November 10, 2016 – The sight of a streetlight fills Sal Schittino with fear. “A light pole makes my heart beat faster,” he says, “especially at night or on a side street.”Two years ago, he slumped against a lamppost in a Baltimore alley at 4 a.m. and almost died. Schittino, a 24-year-old visitor from Ellicott City, Md., had gone out for pizza and was returning to satisfy friends when a youngster grabbed his cellular phone. He then attacked Schittino with a knife and stabbed him in the center, lungs, stomach and back.“It was very overwhelming. I bled to death pretty badly,” says Schittino. “Of course I knew I probably wouldn’t survive. I remember wanting to hold someone or something for comfort or to feel like I wasn't so alone. That was really scary – the fact that it was just me.”He fainted. A rescue team took him to a trauma hospital where surgeons performed open-heart surgery to avoid wasting his life. After the crime, Schittino, now 26, developed post-traumatic stress disorder. Old Sal, an affable young man who wanted a profession as a psychologist, was grateful to have survived. He found comfort in family and friends. He worked again as an assistant in a psychiatric clinic.But a brand new Sal confuses him. He cried for long periods in his bedroom, screamed in fear within the woods near his home and struggled with nightmares and memories of a brutal knife attack. His old self, he says, “cannot comprehend the scope and magnitude of the trauma that has happened.”Many consider PTSD to be a “wound of war” that afflicts military veterans who were traumatized on the battlefield. But civilians who're traumatized by violent crimes, rapes, kidnappings, domestic violence, serious accidents, terrorism, natural disasters and other events that cause them to suffer serious harm or death are also affected by PTSD. Bodily injury will not be required; Even a threat, similar to having a gun pressed against your body, can trigger post-traumatic stress disorder. The same goes for witnessing a terrible event. Most traumatized people adapt over time; only a minority develops PTSD. According to the National Center for PTSD, major stress and life interruptions lasting greater than a month are a warning sign for the latter. It is estimated that 8 million people within the United States suffer from post-traumatic stress disorder annually. About 10% of girls will develop this disorder in some unspecified time in the future of their lives, in comparison with 4% of men.However, many individuals don't realize that PTSD also affects civilians and that treatment can aid recovery. Untreated PTSD poses serious risks, including an increased risk of suicide and alcohol or drug abuse to numb the suffering.Create awareness
In some parts of the country, doctors are taking a proactive stance. In New Orleans, Erich Conrad, MD, associate professor of clinical psychiatry at Louisiana State University School of Medicine, has seen people falling from heights passing through the trauma unit at University Medical Center after being injured in automobile or construction accidents were shot or stabbed on the bottom.
Patients went home treated physically but not mentally. “We knew there was a huge need that wasn’t being addressed,” Conrad says. He now runs a program to screen all trauma patients for symptoms of post-traumatic stress disorder, depression and substance abuse. Those with symptoms are referred to mental health services.
In Oakland, California, Mark Balabanis, PhD, a psychologist in private practice, has treated PTSD patients from all walks of life—civilians and veterans. The two groups report similar symptoms, he says, including some which can be on account of the body's fight-or-flight response: tension and straightforward jumpiness, hypervigilance, intrusive memories, flashbacks, nightmares and avoidance of memories Trauma.
For Schittino, the memories were haunting. “I just wanted to outrun them as far as possible,” he says. At first, just walking on the road was scary. “I was constantly looking ahead and behind me. I wanted to see everything at any time.”
In his nightmares, “someone came to attack me in some way and I was completely helpless,” he says. Flashbacks invaded his waking hours for a couple of seconds. “Just before that, this feeling of panic comes over me. The event of that night – it always comes back to me sitting alone and then being stabbed. I literally couldn’t see what was happening in front of me in real life.”
While facing the fears related to post-traumatic stress disorder is difficult, avoiding triggers and reminders tends to perpetuate the fear, says Balabanis. He teaches patients that the unique trauma was dangerous, but that the memories are usually not harmful, even in the event that they trigger the fight-or-flight response that makes an individual feel unsafe again. “We have to show them that memories don’t overwhelm or hurt them,” he says.
Treatment of PTSD
Treatment for PTSD can take various forms. The goal of long-term exposure therapy is to desensitize patients to the trauma and things related to it. By talking to a therapist over and another time in regards to the traumatic event, people develop into less anxious and learn to achieve more control over their thoughts and feelings.
Sometimes exposure therapy takes place in the skin world. For example, considered one of Balabanis' patients gave up driving after a serious accident and couldn't recognize what sort of vehicle it was. He took her to a automobile lot and exposed her to the identical sort of vehicle until she lost her fear.
For hypervigilant patients — those that obsessively scan their surroundings for threats — Balabanis trains them on neighborhood walks to stop checking people for signs of danger or conflict.
Other PTSD treatments include cognitive therapy and drugs, including antidepressants. With cognitive therapy, patients learn to acknowledge inaccurate or negative thought patterns – for instance, blaming themselves for the trauma. By combating the distortions, they'll reduce the burden.
Some therapists use eye movement desensitization and reprocessing (EMDR). It's unclear how this non-traditional psychotherapy technique works, but proponents consider rapid eye movements help the brain process traumatic memories and weaken its emotional power. A patient thinks in regards to the distressing images and feelings while a therapist controls eye movements along with her hand or an object.
A counselor treated Schittino with EMDR, waving a pointer to guide his eye movements. “She would say, 'Allow yourself to experience this feeling.' Dig really deep.' I think it stopped me from trying to push it into my subconscious,” he says. “The progress I have made in such a short time has been very helpful.”
On the way to a new self
Those affected by trauma know that it can strike anyone without warning and split a life into a before and an after. Many patients integrate a traumatic experience into their lives and form a narrative, “a testimony of what they went through,” says Balabanis. “They know how difficult the world can be, but they also discover great resilience within themselves. Some even want to help other people deal with trauma.”
For Schittino, the trauma is still unprepared and the narrative is still emerging. Recently at work, he checked on a patient in her room. When she didn't answer, he looked at her face. To his horror, he discovered that she had died. “This incident brought everything back to the surface,” he says. “It made me think again about almost dying and I had to deal with the fear of that. The fear became so overwhelming. It was like a thought of mine that I didn’t want to deal with.”
The woman's death triggered a new search for conscience. “I always wanted to focus on being grateful,” he says, “for the fact that I can still do so many things, for so many people around me who love and support me.” I wanted to answer the question “Why me ?” don’t give any space. Why did it have to happen?' ”
But it was a relief to have to deal with these painful questions, he says. Instead of suppressing the feeling of injustice and the fear of death, he sets out on the path to a new self, after the trauma.
“I feel like I still have a lot to overcome,” he says. But as a psychology student, he hopes to one day help trauma survivors and people with PTSD.
His old self is certainly gone, he says. “After this trauma happened, this latest person was now not 'me,'” he says. “I had to create a new meaning in life for myself.”