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My Story: Part 1 by Kimberly Tyler
Thursday, June 7, 2007

I was diagnosed with Post Traumatic Stress Disorder (PTSD) when I was twenty-seven years old. I had been living with the untreated symptoms of PTSD for twenty-five years. I am currently thirty-nine years old, and have been in therapy for twelve.

PTSD is categorized under Anxiety Disorders in the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). PTSD occurs as a result of experiencing an event (or series of events) so severe or grave (or perceived as severe or grave) that an individual is incapable of processing the incident(s) psychologically. In other words, the usual methods of assimilating information are barred and an inability to fully express the emotional impact of the trauma occurs.

The above is only the most basic outline of the formation of PTSD. In biological terms, research shows that it is the amygdale in the brain that holds the ?emotional memory? of the traumatic event until it can be expressed declaratively in context. The lingering effect of not integrating the emotional experience of the trauma with the cognitive knowledge of the trauma is what leads to clinical diagnosis.

There is not a genetic predisposition for this disorder, nor is it a result of a pre-existing psychological condition or character trait of weakness or fragility. A diagnosis of PTSD occurs regardless of a person?s level of intelligence, and it is not a result of a lack of cognitive awareness of the event(s) itself. PTSD is an affective disorder. (It is important to note that not everyone who experiences trauma will develop PTSD.)

The symptoms of PTSD include anxiety, anxiety or panic attacks, depression, disassociation (separation of mind from physical body), hypervilgilence (high startle response), emotional numbness or tuning out, nightmares and flashbacks. Additional symptoms that may also arise are low self-esteem, a sense of worthlessness, perfectionism (or workaholism), lack of boundaries, an inability to trust oneself or others, an inability to adequately assess a situation for danger, and the capacity to be triggered. Being triggered is the terminology used to describe what occurs to the individual when a memory of any type associated with the traumatic event occurs in present time and causes the person to quickly retreat back to the helplessness of the moment of earlier trauma (this is not always a conscious reaction). A trigger can be just about anything: a person, a place, a smell, a sound, a situation, a touch, a phrase, a feeling, an object, or a sensation: basically, anything that suggests or resembles the traumatic event itself.

My initiation into PTSD began with sexual abuse. For five years, occurring on or around major holidays, I was either molested or raped by an uncle. This sexual assault began around the age of two and continued until the fourth of July when I was seven years old.

Early on with PTSD, coping skills and conditioned responses are set into motion to adapt. These early coping skills and manners of response ensure survival and are unconsciously occurring to the afflicted; as time continues, these coping skills very often become detrimental and the ability to achieve healthy interaction with others, and within oneself, may result. Appropriate therapeutic intervention is essential to understand how to recognize belief systems in play, coping skills utilized, and how far reaching and insinuating the trauma and resulting symptoms of PTSD are to the individual. Each person will respond best to individualized therapy tailored for their specific needs. Within my own time spent in therapy?over twelve years?it is only in hindsight that I may see the effectiveness of each therapist and treatment offered. I know that I, personally, came into therapy with a lot of varying issues. PTSD was the major underlying factor for me, but an alcoholic family environment also played a role. A lot of my initial time in therapy was focused solely on either the depression and anxiety or my belief systems and coping skills; I was very resistant to discuss the early abuse. I desperately wanted to move on without having these particular discussions. My thoughts ran something like: If it was terrifying once, it will be terrifying all over again. I will not survive the retelling.

In my experience, understanding the severity of PTSD and how therapy works to undo what was created in the wake of trauma was very difficult to comprehend. Rationally, it just did not make sense. At the onset of my own diagnosis, the fact that a horrific event could cause a ?gap? to be created between cognitive knowledge and affective (emotional) knowledge was elusive even to me. Prior to diagnosis, I had been living ?successfully? under the illusion of adaptive coping skills. Diagnosis for me occurred, I believe, only because these coping skills and my ability to keep myself on guard slowly began slipping away: First came the diagnosis of ovarian cancer; and, although the removal of the cancerous tissue was successful, it was followed hard on by new physical problems created by the surgery, the diagnosis of endometriosis, two additional corrective surgeries, the onset of myofascial pain syndrome in my pelvis and then body-wide fibromyalgia. The first two surgeries occurred within eight months of the other, and the third a year and a half later. Recovery was slow, as I was unable to tolerate painkillers, and alternative forms of physical therapy were needful. It wasn?t until after the second surgery (after losing my job, losing my apartment, running through my savings, going into medical debt, and moving across the country to live with my parents again) that I finally asked the question of a complete stranger over a crisis hotline if the abuse I experienced early on in childhood could have a lasting effect on a person. I was a deeply troubled woman, and I thought I was creating all my problems myself. I called the hotline only because the flashbacks were extreme and I was thoroughly exhausted?physically and emotionally. Once this phone call was placed I was referred to a specialist. I was twenty-seven years old.


Re: My Story: Part I - Kimberly Tyler (Blog)

My Story: Part II Diagnosis and Understanding

by Kimberly Tyler
Friday, June 15, 2007

Prior to diagnosis, I was living "successfully" under the illusion of adaptive coping skills. I was not happy or calm or peaceful, but I felt like I was at least able to pull off this false impression until I fell apart from exhaustion.

