Violence against women/children from returning Canadian soldiers

some stuff i wrote and gathered in regard to PTSD in sex workers....maybe it will help. it is a very difficult issue my brother is an afghan vetran. new treatments are emerging all the time however and explosive rage is definitely a symptom- feeling nothing when you should ( not crying at funerals) fell and feeling too much when you shouldn't ( uncontrolable rage)...addiction follows as a coping mechanism or a form of self harm. hope this helps...

With all of the information emerging about the symptoms of PTSD, addiction as a coping mechanism and the dangers associated with interrupting people's coping mechanisms, it's difficult to find ways to ensure no harm within abstinence based funding environments. "Get clean" or off of drugs to receive support policies are compounding emotional harm for trauma survivors and are in direct conflict with the recommended treatment for such injuries. If you interrupt a person's coping mechanisms before they are ready to deal with their injuries, their emotional stability becomes at risk, their symptoms could escalate and at the very least their recovery will be seriously impeded.

 Some programs have found a way to by pass abstinence based approaches by including treatment of "relapse". Instead of cutting off support because a person has relapsed into addiction and "used", the reasons for the relapse are examined and addressed. New coping strategies and alternatives to self harm can be implemented/ suggested and over time these will help to limit exposure to emotionally triggering environments preventing or at least lessening future relapses.

So, yes "get clean" but with attention to relapse. This way funding for addictions treatment becomes available and still respects the symptoms of trauma survivors. I have included a tool for trauma survivors to map triggers and begin to self monitor in the handout's at the front as well as a sheet detailing some alternatives to self harm you may find effective when providing support.

Physical contact- should be a last resort- touching/man handling the victim's of violent crimes can further traumatize them. Members shared how being grabbed or restrained triggered them and contributed to their lack of trust in the systems designed to protect them. The explosive rage and extreme passion of trauma survivors when triggered can be difficult. Monitor their safety but maintain your distance. Restraining a trauma survivor during an episode can prolong the event and make their recovery from it longer and more difficult. Only in the most extreme cases should physical restraint be employed.

Over prescribing feeds addiction and under prescribing forces people to seek other ways to supplement prescriptions. Both situations are difficult and could result in harm to a trauma survivor. Too much and we are enabling, too little and people will take risks (like work in the dangerous street trade) to fill their needs. Try to remember this and see each individual case for what it is then with potential outcomes I mind asses what treatment/ prescription to employ

There is a tendency to blame the victim in these situations. A person who has been abused repeatedly is sometimes mistaken as someone who has a "weak character." Because of their chronic victimization, in the past, survivors have been misdiagnosed by mental health providers as having borderline, dependent, or masochistic personality disorder. When survivors are faulted for the symptoms they experience as a result of victimization, they are being unjustly blamed.

Awareness is key here. Make yourselves familiar with symptoms and treatment. When a person understands their symptoms better, they can become less fearful of them and better able to manage them. By recognizing the effects of PTSD and knowing more about its symptoms, a person is better able to make decisions regarding treatment.

Researchers hope that a new diagnosis of complex PTSD will prevent clinicians, the public, and those who suffer from trauma from mistakenly blaming survivors for their symptoms and misdiagnosising the survivors of trauma.

 
Triggers

Triggers are things that cause physical, mental or emotional changes within a trauma survivor such as certain smell, sound, place, or person. Generally symptoms and feelings become more intense and survivors may avoid thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming. They may use alcohol and substance abuse as a way to avoid and numb feelings and thoughts related to the trauma. Survivors may also engage in self-mutilation and other forms of self-harm.

When the intensity of these feelings has passed identify any particular smells, touch, place, and/or sound that may have set off the intense feelings and reminders of the crime. Getting a sense of triggers can help a survivor avoid situations where they may encounter them. Then ask, what do you say to yourself?  A survivor's understanding of their reactions to triggers can empower them to change those reactions, see themselves differently or to understand why those feelings emerge.

