My name is Jill Moreton. I'm one of the clinical team at the River Centre for
traumatic stress in NHS Lothian. And as well as providing treatment for people
who have a post-traumatic disorder I've got a special interest in working with
people who are in the emergency services. Whose role involves them in repeated
exposure to potentially traumatic materials so we've been working with the
fire service and with some voluntary organizations who also have a role in
emergency responding.
PTSD involves a kind of cluster of three different kinds of reactions which are
all really linked to the memory not having properly been properly processed.
So the first one of those is very commonly called re experiencing or
reliving and that's when memories of the event or the incident come back into our
mind. It might be when we're sleeping and that can either be in dreams or
nightmares or it can be just randomly during the day. Now sometimes that can be
prompted by a specific trigger something that reminds us of the experience but
other times it can just pop in anyway and that's because our brain is trying
to process this kind of raw data that's very vividly stored at the time of the
trauma. Because that memory hasn't been properly processed and our brain tries
to digest it but until it gets probably processed then we have the other cluster
of symptoms which is called hyper arousal. And that basically means our
system is still on on red alert we're still sort of in the alarm zone. And we
don't quite know that we're safe and that the danger or the threat of the
sort of traumatic experience is over. So we we can be quite jumpy we're kind of
and that often makes us quite irritable it's very difficult to sleep because as
part of our brain that still thinks we need to be on red alert because there's
danger out there. And we have a lot of muscle tension our heart might beat more
quickly we might breathe more quickly all of those things which actually are
part of helping us survive if we're in a scary or threatening situation. If they
keep going after the trauma then they really can cause quite unpleasant and
distressing symptoms. As well as hyper arousal sometimes we have this one
called hypo arousal which is the equivalent of the freeze or the fright
response and that's the play dead impulse. And human beings can't really
predict which one of those they're going to have. So we've got those
re-experiencing when those memories are coming back into our head. And when they
do it really does feel like it's happening again and we can get quite
strong physical memories as well as the ones in our head. And while that's going
on we might either be on red alert or we might be quite switched off which is
feeling quite kind of numb that's the hypo one. And then then third symptoms
are what we would call numbing or avoidance. And that's what people do to
try and manage the other two because it's really
horrible having those memories coming back and it's really horrible feeling
on edge or sort of detached all the time. So people try to manage those
symptoms by not thinking about it not talking about it if they can avoiding
anything that might remind them of it. And while that makes perfect sense the
bad news is that the more you avoid it the more likely it is to come back into
your head. So PTSD is when people are caught in
that kind of negative feedback loop where they're trying really really hard
not to think about the awful thing that's happened. And because they can't
bear thinking about it it means that it doesn't get properly processed and it's
more likely to come back into your head. And for as long as you're caught in that
loop then your body stays on a kind of red alert where you feel like there's
danger everywhere. And people get exhausted so they flip. We talk
about people being wired but tired. Well you just can't settle you can't sleep
you have a constant feeling that something else is going to happen
constant feeling of anxiety which is completely exhausting. So then you just
you know people feel wiped out.