For my first twenty-five years, I was experiencing undiagnosed anxiety as well as depression, thoughts of suicide or desiring to simply disappear, disassociation (separation of emotions/mind from the motions of my physical body), hypervilgilence (heightened startle response), nightmares, flashbacks, emotional numbing, the need to isolate, anxiety attacks that brought me to the ER, a sense of perfectionism that drove my college friends up the wall, non-existent self-esteem, workaholism, and a very bad risk assessment system.

At the initial therapy session, I was given my first explanation of PTSD. Diagnosis came next. In these early therapy sessions, I began to understand the nature of PTSD as well as the depression and anxiety disorders (connecting back to the initial trauma). Apparently, my behavior, patterns, and coping skills were predictable. My belief that I was an inherently bad person was common in others with experiences like mine. It was as if the therapist was putting a template over my life, and I fit squarely inside.

I required several months of therapy to even begin to comprehend the magnitude of information I was receiving. On the one hand, I heard what was being said and logically understood the issues that would generate a condition of PTSD; on the other hand, accepting this diagnosis as it pertained to me was not so easy. It wasn’t that I was skeptical about the seriousness of this mental health condition; rather, I resisted the concept that such a serious matter applied to me.

Up until this point, I did not know that my response to my early years was a "normal" reaction. All the dissociating I did had everything to do with survival, particularly as my abuse began so early in life, and continued for five years. Even one experience would have been enough to set all of this in motion. It was not a matter of the extent of the abuse, or the number of times, but that I was not equipped to handle the experience emotionally, and my brain worked in a way that would protect me.

With the support of various therapists, I have been able to unravel, as well as identify, the majority of the emotions of these early experiences as well as how the resulting behaviors and beliefs show up in my daily life. Integrating these experiences with their emotional counterparts is a safe and effective form of therapy for me. As I am able to identify the emotions that go with the trauma experiences, I am then able to work through their effects on my wellbeing. Paramount to my recovery is mutual trust and respect between the therapist and me.

I was initially ashamed and embarrassed at the snarl I had made of my life. Even with therapists telling me the abuse and the resulting effects were not my fault, it took me a lot of therapy to actually begin to believe it. Having patience with myself did not come easily, nor did loving myself; only through the care and expertise of various therapists have these abilities finally come about. Although I was quite daunted at the onset of diagnosis, over time, I came to understand the benefits of therapy. I also came to understand the benefits of medication to enable me to participate in therapy. (I resisted medication for the first year due to my own rationale that medication equated with failure for my inability to overcome my own issues without a "crutch". I soon enough discovered that medication was not a panacea, but rather a necessity to reset my brain chemistry.) There were a lot of layers to get through, but I have remained committed through the process. Achieving healthy and balanced living is my primary agenda; to do so has required education, various therapists and treatments, group therapy and medication.
The one misnomer I have been told about PTSD is that it is not curable. I learned this early in therapy, and considered myself doomed to be at the mercy of the PTSD symptoms—particularly, the triggers. What I have continued to learn is that although there may not be a guaranteed cure, there is hope for the PTSD not to run my life. I wish I had been told earlier that recovery was possible.

With or without treatment, triggers can still throw me off my footing so fast. In a single moment of being triggered, all I know and have learned can be undone—like blowing down a house of cards. It is a very helpless feeling. I can be emotionally balanced with the depression and anxiety, physically strong and productive, and I can still be triggered; when triggered, I immediately begin to pull back and disassociate. I am staring at all that is occurring around me, very unsure of what to do. I am always terribly frightened and am unable to react the way I would prefer. When I disassociate, I feel as if I am behind a glass wall: I am clear and cognizant, I am just unable to emotionally engage and there are tears streaming down my face or I am simply a blank stare (sometimes both). I am waiting for safety to come and feel that sense of relief. When I disassociate, I physically feel paralyzed and all goes into slow motion.

Sometimes a trigger will set off an anxiety attack, other times a trigger will leave me frozen where I stand. Once triggered, I experience flashbacks to earlier traumas. My anxiety is off the charts and I can not cope. The depression is overwhelming, and intensive therapy is required to bring me to stabilization.

With increased wellness and specialized therapy, my ability continues to improve to prevent complete disassociation when triggered. If I can prevent complete disassociation from occurring by becoming more consciously aware of when it is happening, I will not spiral up or down with crashing speed if I immediately put into practice different techniques to keep me mindfully present. I am still in practice on this issue, but I am improving.

jo will

Oh MY!!!!! I am extremely breathless and blown away!! I think I am in shock!! I am crying as I right this!!
I cannot believe, but I do know and feel exactly the story Kim has told. I cannot believe how this story fits exactly into my own. I have never come across someone with the same particulars as myself in group therapy. I can relate and feel the need to reach out to Kim. I am proud of her and all she has accomplished.
I have not been on here in awhile and came back to check on things. I am just speechless...
Thank you for this story!! I no longer feel alone!!
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