Why can two people who have the same traumatic experience respond and recover differently?
[Lt. Col. Philip Holcombe] People who experience post-traumatic stresses respond differently.
Some people just seem to bounce and spring back.
Some people it just sticks with them for a lifetime.
The differences between those who seem to bounce back
and those for whom it sticks,
the causes of those differences, there are many—a great variety of factors.
Because we all are individuals, we never have the same experience.
We can be looking at the same thing from the same angle,
and we still have different experiences.
So with regard to post-traumatic stress disorder,
post-traumatic stress can be cumulative.
You may have the same two people who go off to war
facing the same two experiences at the moment,
but their life experiences leading up to that are not the same.
We know that people who have had traumas—multiple traumas—
earlier in life will be more vulnerable to trauma,
post-traumatic stress disorder, later.
So it's cumulative.
It adds up.
We also know that the most critical factor in terms of how people will do
has to do with the intensity, frequency, and duration of the trauma or traumas.
So what I'm saying now goes together with what I said earlier,
which is trauma is cumulative.
So we don't know what a person has experienced
up to the point that they have that same trauma.
So because we don't know,
we really need to give people the benefit of the doubt
and understand that it may not—
it's not that one person is weaker than another person.
It's that we've had different life experiences.
Some of us have had more difficult lives than other people.
The other important factors are what I was telling you about earlier
with regard to what context do they return to.
Do they return to a healthy functioning family?
Do they return to a stable economic situation?
What kinds of stresses are they returning to?
A third factor in terms of how people will respond differently
is how they have been taught to cope.
If one has lived in an environment in which they were taught to cope by
isolating, avoiding, using drugs and alcohol,
they're not going to do as well as people who have learned
to respond by seeking out help
and letting people know when they need help.
With people who are able to establish relationships
that are meaningful relationships and not just the,
"Hi, how are you doing?" "Oh, I'm fine,"
when you're really not doing fine.
With people who have learned to exercise
instead of respond with hostility and with anger,
so people who learned how to cope in healthy ways
are likely to do better.
Another factor is willingness to seek behavioral health when needed.
Those who are reluctant to seek help and then therefore don't
and have to struggle with post-traumatic stress disorder
on their own for longer periods of time
are more likely to deal with post-traumatic stress disorder in unhealthy ways.
And those unhealthy ways can take on a life of their own,
like substance use disorders.
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Lt. Col. Philip Holcombe, PhD, Lt. Col. Philip Holcombe is an Army psychologist who serves as the chief of Clinical Recommendations at the Deployment Health Clinical Center at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.
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