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PTSD: 1 No, it’s not all in your head

Originally posted May 26, 2020.

Post traumatic stress disorder (PTSD) is a painful, frightening and frustrating condition. PTSD has debilitating psychological, emotional and physical symptoms. People come into my office with symptoms such as depression, anxiety, dread, fear, dissociation, body pains, headaches, joint pain, foggy thinking, feelings of general unease. People will say that they feel overwhelmed with anxiety and depression and fear. And they feel collapsed with hopeless, helpless, paralyzed. PTSD often has a profound effect on one’s sense of self. My clients often say they don’t feel fully present or they don’t feel like themselves.

Lady Gaga, in her album “Chromatica,” opens up about being a sexual assault survivor. She describes her PTSD symptoms well. In her song “Alice” she “Chromatica,” says , “Where’s my body? I’m stuck in my mind.”

My clients also feel out of touch with their body and their interior selves. They say things like:

  • “I feel depersonalized”

  • ” I don’t feel like myself”

  • “I feel uneasy alot…”

  • “I feel divorced from myself…”

  • “I feel helpless. I feel hopeless…”

  • “I feel like there are parts of my body that aren’t completely attached to me”

  • “I feel like my hands are way over there…”

  • I feel paralyzed, like I can’t move….”

  • “I don’t feel real…”

  • “I feel like I’m hearing from underneath the water..”

  • “My eyes are cloudy…”

  • “Sometimes I feel like I’m in a tunnel…”

  • “I always feel like I’m on high alert…”

  • “There are times I am literally frozen back in time, right in the middle of what happened…”

  • “I feel like I am floating by the ceiling, looking down…”

  • “I have tunnel vision, like everything around me is cloudy…”

  • “I feel like I’m underwater, and everything is muffled…”

  • “I feel like there is plexiglass between me and other people…”

PTSD can be caused by a single incident or by an ongoing situation. A single incident is something such as: surviving a car accident, hurricane, wildfire, a severe illness or being the victim of a crime. An ongoing situation is something such as: chronic childhood abuse, witnessing multiple traumatic events (such as in first responder work, like police, firefighting or medical work). Complex PTSD (or C-PTSD) is the condition resulting from chronic trauma.

As an aside: It might take a few years to get a diagnosis of PTSD or C-PTSD. Over a lifetime, PTSD symptoms may show up as depression, anxiety, panic attacks, insomnia, dissociation, derealization, flashback memories, nightmares, hypervigilance, fatigue and wandering physical pain and numbness. Over the years, these disparate symptoms might reveal themselves at different times. People end up going to different doctors and therapists for help with single symptoms. On top of the PTSD symptoms, substance abuse may occur as in the form of self -medication in order to numb the feelings with alcohol, marijuana or other substances. This further complicates the diagnostic picture.

Getting to the the diagnosis of PTSD/C-PTSD is sometimes not being able to see the whole forest because of the large individual trees in the foreground.

So, why does PTSD carry so many disparate symptoms over a lifetime? For some insight, we need to take a look at the our new, current understanding of neurobiology and the human stress response.

The newer concepts that help us understand the biological underpinnings of PTSD are: neuroplasticity, neuroception, the polyvagal theory of the stress response and how memories (regular and traumatic) are processed and stored. Our enhanced understanding of how the brain and nervous system work help create more effective therapies to heal trauma.

The new somatic therapies allow you to develop your ability to mindfully observe, or track, your current somatic processes, which are the product of your current perceptions. Your perceptions and sensations usually occur below conscious awareness and are non verbal.

These concepts will be discussed in future posts.

For more detailed information, take a look at the suggested readings. Also, check out the annual International Trauma Conference in Boston. The latest researchers and clinicians in trauma present at this world famous venue.


Clancy, Deuchars, & Deuchars, 2013. The wonders of the wanderer. Experimental Physiology, Jan, 98(1) p. 38-45.

Dana, D. (2018). The polyvagal theory in therapy. New York: W.W. Norton & Conpany.

Kain, K. and Terrell (2018). Nurturing resilience. Berkeley, California: North Atlantic Books

Hannaford, C. (1995), Smart Moves: Why learning is not all in your head. Salt Lake City, Utah: Great River Books

Levine, P.A. (2015). Trauma and memory: Brain and body in a search for the living past. Berkeley, California: North Atlantic Books.

Rosenberg, S. (2017). Accessing the healing power of the vagus nerve. Berkeley, California: North Atlantic Books

Van Der Kolk, B. (2014). The body keeps the score. Penguin Books: New York.


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