November 14, 2009

PTSD, The Signature Wound of Modern Warfare

In this reposting I am explaining the split within the combat veteran that allows him or her to be "one person" in a moment and then shift into another completely incompatible individual in the same second. This manifestation of opposing self-states have become a common experience for those of us who have received the "signature wound" of modern warfare.

The leading theorists on the subject recognize that reactions to extreme stress can lead to one or more differing diagnosis, and that inherent in said traumatic reactions is structural dissociation of the personality. Where three types of structural dissociation have been postulated: primary structural dissociation, secondary structural dissociation and tertiary structural dissociation.

Primary structural dissociation involves simple PTSD, and dissociative amnesia, where the Emotional Personality (EP) and the Apparently Normal Personality (ANP) have become disenfranchised or fragmented. The EP " fixated in the trauma and associated experiences....[and the ANP] fixated in avoidance of the trauma, manifesting detachment, numbing, and partial or complete amnesia" (Steele, van der Hart, and Nijenhuis, n.d., para. 8).

PTSD is not only about personal protection or self preservation but in its essence a mechanism of such endeavors, thus becoming a self-perpetual entity in of itself (the EP can develop into a sub-personality, a component of Dissociative Identity Disorder [DID]). Almost as if it has become self-aware and not only will it steer one away from danger, but also away from its own demise; a seemingly serendipitous supra-intelligent guidance of the subconscious.

The EP has evolutionary roots in defensive mechanisms that propelled us through the traumatic experience(s), an inborn reactionary system that can become entrenched within the mind. The EP's success in our survival leads us to firmly identify with this part of ourselves and engages in obsessive and compulsive rumination of the defensive mechanisms and exhibits as symptomatology.

The ANP has become the mode of operation whereby the individual can engage everyday operational tasks. Such as "...attachment, energy management, reproduction and rearing of children, socialization, play, and exploration" (para. 12). To do so, the ANP’s main function is to avoid the intrusive thoughts and fear potentials.

In a constant threat environment, the evolutionary response system and the benefits of survival further encapsulates the differentiated states of mind. Secondary structural dissociation is a result of this prolonged and saturated state of being. A fluid environment demands that we engage in concerted efforts to survive, to do otherwise means death. Animalistic reflexive defense mechanisms such as the fight or flight response or submissive freezing, delve into the realm of “…complex PTSD or disorders of extreme stress (DES), trauma-induced borderline personality disorder, and dissociative disorders not otherwise specified” (para. 12).

Tertiary structural dissociation results from the complete fragmentation of the EP and the ANP. Whereby numerous ANP’s can develop to engage different aspects of a persons life, such as putting on your “work hat” to enable the separation of a traumatic existence to a work self, the social self, etc. Here we find the diagnosis of DID, where traumatic associations or triggers have inundated the individual and submerges them into a function of constantly changing identities governed by situational exchanges.


  1. So, if I read this correctly, the differing hats, which are very normal for most people, seem to be severed one from the other and uncontrollable in the midst of a PTSD episode. As a poet, I am very familiar with exploring those different faces and different states of being, including what I would consider the trauma state of being, which, if you've suffered any trauma at all, is part of your reality. Traumatization will leave a person with a built in defense mechanism, which is difficult to overcome. It makes one 'touchy'. I realize that this is not as severe as PTSD, and am only trying to relate here, come to some sort of common understanding.

    Is it like the regular acknowledgement of different faces we might hold, like protective, public, private, etc -- our various ways of being in the world -- is exagerated in the PTSD sufferer, in the returning soldier? And that the soldier becomes unaware of the transition between these different states of being, since he always feels he is 'under the gun' so to speak? As you say, the PTSD is like an entity to itself, and overtakes the sufferer.

    Have you ever written a poem to the PTSD, or explored it as a different 'entity'? Sorry if that's too personal... I'm a poet. You have to forgive me. That's what I would do, not that you ever should.

  2. I have written poems when inspired to so, you can read them at these links here and here


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