Common Barriers to Recovery from PTSD Explained
Wednesday, January 17 2018 Elizabeth Brico
There are barriers to recovery from posttraumatic stress disorder (PTSD). Mental illness recovery often begins as an uphill battle. It doesn't help that aside from difficult symptoms, those of us living with one or more mental illness also have to combat stigma and wide-spread misinformation--all while navigating a mental healthcare system that often favors the wealthy. Recovery from PTSD is saddled with some very specific barriers. In fact, treatment resistance is actually a symptom of PTSD. If you or a loved one are struggling to recover from trauma, please hold back from judgement. There are reasons for treatment-resistant PTSD behaviors; you or your loved one are not at fault.
Barriers to Recovery from PTSD
1. Trauma Shatters the Belief in a Just World
What is the just world theory? The "belief in a just world" is exactly what it sounds like: many of us are raised to believe that the world is fair--meaning that bad things happen to bad people, and good things happen to good people. We see this message everywhere, from the stories we were raised on to the movies we love. The idea is generally that, though a "good" protagonist may undergo some difficulties, he or she eventually wins out. The "bad guy," on the other hand, loses everything.
Of course, the world is not fair. Tragedy befalls kind people every day. Racist, sexist hate-mongers sometimes ascend to the highest positions of power. Neither trauma nor success discriminates by moral conventions. Nonetheless, many of us are raised to subconsciously believe the world is fair. Because people who have healthy upbringings also tend to think they are good, the belief in a just world is comforting. When trauma occurs, however, that belief is shattered.
Why the Belief in a Just World Makes Recovery Harder
Once someone experiences a trauma that violates his belief in a just world, two uncomfortable reactions can occur. He may believe (either consciously or subconsciously) that he is a bad person who deserves heaps of bad things to happen to him, or he may develop an acute understanding that life is tenuous and unfair. The latter is actually true, but focusing on it can cause undue anxiety, including leading someone to become paranoid or to think it's impossible for him to take any measures to help himself stay safe.
These aberrant beliefs can be barriers to PTSD recovery. If somebody thinks she is inherently bad or flawed, she may not feel deserving of help and healing (Change the Stigma Around PTSD by Changing Self-Perception). If the world is just, and she's a bad person, then healing would be an injustice. On the other hand, if someone is hyper-focused on the fact that terrible events can potentially take place at any moment, he might not think there is a reason to recover. What's the point of recovering if trauma is just going to happen again (Trauma Is Unfair: But You Can Heal Anyway)?
2. The Pain of Working Through Trauma Is a Barrier to Recovery
Another barrier to recovery from trauma is the fact that it is often painful, at least at the start. Remembering trauma, reiterating it to a support person, and consciously working through it can be triggering. Eventually, it does get better. The memories become easier to deal with. PTSD recovery is possible--but making it through those first months or even years is hard work. Motivating oneself to jump into a painful experience after going through trauma is not easy.
How to Help Someone Through Recovery Barriers
It's difficult to watch someone you love resist PTSD recovery, especially when you know that recovery would be possible if he or she chose to do the work. Unfortunately, many of these barriers involve inward, self-reinforcing beliefs. That means that even if you remind your friend that she deserves to heal, and list all the very real reasons why that's true, she will likely still find her own reasons why it's not.
It doesn't mean you should give up, but it's important that you practice compassion. It's excruciating to watch a loved one run circles tearing herself apart, but if you continue to listen and be available for her, you will demonstrate your love for her better than words ever could.
Parents with PTSD Face Specific Barriers to Recovery
Parenting or caretaking with PTSD comes with its own special set of challenges (for example, children can trigger PTSD). In addition to their own self-care, parents are responsible for the care of their children. Posttraumatic stress disorder recovery sometimes has to take the backseat to caregiving duties. In this short video, I discuss some of the specific barriers to recovery faced by parents with PTSD.