Trauma, Retraumatization, and the Value of Long-Term PTSD Treatment

In many ways, Copeland’s cross-country walk symbolizes the long journey people living with PTSD must take in order to heal from their illness. Whether triggered by sexual assault, natural disasters, war, neglect, abuse, or another form of trauma, there is no quick fix for PTSD. Recovery requires work that is often long and hard, and the longer that work is delayed, the more difficult recovery can become. In some cases, people can successfully recover through outpatient treatment alone. Often, though, the symptomatology of PTSD is so deeply embedded that outpatient care cannot adequately address the all-encompassing nature of the illness. This may be particularly true when everyday living itself becomes a re-traumatizing experience.

Andrea Pino knows this well. At the age of 20, Pino was violently raped on her college campus. When she reported the crime, her college failed to take action. Soon after, the environment itself became a constant trigger. “Sending emails, taking exams, hearing laughter, seeing police lights: these were my daily panic attacks,” she writes in a moving essay for the Huffington Post. “My triggers weren’t the memories of my rape. My triggers were my entire world.”

For Pino, trauma wasn’t an isolated phenomenon located solely within the initial traumatizing event itself, but was instead an ongoing process of trauma and retraumatization. Every time someone said they didn’t believe her, told her to just get over it, or implied she was being irrational, she experienced new traumas in the form of psychological violence. Jennifer Norris, a veteran and sexual assault survivor who was retired from the military after reporting her rape, echoes these sentiments. “In the end, I realized that the original oppression AND retaliation for reporting those violent crimes is what truly damaged me.”

Sexual assault survivors are not the only ones who struggle with PTSD retraumatization. Survivors of intimate partner violence, sexual assault, child abuse, and other forms of violence often face ongoing traumas as they struggle to cope with their illness and are all too often met with a lack of validation and meaningful support, even from those who are supposed to protect them. This continuous deepening of trauma can create mental health disturbances that are too complex to heal from on an outpatient basis.

The internal processes attendant to PTSD often manifest in concrete behavioral symptoms as you try to cope with the overwhelming emotions your illness brings. For many, these symptoms translate into profound withdrawal from everyday activities, including school, work, and socialization. If you have experienced retraumatization within previously safe environments, even those places, people, and activities that once used to be benign parts of your everyday life can be particularly likely to become triggering, including relationships with those closest to you. As a result, your ability to participate in normal living may be severely impeded. If you experienced the original trauma at a highly vulnerable phase of life, such as the transition into young adulthood, this may be a particularly likely outcome.

While all PTSD treatment seeks to address the original trauma itself, outpatient and short-term treatment are often not able to adequately touch on the full scope of your particular situation, including retraumatization and functional disturbances. As such, true and lasting healing may not be possible within these environments for some people. Participating in limited or ineffective treatment can not only be demoralizing, but may deepen your suffering as you continue to live in a state of trauma without relief—which is what makes seeking proper care in the right environment so important.