- PTSD can be divided into four phases: the impact phase, the rescue phase, the intermediate recovery phase, and the long-term reconstruction phase.
- The impact phase encompasses initial reactions such as shock, fear, and guilt.
- In the rescue phase, the affected individual begins to come to terms with what has happened.
- The intermediate recovery phase is characterized by one’s adjusting to normal life again.
- Long-term reconstruction is all about rebuilding and continuing to deal with the aftermath of the trauma.
Most of us are familiar with the term “PTSD” (or posttraumatic stress disorder), but our knowledge doesn’t extend much further. We know that it can involve frightening flashbacks and nightmares. That war veterans and assault victims are at a heightened risk of developing the illness. But do we have a clear idea of how this illness unfolds and how it might affect victims over time? If you do, great. If you don’t, you’re going to! Courtesy of myself and Dr. Sal Raichbach, a licensed clinical social worker at Ambrosia Treatment Center. “Posttraumatic stress disorder is comprised of four phases: impact, rescue, intermediate recovery, and long-term reconstruction,” Raichbach explains. “As the individual passes through these stages, symptoms can come and go. These phases aren’t fixed though, and individuals can pass from one into the other during their recovery journey.” Now, keeping that in mind, let’s delve into these four phases.
Impact
This first phase—the impact phase—typically occurs soon after the individual has experienced or witnessed the given traumatic event. It can last as little as a few hours, but may also persist for much longer, depending largely on the severity of the event. For example, someone who has lost their home in a fire may stay in the impact phase for a longer period of time, whereas an individual who witnessed a robbery may experience a shorter impact phase because they can physically escape that nightmare and return safely home. In either and any regard, affected individuals typically experience the following…
- Shock
- Fear
- Helplessness
- Guilt
- Anxiety
- Hypervigilance
Rescue
The next phase is the rescue phase, whereas the individual starts to come to terms with what has happened. This might involve returning to one’s home to assess damage or talking to other survivors—it’s about acknowledging what has happened in one capacity or another. That’s not to say, however, that one fully processes the trauma in this phase—they are still dealing with the initial shock and distress. And they typically experience a range of difficult emotions as well as mental and physical effects. These effects include…
- Denial
- Confusion
- Anxiety
- Flashbacks
- Nightmares
- Despair
- Hopelessness
- Sadness
- Anger
- Numbness
Intermediate Recovery
The intermediate recovery phase is characterized by one’s adjusting and returning to “normal” life again. Once the individual has fulfilled his or her basic safety and survival needs—which is often difficult after one has experienced this high level of trauma—they can begin to cater to other needs that emerge. In addition, this stage often involves addressing new and ongoing adversities, as well as being humbled by an outpouring of love and support or disappointed by a lack thereof. It can ultimately be broken down into two sub-stages:
Altruism: The affected individual is amazed by the support and love they receive from others. So much so that they are inspired to take action and help others, too. They might also feel uncomfortable or hesitant expressing any negativity because they don’t want to appear ungrateful for all that has been done for them.
Disillusionment: This substage is just the opposite of the previous. Rather than feeling overwhelmed by love and support, the individual feels disappointed by the lack of a response. On the flip side, one might experience the effects of this substage when the support seizes, and they realize they’re on their own to deal with the remainder of the mess.
The effects we talked about in the last phase also often continue on into this stage. One may experience physical symptoms such as fatigue and/or sleep disturbances, as well as stress reactions like irritability.
Long-Term Reconstruction
As one might assume, this phase is all about rebuilding and continuing to deal with personal post-event problems. As an individual moves into this phase, they may become concerned about their future, which can present as…
- Fear
- Resentment
- Depression
Additionally, the meaning that one assigns to the traumatic experience can have long-term effects on their mental and emotional wellbeing—which makes talking about the event and coming to terms with the trauma one has experienced extremely important, as explained by Raichbach: “If an individual’s PTSD isn’t adequately treated, the symptoms can last for years after the event. If the emotions and memories of the event aren’t processed, they can have severe mental health consequences.” He goes on to say that processing the memory with help from a mental health professional is vital to long-term recovery.
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Thank you for this. Very helpful!
