Treating PTSD is easier than coming up with an objective definition
of abuse.Anythingis easier than that. By far the most common cases of
PTSD relate to recent dangerous incidents like accidents or injuries. The
delayed kind is extremely rare.
As with all fear disorders, therapy for PTSD involves helping people
approach what they fear and situations that remind them of what they fear.
People need to talk about their painful experiences until they hurt less. As
you can imagine, some kinds of talk make them hurt more. Your job will
be to listen to the talk that helps and do your best to keep from reinforcing
the kind that hurts.
The Physiology of Fear
The physical component of all fear disorders is, of course, the fight or
flight response mediated by the sympathetic nervous system. The response
may start in the amygdala or perhaps in the basal ganglia, but since it
jumps from one area of the brain to another at warp speed, the Heisenberg
uncertainty principle applies. If you pay too much attention to where it
starts, you may not notice where it’s going and what it’s doing.
Though there is no definitive test, it’s likely that people who develop fear
disorders have an abnormally strong fight or flight response. They’re called
autonomic hyper-responders. The word “autonomic” in this case means “sym-
pathetic.” It may be that these people’s genetic makeup is different, causing a
more intense reaction. We’re not talking about a few squirts of adrenaline here,
but in some cases a biochemical torrent that affects every part of the body.
An important element in the treatment of all fear disorders is under-
standing the physiology of fear well enough to know that what it feels like
is not necessarily what it is.
PANIC, EXPLOSION INTO OVERWHELMING FEAR. It is unbelievable to
people who have panic attacks that their very real agony could be caused by
something so insubstantial as fear. They often think they have a serious phys-
ical disease. They may, but it’s usually not the one they believe they have.
You can’t blame them for the mistake. Their bodies tell them
they’re about to die, or are at least very sick. The symptoms of panic attacks
are physical. Sweating, tingling, faintness, dizziness, nausea, chest pain,
Explosions into Fear ❧ 73