My name is Jill Moreton. I'm one of the clinical team at the River Centre for
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
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
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
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
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
fire service and with some voluntary organizations who also have a role in

emergency responding.
emergency responding.

PTSD involves a kind of cluster of three different kinds of reactions which are
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.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
try and manage the other two because it's really

horrible having those memories coming back and it's really horrible feeling
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
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
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
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
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
your head. So PTSD is when people are caught in

that kind of negative feedback loop where they're trying really really hard
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
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
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
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
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
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
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
you have a constant feeling that something else is going to happen

constant feeling of anxiety which is completely exhausting. So then you just
constant feeling of anxiety which is completely exhausting. So then you just

you know people feel wiped out.
you know people feel wiped out.