Piers Morgan who is a rent a gob for the Daily Fail newspaper has taken to twitter over the weekend to comment on Lady Gaga’s rape and her suffering of PTSD. In his comments he suggests that as Lady Gaga is a celebrity that her claim of rape and mental illness is a ploy to gain fans and further her brand. Further more Piers has said that he believes it is an illness which only military veterans can experience.

You would be forgiven for thinking (if unaware of this man) that this maybe someone who suffers from PTSD or who has been raped or possibly that they have a medical degree specialising in neurology or psychiatry. However your assumption would be wrong, this man has NO authority on these matters, he is just a hypocrite who ironically has done the very thing he criticises others of doing. He uses his platform to be controversial and his articles are click bate for anyone who wishes to be angry at “the other” in society.

As you may already be aware (if you follow my blog or art) that I suffer from C-PTSD and have done so most of my life, due to sexual abuse in childhood and then being raped at 15 and then a further 2 times being sexually assaulted in a psychiatric hospital by two male patients. I was first diagnosed with PTSD when I was 15 and later with C-PTSD, with this condition you are affected to a degree that life is no longer functional. We have flash backs which rob us of the opportunity to “move on”, night terrors, hallucinations, dissociation. I have sever pain in my genitalia due to the injuries I suffered and the operations I had due to the violent rape, I developed other mental illnesses like anxiety disorders and depersonalization, as well as having sensory disorders and neurological processing problems.

Read my survivor story here: Confronting my own blood – the aftermath of sexual violence

Here are the tweets that Piers Morgan tweeted:

As you can read for yourself these tweets are rife with misogyny, male privilege, and able privilege as well as perpetuating rape culture, victim blaming and creating more stigma for those who speak out about rape, sexual abuse and violence – as well as those with mental illness and/or neurological disorders.

When people such as this man use their platform to spew opinion as fact and relish in controversy it is as usual the most vulnerable who suffer. These people think that “we” the “victims” are getting some kind of glory from our suffering and illnesses, that we wish to be treated as special little “snowflakes” when in fact all we are faced with is shame, blame and being disbelieved. Piers and others like him, sit in their ivory towers, with no real understanding of what marginalised /minority groups have to deal with and just vomit their privilege upon us from great heights.

As someone who is classed as disabled due to my conditions which all stem from my C-PTSD including my neurological damage, I know what it is to have less rights, visibility, opportunity, earning ability, access to healthcare, being thought of as a danger to others etc.

I have learnt that these kinds of people are just as dangerous as the rapists, the abusers, the paedophiles, the gas-lighters, this is because they open you up again, they re-rape you, abuse you, hit you, torture you, with their ignorance, the erasure they cause and the perpetuation of archaic rhetoric which stigmatises and marginalises people. They are the little helpers to these criminals, with their spreading of misinformation and opinion dressed as fact.

Here were my tweets to Piers Morgan:

Upon waking this morning after a disturbed nights sleep from anxiety and intrusive thoughts, these tweets which flashed up in my twitter feed, re-tweeted by other survivors I know, it felt like another day I had to fight through, another day I felt shamed and judged – my C-PTSD was triggered and the adrenaline started to mount in my body, gulping down the tears and anger. Then I remembered my only role now is that of my activism, in speaking out against people and ideas like this. To survive everyday is a battle, personally I am very grateful to people like Lady Gaga for speaking out, for making people like me feel heard or at least a little more visible and not the shameful secret which society would like us to remain. As a victim who has survived I know that Piers Morgans comments will have hurt Lady Gaga as they did for me, and “hurt” is an understatement – there is no word to describe how these comments contribute to the silencing of survivors and how they normalise rape culture.

So if like Piers you are confused about what PTSD and C-PTSD is, please read this information below.

Here is a copy of the PTSD Leaflet from the Royal College of Psychiatrists:

Introduction

In our everyday lives, any of us can have an experience that is overwhelming, frightening, and beyond our control. We could find ourselves in a car crash, be the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences – they often have to deal with horrifying scenes. Soldiers may be shot or blown up, and see friends killed or injured.

Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years. This is called Post-traumatic Stress Disorder, or PTSD for short.

