Generalized Anxiety vs. PTSD Anxiety

I have devoted a lot of space on this blog to writing about PTSD, C+PTSD, and healing from trauma.  I’ve been honest about my own journey towards wholeness.  What I share here is an attempt to elucidate the emotional experience behind C+PTSD in specific the anxiety experience.

What I can say for certain about healing from C+PTSD is that it is like a disease that remits and exacerbates.  I can go a year and not devote any time to thinking about the man who abducted and trafficked me, my time in captivity with him, or the events that happened to me therein.  I rarely think of my father or stepmother.  My mother doesn’t come to mind much either in the context of her abusive behaviors.  The domestic violence I experienced in my former marriage is no longer foremost in my mind.  It’s not the people or specific events that dog me now.

So, what is left after you deal with the details and process the events? What is left after therapy because there is something left?

I’ve had a hard time defining the quality of what remains until a friend sent me a link to this article yesterday:

We Can’t Keep Treating Anxiety From Complex Trauma the Same Way We Treat Generalized Anxiety

Vicki Peterson, the author of this article, writes:

No one gets a prize for “worst” depression, anxiety, trauma or any other combination of terrible things to deal with, and no one should suffer alone. With that in mind, there is a difference between what someone who has Complex PTSD feels and what someone with generalized anxiety or mild to moderate depression feels.

For someone dealing with complex trauma, the anxiety they feel does not come from some mysterious unknown source or obsessing about what could happen. For many, the anxiety they feel is not rational. General anxiety can often be calmed with grounding techniques and reminders of what is real and true. Mindfulness techniques can help. Even when they feel disconnected, anxious people can often acknowledge they are loved and supported by others.

For those who have experienced trauma, anxiety comes from an automatic physiological response to what has actuallyalready happened. The brain and body have already lived through “worst case scenario” situations, know what it feels like and are hell-bent on never going back there again. The fight/flight/ freeze response goes into overdrive. It’s like living with a fire alarm that goes off at random intervals 24 hours a day. It is extremely difficult for the rational brain to be convinced “that won’t happen,” because it already knows that it has happened, and it was horrific.

Those living with generalized anxiety often live in fear of the future. Those with complex trauma fear the future because of the past.”

This is absolutely true, and most therapists don’t seem to have a clue that there is a difference.  Perhaps this will help someone reading this…

I live with a smoldering anxiety that never leaves me.  It peaks when I’m happy.  Oddly, it ebbs when I’m too busy to pay attention to what’s going on around me, and I suspect that trauma survivors try to stay so busy because it prevents them from feeling this particularistic type of anxiety.  When I’m struck with the evanescent beauty of a moment, fear creeps in like a thief and begins to steal my joy.  I do not know how to escape any of this.  It might be strange, but I’ve tried to make friends with it.  I’ve wanted to understand it in an effort to defuse it.

As Ms. Peterson has said, I don’t fear because I’m generally anxious.  I do not have an anxious personality.  I fear because of what I’ve known.  Because of my past experiences.  When the worst-case scenario has already happened to you, then who’s to say it won’t happen again? Yes, I’ve survived extreme sexual torture, a kidnapping, human trafficking, and years of abuse in my family of origin.  I was duped by my ex-husband for twenty years and sexually assaulted by him.  My former therapist told me that I could clearly survive anything.  My brain fears that I will have to do it again.  Over and over again.  This is the flavor of anxiety that belongs to trauma survivors.  This is the nature of PTSD and C+PTSD anxiety.

I do practice mindfulness, but becoming mindful does not shut down my anxiety.  It often only makes me more aware that I’m fearful and feeling helpless.  It can promote the very hypervigilance I’m seeking to escape.

The remedy for both anxiety and trauma is to pull one’s awareness back into the present. For a traumatized person who has experienced abuse, there are a variety of factors that make this difficult. First and foremost, a traumatized person must be living in a situation which is 100 percent safe before they can even begin to process the tsunami of anger, grief and despair that has been locked inside of them, causing their hypervigilance and other anxious symptoms. That usually means no one who abused them or enabled abuse in the past can be allowed to take up space in their life. It also means eliminating any other people who mirror the same abusive or enabling patterns.

Unfortunately for many, creating a 100 percent abuser-free environment is not possible, even for those who set up good boundaries and are wary of the signs. That means that being present in the moment for a complex trauma survivor is not fail-proof, especially in a stressful event. They can be triggered into an emotional flashback by anything in their present environment.

It is possible (and likely) that someone suffering from the effects of complex trauma is also feeling anxious and depressed, but there is a difference to the root cause. Many effective strategies that treat anxiety and depression don’t work for trauma survivors. Meditation and mindfulness techniques that make one more aware of their environment sometimes can produce an opposite effect on a trauma survivor.  Trauma survivors often don’t need more awareness. They need to feel safe and secure in spite of what their awareness is telling them.”

Feeling safe and secure, for me, is key.  Safety and security in my relationships and environment seem to be the cure.  I know why feelings of relief and happiness trigger feelings of fear and, sometimes, emotional flashbacks.  My father deliberately cultivated feelings of happiness and relief in me in order to overturn them and further engage in abuse.  He was a pathologically cold man.  My mother’s emotional and personality disorders caused constant instability in our family environment.  As soon as any sort of happiness was achieved, it vanished just as quickly due to her inability to maintain a consistent mood or affect.  She also attempted suicide numerous times.  As soon as any family member felt relief that she might be doing better, she would attempt suicide again or lash out in talionic rage against someone in the family.  Nothing in my family life was ever predictable.  We consistently waited for “the other shoe to drop”.  I grew up on edge.  If there were ever a moment of happiness, I knew that my mother would ruin it.  Or my father.  That has proven to be true over the years.

Consequently, when I feel this rising panic borne of this nebulous but constant fear that follows me everywhere, it isn’t generalized.  It is quite specific, and I find myself saying, “I can’t go back to that.  I can’t do that again.  I won’t do that again.”  And, I feel frozen and terrified as if an old enemy has found me.  I feel a strong urge to cut all ties and run away mixed with a terrible almost existential fear that I will live out my life completely alone.  And, yet, I know that this will all pass.  It is, as I said, like an exacerbation of an autoimmune disease–an autoimmune disease of the mind and soul.

With that said, what is to be done? Well, I have therapized, read, studied, and pursued many roads over the last twenty years in order to answer that very question, and I’ve had a fair amount of success.  For the survivor of trauma, however, consistently establishing safety and security in your myriad environments and relationships is the number one thing to do to defuse anxiety and flashbacks related to trauma.  This will always be the first and last step.  It is also the first question to ask when you feel that familiar fear rise: “Do I feel unsafe or insecure anywhere in my life or in any relationship?”

I hope that this has been helpful to you.  Ms. Peterson’s article has been very helpful and validating for me.

As always, keep going…

Shalom, MJ

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2 thoughts on “Generalized Anxiety vs. PTSD Anxiety

  1. Oh my gosh thank you for spelling this out for me. I started having night terrors when i was like 22 years old. I couldnt figure out why, but this post explainst a lot. Thank you.

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