PTSD

Psalm 23:4 NASB: Even though I walk through the valley of the shadow of death, I fear no evil, for You are with me.

There is a type of anxiety that was originally associated with veterans and has now become mainstream in psychology. I’m speaking, of course, of PTSD, or post-traumatic stress disorder. This anxiety disorder was initially called “Soldier’s Heart” during the Civil War, as clinicians recognized that returning veterans experienced palpitations, breathlessness, fatigue, anxiety, and other symptoms.

We now understand that PTSD is a complex disorder involving memory, threat detection, attention, emotion, and physiological arousal. The term “trigger” refers to something that elicits a powerful response, even when the person consciously knows they are in a safe situation. Although they may know they are safe cognitively, their body feels as if they are in danger and reacts automatically.

At the heart of this type of anxiety is a heightened, exaggerated response rooted in past trauma, which alters how a person both perceives and responds to a threat. Notice the sequence: first, there is a trauma, a real experience that affects the individual physically, emotionally, spiritually, socially, etc. I represented this in my art piece as a crater caused by a landmine.

The harm caused by the trauma then leads to hypervigilance to avoid anything that might trigger the trauma again. This, in itself, is a natural human response; if I triggered a landmine explosion, I would try to avoid any future landmines!

The problem lies in triggers, which are cues the nervous system has learned to associate with past trauma. A trigger can be especially powerful when it is unexpected: something happens that immediately brings up the past traumatic event, and the body re-experiences a variation of the past harm. The autonomic response is so fast that the mind doesn’t have time to determine whether the trigger is actually harmful or merely a reminder of the past harm.

A trigger that produces a powerful trauma response can convince the person that they must now anticipate even the triggers. A continuous scanning begins, and the person develops anticipatory anxiety, which paradoxically allows even smaller surprises to become triggers. As I tried to illustrate in my piece, this intense scanning and hyperfocus can lead to missing triggers (and thus being surprised, as the woman will soon step on the balloon in the image), but it also often leads the person to miss living life to its fullest (the vibrant green grass is avoided or ignored in an effort to stay safe).

I chose balloons to represent triggers because a popping balloon can be surprising but not dangerous. Part of healing from PTSD involves learning that triggers are reminders of danger, not necessarily signs of present danger.

Let’s connect that thought to our verse. David describes being in the valley of the shadow of death. A shadow can resemble something dangerous, but the shadow itself isn’t harmful. It evokes the reality of danger without being the danger itself. In the same way, healing from PTSD involves learning to distinguish the shadows of past danger from present danger and slowly discovering that we can walk through the green grass again—especially when God is with us!