b. Efforts to avoid activities, places, or people that arouse
recollections of the trauma.
c. Inability to recall an important aspect of the trauma.
d. Markedly diminished interest or participation in significant
activities.
e. Feeling of detachment or estrangement from others.
f. Restricted range of affect (e.g., unable to have loving feelings).
g. Sense of a foreshortened future (e.g., does not expect to
have a career, marriage, children, or a normal life span).- Persistent symptoms of increased arousal (not present before
the trauma), as indicated by two (or more) of the following:
a. Difficulty falling or staying asleep.
b. Irritability or outbursts of anger.
c. Difficulty concentrating.
d. Hypervigilance.
e. Exaggerated startle response.
In post-traumatic stress disorder, the fight or flight response is switched
on in reaction to a real threat to the life or the psyche, and doesn’t
switch off. A part of the person’s mind stays stuck in crisis mode.
Trish became a different person after a pickup truck ran a red
light and smashed into her car. Nothing in her body got broken,
thank God, but something cracked in her mind. She’s too fright-
ened to drive; even the sound of traffic makes her jumpy. Dur-
ing the day she feels numb and distant. At night she dreams that
the pickup is coming at her but she just can’t move herself out
of the way. She wakes up screaming.Awake and asleep, people with PTSD are perpetually on the alert for
danger. They tend to be on edge all the time, easily frightened or irritated.
Their physical startle responses are far more intense than normal. They
avoid situations that remind them of the dangerous event. They tend to feel
worn out and numb. Much of their energy is used up in the attempt to keep
themselves safe, though the danger that stalks them is only in their past.
So far, this description could, to a greater or lesser extent, apply to any-
body who has been through a frightening situation. To warrant a diagnosis
Explosions into Fear ❧ 71