How Trauma Changes Us: Avoidance and Self-Medication
anonymous Asks ...
I got attacked walking home from work a couple of months ago. I am a waitress and finish around midnight. This guy pushed me down and ripped off my jewelry and purse. He pulled my necklace so hard I had a red line around my neck for like 2 weeks after. Now, I don’t walk home alone any more but I find that I don’t even like to go home to an empty house so now I go out every night after work for a few drinks and now I think I am an alcoholic. I need to get drunk enough to pass out every night. How do I stop drinking? My friend said I should go to AA but if I don’t drink I am scared on my own so I don’t think this is going to work.
Dr. Richard Schultz Says ...
Thank you so much for writing, and I am very sorry to hear of the terrifiying event you experienced.
Such a traumatic incident, particularly one that involves feelings of helplessness, shock, and fear of injury to ourselves or others, can often give rise to the onset of Posttraumatic Stress Disorder (PTSD). This is a form of anxiety that can negatively affect our thoughts, feelings and behavior. PTSD may include distressing memories/flashbacks or nightmares about the event, avoidance of any reminders of the event, as well as a sense of numbness and/or hyper-arrousal (i.e. difficultiy sleeping or concentrating, or exaggerated startle response).
Based on what you wrote, it would appear that your sudden avoidance of your empty house, and your attempts to suppress or medicate your anxiety and insomnia with alcohol are strong indicators of PTSD. Although your friend's specific concern about your drinking is quite understandable, I believe it will be more important for you to first get some assistance in working with the primary underlying condition of PTSD that appears to be triggering the drinking and other behavioral changes. AA is not designed to provide that kind of intervention. I therefore strongly recommend that you seek consultation with a qualified mental health professional who can help you better understand how this traumatic event has impacted you, and help you to recover from your symptoms. I also suggest you try and connect with a provider skilled in cognitive-behavioral therapy (CBT), which has be shown in research to be particularly effective for anxiety conditions such as this one.
Effective treatment for PTSD typically involves a re-processing of the event, and the thoughts, feelings and behaviors associated with it, help in coping with physical symptoms of anxiety, as well as a gradual return to your pre-trauma behavioral routines. Paradoxically, the more we try to avoid thinking about a troubling event, having feelings associated with it, or being reminded of it, the more fearful of that event and it's potential for recurrence we become. Through avoidance, we can even start to become afraid of our own feelings themselves. Given the progressive nature of anxiety, it will therefore be best for you to seek help sooner than later. This is not a rare condition, and it is quite successfully treated (with the right treatment, of course).
If you wish to read more about PTSD, prior to, or in conjunction with seeking treatment, I recommend the book, "Trauma and Recovery" by Judith Herman. This will likely be helpful to you. You can also receive guidance in identifying a therapist through your primary care physician, by visiting apa.org, or through your state's psychological association (just google the name of your state and "psychological association"). Of course, you can also ask friends, family or colleagues if they have worked with any skilled practitioners, if you feel comfortable doing so.
I hope you have found this information useful. Please feel free to write back if you have additional questions, to keep me posted on your progress, or to get further guidance of any kind.
I wish you great peace and courage in your recovery.
Richard E. Schultz, Ph.D.