Complex PTSD

People who have repeatedly experienced:
severe neglect or abuse as an adult or as a child
severe repeated violence or abuse as an adult, such as torture or abusive imprisonment
can have a similar set of reactions. This is called ‘complex PTSD’ and is described later on in this leaflet.

How does PTSD start?

PTSD can start after any traumatic event. A traumatic event is one where you see that you are in danger, your life is threatened, or where you see other people dying or being injured. Typical traumatic events would be:
serious accidents
military combat
violent personal assault (sexual assault, physical attack, abuse, robbery, mugging)
being taken hostage
terrorist attack
being a prisoner-of-war
natural or man-made disasters
being diagnosed with a life-threatening illness.
Even hearing about the unexpected injury or violent death of a family member or close friend can start PTSD.

When does PTSD start?

The symptoms of PTSD can start immediately or after a delay of weeks or months, but usually within 6 months of the traumatic event.

What does PTSD feel like?

Many people feel grief-stricken, depressed, anxious, guilty and angry after a traumatic experience. As well as these understandable emotional reactions, there are three main types of symptoms:
1. Flashbacks & nightmares
You find yourself re-living the event, again and again. This can happen both as a ‘flashback’ in the day and as nightmares when you are asleep. These can be so realistic that it feels as though you are living through the experience all over again. You see it in your mind, but may also feel the emotions and physical sensations of what happened – fear, sweating, smells, sounds, pain.
Ordinary things can trigger off flashbacks. For instance, if you had a car crash in the rain, a rainy day might start a flashback.
2. Avoidance & numbing
It can be just too upsetting to re-live your experience over and over again. So you distract yourself. You keep your mind busy by losing yourself in a hobby, working very hard, or spending your time absorbed in crosswords or jigsaw puzzles. You avoid places and people that remind you of the trauma, and try not to talk about it.
You may deal with the pain of your feelings by trying to feel nothing at all – by becoming emotionally numb. You communicate less with other people who then find it hard to live or work with you.
3. Being ‘on guard’
You find that you stay alert all the time, as if you are looking out for danger. You can’t relax. This is called ‘hypervigilance’. You feel anxious and find it hard to sleep. Other people will notice that you are jumpy and irritable.

Other symptoms
muscle aches and pains
diarrhoea
irregular heartbeats
headaches
feelings of panic and fear
depression
drinking too much alcohol
using drugs (including painkillers).
Why are traumatic events so shocking?

They undermine our sense that life is fair, that it is reasonably safe and that we are secure. A traumatic experience makes it very clear that we can die at any time. The symptoms of PTSD are part of a normal reaction to narrowly-avoided death.

Does everyone get PTSD after a traumatic experience?

No. But nearly everyone will have the symptoms of post-traumatic stress for the first month or so. This is because they can help to keep you going, and help you to understand the experience you have been through. This is an ‘acute stress reaction’. Over a few weeks, most people slowly come to terms with what has happened, and their stress symptoms start to disappear.

Not everyone is so lucky. About 1 in 3 people will find that their symptoms just carry on and that they can’t come to terms with what has happened. It is as though the process has got stuck. The symptoms of post-traumatic stress, although normal in themselves, become a problem – or Post-traumatic Stress Disorder – when they go on for too long.

What makes PTSD worse?

The more disturbing the experience, the more likely you are to develop PTSD. The most traumatic events:
are sudden and unexpected
go on for a long time
are when you are trapped and can’t get away
are man-made
cause many deaths
cause mutilation and loss of arms or legs
involve children.
If you continue to be exposed to stress and uncertainty, this will make it difficult or impossible for your PTSD symptoms to improve.

What about ordinary ‘stress’?

Everybody feels stressed from time to time. Unfortunately, the word ‘stress’ is used to mean two rather different things:
our inner sense of worry, feeling tense or feeling burdened
or

the problems in our life that are giving us these feelings. This could be work, relationships, maybe just trying to get by without much money.
Unlike PTSD, these things are with us, day in and day out. They are part of normal, everyday life, but can produce anxiety, depression, tiredness, and headaches. They can also make some physical problems worse, such as stomach ulcers and skin problems. These are certainly troublesome, but they are not the same as PTSD.

Why does PTSD happen?

We don’t know for certain. There are a several possible explanations for why PTSD occurs.

