Can I Be Traumatized Again If I Have PTSD?
Wednesday, September 13 2017 Elizabeth Brico
What happens when someone with posttraumatic stress disorder (PTSD) is traumatized again? It's a question that has been on my mind a lot lately. So many scary and potentially traumatic or anxiety-provoking natural phenomena are taking place in the world right now. Whether we're talking the hurricanes in the Southern United States, the West Coast wildfires that caused ash to rain over my city for a day and a half, or the fatal floods in Southeast Asia, the world has watched a lot of unpredictable events unfold. Statistically speaking, some of the people affected by these natural disasters must already have PTSD.1 Are those people with PTSD being traumatized again?
I Was Traumatized Again After My PTSD Diagnosis
A couple weeks ago, I awoke suddenly to a sharp bang outside. Judging by the flurry of youthful laughter that followed, it was probably a firecracker left over from the Fourth of July. But at two in the morning, I thought the sound that woke me was a gunshot.
About three or four years after I ended my abusive relationship and was subsequently diagnosed with PTSD, a man was shot dead in front of me. I was working on the streets of downtown Seattle as a canvasser for an international children's charity. The event took place about half a block from where I stood, near a popular downtown tourist attraction. My back was turned, so I didn't see the actual shooting take place, but I looked in time to see the victim fall to the ground, and to see the shooter and several onlookers run away. Rumor says the shooter went into a nearby shop to order a sandwich.
I don't even know the name of the man whose last moments of life I witnessed. The little media coverage the event received focused on the way his death affected traffic and on the shooter's sandwich. But I remember how the victim's body looked vacant already, even though he would not be pronounced dead until he reached the hospital. Like nothing more than a bundle of clothes on the floor. And I remember the pain in my heart when that gunshot sounded, so sharp I was momentarily afraid to look down. I thought I had been shot.
When the firecracker awakened me two weeks ago, I was flooded with images of that shooting. It hadn't come up for me before, even though it took place years ago. The trauma that caused my PTSD happened to me directly. It was prolonged, targeted domestic abuse. Although the shooting was certainly a horrible event, I hadn't related it to my PTSD, because it was not one of the events that led to my diagnosis. Yet, there I was five years later, lying on my bed with full-color images from that day flashing through my mind.
How Could Someone Who Was Traumatized Once Be Traumatized Again?
It is actually fairly common for someone who develops PTSD to experience one or more traumatic events after the initial trauma. Consider that many people with PTSD show impulsiveness. Impulsiveness is, in fact, a category symptom of posttraumatic stress disorder. People who were traumatized often also find themselves unable to properly assess danger. What do you get when you mix impulsive behavior with a poor gauge of danger? Sometimes, you get more trauma.
It is well documented that some domestic violence survivors will enter into new abusive relationships after ending the initial one. Survivors of natural disasters or accidents may thrill seek. Childhood sexual abuse can lead to reckless promiscuity. There's also random chance. Someone can be in an abusive relationship, and then get caught in a violent home invasion. A survivor of a flood can later experience an assault. It seems really unfair, but these things happen.
Being Traumatized Again and Complex PTSD
Complex posttraumatic stress disorder (C-PTSD) is currently a proposed disorder. That means it doesn't appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but mental health professionals are discussing potentially using it as a genuine diagnosis. Many trauma survivors--and even some professionals--already use the term "C-PTSD" to define their condition.
People can develop PTSD from a single event, such as a car accident or rape, but when people experience chronic trauma, the symptoms may differ. Complex PTSD occurs as the result of a prolonged trauma, or in response to multiple traumatic incidents. What begins as PTSD can develop into complex PTSD if someone experiences other trauma.
The U.S. Department of Veterans Affairs describes people with C-PTSD as being at heightened risk for suicide, plagued by strong dissociative symptoms, prone to extreme isolation and distrust, and given to crises of faith. They are also highly susceptible to substance abuse and other forms of self-harm. They may be considered "treatment-resistant." Complex PTSD symptoms can be more intense, and last longer than typical PTSD symptoms.2
Can Someone with PTSD Avoid Being Traumatized Again?
The truth is, we don't have control over everything that happens to us. Trauma is not your fault, but if you have PTSD, it is possible to manage some of the symptoms that make you more susceptible to experiencing further trauma. For example, a licensed mental health professional can help you identify and correct impulsive behaviors. She can also walk you through exercises, such as those found in cognitive behavioral therapy, that are designed to help recalibrate your gauge of danger.
But all of the therapeutic support in the world cannot stop trauma from entering your life. Sometimes, traumatic events just happen. You could be caught in a hurricane, or targeted by an abuser, or countless other traumas that are impossible to prevent. These things can happen to anyone, but because you're already affected by PTSD, you are especially vulnerable to having a traumatic reaction to an extreme event. That's why it's so important to seek professional, therapeutic support for PTSD.
When I witnessed the murder, I had been officially diagnosed for several years but had not gone to therapy for a consistent period of time. I was self-medicating PTSD with drugs. I had little if any, support in place. No wonder the murder became integrated with my PTSD.
Not everyone who experiences trauma will become traumatized, and that applies to people who already have PTSD, too. Talk to your support team about ways you can cope with future trauma. There's no need to obsess over the possibility, but having some realistic coping skills in place can help you avoid developing more complex PTSD symptoms, just in case.
1 How common is PTSD? (2007, July 05). Retrieved September 13, 2017.
National Center for PTSD, US Dept. of Veteran Affairs
2 Complex PTSD. (2007, January 01). Retrieved September 13, 2017.
National Center for PTSD, US Dept. of Veteran Affairs