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PTSD in prison

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What you will find on this page

What is PTSD
PTSD and prison
Some causes of PTSD in the prison environment
The signs and symptoms of PTSD
Triggering flashbacks
Do I have PTSD

What is PTSD?

Post traumatic stress disorder (PTSD) is caused by very stressful, disturbing or traumatic events such as being involved in a car crash or being a witness to a serious violent assault. PTSD can affect each person differently. While you may have experienced the same trauma as another person, you may have been affected differently.

 

Some situations may cause PTSD to be described differently:

 

Birth trauma. Traumatic birth experiences are also known as birth trauma. 


Complex PTSD. Traumatic experiences that occur at a young age or that last for a long time might be classified as 'complex PTSD.


Delayed-onset PTSD. The expression "delayed PTSD" refers to symptoms that appear up to six months after experiencing a trauma.

PTSD and prison

In a prison context, this might be witnessing, or being subject to, an assault or violent physical or sexual attack, where serious injury or even death might have occurred. It could also have been a large-scale event, such as a riot. 

 

However symptoms may not appear until months or even years later (Delayed-onset PTSD) which means:

 

  • The effects of a traumatic experience/s prior to imprisonment can manifest in the prison environment

  • Witnessing or being a victim of a violent attack may actually present symptoms of PTSD when released from prison and back in the community.

 

The initial reaction to such an event might be shock or disbelief and, over time, the physical and psychological impact will fade. It is equally possible that the resultant troubling thoughts and feelings will intensify. In the latter instance, these feelings might manifest themselves as anger, a sense of helplessness, or fear. It can often be difficult for an individual to process the memories and lingering images of a traumatic event, (re-experiencing) and to rationalise the reasons for why it might have happened, especially in an often hostile prison environment.

 

It is not unusual for an individual to re-experience a traumatic incident through intrusive flashbacks or nightmares, or to develop adaptive patterns of behaviour designed to specifically avoid triggering memories of the incident.

“experiences of ‘fear, anxiety, loneliness, trauma, depression, injustice, powerlessness, violence and uncertainty’ have been identified as common to prison life” (Liebling & Maruna, 2005, p.3)

Some causes of PTSD in the prison environment

  • Historical physical,sexual or emotional abuse

  • Imported trauma (pre prison)

  • Military combat

  • Being kidnapped or held hostage

  • Being  robbed

  • Witnessing someone being seriously hurt or killed

  • Losing someone very close to you

  • Being diagnosed with a life threatening condition

  • Being involved in a serious prison riot

The signs and symptoms of PTSD

Re-experiencing:

The most common symptom of PTSD. This is where the individual involuntarily relives the traumatic event in the form of flashbacks, nightmares,repetitive and distressing images or sensations and physical sensations, such as pain and feeling sick.

Avoidance:

The person constantly tries to avoid being reminded of the event. This usually results in avoiding certain people or evading places that remind them of the trauma .This can lead to the person isolating themselves in their cells and giving up activities they used to enjoy.

Hyperarousal

Feeling very anxious and constantly alert to potential threats.

This may also be described as feeling `on edge` and often leads to irritability, outbursts of anger,difficulties sleeping and problems concentrating.

Other possible effects:

  • Drug and alcohol misuse

  • Self harming

  • Aggressive behaviour

  • Headaches and dizziness

  • Chest pain and stomach aches

  • Feelings of hopelessness

Triggering flashbacks

Any event, person, or situation can act as a trigger if it brings back memories of the trauma. In some cases, it's obvious what triggers them (for example, a car accident victim may be triggered when inside a car, a burglary victim may be triggered by breaking glass, and a veteran might be triggered by loud noises that sound like gunfire). Identifying and understanding other triggers may take some time. The sound of one song playing during your trauma is triggering now, or even various songs in the same genre. A victim of an assault may be triggered by the smell of alcohol if their assailant had drunk.

 

Also be aware that symptoms of PTSD are also triggered by emotions, internal feelings, and sensations.


 

Tips on coping with flashbacks

 

Having flashbacks can be very distressing, but there are some things you can do to ease the pain. As an example:

 

Keep your attention on your breathing. During times of fear, your breathing may become shallow. In order to reduce these feelings of anxiety, it is helpful to breathe slowly in and out  while counting to five.

 

Tell yourself, I`m safe. It may help if you tell yourself that the trauma has passed and that you are safe now. During a flashback, it can be difficult to think this way, so jotting down or recording some useful phrases when you feel better may help.

 

Carry an object that brings you back to the present. Touching or looking at an object during a flashback can be helpful. An item you carry in your pocket may be an item that already exists with you, such as your I.D card or a photo of a loved one.

 

Practice grounding techniques. Using grounding techniques can help you stay in the present and cope with intrusive thoughts and flashbacks. A good example would be to describe your surroundings aloud or count objects of a particular type or colour. 

Relax. Listen to soothing music, watch something on T.V

 

Write down your thoughts in a diary. When you write down what happens when you have a flashback, you may notice patterns in what triggers them. In addition, you might learn to recognize early signs when they are happening.

Example of someone who may experience PTSD as a result of witnessing a violent assault in the prison environment

Criteria to meet a diagnosis of PTSD 

To meet the criteria for PTSD, symptoms must last longer than 1 month, and they must be severe enough to interfere with aspects of daily life, such as how you communicate with others or how your symptoms impact on others. It is crucial that at any point you feel “out of control” or you cannot cope and seek immediate help. 

Criterion A: stressor  A person has been  exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.

Criterion B: intrusion symptoms The traumatic event is persistently re-experienced

Criterion C: avoidance Frequent avoidance of reminders associated with the traumatic event.

Criterion D: negative alterations in cognitions and mood  Negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event:

Criterion E: alterations in arousal and reactivity  Changes in arousal that started or worsened following the experience or  of a traumatic event:

Criterion F: duration Continuation of symptoms (in Criteria B, C, D and E) for more than one month.

Criterion G: functional significance Significant symptom-related distress or impairment

Criterion H: attribution  Symptoms is not due to medication, substance misuse, or other illness.

Do I have PTSD?

If you have answered yes to three or more questions below, you could have PTSD. It may be worthwhile to visit healthcare or speak with prison staff to initiate getting help.

 

  • Have you witnessed or experienced a traumatic or life-threatening event?

  • Did you experience intense fear, horror, or helplessness?

  • Are you having trouble forgetting the event?

  • Do you feel more irritable, angry, or startled than before the event?

  • Are you avoiding activities, people, or thoughts that bring back the memories of the event?

  • Are you having difficulty falling asleep or focusing since the event?

  • Do you have symptoms that have persisted longer than a month?

  • Are you finding it hard to function normally because of your distress?

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