- 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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I had went through a home invasion back in March of this year at my parent’s house. I had left my estranged and controlling husband of 10 years just days before it happened. I am a developmentally handicapped female. I am 42 years old. I have other health issues as well. I am a kid at heart and love to decorate my bedroom in fun colors and it is in Disney theme. I am wondering on how fun lights and fun colors help me?
My husband was the intruder that snuck in the house with a gun pointing at my father. He was mad because he lost control of me. He was controlling of my social life, my own disability money, tight and he was also getting more meaner. I couldn’t deal with him no more. Plus, he was making me do hard labour work around the house even when I can’t. I also have balance problems, hearing and vision impaired. When I get my hair done, go to a doctor’s appointment, go on a small trip with people other than him, he would complain and say that I am getting too expensive. I am also a 10 year bellydancer. When I went to those events, he would complain. I hope this isn’ t too much info on how he was with me. I will be getting a divorce with him.He is in jail til his sentencing .next month. My parents think I got PTSD from this drama.
Hello Brian, my name is Joanne. It sounds like you have had a pretty tough time lately, and your struggling to make sense of everything you have experienced. Seeking out treatment would be the best place to start here. Only don’t settle on just any therapist. Advocate for what you need and hope to get out of therapy. Cognitive Behavioral Therapy is the very latest breakthrough treatment for trauma recovery. It should help you learn new ways of thinking about things and help to put your thoughts in order. Right now your thoughts are pretty loud I would bet. As the shock stemming from the first event (prison) was being processed something else equally shocking occured (brother’s death) and the emotional and cognitive turmoil created during the second event got dumped on top of the turmoil created during the first event. Which makes it impossible to process either one. It also means that these two tragic events have been related to one another in your mind. As you said in your post, “took away two years I should have had with my brother”. As a result your emotional turmoil has doubled. Your much angrier, and upset than you would be towards these problems if you were just dealing with one of them at a time. Does that make sense? If you can, separate these three tragedies. They are in no way related, and give yourself a huge break. Nobody knows what to say to someone who is depressed, or suicidal. This is a state of existence that takes years to reach. People don’t just snap out of it, what you said, what you didn’t say, it doesn’t matter. Your words were never going to be enough to pull him back from that place. But I know that your brother appreciated the relief that you yourself brought to his life. With your words, your heart and your strength, you gave him more than you know. Be kind to yourself Brian. That’s about the only thing that will bring you back. Take care, Joanne
Dear Brian,
Thank you so much for sharing your pain. We are all so sorry to hear what you have been through and can totally understand the level of pain and suffering you must be in is enormous. Each person who has written in the comments has the best of intentions. I know I certainly do. I would love for you to read our words and receive the support and compassion that is intended. The pain and suffering you are going through deserves attention, you deserve to experience peace and from what I am reading thats far from your current experience. I cannot change the past, I wish I could. From where you are now there are some options of baby steps you can take to receive the support, care and attention you need in order to tend to your pain. I would like to share that although I can’t go to my family for support, I have been in support groups with strangers that have shown me the kindest of compassion and understanding without judgement or without trying to “fix” anything. I believe healing these devastating wounds comes from having our pain heard again and again without judgement, comes from hearing it ourselves for ourselves, and building a support network. This might sound like an enormous task right now, and I hope the courage you’ve shown in your survival and willingness to share here will continue to guide you to get the support and love you needs from safe and reliable places. Please keep going, you deserve peace and joy, my heart goes out to you.