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The ptsd cup explanation

Nearly a decade ago (2006) I wrote The PTSD Cup Explanation, a simple view of how PTSD causes symptoms in day-to-day life. This article is an update to that original piece.

Regardless of the type of trauma endured, the PTSD Cup does not change, deviate or apply differently to your circumstance. The PTSD Cup is a basic representation of your capacity for tolerating stressors. As your cup fills, symptoms get worse. When your cup overflows, you may break down crying, become psychotic or manic, attempt to kill yourself, and many other possible outcomes.

The differences unique to each individual lay within their environment (exposure to daily life), their ability to manage stressors, and finally, the actions that occur upon overflow.

One example of this uniqueness is seen in a high functioning PTSD sufferer. They have the same cup as any PTSD sufferer; however, they may differ in their ability to manage work stressors. Their work may make them feel positive, good about themselves. Another area of their life may suffer, say... relationships. They feel good about their work, but a partner or friendship may cause stress they can't reconcile.


The above image contains one cup, through three stages. There is a fourth stage to the PTSD cup, applicable only to combat veterans. I will discuss that briefly at the end.


Each block within a cup is variable. Simply put, each block will move up or down with some predictability, based on your daily activities, how you feel, what you're thinking, and so forth.

Cup One (Left Cup)

Many people think good things don't cause stress. Well, they do! The difference is the net effect. When you get out of bed, have a shower, brush your teeth, comb your hair, drink your morning coffee, and so forth, you feel good after performing these daily tasks. This is called "good stress," and creates positive emotion.

These menial, often disregarded, tasks help reduce your bad stress. Positive and joyous interactions and feelings continuously counter negative stressors.

Cup Two (Middle Cup)

Here we've introduced bad stress. Bad stress is just that -- negative interactions that create negative emotion.

This cup represents everyone without PTSD. You can see how much room there is in that cup. Lots! People without PTSD have the capacity to deal with daily stressors. They balance their day with good stressors, and rarely overflow their cup.

When you go to sleep, sleep reduces negative stressors from your cup so you start the next day fresh. When a person ruminates overnight, they may awake with bad stress in their cup. An example is a teenager giving a presentation. They awake tired, grumpy and partially stressed, thinking they aren't prepared, or their presentation lacks something. When they deliver their presentation without incident, and obtain positive feedback, this creates positive emotion and removes the negative stress. That night, they will sleep better and remove all their remaining bad stress.

Think broadly when applying this to yourself.

Cup Three (Right Cup)

Now we introduce PTSD. The problem is that we still have the same good and bad stressors, but without the same overall capacity as a non-PTSD sufferer.

Who thought good stress could make you overflow? With PTSD, it can do just that - not to mention what bad stressors can do.

Think about it like this -- the reason you don't want to get out of bed, have a shower, do anything at all, is that your cup is full. Your brain tells you to stay in bed, otherwise you overflow. Place your own situation here; the model does not change.

The Obvious Question

It's easy to talk about a problem, ignoring its solution -- but this solution isn't rocket science.

Trauma is the problem. Trauma is full of bad stressors. Work through trauma and you reduce bad stressors. Make life changes where you're negatively stressed. Reduce your traumatic effect, you reduce your PTSD symptoms.

Depending on your level of trauma, this may take months, a year, or many years.

The Fourth Cup (Military Training)

The cup I didn't show is specific to those who have deployed within an operational zone where military training kept them alive. Add an additional block to the cup, call it "training." Now you have good and bad stress, PTSD, and training.

The above cup has little capacity already, so how does training fit? Well, it's squeezed and compresses all blocks. Part of the military training block is a lid with button. This lid and button is effective within a military environment, the cup is full, compresses, an order is given, the soldier explodes against the enemy.

Notice how overflow has been removed from the below image? Combat veterans have a lid and button. Everything builds-up, compresses, then explodes -- instead of overflowing.


This is useful in active service, but not very effective in regular society. The military used to control the button, for the most part; post-service, PTSD is in control. The cup can only take so much pressure before the button fails. With a constantly full and compressed cup, all it takes is for the toilet roll to be around the wrong way -- the veteran explodes at someone (spouse or child), or something (wall or door), and only then will the pressure be released.

This is behavioral conditioning that helped the veteran remain alive. When differentiating between a combat zone and civilian life -- the brain knows the difference, but still functions on instinct, in the ways that have been proven effective in order to stay alive.

The most obvious question is, why do combat veterans have this extra block and not all military?

When military are trained, they're trained to have some PTSD symptoms, especially Army, Marines, or Special Forces-type training. Hyper-vigilance, startle response, alertness -- these are all symptoms of PTSD. When leaving the military and without combat, this training quickly subsides and the person reverts to civilian behavior.

Once a soldier enters a combat zone the brain accepts that this training saved their life, or their buddy's life. This makes training a priority for survival. The training becomes instinctual, regardless of whether they are in a combat zone, or not. This block is one of the most difficult to lessen, and typically only diminishes from a combination of time, and decreasing the traumatic effect.


