PTSD Treatment: More Complicated than Just "Letting Go"

Patient Expert

For many of us with Post Traumatic Stress Disorder (PTSD), we may be questioned why we just can't "let go" of the past and move forward and live in the present. Such a concept to "let go" and be free of the past would be wonderful... if only it were that simple.

One of the components of PTSD that is misunderstood is this very concept of "letting go." The practicality or logic of "letting go" is not a factor of recovery for PTSD and never has been. If it were that simple, the diagnosis of PTSD would not exist.

To the general population, "letting go" equates with "releasing the hold" on a past occurrence; not obsessing over it, forgiving the perpetrator, or moving on from the unfairness of the event. It is simply a moment in time that can be moved beyond without long-lasting consequences.

Those diagnosed with PTSD can do the exact same thing and still** not** have it automatically alter their present reality. The diagnosis of PTSD hinges on the fact that when an event of horrific magnitude occurs, a person is unable to process such an event emotionally in context. PTSD therapy is utilized to provide an opportunity to connect the emotional (or internal) experience to the external event itself. The purpose of this therapeutic goal is to integrate the emotional response to the event itself: it enables those of us with PTSD to understand our traumatic experiences for what they are and our continually unconscious emotional response to triggers that occur in present day. When "triggered" we are highly susceptible (if not entirely unconscious) to spiraling back to the original event that created PTSD in the first place, and finding ourselves disconnecting from present reality into a state of helplessness.

If we with PTSD are at the whims of triggers (a sight, a sound, a smell, a touch), the triggers override cognitive awareness in the present and send us back to the emotional response of the original event itself. In these moments, the trigger has greater hold and bypasses conscious knowledge: such swift bypasses dive straight into the depths of the fight or flight response (or anxiety, anxiety attacks or disassociation). Even if what is occurring in the present is a benign moment, the triggered reaction holds no bearing to the present event beyond a reminder or stimulus to the original event.

By integrating the cognitive and emotional context of the original event or series of events, we then become sensitized to triggers and may then catch ourselves before our brain takes over to escalate emotionally. The goal of therapy is to "even out the playing field" so that if a trigger should occur, we may be conscious to it and remain in the present and not disassociate (create a separation of mind and body to carry us through the terror we are re-experiencing).

No matter how much a person with PTSD desires to "let go" of the initial event or series of events, the concept means little to nothing. The event or series of events has become lodged and hardwired. Period. We may no longer think about the event itself, but our sensitivity to the event is ingrained within us. Our brains have become programmed to respond to the extreme.

Recognizing triggers for what they are takes practice. A lot of practice and awareness. Being alert to what may be a trigger requires additional awareness and practice as well. We may not even be conscious of all triggers. The goal of therapy is to recognize triggers and respond accordingly--breathing, reminding ourselves we are in the present and not the past, looking to objects and identifying them around us to stay present--even to the point of reminding ourselves of what year it is and if we are in a grocery store rather than a basement if a person passes us who is wearing the same cologne as our abuser. Reprogramming our mindfulness takes both time and practice. This process can be exhausting and exhaustive.

To tell a person with PTSD to "let it go" is to misunderstand what the PTSD diagnosis is. The person diagnosed with PTSD is not unwilling to let their experience go; rather, the experience has become trapped inside and that person needs our support as they go through the therapeutic process to integrate the emotional within the contextual event and then recognize what stimuli can trigger a memory of the originating events in order to not have the past alter their present. It is a process of learning; it is a process of understanding how the brain works to protect ourselves in times of terror. The after-effects that require the rewiring of the brain take time, practice and awareness.

If you have PTSD and become annoyed because you can't seem to "shake off" the event or "let it go" this is a response due to lack of complete understanding of how the brain works. "Letting it go" is not a matter of ability. The PTSD response to a traumatic event ensures our survival in the moment the event is occurring. Not allowing the traumatic event to take over present reality requires time, education, therapy and practice. Cutting ourselves some slack as this process ensues is important; it is equally important for those who support us to understand this concept as well.