TO KEEP THINGS FROM GETTING WORSE

My patients have made it clear to me how important their feeling responsible for others is in maintaining PTSD symptoms. It seems that taking responsibility for others develops as a way of coping with abuse.  It makes sense in that people who are being abused are not being protected by adults around them and therefore they can feel more in control by taking on responsibility for others.  However, I have wondered what the nature of the control experience is.  Now I believe that it is to prevent things from getting worse. This idea has surfaced with many of my patients who come to me for help with PTSD. They believe that the abusing person will be less likely to lose control if they do this. They also do not feel confident enough to resist taking responsibility for others and standing on their own. Any person who loses control, or threatens to, can cause someone who has PTSD to respond by feeling responsible for them. This maintains the old pattern and as I have previously discussed the brain is very good at helping us to maintain old patterns of behavior.

The significance of feeling responsible for others is that when we act this way because of a fear that things will get worse tells our brains that we need to be on guard to be alert in case the something worse happens.  For this reason it is very important for people with PTSD to have a goal of no longer doing things to keep things from getting worse.  They need to be able to identify all the ways that they act this way and make it clear to themselves [their brains] that they want to stop doing this.  It also helps to be able to tell themselves that they no longer need to fear past stressful situations as they do not have any power over them now.  This requires that we choose to think of past stressful events and then, staying calm, tell ourselves that we no longer need to be stressed by these memories.  Even with this accomplished, the behavior pattern of doing things to keep things from getting worse can continue unless stopping it is addressed directly.  If it is not stopped, automatic stress reactions to past events will continue.