn't able to feel physical pain, he did regain consciousness. The last 20 minutes of the operation, when they cleaned and stitched him up, he went through agony. John didn't experience pain, but was overwhelmed by feelings of helplessness as he was unable to move or let the medical staff know that he had become conscious.

The experience left him traumatized. Subsequently, his sleep was severely disturbed with repeated flashbacks of the alarming "wake up" during surgery. His blood pressure remained high. He was very snappy, agitated, and irritated. When asked about it, he admitted that he was very angry with the medical staff for not acknowledging that something like this could happen, and for not administering the right dose of anesthetic. His wife said that sadly, John is not the same man that he used to be.

Case Study PTSD #2: Car Accident

Ella is in her thirties, ambitious and active in life. On a wintry evening, while driving back home from work, she lost control of her car while negotiating a bend in the road. The car spun and came to a halt after it crashed into a tree. She was taken to the hospital, unconscious, with fractured ribs, a torn spleen, and concussion. Ella had no memory of the event after losing control of the car; however, months after the accident and her release from the hospital, she suffered from anxiety and fatigue accompanied by chronic pain. She managed to work only part time, but forced herself to drive again.

Case Study PTSD #3: Rape

Jane is married and has two children. Outwardly they seem to be a happy, normal family. She sought treatment as she had frequent outbursts of anger, often for little things and against her children. She also had difficulties with intimate contact with her husband, and always needed some kind of background noise, like music or television, or some kind of occupation. As we progressed in our work, it came to light that Jane was raped by a friend of the family at a young age. Her shame and pain about what happened was covered up by anger, which expressed itself in her family surroundings.

Case Study PTSD #4: Falling Accident

Doug fell in the basement after having a verbal fight with his partner. Though he didn't hurt his head, he’d hurt his back and the stiffness and dull pain didn't go away even though it had been there for some time now. He continued to take prescription drugs for pain and inflammation, which upset his digestion and made him feel nausea from time to time. He angrily blamed himself for losing his footing. This is a clear case where the anger of an argument was coupled with and projected onto the fall, and was then internalized through self-reproach. The persistence of back pain turned out to be the psychosomatic holding on to anger. Although Doug didn't suffer the usual PTSD symptoms, this is still a post-traumatic stress condition!

Case Study PTSD #5: Grief/Bereavement

Karen lost her son in a motorcycle accident. She’s retired, widowed, and lived on her own. She smoked heavily, suffered from insomnia, and admitted that she was overcome by grief, and often felt lonely and depressed. She was able to positively identify that her condition was related to the death of her son, but was not able to let go of her attachment to him.

Case Study PTSD #6: Cesarean Birth

Kelly initially visited me to let me have a look at her little girl, who was just a few weeks old. She was very concerned because the baby cried herself to exhaustion before succumbing to sleep. Doing the routine intake/checklist questions I discovered that the birth had been anything but normal, and had turned into an emergency cesarean.

The pregnancy had gone very well with the baby in the right position. Karen was taken to the hospital once the contractions had started. After some hours of labor, with very little cervix dilation, the doctor opted for emergency cesarean surgery, as the baby had descended and it had been stuck for too long with the head in the base of the mother’s pelvis. Kelly and her husband had no time to take in and consider the situation, and went along with the decision of the doctor.

Dealing with Helplessness

Looking back, Karen realized that she felt out of control and overwhelmed by the suddenness of the changed circumstances. She was severely frustrated with how things turned out, and felt angry with the medical staff. Rationally, she understood that the doctor did the right thing. Emotionally, she felt a sense of helplessness for having had to give in to the "rules" of surgery and medical practice. Finally, what emerged was that she had trouble accepting her child due to her desire for a natural birth; again, the anger and resentment towards the medical intervention were masking her sense of helplessness, and her frustration was coupled with and projected onto her non-acceptance of the child, which resulted in the crying and misery of the little one.