I have been trapped in a depression of sorts and I am hopeful to get an opinion of others on my best chance for recovery. About 5 years ago I was betrayed, lost the love of my life and was sent to prison for something I didn’t do partly to protect others partly because I had to choose between bad or worse. I was released on parole 2 years later and as I was readjusting to society I found the love of my life never paused her life in anyway…it was like rubbing salt into a wound. Then when I thought things couldn’t be worse my brother committed suicide…I was devastated….I was the only one he reached out to and I didn’t have the words to stop him…I couldn’t get to him fast enough…as I tried to breathe again I found anger towards police and prosecutors who took away two years I should have had with my brother. About six months after my brother died I started recovering…my best friend was going through some issues so I travelled to help him…he was going to come stay with me a few weeks….when I got to the place he was staying there was no answer at the door….finally the owner arrived we opened the door to my friend of 40 years dead…overdose…couldn’t revive him….all lost….all lost…permanent…I struggle, I may have bits of recovery followed by unimaginable pain, nightmares and hyper vigilance towards the establishment that put me in jail…but only as a distraction to problems I am in
I’m so sorry to hear about what you are going through. If you are at risk of hurting yourself or others, please immediately call 911 or go to the nearest Crisis Center or Emergency Room.
I’m so very sorry for your pain. It’s not your fault. Get help please. God restores
My mother gave me PTSD…..she unwittingly tricked me into helping
her with her abortion of my baby brother….
That was 50+ years ago and I still agonize over it….
She is very angry and dismissive of me because I won’t act like it never happened…
It is hard to forget taking a little person out of a toilet to be wrapped in newspaper and never knowing what happened with him…….
He was never mentioned…. it was like he never existed….
I don’t understand how people can throw away their babies….linda
I’m pro life and I’m so sorry to hear about that. I pray you feel forgiven
Get the book
The body keeps score
By Bessel VanDerKolk MD
It will help you heal
Thank you for the recommendation. I will buy it because I have CPTSD and I’m really struggling. My identical twin has severe autism, is non verbal, has CPTSD and Bi polar.
She was forcefully taken from the family home at the age of ten, and institutionalised for 30 years, for no other reason than having an intellectual disability.
She was abused, neglected, yelled at, starved, then forced fed when she became anorexic, beaten to a pulp, locked in a dark room for weeks, locked in a tiny wardrobe, raped, tested on pharmaceuticals like a guinea pig. This went on for thirty years.
She was removed from home in 1985, in a regional area in Australia.
My parents were threatened with imprisonment if they didn’t give her up.
The authorities said she needed to get an “education”.
We lived on a farm, and while our 6 siblings went to school, she didn’t because there was no special school for her in the country side.
She had been to special school in Melbourne but then we moved to the country because my parents were farmers.
Family services lied to me. They told me she was being taken away to receive an education and “special care”. Instead they took her 12 hours drive away.
This effected me immensely. I had to fight bureaucracy for two decades to become her carer. I was denied visiting rights and was prevented from talking to her on the phone.
People don’t believe my story because they think Australia is a free country. We escaped Romania (a Communist / dictatorship country at the time) and arrived when we were five. That escape in itself was traumatic.
I had a drinking problem for 15 years. It wasn’t until I was finally reunited with her that I stopped drinking. I fought my battle with no support from family or friends.
Both my parents have passed more than a 15 years ago. My sister and brothers want nothing to do with her. And these siblings have the nerve to promote themselves as devout Christians.
I have been looking after her for the last 6 years and although I’ve managed to turn her life around and she has come along way since I first took over, I am exhausted.
She no longer smears poo every where on the walls, wets the bed, or pisses on the floor instead of using the toilet.
She no longer is stuck in trauma where she screams and harms herself. She was stuck in trauma (which presents like psychosis) for nine months, until I took her to a psychiatrist.
She no longer looks like she is possessed by demons, or looks like she has multiple demon personalities coming out of her.
She no longer hides in the wardrobe in the hot humidity rocking violently.
She no longer harms herself to the same extent that she used to.
She still rips up her clothes, and still has behaviours but her life has improved.
I think I need help, because I’m exhausted.