The PTSD cup is a simple representation that defines your internal stress. We all react differently when our cup overflows. Some may cry, some may dissociate, some may become angry. A soldier may explode with horrific rage and violence. To control the effect is to minimize the cup's content, where possible.

I might wish we could remove the PTSD block -- that would be ideal. Unfortunately, there is no cure. So, work with what is within your reach. What immediate stressors can you reduce or remove with the least amount of change? What did you used to do that made you happy? Remember, good stress counters bad stress, so do things that make you happy to create capacity within your cup.

Remember that this is, more often than not, a long-term process. Managing your internal stressor cup takes time, education, and skills learned for future improvement.
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Cptsd and childhood survivors like myself are trained to squash stress and our emotions until it also explodes in order to survive
so I guess it won’t just be military
Hi David W.

I think a lot of people (myself included) consider police/fire/EMT etc to be paramilitary and therefore included in this. I’m no clinician, I’m just a person who likes my free county… and I consider first responders “setvants” who give service to this country just as vets have.

Just my 3-cents;)
Thank you Anthony for the article with metaphor.
I’ve been abused …earliest remembrance is 2. My whole life I’ve been tortured in all manners of abuse. CPTSD is diagnosis. I’m 49 and have shut down. The abuse continues. Suicide I did, and somehow survived. I’m not dramatic, scared that I should even be putting this on here. My first time. I can’t even get through my settings for joining the site.
I’m on medication, under psychiatric care, the whole thing.
I don’t believe they’re is not enough of anything to help.
Please don’t be scared for putting your thoughts on here, thats what this site is for. Just reading your little blurb tells me you’ve been through so much. Its really nice to see you getting help but I just want to say that what you said about there not being enough of anything to help you- I don’t think thats true. I really do think there are so many things out there that can help you, even if they may seem little. You trying to join this site was one of them. Just seeing other people’s experiences and pain can help connect ours to theirs and help us through. I really do believe theres enough of everything to help you. I really hope you read this and if theres anyone else reading I do believe the same for you.
That button metaphor really opened my eyes. I always read about people overflowing and exploding and it didnt click for me. In nearly a decade of suffering from ptsd, I can only recall a handfull of times when I broke down; always with tears never anger. By and large the things that terrify me the most, are not the things I do when I lose control. Even my twisted mind can only blame me so much for crying. The things that stops me from living a normal life are the things I did when I was IN control of the situation. Crying because you are depressed is normal. Demanding that loved ones behave in the manner I prescribe, or the enemy will kill us, that’s the stuff that keeps me up at night. I see the look on peoples faces. For me its just another day at the office. For everyone else it looks like theyr’e trapped in a room with a killbot…with a broken switch
Now I understand this and what’s actually going on inside of me. This has really helped me. This explains why I am doing the right and healthy thing when I limit my time and any conversation with those who have always been toxic, neurotic or the damaging stressors in my life since I was born. This is why my husband will say that I am a different person when I’m not around them. Sad, but it is my reality. My breakdowns were the result of just way too much damage without any relief to rest and heal. I have to take care of myself, my health. Like the Bible says, guard your heart and your mind. I’ve turned to the wrong people for support and it was further damaging. I must face what works individually for me and not compare my life with others like a meaduring stick of success. Its actually a very wrong and stupid thing tp do. I do matter, and what helps me is just as important as it is for everybody else. I am not less than those who have hurt me. I do matter. Thank you. This has really helped and it’s easy to visualize and that always helps me understand a lot better. May God bless you, richly ❤
This explains a lot. I already had this idea of a stress bucket in my head. I really think my brain is different to other people, without PTSD and i really am trying to understand what is going on? I dont work in emergency services, but in homeless sector with families, refugees, addiction, mental health etc and sometimes the chaos is almost addictive, the adrenaline rush, and I can manage a big caseload, hardly supervised, but then one tiny irrelevant thing occurs and I’ve lost the plot… And can end up forced into sectioned. They still allow me back, and I’m more aware now.
From the sounds of it @BM2A, you just need to teach yourself to recognise that point where you’re about to explode and lose it… walk away for a day or two at that point, then return, all without losing it to begin with.
I wasn’t looking for advice. I think that reply is a little bit patronising. I have a lot of symptoms that I’m managing, I’m on meds, I’m in therapy, ive worked hard to get to this point. Ive been through some really traumatic sexual violence. I just meant the article the PTSD cup makes sense to me.
i grew up in a household with four children. I was trained not to bother anyone, that my opinion didn’t matter. Growing up, my father would tell me I did perceive things as they really were. I guess this was his way of gaslighting me. Now I am married to a spouse who could care less about the way I see things and doesn’t listen to me much of the time. So neither do my kids, now.
That's a really good article and I can relate to it alot. Good luck to everyone who is affected by this. Managing Ptsd is a job in itself.