The Link Between PTSD and DID
May 8th, 2007On May 8, 1991 a group of incest survivors gathered with their families, therapists, and one reporter in a small auditorium on a Colorado University campus to discuss the prevention and treatment of child abuse and neglect. Attending that meeting was a surprise speaker by the name of Marilyn Van Derbur Atler, Miss America of 1958. She shocked her audience with a statement that exposed the sexual violation she had endured at the hands of her father, which began at the time she was five years old and continued until she was finally old enough to leave home for college. Dr. Lenore Terr (1994) commented in her book as she recounted this story that “The part of the story that held the most interest… was Marilyn’s statement that she had remembered nothing about her sexual ordeals until she was twenty-four years old” (p. 123). This is an example of someone who had suffered from Post Traumatic Stress Disorder.
Post Traumatic Stress Disorder, or PTSD, is an acquired (reactive) disorder that results from exposure to extreme trauma, “an event outside normal human experience” that leaves the one experiencing it feeling powerless, helpless, paralyzed, and yet forced to focus consciousness in attempts to cope. PTSD was officially recognized as a psychological disorder in 1980 when a great number of war veterans were displaying the after-affects of their wartime experiences. It was once thought that when a conflict ended and danger was past that the symptoms of having been involved in an extreme or life-threatening trauma would naturally abate with the passing of time. In recent years, however, the medical and psychological communities have begun to realize that the psychological and emotional damage these experiences can cause do not heal so naturally as was earlier assumed or hoped.
War veterans were not the only ones exhibiting the signs of PTSD. Many survivors of other types of traumas or terrifying ordeals, such as victims of rape, violent assaults, childhood abuse, and/or those who had witnessed any event where an experience of terror or threat (or perceived threat) to “life or limb,” also displayed the same kinds of symptoms. Recent studies have revealed that one group, in particular, has been shown to be at extreme risk for developing this condition: Victims of childhood sexual abuse face the greatest risk of developing Post Traumatic Stress Disorder.
Individuals who have been abused as children, especially when the nature of the abuse is sexual and/or physical in nature, are highly prone to a chronic form of this disorder. Studies of abused children support this, particularly in cases where the abuse is physical and/or sexual (Widom, p. 1223-1229, 1999). Many people still only equate combat trauma, once called shell shock or battle fatigue, with PTSD, but some experiences such as rape and repeated or severe abuse are even more likely to produce symptoms of post traumatic stress in individuals (Sidran Foundation, p. 1-3, 2001). According to the Associate Professor of the School of Social Work at the University of Southern California, Ferol Mennen (2002), “Child abuse has increasingly been recognized as a serious life trauma and a potential trigger for Post Traumatic Stress Disorder and PTSD like symptoms” (In Press).
Many children who have been abused in these ways may not display the signs of post traumatic stress until long after the abuse has ceased (Sidran, 1995-2000). Most often the symptoms do not become obvious enough to be recognized and then treated until well into the adult years. Often a victim of repeated abuse develops a form of coping, called dissociation, in order to block out the traumatic experience from the conscious mind. Throughout their lives, abuse survivors will attempt to dissociate from or avoid situations that remind them of their traumatic experiences, thereby delaying recall of the events. Van der Kolk (2001), one of the foremost authorities on traumatic memory, has noted that “many cognitive scientists [take] an incredulous stance” (p.10) on this issue, denying its validity, arguing that because of lack of empirical evidence retrieved traumatic memories could be inaccurate. He points out, however, that not being able to observe this process of delayed recall in a laboratory setting does not justify the stance that retrieved traumatic memories are unreliable (p.11-12). Forgetting, and then later recovering, traumatic memories has, in fact, been well documented over the years. Freyd (1998), an academic psychologist and an abuse survivor who experienced delayed recall of her own abuse, asserts in her letter to the editor of the Register-Guard that there has been an explosion of empirical research in this area, especially research on memory for childhood sexual abuse (12A).
Individuals with a history of childhood sexual abuse (CSA) most often develop this disorder as a result of their extreme need to find some way to cope with ongoing trauma, leading to chronic PTSD. Van der Kolk (1996) stresses that “dissociation that occurs at the time the of trauma appears to be the single most important predictor for the establishment of chronic PTSD” (66). He further asserts that the connection between CSA and the emergence of these disorders “has become increasingly clear” (66). Because children are easily overwhelmed by the feelings of helplessness, powerlessness, and the inability to escape what would be for anyone intolerable circumstances, “forgetting” the trauma by dissociating from it is a much more common coping mechanism than once was originally thought. According to Hopper (2001), “Amnesia for childhood sexual abuse is a condition. The existence of this condition is beyond dispute” (p.1).
References:
American Psychiatric Association. (2000 ). Diagnostic and Statistical Manual of Mental Disorders (4th ed. TR). Washington, DC: Author.
Freyd, J. (1998) Recovered Memories Not Inherently Less Accurate. The Register-Guard Feb.5, 12A
Hopper, J. (2001). Recovered Memories of Sexual Abuse: Scientific Research & Scholarly Resources. http://www.jimhopper.com/memory/
Mennen, F. (In Press) Post Traumatic Stress Symptoms in Abused Latino Children. University of Southern California.
Sidran Traumatic Stress Foundation (1995-2000). Author. Towson, MD. http://www.sidran.org/ptsdfacts.html
Terr, L. (1994). Unchained Memories. New York: Harper Collins Books.
Widom, C. (1999). Potttraumatic stress disorder in abused and neglected children grown up. The American Journal of Psychiatry; 156, 1223-1229.
Van der Kolk, B. (1987, 1996, 2001). Traumatic Stress; New York: The Guilford Press.