Why Do Only Some Traumas Create Ptsd?

[anthony]

I wouldn't be so specific as to say families prime their children for PTSD, because that isn't quite factual. Sure, it has validity in cases, yet not in many others, as such would other specific aspects.

It would be far more accurate to say that environmental and behavioural factors play a significant role in the biological outcome for PTSD.

A person can have the most supportive, perfect, family possible - yet the individual just wants to get into trouble, hang around the wrong people and place themselves in a riskier group for abuse or susceptibility. You then have abusive families who create the problems.

Environment and behaviour = biological outcome (PTSD).

 

[LizardViolet]

This is a good question, and really interesting. @Tesseract has a big part of it.

- If you are helpless during the traumatic event, chances are higher that you'll develop symptoms.

- If you have little or no social support after the traumatic event, chances are higher you'll develop symptoms.

Resilience, as @Chava says, plays a role. Resilience is not something you decide to have, and if you don't have it, it's not a personality defect. Resilience includes social supports, but it's mainly developed in early childhood. If you're securely attached - you have an affectionate, responsive caregiver, you're comforted when you're in distress, you are touched - then you have the internal resources, literally, the brain chemistry and the capacity in your body systems to return to equilibrium after a stressful event. (If you suffered a big trauma, it may take a while, but you're more likely to eventually recover.) If you have abusive or neglectful caregivers, or you suffer a loss or other traumatic event in early childhood, a later traumatic event is much more likely to lead to symptoms because you have less resilience.

@anthony notes that there are people who come out of "perfect" families who engage in risky behavior. I'd argue that (a) they might not be as perfect as they appear, or (b) that there was some single traumatic event in early childhood (rather than ongoing abuse or neglect) that caused a psychic wound. There is also some current research about what's called epigenetic effects - those are traits that are actually acquired by a parent or grandparent from environmental factors, which are transmitted to you the child or grandchild. The biology of epigenetics is pretty clear, and there is some evidence of epigenetic tendencies toward post-traumatic symptoms in the children and grandchildren of, for example, Holocaust survivors. There's also evidence of epigenetic effects of trauma in at least one rat study. So you might have a perfect childhood, but you've got some brain chemistry that makes you more vulnerable because of trauma suffered by a parent or grandparent.

I should note that there is something called trauma first aid. Peter Levine discusses it in one of his books. In In An Unspoken Voice, he relates his experience of being a pedestrian hit by a car and how he discharged the traumatic energy afterward, in the presence of a supportive witness. He was able to recover from the event and did not develop PTSD.

 

[Catlynn]

If you're going by the DSM definition of what trauma is then there are a lot of people out there that have just had a bad day and don't really have PTSD. My personal opinion is anyone experiencing a traumatic or horrific life altering event cannot help but experience PTSD on some level.

 

[Chava]

Resilience is not something you decide to have, and if you don't have it, it's not a personality defect. Resilience includes social supports, but it's mainly developed in early childhood.

Agree. I manage many kinds of stress really well (typical "good" stressors like deadlines and high expectations at work, etc) but for my emotional world, physical health stuff, or reaching out for help....it's like I don't even have the language for it. Very little tolerance or easy ways out. Those stresses just get stuck somewhere if I can't numb them away. Slowly trying to re-work some of this through therapy.

 

[Friday]

@anthony notes that there are people who come out of "perfect" families who engage in risky behavior. I'd argue that (a) they might not be as perfect as they appear, or (b) that there was some single traumatic event in early childhood (rather than ongoing abuse or neglect) that caused a psychic wound. There is also some current research about what's called epigenetic effects - those are traits that are actually acquired by a parent or grandparent from environmental factors, which are transmitted to you the child or grandchild. The biology of epigenetics is pretty clear, and there is some evidence of epigenetic tendencies toward post-traumatic symptoms in the children and grandchildren of, for example, Holocaust survivors. There's also evidence of epigenetic effects of trauma in at least one rat study. So you might have a perfect childhood, but you've got some brain chemistry that makes you more vulnerable because of trauma suffered by a parent or grandparent.

If childhood stuff ever becomes required for PTSD... Then I would no longer qualify. Nor a lot of vets I know. Whether we were wildchilds or not.

I worry that this is the tail wagging the dog in some ways.

Helluva lot of hard childhoods in the military. Military is one of the IMO best ways on up and out of a bad situation... Whether it's abuse, poverty, lack or skills or education... And a whole lot of people use it as an up and out. But there's also a lot of good childhoods. People who aren't serving to escape, but for a multitude of other reasons. At least anecdotally, there was not however, any kind of line between who got PTSD or not. Sure, people could be lying about good childhoods from loving homes (regardless of socioeconomic status and future prospects)... But since I'm not? And I've met & seen my friends with their families? I'm disinclined to think that there must be abuse or anything else lurking somewhere in someone's past to prequalify or prime them for PTSD.

As far as epigenetics goes... Nature v nurture is a 3 way debate in Science that's been around for half of forever, and is likely to continue for just as long, lol.

But same as the steadfast refusal to believe PTSD really can happen to anyone (which, granted, may not be true) but has to have some kind of childhood link no matter what the person themselves says... Epigenetics feels like it's grasping at straws in this situation. Mostly because I would be surprised to find anyone on the planet who comes from any kind of family tree completely devoid of trauma for more than a generation or two. And I wouldn't be unsurprised to find the same results (zip, nada, zilch) even restricting it to a generation or two.

I could be wrong, often am, just my thoughts on it.

 

[moonbeam]

My personal opinion is anyone experiencing a traumatic or horrific life altering event cannot help but experience PTSD on some level.

I disagree. Someone who has survived a traumatic event can have post trauma symptoms (understandably) and then recover just fine. There is a huge difference between feeling symptoms post event and developing PTSD.

Getting dumped, getting cheated on, getting let go from work are all examples of life changing events that can feel like a huge deal. And understandably so. Its reasonable to feel strong emotions, depression, anxiety about being in future relationships, etc. Once burned, twice shy. But that doesn't mean they have PTSD. And unless it included things like violence, being held against their will, etc. It really doesn't qualify because it wouldn't have ilicited a fight or flight or freeze response.

Additionally I think the line does need to be drawn somewhere or else everyone will have PTSD. The mental health community has to try to differentiate between what is a normative response to a traumatic event and what is someone stuck post-trauma (PTSD).
Criteria A is important but its only one criteria as well so surviving a criteria A event(s) isn't grounds alone. They still also have to meet criteria B-H.

 

[anthony]

My personal opinion is anyone experiencing a traumatic or horrific life altering event cannot help but experience PTSD on some level.

The problem with that opinion though, is that you're blanketing everything traumatic with PTSD, and discarding there is a difference between your version, being post traumatic stress (PTS), and then the disorder variant, post traumatic stress disorder (PTSD).

They're not the same thing.