I am quite new here. I liked this article very much. Thank you for sharing. At one point I asked my now ex-Therapist (didn't go well) how much he actually knows about what physically happens in the brain with people that have PTSD. He honestly said he doesn't know much about that, but that he also doesn't focus on this kind of thing. My question is: how can one treat something of which you don't know how it works on a biological level? OK, many things we don't know, but still want to make people to get better, so we just try blindly. What else is there to do? However, there is so much to know about brain function these days..... Maybe I should send the article to my ex T...:)
What is missing in this article though is an explanation of how these changes in the brain take place. What is the mechanism? They call it "injury" like so many others, and I agree that this is fair, but what is actually happening? Did the nerves not survive doing overtime, did they got overheated or torn, like what I would associate with the word "injury"? The problem I have with this "injury" and "healing" thing is that it sounds like you just put some antibiotics on your burn, keep it nicely clean and cover it up, and it will be just fine within a couple of weeks just by itself. So, don't worry about it, our body knows how to heal itself just fine. This doesn't work for PTSD. OK, somebody could say this "injury" was so dramatic that it caused permanent damage, but how did that damage come about on a biological level? The answer is actually in the article, but hidden -likely for good reason. It says that PTSD means that the way how neurons/brain parts interact with one another changed (semi) permanently. I think the problem with how this actually happens, what re-dues that, and the word that describes that, is that this is in the general public associated with wanting, doing it consciously and if we fail, we brought that up on our self. However, this is false in this case because it needs to happen on the level of the autonomous part of our nervous system which fortunately is build to refuse to answer to reason and wanting. Imagine we could easily make us not automatically jumping out of the way when a car misses us walking on the sidewalk while getting into the driveway just by reasoning and wanting..... A functional "auto-drive" is vital, without it we wouldn't exist and it is fortunately not meant to be screwed with by consciousness for our own damn good. PTSD means this live saving auto-drive is messed up and stuck at high alert and alarm 24/7 instead of only switching briefly on for a couple minutes or maybe a couple hours in an event of a "real" threat, as it should - if it learned correctly when we are save and when we are in danger. I can read real scientific articles, know about how it works on a biological level (part of my job), and still have trouble getting my brain to behave reasonable....though, I get really frustrated by therapists that now less than I do (and I don't know much) and thus are the absolute "dream" patient and people telling me that I just need to "heal".
By the way, these changes are likely to happen in particular situations, but from a mechanistic perspective, its not situational because stress is simply stress for our autonomous nervous system regardless of the actual situation (read the article). It is rather stress level and duration related, so I agree, PTSD can happen in any extreme stress/long lasting stress situation, this is logic knowing the mechanism. It just happens to be that facing death or seeing someone being killed is a case of such extreme stress.....and that humans generally have the inability to withstand having to put labels onto everything.