Coping Mechanisms in PTSD

Coping mechanisms can also be described as Survival Strategies. These strategies have been utilized by survivors in the past, or they are using them at present to help numb the pain of the abuse. They are also used to control feelings, which may threaten to overwhelm survivors. Survivors may have experienced or are presently experiencing problems associated with drugs, alcohol, food/eating, and/or self-injury.

• Recent studies have shown a relationship between the frequency of drug use and a history of abuse.

• A similar relationship has been noted with the development of alcoholism and the impact of abuse.

• Eating Disorders are common to female survivors. They may develop anorexia nervosa or bulimia. For a survivor, compulsive control of food intake can be a way of exerting control over her body, control that was denied when she was being abused.

• Some survivors injure themselves, hurting their bodies by burning, slashing or cutting. The reasons for this behavior vary. It can be a way of relieving unbearable anxiety, triggered by memories of the abuse. It can also develop as a way of dealing with and confronting strong, painful emotions, "using new pain to hide old pain". 
• Social Isolation and withdrawal is also common.  Survivors report feeling uncomfortable and unsafe around others.  They also report feeling uncomfortable talking about themselves and their experiences.

Common features of Complex PTSD

People suffering Complex PTSD as a result of criminalization or bullying report consistent symptoms which further help to characterize psychiatric injury and differentiate it from mental illness. These include:

Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)
An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear)
An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience
A simultaneous and paradoxical unwillingness to talk about the experience
A lack of desire for revenge, but a strong motivation for justice
A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty
Extreme fragility, where formerly the person was of a strong, stable character
Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)
Clumsiness
Forgetfulness
Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled
An enhanced environmental awareness, often on a planetary scale
An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat
Willingness to try complementary medicine and alternative, holistic therapies, etc
A constant feeling that one has to justify everything one says and does
A constant need to prove oneself, even when surrounded by good, positive people
An unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as "persecution"
Occasional violent intrusive visualisations
Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable
A feeling of being small, insignificant, and invisible
An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you
In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later
Excessive guilt - when the cause of PTSD is bullying, criminalization or bullying by the system , the guilt expresses itself in forms distinct from "survivor guilt"; it comes out as:

• an initial reluctance to take action against the bully or system and report him/her knowing that he/she could lose his/her job
• later, this reluctance gives way to a strong urge to take action against the bully or system so that others, especially successors, don't have to suffer a similar fate
• reluctance to feel happiness and joy because one's sense of other people's suffering throughout the world is heightened
• a proneness to identifying with other people's suffering
• a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)
• a heightened sense of indebtedness, beholdenness and undue obligation
• a reluctance to earn or accept money because one's sense of poverty and injustice throughout the world is heightened
• an unwillingness to take ill-health retirement because the person doesn't want to believe they are sufficiently unwell to merit it
• an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled
• an unusually strong desire to educate the system and help the system introduce an anti-bullying/fair treatment ethos, usually proportional to the system's lack of interest in fair treatment measures
• a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself
• an unusually high inclination to feel sorry for other people who are under stress, including those in a position of authority, even those who are not fulfilling the duties and obligations of their position.

Fatigue

The fatigue is understandable when you realize that in CPTSD, the victim's fight or flight mechanism eventually becomes activated all of the time in particular for sex workers who often face violence and unfair treatment at the hands of would be clients or the systems intended to protect them on a regular basis The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes permanent, the body's physical, mental and emotional batteries are drained dry, because:

• the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;
• sleep is non-restorative and unrefreshing - one goes to sleep tired and wakes up tired
• this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends a lot of time with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteries never have an opportunity to recharge.

When activated, the body's fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It's no coincidence that people experiencing constant abuse, harassment and bullying report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc). The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired.

There is a tendency to blame the victim in these situations. A person who has been abused repeatedly is sometimes mistaken as someone who has a "weak character." Because of their chronic victimization, in the past, survivors have been misdiagnosed by mental health providers as having borderline, dependent, or masochistic personality disorder. When survivors are faulted for the symptoms they experience as a result of victimization, they are being unjustly blamed.

Researchers hope that a new diagnosis of complex PTSD will prevent clinicians, the public, and those who suffer from trauma from mistakenly blaming survivors for their symptoms.