Cathy Hartt, RN, CNM, MS

Most Americans have some memory of the Vietnam war and the scars it left   on the soldiers who were there, formed both from the brutality of the combat   and also in the return home, often without honor. It was during this era that   we saw some recognition of a syndrome called "Post Traumatic Stress   Disorder" or PTSD. Trauma, such as fighting in a brutal war and returning   home without honor, is an event which is not commonly experienced in everyday   life. When such an event is very disturbing to the individual (partially based   on the person’s response to the trauma), then PTSD can occur. Previous life   experience, personality coping mechanisms and availability of support systems   (as well as the intensity of the event) are what determine if PTSD will occur   after a traumatic event.

Can women experience PTSD? Certainly they can. While combat is, perhaps,   the most common reason for a man to experience this - Rape has a similar   impact on a woman. Other factors that can, and do, put women at risk for   developing PTSD include loss of a loved one, a serious accident, violent   crime, a natural disaster, or ongoing physical or emotional abuse. Post   traumatic stress may be seen more frequently in people who are single,   divorced, widowed, poor, or socially isolated.

The symptoms of PTSD can be nearly as frightening as the original event,   especially if the person is unaware of the syndrome and does not seek the   appropriate help and support. The symptoms can include:

Persistent and painful re-experiencing of the event, either through     nightmares (while asleep) or flash backs (while awake).

Emotional numbness or a difficulty in expressing emotions to friends or     loved ones.

Having a difficult time making plans for one’s life.

Various physical symptoms, including pelvic pain occurring without other     causes.

In my own life, I experienced PTSD after a prolonged battle against   cultural discrimination which eventually ended in a painful loss of almost   everything I had once loved. While my symptoms were fairly mild, I recognize   that I was more at-risk for this because I had a similar traumatic experience   with discrimination as a young child in grade school. My sister was   handicapped and, in our small town, I often caught the brunt of the painful   treatment we both received from our classmates. I firmly believe that I got   the strength and determination to fight the cultural discrimination I   experienced as an adult (which benefited the entire community) from my   childhood survival of similar trauma. At the same time, because of my   childhood encounter, I also can see that experiencing similar issues again as   an adult did intensify the pain at times. Being divorced, I fully believe I   was seen as an easier target and, also, had less (financial) supports to fall   back on when the rug finally was pulled out from under me. I had learned   (perhaps from my childhood experience) how to maximize the existing supports   and this, I believe, was key in my own long-term success and recovery.

In my own case, I experienced an incredible feeling of impending doom (this   lasted several months), joint aches (perhaps an immune response from feeling   "rejected"), vivid nightmares about the loss, and a difficulty in   making future plans for my life. My symptoms were mild compared to what some   people experience, and yet were a real wake-up call for me as a healthcare   professional, to the serious impact PTSD can have on our lives.

In my own clinical practice as a nurse-midwife, I see PTSD issues for women   surface most commonly after rape, incest, abuse or loss of a child/pregnancy.   I deal mostly with at-risk, low income women with few supports and frequently   some childhood history of trauma. Because of my own experience with PTSD, I   now believe that this reaction to severe trauma may be more common in women   than most people realize.

What can a woman do if she believes she is experiencing PTSD or is at risk?   Early recognition and treatment is the most effective approach I have found.   (Remember, sometimes the symptoms don’t surface until long after the   trauma.) Early treatment includes quickly recognizing and acknowledging the   traumatic event, talking about your feelings soon after the event, and being   reassured that what you are feeling is normal. From my own experience, I would   also say that recovery is not an overnight process. There are times even years   later when something will serve as a trigger to remembering the trauma. At   these times, it is wise to seek out support systems which allow the woman to   talk freely about her feelings without being told "it is in the   past" or "just move on".

Trauma heals only from talking about it openly with those who understand   and can support. I recommend women who believe they may have PTSD to seek   counseling early, to look for support groups (there are some excellent ones on   the web) and to find those friends who are willing to listen and support as   the deep wounds heal. In time and with proper healing, experiencing such deep   trauma can and does lead to us being even stronger human beings who will reach   out to help others.

Editor, VHPublishing's Empower! - women empowering women

Self Respect: "The willingness to accept responsibility for one's own life is the source from which self respect springs." - Joan Didion

Articles

Most Americans have some memory of the Vietnam war and the scars it left on the soldiers who were there, formed both from the brutality of the combat and also in the return home, often without honor.