We’re so sorry to read what you’re going through. If you are struggling with suicidal thoughts, or thinking about hurting yourself or others, please seek immediate help. Call 911, go to your closest emergency room, or call the National Suicide Hotline at 1-800-273-8255. You can also visit their website at https://suicidepreventionlifeline.org. This national network of local crisis centers provides free support, and someone is always available to talk.
You can also find a list of other helpful resources here, such as the Crisis Text Line, National Domestic Violence Hotline, and more. Remember, life can get better with the right help.
Go get professional help. If you broke your leg, you’d go to a doctor. The “impact” of traumatic things happening to you has “broken” your brain’s ability to adjust to them. Doesn’t mean there is anything intrinsically wrong with your brain (weakness, etc.), anyone’s leg would break with enough pressure. Doesn’t mean you “deserve” to have psychological problems because there is something wrong with you. No one deserves to have his leg broken. But you need professional help just like your leg would need it to be set and “heal” properly. Please go get professional help. Not your friends, church, school teachers, the internet, etc. but PROFESSIONAL HELP! You wouldn’t expect a friend to set your leg now would you? Try to find one that deals with trauma and PTSD. They will understand and can help you!
Do you know anyone/websites that can help like they helped you?
Brian, it is so easy for others to say “get help”, and yes you should, but unless they have experienced even a small part of what you have been through, they just don’t know. When life keeps pulling the rug out from under you, it doesn’t take very long to have no compass, no horizon, no rock to stabilize your heart, mind, body and spirit. I don’t know what your beliefs are, but I know in my case, the only way I get through each day, each hour, is my absolute faith in Jesus Christ who is continually saving me and lifting me up. It is what makes my journey through this life have meaning. I pray you are moved to reach out to Him as well, I know He is reaching for you.
It’s been a while since what happened happened. I was involved in an accident where someone died on impact and I saw the other person die in front of me. I couldn’t do anything about it because I was too scared. I heard her screaming and gasping for air. A week later my best friend got into a really bad car accident, which he was close to passing away as well it was a miracle he survived. I have been struggling a lot with reality. I struggle with nightmares and a lot of the symptoms of ptsd. The one that seems to get stuck in my mind is that either I died in my car accident and I’m living in a type of hell (it doesn’t help everything in the media, mainly things that seem like they would happen in my personal hell) or that my best friend died and I’m just lying to myself to protect what I have left of him. Saying it out loud and writing it seems to help filter the thoughts but it’s when I’m alone and driving mainly that I struggle with telling apart facts and what my mind is making up. I’m not sure if that is a part of ptsd, and I wasn’t even sure if I should post this comment. But lately I’ve been thinking more and trying to help myself more. So in short, could that be a symptom of ptsd?
Hey, Riley! I think it would be a great decision to go find someone to help you be able to cope and find comfort where you are now. i do believe flashbacks, rejection, denial, and such responses to traumatic events are PTSD. Whenever we have very very bad moments and we don’t have much support to help us recover, an initial bad crisis can affect our emotion and psychological processes to how we handle the stress and everyday life. Thankfully there are people out there who can support us. Therefore, the means to cope. Please reach out to a Trauma and PTSD counselor. Counselors specialize in Trauma and understand many PTSD patients of all different backgrounds. They will have the ability to be a support and guide, allowing you to be able to move forward and appreciate the future in a brighter picture with those whom you love. I also think that should clear up the constant episodes of grief.. however, please do find a counselor. It can be dangerous to drive around and become distracted with those episodes. Therefore, it might not only be important for your mental health, but also your physical health, to find some help. Good luck to you, Riley! I hope you find happier and easier days in your future. – NB.