Psychological
When we are frightened, we remember things very clearly. Although it can be distressing to remember these things, it can help us to understand what happened and, in the long run, help us to survive.
The flashbacks can be seen as replays of what happened. They force us to think about what has happened so we might be better prepared if it were to happen again.
It is tiring and distressing to remember a trauma. Avoidance and numbing keep the number of replays down to a manageable level.
Being ‘on guard’ means that we can react quickly if another crisis happens. We sometimes see this happening with survivors of an earthquake, when there may be second or third shocks. It can also give us the energy for the work that’s needed after an accident or crisis.
But we don’t want to spend the rest of our life going over it. We only want to think about it when we have to – if we find ourselves in a similar situation.

Physical
Adrenaline is a hormone our bodies produce when we are under stress. It ‘pumps up’ the body to prepare it for action. When the stress disappears, the level of adrenaline should go back to normal. In PTSD, it may be that the vivid memories of the trauma keep the levels of adrenaline high. This will make a person tense, irritable, and unable to relax or sleep well.
The hippocampus is a part of the brain that processes memories. High levels of stress hormones, like adrenaline, can stop it from working properly – like ‘blowing a fuse’. This means that flashbacks and nightmares continue because the memories of the trauma can’t be processed. If the stress goes away, and the adrenaline levels get back to normal, the brain is able to repair the damage itself, like other natural healing processes in the body. The disturbing memories can then be processed and the flashbacks and nightmares will slowly disappear.
How do I know when I’ve got over a traumatic experience?

When you can:
think about it without becoming distressed
not feel constantly under threat
not think about it at inappropriate times.
Why is PTSD often not recognised?

None of us like to talk about upsetting events and feelings.
We may not want to admit to having symptoms because we don’t want to be thought of as weak or mentally unstable.
Doctors and other professionals are human. They may feel uncomfortable if we try to talk about gruesome or horrifying events.
People with PTSD often find it easier to talk about the other problems that go along with it – headache, sleep problems, irritability, depression, tension, substance abuse, family or work-related problems.
How can I tell if I have PTSD?

Have you experienced a traumatic event of the sort described at the start of this leaflet? If you have, do you:
have vivid memories, flashbacks or nightmares?
avoid things that remind you of the event?
feel emotionally numb at times?
feel irritable and constantly on edge, but can’t see why?
eat more than usual, or use more drink or drugs than usual?
feel out of control of your mood?
find it more difficult to get on with other people?
have to keep very busy to cope?
feel depressed or exhausted?
If it is less than 6 weeks since the traumatic event and these experiences are slowly improving, they may be part of the normal process of adjustment.
If it is more than 6 weeks since the event, and these experiences don’t seem to be getting better, it is worth talking it over with your doctor.

Children and PTSD

PTSD can develop at any age. Younger children may have upsetting dreams of the actual trauma, which then change into nightmares of monsters. They often re-live the trauma in their play. For example, a child involved in a serious road traffic accident might re-enact the crash with toy cars, over and over again.

They may lose interest in things they used to enjoy. They may find it hard to believe that they will live long enough to grow up.

They often complain of stomach aches and headaches.

How can PTSD be helped?

Helping yourself
Do ………
keep life as normal as possible
get back to your usual routine
talk about what happened to someone you trust
try relaxation exercises
go back to work
eat and exercise regularly
go back to where the traumatic event happened
take time to be with family and friends
be careful when driving – your concentration may be poor
be more careful generally – accidents are more likely at this time
speak to a doctor
expect to get better.
Don’t ……..
beat yourself up about it – PTSD symptoms are not a sign of weakness. They are a normal reaction of a normal person to terrifying experiences.
bottle up your feelings. If you have developed PTSD symptoms, don’t keep it to yourself because treatment is usually very successful.
avoid talking about it
expect the memories to go away immediately; they may be with you for quite some time
expect too much of yourself. Cut yourself a bit of slack while you adjust to what has happened.
stay away from other people
drink lots of alcohol or coffee or smoke more
get overtired
miss meals
take holidays on your own.
What can interfere with getting better?

