29. PTSD is a major recovery challenge

By Tom O'Connell

Post Traumatic Stress Disorder (PTSD) is a recovery factor that cannot be overemphasized. As people enter sobriety and abstain from alcohol and other drugs, those who have experienced sexual and/or physical abuse are likely to suffer from intrusive memories of traumatic events they thought they had dealt with and relegated to the past.

One of the finest explanations of this subject that I was ever exposed to came from an interview with Victor Pantesco, Ed.D., who was director of psychological services at Beech Hill Hospital in New Hampshire during the time I served as the hospital's communications consultant.

He explained to me that he had started a therapy group for men with PTSD because a short time into sobriety these patients were reporting that they were in danger of going crazy or relapsing into their former addiction because of emerging memories.

"I see this as a backlash to the anesthesia that alcohol and drugs had been performing on that early pain," he explained. "When you take away the anesthesia and leave a healthy mind-body system, the pain is then free to rise."

In group sessions, the recovering addicts learned about the impact of the abuse and trauma on their lives, became aware of the symptoms, and began to understand the relationship PTSD had with their chemical dependency. Some candidates for this therapy were identified in detox screening when they expressed concern about painful issues. Others were referred by counselors who assessed them during treatment.

"For many, it's their first opportunity to let this go," said Dr. Pantesco. "Being in a group with other men who have been similarly victimized is very powerful. Most of them have been very uncomfortable keeping secrets about their abuse or victimization." In group, they learned to talk about their experiences and in sobriety they could learn to come to terms with the painful past.

Pantesco said, "Often, men seem to have within them a deep-seated message that they should have been able to forestall the attack and invasion, even though they were only boys. Sexual abuse is especially difficult for men to admit to, but many men have rape or abuse in their history and more are now speaking about it."

In group, the stigma loses its power, and healing begins when people get in touch with the memories and feelings that have been repressed or suppressed. The healing may involve both the body and the mind. "It's my belief that the body remembers things from the time they happened," said Pantesco. "A 30-year-old man clearly recalling the abuse he suffered may enter an emotional state in which he feels the pain as if he's age six, not thirty, and he may tremble like a child."

The point of the therapy is not to prompt emotional reactions, reported Pantesco. It's to invite people to recognize what happened, make some sense out of it, and give it some attention so it won't cause as much distress when they encounter it in sobriety.

"This emotional information helps people survive the distress sober even if they have a rough time," he explained. "We try to change their memories from moving ghosts of the past that occasionally come up and grab them, to monuments of stone. When they look over their shoulders, the memories will still be there but they won't be harmful."

Some of the bodily symptoms that are usually allied to the anxiety and panic symptoms of PTSD are as follows:

* Tachycardia (rapid heartbeat)

* Shortness of breath

* Sweats

* Thickness of the throat

* Dizziness

* Terror and fear of death

When organic disorders are ruled out, headaches and hypertension can also be related to a history of abuse, said Pantesco.

He reported that for people in recovery from addiction, group therapy often brought relief  of anxiety and panic during the balance of their treatment at the hospital. Then, on completing treatment at Beech Hill, it was frequently recommended that abuse victims continue in outpatient therapy, depending on their overall condition and the kinds of challenges ahead of them in sobriety.

Beech Hill Hospital did pioneering work on the relationship between PTSD and addiction recovery, and in recent years there has been more awareness of PTSD throughout the health community. However, it is a factor that can easily be overlooked or played down, and when that happens patients' lives are at risk.

Questions about PTSD possibilities need to be posed in all health screening and diagnosis situations because confronting and ameliorating the PTSD response to abuse is critically important in restoring patients to wholeness and health.

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