Shining a Light on Post Traumatic Stress Disorder

June is Post Traumatic Stress Disorder (PTSD) Awareness month, and we’re taking this opportunity to shine a light on PTSD in individuals with intellectual or developmental disabilities (I/DD) and how treatment can have benefits outside of PTSD.

“People who have I/DD experience life completely differently than people who are neurotypical,” said Morgan Maffett, a licensed social worker (LSW) at Boundless, “Things that make us happy make them over the moon. Things that make us upset feel like the end of the world to them. It can be like that with PTSD, too. The symptoms are so intense for them that it causes them to behave in ways they might otherwise not have acted. A lot of people with I/DD get put on this dialogue of ‘they are bad,’ but really, they’re hurting and scared. I think if we address the root cause of these behaviors, people with I/DD and PTSD would have a much better outcome in life and they’d be able to enjoy their life much better.”

The understanding of PTSD has come a long way since the World War I era term “shell shock.” Anyone can suffer from PTSD after any traumatic event, whether it’s a violent incident, abuse or an accident. However, because people with I/DD are more vulnerable to traumatic events, PTSD is a real and serious risk for them.

Symptoms of PTSD may include flashbacks, nightmares, severe anxiety or uncontrollable thoughts about the traumatic event. This is true for people with or without I/DD. However, people with I/DD can’t always explain how they’re feeling or express that they’re having trouble coping with the traumatic event.

Many times, symptoms of PTSD manifest in people with I/DD as an increase in negative behaviors such as aggression toward others, self-injury and elopement. Maffett warned about more subtle signs like a loved one suddenly starting to look over their shoulders more or needing to know where all the exits are. She said that caregivers and family members should watch out for “any change in pattern that wasn’t there before.”

However, “PTSD isn’t forever,” said Maffett. With the right treatment, PTSD symptoms can go away completely, and memories of the traumatic event can be nothing more than memories. After treatment, Maffett explained, “some people can say ‘I used to struggle with PTSD,’ and not experience symptoms anymore.” And that’s ultimately the goal of therapy for PTSD, to not just be able to cope with the effects of PTSD but for there to be no symptoms of it at all. And that’s where eye movement desensitization and reprocessing (EMDR) therapy come in.

EMDR is considered one of the leading treatments for PTSD. It relies on back-and-forth eye movements, sounds or vibrations that are used to help neurological pathways become more open and is paired with healthy cognitive patterns. Essentially, if a patient is receiving EMDR treatment for PTSD from an event that made them feel like they weren’t safe or in control, they may hold two small devices in their hands that vibrate back and forth while deliberately thinking something like I can make safe choices regardless of the circumstances. Similarly, this therapy can be done with back-and-forth eye movements or sounds while the patient thinks positive statements about themselves and their perception of the world.

Maffett also emphasized that grounding techniques are an important part of any PTSD treatment, including EMDR. Because PTSD causes intense memories of scary events and EMDR can bring up vivid memories up to two days after a session, individuals with PTSD need to know how to calm themselves and remind themselves that they are safe. Most EMDR therapists, including Maffett, will usually spend the first few sessions with a patient building up their coping skills.

People with I/DD often need to be prompted to use their coping skills when they’re feeling overwhelmed, so it is also important for individuals experiencing PTSD to have supportive family members or caregivers that can remind them to use their coping strategies. However, Maffett has also found that after a month or two of EMDR treatment, many individuals who previously needed to be reminded to use their coping strategies no longer need that prompt.

There are uses for EMDR outside of processing trauma, including building stronger coping skills. Maffett explained, “There are two speeds for EMDR. The fast speed, or the reprocessing speed, is what we use to reprocess trauma, but the resourcing speed is the speed that we use to help build up their coping skills.” When a therapist finds a coping skill that their patient feels would be helpful to them, “we use the slower vibrations back and forth, and that is putting that coping skill into their neuropathways. You can build coping skills so much faster by using EMDR,” said Maffett.

Maffett said that, unfortunately, many people struggle for years before seeking out EMDR treatment. “I wish we could get to the point where EMDR is not the last-case scenario because it could help so much faster, in a much shorter amount of time, if we were able to do it sooner,” Maffett explained. “The sooner you can target a traumatic incident, the faster that your brain and your body can process what happened.”