You may find that other people may:
not let you talk about it
avoid you
be angry with you
think of you as weak
blame you.
These are all ways in which other people protect themselves from thinking about gruesome or horrifying events. It won’t help you because it doesn’t give you the chance to talk over what has happened to you. And it is hard to talk about such things.

A traumatic event can put you into a trance-like state which makes the situation seem unreal or bewildering. It is harder to deal with if you can’t remember what happened, can’t put it into words, or can’t make sense of it.

Treatment

Just as there are both psychological and physical aspects to PTSD, so there are both psychological and physical treatments for it.

Psychotherapy
All the effective psychotherapies for PTSD focus on the traumatic experience – or experiences – rather than your past life. You cannot change or forget what has happened. You can learn to think differently about it, about the world, and about your life.

You need to be able to remember what happened, as fully as possible, without being overwhelmed by fear and distress. These therapies help you to put your experiences into words. By remembering the event, going over it and making sense of it, your mind can do its normal job of storing the memories away, and moving on to other things.

When you start to feel safer, and more in control of your feelings, you won’t need to avoid the memories as much. You will be able to only think about them when you want to, rather than having them burst into your mind out of the blue.

All these treatments should all be given by PTSD specialists. The sessions should be at least weekly, with the same therapist, for 8-12 weeks. Although sessions will usually last around an hour, they can sometimes last up to 90 minutes.
Cognitive Behavioural Therapy (CBT) is a talking treatment which can help us to understand how ‘habits of thinking’ can make the PTSD worse – or even cause it. CBT can help you change these ‘extreme’ ways of thinking, which can also help you to feel better and to behave differently.

EMDR (Eye Movement Desensitisation & Reprocessing):
This is a technique which uses eye movements to help the brain to process flashbacks and to make sense of the traumatic experience. It may sound odd, but it has been shown to work.

Group therapy
This involves meeting with a group of other people who have been through the same, or a similar traumatic event. It can be easier to talk about what happened if you are with other people who have been through a similar experience.

Medication
SSRI antidepressant tablets may help to reduce the strength of PTSD symptoms and relieve any depression that is also present. They will need to be prescribed by a doctor.

This type of medication should not make you sleepy, although they all have some side-effects in some people. They may also produce unpleasant symptoms if stopped too quickly, so the dose should usually be reduced gradually. If they are helpful, you should carry on taking them for around 12 months. Soon after starting an antidepressant, some people may find that they feel more:
anxious
restless
suicidal
These feeling usually pass in a few days, but you should see a doctor regularly.

If these don’t work for you, tricyclic and MAOI antidepressants may still be helpful. For further information, see our leaflet on antidepressants.

Occasionally, if someone is so distressed that they cannot sleep or think clearly, anxiety-reducing medication may be necessary. These tablets should usually not be prescribed for more than 10 days or so.

Body-focussed therapies
These don’t help PTSD directly, but can help to control your distress and hyperarousal, the feeling of being ‘on guard’ all the time. These include physiotherapy and osteopathy, but also complementary therapies such as massage, acupuncture, reflexology, yoga, meditation and tai chi. They can help you to develop ways of relaxing and managing stress.

What works best?

At present, there is evidence that EMDR, Cognitive Behavioural Therapy, behaviour therapy and antidepressants are all effective. There is not enough information for us to show that one of these treatments is better than another. There is not yet any evidence that other forms of psychotherapy or counselling are helpful for PTSD.

Which treatment first?

Guidelines from the National Institute for Health and Care Excellence (NICE) suggest that trauma-focussed psychological therapies (CBT or EMDR) should be offered before medication, wherever possible.

For friends, relatives & colleagues

Do …….
watch out for any changes in behaviour – poor performance at work, lateness, taking sick leave, minor accidents
watch for anger, irritability, depression, lack of interest, lack of concentration
take time to allow a trauma survivor to tell their story
ask general questions
let them talk, don’t interrupt the flow or come back with your own experiences.
Don’t …….

tell a survivor you know how they feel – you don’t
tell a survivor they’re lucky to be alive – it doesn’t feel like that to them
minimise their experience – “it’s not that bad, surely …”
suggest that they just need to “pull themselves together”.
Complex PTSD