I don’t really know what or how to ask. In July of 2019 I was nearly crushed to death by a man who lost control of a steamroller. I can still hear the sound of the machine. Ivan still hear the sound my body was making as I was being crushed. What really bothers me today is the overwhelming amount of fear that comes over me when something startles me or loud noises. I feel like a scared little kid sometimes and I’m a 44 year old man with a family. Does this get better with time and does anyone know how long it takes. I’m just tired of feeling this way. I knew I had a long road of physical recovery ahead of me but I really didn’t know or expect the mental part of this injury. It’s been much harder to deal with. My broken body is healing but sometimes I can’t even leave the house due to fear of the what ifs. Anybody have anything helpful fore
Brian, please go and get professional help. I just had my worse breakdown yet and was rushed to the emergency room with psychosis. Another emergency room, an ambulance ride to a psych ward, and 6 nights later I am finally home. I actually understand what is happening to me and learned some coping skills. I had my medications adjusted, talked to counselors and people like me, and understand my illness better. It was very hard to do (as I checked myself in), but I did it because I saw the fear in my family’s eyes (my 12 year old daughter was screaming, crying and vomiting because I asked everyone if “I was dying?”. My daughter’s biggest fear in life is that I will die – she also has Generalized Anxiety Disorder. I am now focusing on my issues and getting help for my husband, daughter and son. Know why? They are the only 3 people who have always loved me unconditionally. Do you know how I know that? I went through extensive therapy and dealt with my traumas. This doesn’t meant that I won’t struggle, but knowledge is power. At least now, my family knows what is happening to me and they are here to support me when I have anxiety attacks (every single day of my life). I’m having one right now writing this but I want to help you because sometimes it just takes one person to say the right thing. That’s what I learned in GROUP THERAPY, I need to be supported by others who understand me. Anyone who is not a SURVIVOR like me, doesn’t understand the hell I live through every day. They love me, but I frustrate them and they worry about me. I need to finally be truthful about what is happening inside of me – I’m not crazy or broken. I broke but I’m not broken. Please think about setting yourself free.
Reading this and I feel for you, man. I am sorry you’re going through this loss & hurt. Seems neverending, but everyone and just do what YOU need to feel better. Much strength & love to you, man.
Thank you for this article I am currently receiving treatment and probably like many as someone who wasn’t a soldier who had suffered what they have i found it hard to accept i have ptsd but everything in this article matches my symptoms,it has made it easier to accept my diagnosis, thank you again
I just did 17yrz n prison n I have been out a year.i was I’m varner super max and a guy I talk to n the cell next to me hung hisself.i watched them cut him dwn from his vent an carry his dead out his cell and lay him on the ground..
cool
Best treatment for veterans is go to the VA Hospital they really care …… I did in 2012
I lost my son in November 2018 then my sister in December 25.2019.. i live in Denial confusion.having nightmares..on the inside of me it just numbness and anger I was having bad headaches Anxiety.. contacted my doctor .. she recommends mirtazapaine also conclling therapy..i m sleeping ats but im getting fash backs..i Moffat from work becuz of the traumatic stress.lord help us please
Hi Angela,
I am so sorry to hear about your tragic loss’. I am also recovering from PTSD and I too am now on Teva-Mirtazapine and I take it before bed. It helps to sedate you into sleeping a full night’s rest. It has helped immensely as well as counselling. I know hearing advice feels pointless around times like these, but I have started to list out loud everything I am grateful for before I go to sleep and thank what it is I do have left in this world. Feels ridiculous, especially after losing a son, but soon it will remind you that you have a purpose here and are loved and are important in this world. If you ever need to talk, please reach out to me, and if you’re ever feeling suicidal or harmful to yourself or others please reach out to a helpline and call 911.
I am with you. My brother also recently committed suicide and the system failed him completely. I’ve lost so many to drug overdoses, suicides, cruelty and more. Sometimes it’s unreal to me that I have gone through so much and continue to try and see the better side of things. But when I am alone I allow myself to be upset and remember that it is all real. It feels sort of like living a fake life. All this to say, You are not alone, though I can’t know how you feel within your own pain and grief and PTSD. Please reach out to me on here if you need anyone to talk to.
Be not dismayed what’er be tide,
God will take care of you.
Beneath His wings of love abide,
God will take care of you.
God will take care of you,
through every day o’er all the way.
He will take care of you.
God will take care of you.
All will be well for you.
Be not dismayed what’er be tide,
God will take care of you.
Beneath His wings of love abide,
God will take care of you.
God will take care of you,
through every day o’er all the way.
He will take care of you.
God will take care of you.
The nayional crisis hotline can help. Please call 18006624357 if you need someone to talk to.
This was very helpful