Many trauma survivors, regardless of the specific nature of their trauma, go on to suffer PTSD in isolation and in silence. And, this can make the suffering worse.
If the initial trauma included physical injury or wound, then long after the actual event, long after the injury or wound has healed and is no longer obvious or physically debilitating, the survivor may still continue to suffer in silence.
Even in cases of amputation, burns, and obvious scarring, there often comes a time where society determines that the person is no longer on the medical critical list and allows their attention to go elsewhere. In the case of triage medicine this is required; however, I am talking about post-triage after the initial medical situation has been assessed and the patient saved or stabilized.
Essentially, society takes its eye off the ball. When it comes to treating obvious, visible, wounds, we do a pretty good job. But when it comes to treating invisible wounds, such as PTSD or depression, we are often blind.
After the diverse challenges of physical trauma, the immediate healing, the physical therapy, have been met, families, churches, and other institutions sometimes believe that all the hard work is completed and they no longer need to pay close attention. (This is not unlike how the US ejected the Taliban out of most of Afghanistan and then took their eye off the ball and now we’re fighting the Taliban yet again for the same ground and the same population. One also finds this reminiscent of how the US invasion of Iraq went fairly smooth through the combat phase, but there was no successful plan on how to administer Iraq in a way that created peace. For those playing the home version, yes, healing is political. So is theology.)
We are pretty good at triage medicine. We have yet quite a bit to learn on how to help people be at peace given their injuries or wounds.
Survivors may learn how to function without one of our limbs and learn how to tolerate it when people blanch away from our physical appearance and/or our debilitated state.
When we are off the critical list most people seem to think that our suffering is over. In many ways a more persistent form of suffering begins: we suffer in silence. The suffering and isolation in silence, unrecognized by others, sharply decreases any possibility of our living in peace.
When the physical/critical survival point is behind us we will continue to suffer.
Regardless of how many people are around us, if we walk in a crowd, whether we sit in the bleachers or in a crowded classroom, or in a pew at church, many will not notice (nor care) that we continue to suffer at a deeper level than just the physical level.
Bonus Points: We Get To Suffer In Silence!
We recall that one of PTSD’s goals is to isolate us. Given the public stigma about PTSD, the fact that it can hurt one’s career, that many people will deny that PTSD even exists, makes it harder for us to acknowledge our own PTSD and take steps to preserve our life and our healthy relationships.
When we isolate ourselves our risk factors go up.
Sometimes our experience of other people who do not, or will not, understand our ongoing PTSD suffering, encourages us to withdraw.
This can be a delicate line for us to tread.
There are times we need to withdraw because people are so toxic and they make our situation worse.
Sometimes we may withdraw out of the fear or certain knowledge that we may say or do something we will regret because toxic individuals have rubbed us so raw.
This withdrawal to either protect ourselves or to protect others can at times be the right thing to do. But it carries risks as well. Too much withdrawal can damage our healthy relationships. Too much withdrawal can shut down effective communication and caring. We are not called to become hermits.
It is a fine line to distinguish, in terms of our PTSD, when we need to back away from societal interactions.
Like so many things involving PTSD we must do frequent self-assessment as to how we are doing.
We need to daily ascertain how vulnerable we are to our particular triggers. We need to understand our current ability to put up with society’s dickweeds (and do please notice that I use the word “society” in a sentence).
All too often our sense of vulnerability turns us into recluses, into hermits. Given that PTSD will amplify feelings of fear, agoraphobia, anxiety, vulnerability, and even guilt, we can find plenty of good reasons to not go out and interact with other people.
I’m not saying that we should always go out no matter what, or that we should blithely put up with people’s ignorance about PTSD in general, or about our own ongoing suffering in particular. Sometimes, avoiding morons is a good thing.
And yet, in spite of all the good reasons that sometimes exist to stay home and turn the ringer off the phone, PTSD-based isolation carries significant risks.
When we are in isolation, physical and/or psychological, we are more prone to lose hope.
If we lose hope we are more prone to engage in negative PTSD coping behaviors, such as too much alcohol, self-medication with legal or illegal drugs, pornography, or watching daytime television. These activities go up when our self-esteem and sense of hope goes down.
If we lose hope we are more prone to self-harm.
So What Is There To Do?
We acknowledge that there are those people out there who just don’t want to know. It is important to be realistic and know that it is sometimes beyond our ability to help others be compassionate. When we understand this we reduce the risk of opening up our vulnerabilities to people who will only sneer at them.
Recognize We Are Never Truly Alone
I have an app on one of my electronic gizmos that includes the Office of Prayer, a schedule of prayer and scripture readings throughout the different hours of the day. “Praying the Office” is a practice that dates back to early Christianity and has continued up to the present time.
These prayer and scripture sessions can be done in community with other like-minded people. They can also be done when no one else is around. But even if I am physically by myself and I am praying, then I know that I am not truly alone. The app on my gizmo will even tell me how many other people around the globe are currently “Praying the Office.”
The Gospel of Matthew (18:20) mentions that wherever two or three are gathered in my name (meaning Jesus’ name), that Jesus is himself among them. This is important for people who suffer with PTSD. Even though PTSD wants to isolate us, cause us to lose hope, and then kill us, we can overcome this because we know we are never truly 100% alone. So while we may look to be physically alone, we are not completely alone. We are in a community of suffering.
It is easier to endure suffering if we can find some meaning and/or if we are not suffering completely alone. One of the points that I’m trying to make in this long ramble of words is that we need not give up hope. Why? Because we are never truly alone.
Your suffering is real and it is valid. It is by no means an easy journey to travel. Many will throw obstacles in our path, out of purpose or out of ignorance, but we need not to give up the journey. Even if we are physically isolated, we share this journey with people who suffer as we do, who share the soul-wound of PTSD. From the outside it may look like we suffer alone and suffer in silence, yet we are in the vanguard of humanity.
And, lastly, it is crucial to know that we are able to heal to some degree,
that our current level of silent suffering does not have to be the new normal.
There is hope, there is life.
As long as you are here, hope remains, life remains.
You Have Value.
Semper Pax, Dr. Z