This can start weeks or months after the traumatic event, but may take years to be recognised.
Trauma affects a child’s development – the earlier the trauma, the more harm it does. Some children cope by being defensive or aggressive. Others cut themselves off from what is going on around them, and grow up with a sense of shame and guilt rather than feeling confident and good about themselves.
Adults who have been abused or tortured over a period of time develop a similar sense of separation from others, and a lack of trust in the world and other people.
As well as many of the symptoms of PTSD described above, you may find that you:
feel shame and guilt
have a sense of numbness, a lack of feelings in your body
can’t enjoy anything
control your emotions by using street drugs, alcohol, or by harming yourself
cut yourself off from what is going on around you (dissociation)
have physical symptoms caused by your distress
find that you can’t put your emotions into words
want to kill yourself
take risks and do things on the ‘spur of the moment’.
It is worse if:
it happens at an early age – the earlier the age, the worse the trauma
it is caused by a parent or other care giver
the trauma is severe
the trauma goes on for a long time
you are isolated
you are still in touch with the abuser and/or threats to your safety.
Getting better

Try to start doing the normal things of life that have nothing to do with your past experiences of trauma. This could include finding friends, getting a job, doing regular exercise, learning relaxation techniques, developing a hobby or having pets. This helps you slowly to trust the world around you.
Lack of trust in other people – and the world in general – is central to complex PTSD. Treatment often needs to be longer to allow you to develop a secure relationship with a therapist – to experience that it is possible to trust someone in this world without being hurt or abused. The work will often happen in 3 stages:

Stabilisation
You:
learn how to understand and control your distress and emotional cutting-off, or ‘dissociation’. This can involve ‘grounding’ techniques to help you to stay in the present – concentrating on ordinary physical feelings to remind you that you are living in the present, not the abusive and traumatic past.
start to ‘disconnect’ your physical symptoms of fear and anxiety from the memories and emotions that produce them, making them less frightening.
start to be able to tolerate day-to-day life without experiencing anxiety or flashbacks.
This may sometimes be the only help that is needed.

Trauma-focussed Therapy
EMDR or Cognitive Behavioural Therapy can help you to remember your traumatic experiences with less distress and more control. Other psychotherapies, including psychodynamic psychotherapy, can also be helpful. Care needs to be taken in complex PTSD because these treatments can make the situation worse if not used properly.

Reintegration
You begin to develop a new life for yourself. You become able to use your skills or learn new ones, and to make satisfying relationships in the real world.
Medication can be used if you feel too distressed or unsafe, or if psychotherapy is not possible. It can include both antidepressants and antipsychotic medication – but not usually tranquillisers or sleeping tablets.

Internet rresources

UK Psychological Trauma Society (formerly UK Trauma Group): clinical network of UK Traumatic Stress Services.
PILOTS database of the National Center for PTSD (USA): published international literature on PTSD.

David Baldwin’s Trauma Pages website: up-to-date comprehensive information about trauma including leading articles.

Sane Charity – PTSD

References

Post-traumatic Stress Disorder – The Invisible Injury ( 2002). David Kinchin. Successunlimited.
Effective Treatments for PTSD: Practice Guidelines from the International Society of Traumatic Stress Studies (2nd edition) (2010). Eds. Foa E, Keane T, Friedman M & Cohen JA.
Treating Trauma: Survivors with PTSD (2002). Ed. Yehuda, R. Washington DC. American Publishing.
Adshead G and Ferris S. Treatment of victims of trauma. Advances in Psychiatric Treatment (September 2007) 13:358-368.
Bisson JI, Pharmacological treatment of post-traumatic stress disorder. Advances in Psychiatric Treatment (March 2007) 13:119-126.
Coetzee RH and Regel S, Eye movement desensitisation and reprocessing: an update. Advances in Psychiatric Treatment (March 2005) 11:347-354.
Hull, A.M., Alexander, D.A. & Klein, S. Survivors of the Piper Alpha oil platform disaster: long-term follow-up study (2002). Br. J. Psychiatry, 181: 433 – 438
NICE guidelines (update 2012): Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care.
Lab, D., Santos, I. & de Zulueta, F.Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches (2008). Psychiatric Bulletin, 32: 8-12.
Frueh BC, Grubaugh AL, Yeager DE and Magruder KM. Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics (2009). The British Journal of Psychiatry, 194, 515–520.