By Holly Austin Smith — From her column Speaking Out in the Washington Times Communities
ST. LOUIS, Missouri, May 1, 2013 ─ Many believe that PTSD is a disorder that exclusively affects war veterans; however, professionals like Licensed Master Social Worker, Margaret Howard, have learned that many survivors of human trafficking have undiagnosed PTSD symptoms. Since many survivors aren’t familiar with the signs and symptoms of this disorder, Margaret Howard, who is also a blogger for the Huffington Post, has agreed to help dispel some of the dynamics associated with PTSD.
Margaret, what is PTSD?
PTSD, or Post-Traumatic Stress Disorder, is actually an injury to the nervous system. Some – but not all ─ advocates, researchers, and clinicians think PTSD should be classified as an injury, rather than a disorder, and renamed Post Traumatic Stress Injury, or PTSI. Traumatic injury to the nervous system occurs when a person’s natural “fight or flight” response is blocked or squelched by outside forces, such as being pinned down in a car accident or by an assailant in rape, kidnapping, or other violence. “Fight or flight” is a natural, protective response of the sympathetic and parasympathetic nervous systems. These involuntary components operate outside of conscious control and take over when one is caught in overwhelming circumstances. But here’s the thing: If that protective response of “fight or flight” is blocked, then the human organism will go to the next level of emergency response in order to survive. That level can involve freezing, dissociation, or collapse. Of course, going to the next level is good because survival is good. But that level of response comes with a price, and the price can be traumatic injury. That traumatic injury is what we call PTSD.
What are the signs and symptoms?
How this looks from an outside point of view can vary widely. Sometimes, it can look like someone getting angry, or very sad, or feeling like they are being attacked. Sometimes it can look like someone being very quiet, or spacing out, or going to sleep.
What are “triggers?”
“Triggers” are environmental factors or events that trip the involuntary nervous system into responding as if the original trauma is happening all over again. This word is often misused. To be “triggered” does not mean to just be sad, or angry, or to be encountering something [that feels uncomfortable]. To be triggered, in terms of trauma, means to be thrown back into a state of re-experiencing [feelings associated with the original trauma]. [W]ithin the nervous system, [this feels] as intense and real as the original event. As far as the nervous system is concerned, the event is happening again.
Does PTSD affect survivors of human trafficking, or survivors of any trauma, the same way it affects war veterans?
Yes, it does. As a matter of fact the comparison with what war veterans go through is very apt. There has been a lot of research about how PTSD affects veterans. But there has been less about how PTSD affects victims and survivors of sexual crimes, and little to none at all regarding victims and survivors of human trafficking. I’ve been looking at the literature around PTSD and combat, and I’m finding it very informative for thinking about, for instance, survivors of sex trafficking. Here are some commonalities:
Combat veterans experience trauma when there is an explosion, when their comrades are killed, and when they themselves are made (by the circumstances of their jobs) to kill others. There is some evidence that killing may be even more producing of post-traumatic effects than witnessing others killed. In combat, people can’t just leave. They can’t walk off and say, I quit. If they try to, they’ll be punished. Also, the experience goes on and on, over months or years. So the traumatic effects are compounded over and over again. In order to survive this, combatants have to shut off one part of themselves, just shut it down…maybe they shut down the part that knows it does not want to kill, and in turn, other parts that “mask” this feeling emerge, in order to survive the situation.
Many survivors of sex trafficking have been, to some degree or another (depending upon the details of their experiences), subjected to similar psycho-physiological circumstances. When sex trafficked, a person cannot just walk away. The “fight or flight” response is squelched over and over again. A person is compelled to do things that the person either knows are harmful to the self, or wrong. A person has to suppress the true self and go into a false, masked self in order to survive.
In recognition of May being Mental Health Awareness month, Margaret Howard has graciously agreed to answer additional questions related to PTSD and human trafficking in a follow-up article. Please email your questions directly to Margaret via her blog with the Huffington Post, or directly to me via my website. Some questions and answers will be posted in a follow-up article.
If you are in need of immediate assistance, please contact a mental health specialist or your general practitioner.