Is there a statute of limitations, a critical point beyond
which it is too late for a person with PTSD to make changes
in themselves? One reader of my website wrote the following:
"I was wondering. Can it be too late for someone to
get better. I'm getting older and well, I've just been wondering.....
Maybe it doesn't matter once you get beyond a certain age--
what if the "thought ruts" that I seem to fall into
can't be adjusted? Entering my early forties makes me think
of that old saying--- " you can't teach an old dog new
tricks". Honestly, is there an age limit recommendation
for this type of mental re-adjustment? --I'm trying hard **sigh**
but I seem to fall back into those awful yet familiar trails
my mind knows so well."
This is not an unfamiliar question. In fact I have been asked
it many times. And I have answered it, but this time my reader's
question inspired me to write down my thoughts and add them
to the growing volume of recorded information about PTSD.
How we feel is a function of brain chemistry. Brain chemistry
can be modified through medication. However, it can also be
modified through therapy. By "therapy" I mean any
and all of those things that we do to help ourselves improve
how well we deal with our PTSD. The goal of therapy is to
modify neural pathways. The thing is that neural pathways
gain or loose strength depending on how much use they get.
Here are some examples to illustrate this point. Think about
a foreign language, a piece of poetry, a song or a piece of
music that you used to know but haven't used, recited, sung
or played in years! Now try to recall as much as you can about
it! Now think of one you've used, recited, sung or played
recently. You know it a lot better, don't you? That's because
the neural pathways have had recent use and have been reinforced.
Okay, well, in PTSD, the same thing happens. Whatever gets
our brain time gets reinforced.
The neural pathways for PTSD of course, got laid down at whatever
point the trauma occurred. The earlier in life that it was
when the neural pathways got formed, the more indelible they
are. So, yes, okay, if your trauma was early you will probably
never be "cured", in the sense that these pathways
cannot be eradicated. But I don't define "cure"
that way. I define cure as "less often, less severe and
less duration". I am of course referring to how we exhibit
the symptoms of PTSD.
I see the goal of therapy for PTSD as being to diminish symptoms.
Of course that also means modifying neural pathways. That
is how we diminish symptoms. The challenge is to diminish
the amount of play time that the PTSD neural pathways get.
If they are reinforced less frequently, less strongly and
for shorter periods then these pathways become weaker. So
the challenge is to figure out ways to reduce the play time
that we give to our automatic PTSD reactions and behaviors.
And, yes, these behaviors are more or less automatic, but
that doesn't mean that we cannot do anything about them.
There are many ways to override the automatic attitudes, reactions
and behaviors of PTSD. One very powerful way is to form a
relationship with someone wherein the level of trust is such
that we can be comfortable with behaving and feeling in a
way that does not repeat the old patterns. We can do this
with a partner, with a close friend or family member, and/or
with a trusted therapist. We can invent, learn and put into
action various devices for heading off symptoms rather than
repeating them. We can learn to recognize our PTSD reactivity
at the point where it is only an impulse or mood and has not
taken the form of an attitude or behavior yet. They we can
redirect our attitudes and behaviors so that those synapses
do not get reinforced. We can enlist the aid of the people
we trust to help us catch ourselves when we are "PTSDing"
as one of my clients calls it. We can read books and articles
about PTSD. We can do the exercizes in workbooks and attend
workshops designed to help people overcome dysfunction and
more fully embrace their lives. We can engage in spiritual
practices that help us focus on and reinforce more positive
life paths/neural pathways. We can do yoga, meditate, pray,
retreat and reflect, etc. to help us regain our composure
and our center so that more positive neural pathways get thereby
reinforced.
So what does all this have to do with age? Well, I believe
that a person can positively impact and reduce the impact
of trauma at any age as long as they still have their mental
faculties. In fact I believe that the older we get the more
aware we tend to become of those methods, means and opportunities
that area available to us to help us grow.
However I have frequently heard it said and had clients complain
that their PTSD didn't manifest itself until they reached
a certain age or it didn't seem to be much of a problem until
a certain age. I believe that there are several reasons for
this phenomenon. It may be simply that as we grow older we
become more aware of our own dysfunction. Prior to a certain
age we may be too well defended against seeing our dysfunction
to seriously address it as a problem. We may act it out in
one way or another. But if we saw this as a problem at all
we may only have seen it as a behavior problem and not as
something deeper and more ingrained. We were probably manifesting
symptoms all along, but they were masking our PTSD. The good
news is that once we do become aware of our PTSD, we can do
something about it.
Many people with PTSD are very strongly motivated to avoid
or deny any recognition of it. Owning and embracing our trauma
histories profoundly impacts the way we think about our selves,
our families and the world around us. Also, the recognition
of our trauma history throws us into the enormous task of
reprocessing those experiences. This can be a very overwhelming
task and we may feel afraid to take it on. All of this may
seem like too big a price to pay for self-awareness. But the
alternative is to sleepwalk through our lives and never become
completely awake to the fullness of experience that is available
to us as human beings on this earth.
Another factor that may contribute to the sense that our PTSD
is getting worse may be the fact that during our twenties
and thirties we tend to be full of hope and focused on the
future. We are working to accomplish certain life goals and
have not yet come to the realization that people for the most
part never fully realize their life goals. Then we hit middle
age and have our midlife crisis. This is when we realize that
we are not as far along as we expected to be by this time
and that we will probably never reach the finish line with
respect to our life goals, not in this lifetime at any rate.
It takes a few years for this realization to sink in and a
few more for us to reach a point of acceptance about it, if
we ever do.
During the years prior our reaching that point of acceptance,
we feel edgy and there can be a lot that triggers us. This
can very definitely feel like our PTSD is no better and in
fact it can feel as if it is getting a lot worse. But the
reality is that we are just processing a lot of major life
issues along side a lot of major trauma issues. It is like
taking on an enormous project that for a long time feels like
it is not moving very rapidly toward fruition. However, the
good news is that if a person is mature enough and evolved
enough to ask a question like that of the website reader quoted
above. They are doing very well indeed, because obviously
they are awake, aware and addressing the questions that they
need to be addressing.
Desired Outcome:
To gain an increasing acceptance of where we are on the path
to enlightenment, to continue reprocessing our trauma, to
recognize and appreciate the progress that we have made and
to embrace wholeheartedly and with great optimism the tasks
that still lie ahead of us.
Discussion Starters:
Have you ever felt like you were too old to do much of anything
about the way your trauma history impacts your life? Have
you ever felt stagnated or plateaued in your progress toward
your goals for dealing with your trauma history? Have you
ever felt like you were loosing ground? Can you see how these
sorts of feelings are not really measures of failure but rather
measures of success? Can you see how they are part of the
process and how they help to point the way to what needs to
be done to help move the process forward? Where are you on
your path to enlightenment? What is your next task or tasks
to move your process forward? What do you need to help you
along your way? How can you congratulate yourself and celebrate
all those many successes that you have achieved so far?
John C Flanagan, LCSW
818 NW 17th Avenue, Suite 7
Portland, OR 97209-2327
503-228-7574
www.johncflanaganlcsw.com
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