A Woman's Experience of Traumatic Stress

He leaned back comfortably in his swivel chair behind the   elegant desk, placed both hands behind his head in a attitude of pure   superiority and said condescendingly (while rolling his eyes and shaking his   head), "No one really reads your newsletters. Mostly, I find them in the   trash around here." You are stunned, confused and hurt. All your life you   have been complimented on your writing abilities and you know lots of folks   who love your newsletters. In fact, you feel this is something you enjoy and   do well. Why would a supervisor not see the gift you are giving to his   organization with your talents?

The reason is simple, once you come to recognize verbal abuse.   There are a couple of excellent books written on the verbal abuse that   frequently occurs in couple relationships by an author named Patricia Evans,   which I refer you to for a more in-depth look at the cycle of verbal abuse.   For the purposes of this article, I will focus on verbal abuse that occurs in   the workplace.

To make a long story short, verbal abuse occurs because the   abuser is in a reality where he feels he must overpower his victim to feel   good about himself. Often he was abused as a child. Or perhaps both victim and   victimizer are influenced by cultural beliefs which support the man dominating   and controlling the woman. Often the victim is confused, as in the scenario   above, because she wants an equal relationship with the male. She wants to   feel empathy, respect, compassion and acceptance from him. She may believe she   can elicit this behavior from him by modeling it - by treating him as she   wants him to treat her. Unfortunately, from his reality, he sees this as a   weakness on her part and will, most often, only escalate his abuse because   scoring a "win" makes him feel good about himself. He suffers low   self esteem and the abusive behaviors help him cover up the part of himself he   doesn't like. He blames his faults on the victim, thereby feeling the abuse is   justified.

So what happens when this dynamic occurs in the work setting   in a supervisor/employee relationship? Several things might happen. The abuse   might be very subtle, such as the example in the first paragraph. Just enough   to make her doubt herself and wonder if her talents are really something   shameful. Or, perhaps it is more overt abuse, such as name calling, belittling   jokes, or yelling. Over time, the female employee may begin to believe the   abuser's perceptions, like a kind of brainwashing has occurred. She may even   loose interest in the things she is most passionate about related to her work.   The key question is: Does my employer applaud the talents I bring to the   organization or does he belittle me when I am successful and believe I am   using my talents to "manipulate" him? If he is not applauding you,   chances are good that this may be abuse.

Because most abusers are in a position of being highly trusted   and usually appear to be the "good guy" to bystanders, often the   woman's coworkers will blame the victim for the abuse. They may try to get her   to believe she is emotionally less healthy than they are, because this   "nice" supervisor is not abusing them. On top of this, most verbal   abuse occurs in one-on-one meetings where there is no witness to help validate   the woman's experience of what her boss has just done to wound her. Perhaps   slowly she begins to wonder if everyone is right - if she is doing something   to deserve the abuse. She begins to doubt her perceptions because everyone   else does. If she believes the abuse is her fault, she will often try harder   and harder to please the boss (or to "fix" herself), only to find   out that the blaming and put-downs have nothing to do with her. They are about   his need for control over her.

What should a woman do if she believes she is being verbally   abused in the workplace? I think there are several answers, depending on the   individual and the situation. First, remember the abuser is not going to   understand that he is abusive if she tries to explain this to him. This is not   his reality - he will see any explanations as her weakness. The best thing is   just to tell him to "stop", that his behavior is abusive and will   not be tolerated. In the best scenario, this will bring him to a realization   that he is abusive and he will be open to trying to change his behavior. All   too frequently, however, this confrontation about the abuse may actually make   the behavior escalate as he struggles for control. He may accuse her of   attacking him! He is often in a position to end her employment or make her   even more miserable, and she may be forced to find another job.

Fortunately, there are some avenues a woman can pursue if she   can substantiate that she is in a hostile or abusive work environment. These   could include the institution's human resources or affirmative action offices,   a professional mediator or attorney, or the EEOC. The most important thing for   the woman to keep in mind is to trust her perceptions and to stand up for her   right to be treated with respect in the workplace. This can be tough, as the   all too frequent response from her coworkers is to blame the victim and   support the perpetrator. For these reasons, it is imperative that she find   supportive friends, a support group or a qualified counselor as she works to   resolve this painful situation. Above all, she must believe that the abuse is   not her fault! The abusive supervisor is accountable.

Cathy Hartt, RN, CNM, MS Editor, VHPublishing's woman2woman

He leaned back comfortably in his swivel chair behind the elegant desk, placed both hands behind his head in a attitude of pure superiority and said condescendingly (while rolling his eyes and shaking his head)

Cathy Hartt, RN, CNM, MS

Articles

A Woman's Experience of Traumatic Stress

Sticks, Stones and Broken Careers: Verbal Abuse in the Workplace