Maybe you have seen the discussion in the media lately around whether PTSD is a disorder or an injury. It is an injury.

Psychological trauma affects the entire body through the Hypothalamic-Pituitary-Adrenal (HPA) Axis. As we discussed before, (see The HPA Axis, Trauma and You), this axis governs the body’s entire endocrine (hormonal) system. This is not in control of the victim, any more than bleeding and swelling is for the victim of a beating. PTSD always involves injury to the body’s mechanisms. Always. This is one of the reasons the disorder is so painful and so hard to describe.

I have come to believe that all symptoms of PTSD are related to these disturbances or attempts to ‘heal’ the disturbances.

Let’s take an extreme symptom, cutting or self-mutilation. We know in neurology that pain in one part of the body cancels out pain in another part of the body. This is a joke with my acupuncturist. Some times a painful needle will be inserted and he’ll ask how my symptoms are. I’ll answer, “fine, now that all I can feel is your painful needle!”. 

So, in a strange kind of way, cutting can be “adaptive” for forms of extreme trauma by managing through diversion and re-routing of pain signals, which then gives the victim a feeling of control.

Avoidance is another one of these symptoms. People with PTSD go to great lengths to avoid (or scare off, if it’s a person) reminders of their trauma, sometimes resulting in strange “phobias” or behaviors. That saying, “you always hurt the one you love” goes twice for PTSD sufferers when their partners inadvertently trigger them. We need to learn when our PTSD injury is manifesting and make ourselves safe in ways that don’t injure our relationships.

When medicine embraces the physiologic basis for PTSD, sufferers will finally gain the help that they need to heal from this profound HPA injury.