Lately, it seems we’ve been increasingly hearing a great deal about Post Traumatic Stress Disorder, whether it is because of the impact of war on returning soldiers and civilians caught in the midst of the conflicts, or because of the greater public awareness in our community of the recurring trauma experienced by survivors of physical, emotional, and sexual abuse.

Post Traumatic Stress Disorder (PTSD) is a very real and frightening malady that can last decades with symptoms that include flashbacks, sleep disturbances, difficulty trusting relationships, depression, and anxiety. Significantly, it has been found that exposure to trauma, even just a single exposure, can change certain key components of the brain. These include two major structures of the limbic system, the amygdala and hippocampus, which are implicated in storing memories and regulating emotions. In PET scans of individuals who have PTSD, these two areas appear smaller in size and different in shape than those of people who have not been exposed to trauma. These findings imply that trauma causes not just psychological changes, but physical brain changes which form a core for some very profound complications that can impede an individual for a lifetime following the trauma that initiated the disorder. Yet there are some individuals who were exposed to the same types of traumatizing events who seem to show a better outcome with fewer symptoms and complications. We refer to these individuals as being more resilient in the face of their trauma.

Attempts have been made in recent years to determine if there is a specific psychological technique or personality style that serves to buffer certain individuals from developing severe Post Traumatic signs and symptoms. In some of our own research with Holocaust survivors, we found that those individuals who survived through and were able to speak about their experiences were less likely to suffer severe symptoms of stress than other survivors who did not speak about their traumatic experiences. What was even more notable in our findings is the fact that the children of survivors who had parents that spoke about their Holocaust years also had fewer symptoms of what has become known as “Second Generation Syndrome.”

These findings can be used to argue for both a nature and a nurture understanding of resiliency. Those who spoke of their experiences may have the inborn temperament that caused them to be more open, and thus better able to fend off the long-term impact of their traumas. Or they may have been in an environment that encouraged them to speak of their experiences in a supportive way, thus allowing a natural therapeutic method to help them cope with their hidden suffering. Similarly, some children raised in environments which were, by all accounts, traumatic – e.g. had lives that were marked by chaotic daily routines, irregular or harsh schooling, poor parenting, and severe poverty – managed to become successful adults, while others from the same communities continued in the cycle of poverty and suffered Post Traumatic symptoms their entire lives.

Virtually all studies of the Post Trauma issue and resiliency tend to show this bifurcated finding: Some people continue to lead lives that are highly traumatized, while others seem resilient and are able to go beyond. This is, however, a bit of an oversimplification. There are not just two possible outcomes for trauma survivors, but a range that goes from a severe lifetime impact with major signs of the trauma that recur regularly, to only a fleeting acknowledgement that trauma occurred and there are virtually no measurable symptoms. Some people are more temperamentally capable of fending off the effects of a stressor while others are not genetically preprogrammed quite the same way. Some people are capable of fending off a trauma because they have a very supportive environment, while others whose environments are not so supportive may suffer worse consequences. What this suggests is that resiliency or the ability to bounce back from a trauma unscathed, like most other things in our lives, results from a combination of both nature and nurture. It is not something that an individual who has been traumatized can easily choose to do.

What is among the most frustrating thing for a trauma survivor to hear is the expectation that someone else may have for the survivor to “just get over it.” Unfortunately, I am told by survivors that they hear this from well-intentioned yet misguided people far too often. People cannot just get over something that has had a profound impact on them if they are not genetically pre-programmed to and do not have a highly supportive family and community assisting them to. As the science of treating survivors and helping them cope with their symptoms and overcome their reactions to the stressors grows, we will learn even better therapeutic techniques for aiding PTSD survivors. Until then, asking a survivor to just be resilient if it is not in their personality makeup may only serve to create more trauma. The most helpful technique is to just listen and try to understand and see to it that the survivor is treated by a competent professional.

 

 

Dr. Michael Salamon, a fellow of the American Psychological Association, is the founder and director of ADC Psychological Services in Hewlett, New York and a board member of P'TACH. He is the author of numerous articles and several psychological tests and books including "The Shidduch Crisis: Causes and Cures" (Urim Publications) and "Every Pot Has a Cover" (University Press of America). His latest book is called Abuse in the Jewish Community: Religious and Communal Factors that Undermine the Apprehension of Offenders and the Treatment of Victims.