One of the diagnostic criteria for PTSD is hypervigilance.
Hypervigilance is watchfulness or checking one's surroundings
that is over and above what is normal or reasonable. Hypervigilance
takes many forms. It is what makes some of us always choose
an aisle seat or one where our back is to a wall. It's what
makes some of us carry defensive weapons such as guns, knives,
mace or pepper spray, a police whistle or a cell phone set
to 911. It makes some of us cross the street to avoid suspicious
people. Some of us have alarm systems, multiple locks, window
locks, high fences, guard dogs, etc. Another form of hypervigilance
is studying people very carefully in an attempt to look deeply
into their soul to determine exactly what they are made of.
Hypervigilance is included in the cluster of symptoms referred
to as "increased arousal". This cluster also includes
difficulty sleeping, irritability or outbursts of anger, difficulty
concentrating, and exaggerated startle response.
This increased arousal stems directly from our trauma and
the form it takes is shaped directly by the nature of our
trauma. If we have difficulty sleeping, it may be because
we were afraid to go to sleep or stay asleep for fear of an
attack of some sort while we were not conscious to repel it
or avoid it. If we are irritable, it may be to warn people
to keep their distance or to not behave in ways that might
trigger us. If we can't concentrate it may be because we are
too busy trying to monitor all inputs from possible dangers.
If we startle easily it may be because we learned to jump
quickly to get out of harm's way. And if we are hypervigilant
it is probably because we saw our environment as having multiple
and unpredictable dangers that we should be on constant alert
for. In fact, much of the time our hypervigilance helps to
keep us safe.
However, the "hyper" in hypervigilance suggests
that we do more than is normal or reasonable. It is too much
because it is an inconvenience or an encumbrance. While it
is probably true that we with PTSD are indeed safer because
of all the precautions that we take, it is probably also true
that our hypervigilance does often get in the way. It may
be that we deprive ourselves of going certain places and of
partaking in certain events. For example, we don't go to an
event because we can't get an aisle seat, or because we don't
know what kind of people are going to be there. Sometimes
we see people looking at us and we think that they are judging
us or are hostile toward us. Sometimes we are afraid to eat
certain foods because we are afraid of being poisoned or made
ill. And, there are probably numerous other examples of ways
in which hypervigilance inconveniences us.
Desired Outcome:
Gain an increased understanding of the sources of our hypervigilance,
acknowledge its advantages and disadvantages and increase
our ability to manage our unwanted behaviors that are driven
by our hypervigilance.
Discussion Starters:
When, where and how have you been hypervigilant? How have
you reacted to your own and others hypervigilance in the past
and how do you tend to respond to it now? When do you feel
that hypervigilance is bad and when do you feel that it is
good? What have you done to try to manage unwanted hypervigilance
and what has worked or not worked?
John C Flanagan, LCSW
818 NW 17th Avenue, Suite 7
Portland, OR 97209-2327
503-228-7574
www.johncflanaganlcsw.com
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