2/05/2012

Symptoms of PTSD: Avoidance (Part 2)

I have been reading the second edition of Coping With Trauma: Hope Through Understanding by Jon G. Allen, PhD, sporadically for the past 2 years. He discusses the topic avoidance a lot in this book. Before you even make it to the double-digit page numbers, he has pretty well defined the role of avoidance in PTSD. He describes it as a primary symptom, saying that anyone who has experienced trauma will likely avoid any reminders of the event. Even thinking about the trauma can trigger overwhelmingly unpleasant emotions. And although avoidance is a natural coping strategy, it can ultimately keep you stuck. To move forward, it is vital to think about the trauma rather than to avoid it.

One recent afternoon, probably as I was trying to avoid other trains of thought, I was thinking, Well, yes, it's true that I avoid things I shouldn't. But there are things that I should avoid. What are those things? I delved into the book of Proverbs and found some very sound advice from King Solomon.

  • Avoid sin.
    • Prov 4:14–15—Enter not into the path of the wicked, and go not in the way of evil men. Avoid it, pass not by it, turn from it, and pass away.
    • Prov 22:3—A prudent man foreseeth the evil, and hideth himself: but the simple pass on, and are punished.
  • Avoid certain types of people, especially in certain situations.
    • Prov 14:7—Go from the presence of a foolish man, when thou perceivest not in him the lips of knowledge.
    • Prov 20:19—He that goeth about as a talebearer revealeth secrets: therefore meddle not with him that flattereth with his lips.
    • Prov 22:24–25—Make no friendship with an angry man; and with a furious man thou shalt not go: Lest thou learn his ways, and get a snare for thy soul.
    • Prov 23:20–21—Be not among winebibbers; among riotous eaters of flesh: For the drunkard and the glutton shall come to poverty: and drowsiness shall clothe a man with rags.
Note that Solomon's advice is for our own good: to keep us from foolishness, to keep our secrets safe, to keep our souls, and to keep us from poverty.

Several of Solomon's ancestors fled people and situations when avoidance was the best action to take.

  • Solomon's father David fled from King Saul in 1 Sam 19:10–12:
    And Saul sought to smite David event to the wall with the javelin; but he slipped away out of Saul's presence, and he smote the javelin into the wall: and David fled, and escaped that night. Saul also sent messengers unto David's house, to watch him, and to slay him in the morning: and Michal David's wife told him, saying, If thou savest not thy life tonight, tomorrow thou shalt be slain. So Michal let David down through a window: and he went, and fled, and escaped.
  • Joseph fled his master Potiphar's wife in Gen 39:7–12:
    And it came to pass after these things, that his master's wife cast her eyes upon Joseph; and she said, Lie with me. But he refused, and said unto his master's wife, Behold, my master wotteth not what is with me in the house, and he hath committed all that he hath to my hand; There is none greater in this house than I; neither hath he kept back any thing from me but thee, because thou art his wife: how then can I do this great wickedness, and sin against God? And it came to pass, as she spake to Joseph day by day, that he hearkened not unto her, to lie by her, or to be with her. And it came to pass about this time, that Joseph went into the house to do his business; and there was none of the men of the house there within. And she caught him by his garment, saying, Lie with me: and he left his garment in her hand, and fled, and got him out.
  • Joseph's father Jacob fled his own father-in-law in Gen 31:3–7, 20–21:
    And the Lord said unto Jacob, Return unto the land of thy fathers, and to thy kindred; and I will be with thee. And Jacob sent and called Rachel and Leah to the field unto his flock, And said unto them, I see your father's countenance, that it is not toward me as before; but the God of my father hath been with me. And ye know that with all my power I have served your father. And your father hath deceived me, and changed my wages ten times; but God suffered him not to hurt me.… And Jacob stole away unawares to Laban the Syrian, in that he told him not that he fled. So he fled with all that he had; and he rose up and passed over the river, and set his face toward the mount of Gilead.

In a first therapy session with a healthcare professional, one of the first questions asked to someone who has been abused is, “Are you in a safe living situation?” To heal and cope, you need to be in a situation conducive to healing and coping (speaking from personal and unfortunate experience). If someone is threatening your life, forcing or coercing you into a sexual relationship, or otherwise taking advantage of you, you have the support of this lowly blogger, hundreds of healthcare professionals, and the Almighty God to leave that situation.

Yes, avoidant behavior is a major symptom of PTSD, but it often has to be the first step on the road to recovery.

More on avoidance (the bad kind) soon …

Scripture quoted from the King James Version of the Bible. The KJV is public domain in the United States. See version information here: https://www.biblegateway.com/versions/King-James-Version-KJV-Bible/#vinfo.