PTSD and Trauma Explained by Dr. Glenn Schiraldi

glenn schiraldi ptsd sourcebook excerpt

 

 

One of my favorite books that I’ve ever read about PTSD recovery Dr. Glenn Schiraldi’s, The Post-Traumatic Stress Disorder Sourcebook. To call this a “sourcebook” is an understatement.

Whether you’re just beginning to learn about symptoms of posttraumatic stress or wanting to develop a deeper understanding of a single topic in the PTSD and trauma mix this book is a fantastic guide — which is why I’m so excited today to post an excerpt from the newly expanded version….

Excerpt from The Post-Traumatic Stress Disorder Sourcebook, Revised & Expanded

By Dr. Glenn Schiraldi

 Resolving Guilt

Guilt is an unpleasant feeling. In guilt we feel responsible for what happened. Our conclusion is that our role in the event resulted in the negative outcome. Guilt is not a useless emotion. Guilt affirms morality. We would be concerned, for example, about a drunk driver who felt no remorse for injuring someone. We would hesitate to form a relationship or enter into business with someone who had no conscience.

Guilt is a motivator for change. If we hurt someone we care about, guilt helps us to improve our behavior. Guilt is an ally when it leads directly to a satisfactory resolution. It can help us see clearly what happened so that we can make needed adjustments and then put the guilt to rest. Unresolved guilt keeps memories emotionally charged and in active memory.

To integrate memories, we must recall the memory fragments in sufficient detail to put them back together again, and then emotionally defuse the whole memory so that it can be stored in long-term memory. To begin this process, let’s begin by considering how we might be experiencing guilt.

What we do, think, or feel. Examples are:

  • Drinking too much
  • Feeling afraid
  • Going along with the demands of the perpetrator (rapist, terrorist, batterer, abusive parent, robber)
  • Going along with the immoral behaviors of others (e.g., leaders or friends)
  • Feeling relief for surviving when others did not
  • Having PTSD when others “had it much worse”
  • Causing the offender to commit the crime (e.g., by making oneself attractive, wanting attention)
  • Saving myself but not others; abandoning others
  • Killing (as in combat or police work), which violates cherished values
  • Errors in judgment (e.g., permitting a teenager to travel with an irresponsible driver)
  • Identifying with the victimizer (seeing good points, trying to win favor or privileges, becoming a participant in the offense)
  • Wanting to die and be released from pain
  • Living a life that we think is so imperfect as to warrant traumatic events
  • Feeling ambivalent about those who died
  • Carelessness; thoughtlessness
  • An innocent mistake or accident
  • Hating the perpetrator; wanting to harm him
  • Enjoying aspects of sexual abuse
  • Acting unkindly to someone who was later injured or killed
  • Trusting someone’s judgment or decisions, which later resulted in harm to people
  • Using or exploiting others sexually to feel better after the trauma

What we fail to do, think, or feel. Examples include:

  • Failing to save or protect others (parent doesn’t stop kidnapping or rape, firefighter does not save burn victims)
  • Failing to take suitable precautions
  • Freezing and doing nothing; didn’t fight harder
  • Failing to leave a relationship with a batterer who severely injures a child
  • Failing to stop chronic abuse
  • Wishing that you could have done more
  • Failing to live up to your ideal or normal expectations
  • Letting others down
  • Failing to control symptoms or recover
  • Failing to say “I love you” or tell the deceased how much you valued them
  • Not having a proper way to say good-bye to someone who has died
  • Not pressing charges or reporting a crime to the police
  • Not feeling sympathetic to others’ suffering
  • Unreasonable accusations that we internalize (“I feel guilty, so I must be.”)
  • Police don’t believe your story and imply you are making it up or asked for it
  • The lawyer defending the perpetrator attacks your character
  • People think that the crime against you was your fault

The successful resolution of guilt follows a course similar to other intense feelings common to PTSD:

  1. Denial. Because guilt is so uncomfortable, we may deny responsibility at first. We may be shocked and numb.
  2. In time, we accurately assess the harm done and legitimately assess our responsibility. We learn our lessons and neutralize emotions by clarifying faulty thinking.
  3. Here we express appropriate sorrow for the hurt we have caused and make amends as appropriate. Guilt and self-punishment are released. The focus transitions to constructive change and growth. We again look ahead, concentrating on elevating humanity—self and others.

We can’t process what is not adequately retrieved from memory. If we avoid thinking about the event, then memory fragments will intrude, but not sufficiently for processing. Unresolved guilt continues to be replayed like a broken record. In attempts to kill the pain, we numb our conscience and sensitivity to the pain of others while becoming unable to emotionally connect with them.

Many inaccuracies can enter our memories during the stress of a traumatic focused on survival that we do not see the whole picture. We may assume an exaggerated sense of responsibility and underappreciate mitigating circumstances. These views are never effectively challenged as one tries to “just forget the past and move on.”

Without complete processing, many other unkind ideas remain unchallenged. Shame often rides in on guilt’s coattails. Shame goes one step further than guilt, saying, “Not only did I do something bad, but I am bad to the core.” Shame is frequently a pattern learned in childhood. Perhaps the survivor felt

worthless when she was abandoned, or was constantly given messages of badness. The child does not think to question these messages, and so remains vulnerable when a traumatic event later occurs. A variety of other unkind ideas can be learned and connected to the trauma. If they remain unchallenged, they retain their ability to disturb the survivor. The following list is a sampling of distortions and core beliefs that are often associated with guilt.

  • I am either all responsible or not at all. I cannot be partly at fault.
  • I feel so badly that I must be completely responsible.
  • I don’t deserve to live or to live happily because of my behavior.
  • I should have done better.
  • The more I punish myself, the more I show I care.
  • The more I suffer and punish myself, the more I will ease another’s suffering.
  • The more I suffer, the less likely I will be to repeat the mistake.
  • If I give up guilt, I will be disloyal to my values, God, or those who have suffered.
  • If I suffer enough, I will somehow restore fairness and justice.
  • I should be able to fix all problems, right all wrongs, save all who are in trouble, and vanquish all evil.
  • I shouldn’t have been afraid.
  • I am somehow responsible—even totally responsible—for a crime committed against me.
  • There is absolutely nothing I can do to improve upon the past.
  • My character is flawed and unchangeable. (In truth, everyone’s character is flawed, but not unchangeable.)
  • I should have acted in a way that only came to me later (hindsight bias).

How Is Guilt Resolved?

In order to begin the processing of the guilt aspects of your traumatic memory, please respond to the following questions. This is now just a fact-gathering exercise.

Think of yourself as a reporter researching a story. I suggest writing the answers because writing tends to make the processing slower and more deliberate.  You might prefer to speak your responses to your therapist.

  1. What happened? (Describe the event. List all the facts. What did I do that was good and bad? What did I fail to do that was good and bad?)
  2. Why did the event happen? (Why did it happen to me? Was it a random act of nature or of God? Was it something about me?)
  3. Why did I act the way I did during the event?
  4. Why have I acted the way I have since that time? (How and why have I changed as a result of the event for good and bad?)
  5. If something like this were to happen again, what would I do differently to cope and survive? (What strengths and knowledge would lead to a more optimistic outcome?)

 
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