Why do some people develop PTSD and others not?

People who experience a traumatic event will often recover without professional intervention. Unfortunately, a common but incorrect view exists that “strong” people do not develop PTSD.

There are various reasons why some people develop PTSD and others do not. The following factors are known to play a role:

  • Genetics and epigenetics.
  • A prior history of exposure to traumatic events.
  • Recognition by the affected person and the people around them of the severity of the event, and acceptance of the traumatized person’s experience.
  • The existence of an emotional support network and the ability of the affected person to describe their experience to a trusted, non-judgmental person/group.
  • Being able to share their experience with others who have had similar experiences, e.g. fire fighters can better understand the experience of other fire fighters.
  • The extent to which the person was mentally prepared prior to the event e.g. knowing in advance that events could turn out very badly and knowing how to respond when something goes seriously wrong.
  • Being able to make sense of what happened. For instance, it is believed that American soldiers who returned from the Second World war were much less likely to suffer from PTSD than soldiers who returned from the Vietnam War because fighting in the Second War was viewed as fighting a “just” war whereas the Vietnam War was viewed as unjustified and the war was lost anyway – so the sacrifice was meaningless.
  • For some people a physical activity such as a sport, gardening , chopping down a tree, or painting can provide an environment for working through emotions.

What to do if someone you know has experienced a traumatic event?

The key is to let the affected person determine:

  • Who do they want to share their experience with, when and where.
  • How they feel about the situation and what sense they make of it.

What you can do for someone who has experienced a traumatic event:

  • Be present and listen attentively…
  • Without interruption;
  • Without judgement or condemnation;
  • Without saying “I know how you feel” – rather ask the person how they feel;
  • Avoid side-tracking the affected person’s story by going into detail about your own experiences;
  • Without trying to make sense for the affected person, e.g. “This happened to make you stronger”.

Traumatic events often challenge people’s world views, for instance, believing that good people who do the right thing will be protected from tragedy. When tragedy strikes, such a person has to deal with both the direct consequences of the tragedy and the shocking discovery that their world view was wrong. Well-meaning supporters who try to make sense of the situation on behalf of the affected person usually make things worse. It is best to let the person come to terms with the meaning of their experience themselves – the best course of action is to follow their process with empathy and understanding and without judgement.

The most helpful form of empathy is not to imagine how you would have felt if you had been in the other person’s shoes, because your reaction may be very different to the reaction of the other person. It is better to observe the other person’s reaction, and then recall a time when you had a similar reaction, possibly for a very different reason, and then imagine the other person experiencing what you recollect about your experience. For instance, one person may get over the death of a pet fairly easily whilst such a loss may be devastating to another person. So if your friend “overreacts” to the death of a pet, then recall a time when you lost something or someone precious to you.

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