What Role Does Guilt Play in Women With PTSD?
Current findings indicate that women have unusually high chances of developing post-traumatic stress disorder (PTSD), especially when they feel guilty or responsible for the circumstances of their trauma exposure. In a study published in December 2014 in the Journal of Traumatic Stress, researchers from two U.S. institutions explored the connection between a severe, in-the-moment trauma reaction called tonic immobility and the eventual presence of PTSD in women who feel guilty after trauma exposure. These researchers concluded that guilt can play an important role in the development of PTSD in women who become temporarily immobilized in trauma-inducing circumstances.
Women’s PTSD Risks
When considered as a whole, women have much higher chances than men of experiencing post-traumatic stress disorder in the months or years that follow exposure to potentially life-threatening circumstances such as childhood abuse, combat exposure, sexual assault, natural disaster, major accidents and severe illness. This fact holds true even though men experience traumatizing events and situations more often than women over the course of an average lifetime. Much of the increased PTSD risk in women is associated with the odds of developing the disorder after exposure to specific kinds of trauma. One of the trauma sources most strongly linked to the eventual onset of PTSD, sexual assault (including rape and other forms of sexual attack), affects women much more often than it affects men.
A woman who blames herself for exposure to a trauma-inducing situation or event also has a substantially increased risk for post-traumatic stress disorder, the U.S. Department of Veterans Affairs’ National Center for PTSD reports. Other risk boosters include having a severe in-the-moment reaction to trauma exposure, experiencing a physical injury during trauma exposure, having a history of mental illness before trauma exposure, experiencing additional (if less severe) sources of stress after trauma exposure and having an inadequate personal/social support system in the days and weeks following trauma exposure.
Researchers and other scientists use the term tonic immobility to refer to a form of involuntary, temporary muscle paralysis that sometimes appears in association with severe or excessive fear. Most instances of this in-the-moment trauma reaction are reported in other animals, not in human beings. However, current evidence indicates that some people do experience tonic immobility while under severe fear-based duress. According to the results of a 2009 study published in the journal Depression and Anxiety, tonic immobility may be an extreme form of dissociation, or detachment from the mind and body. The researchers who conducted this study also concluded that sexual assault, in particular, may serve as a source of a temporarily paralyzing trauma reaction.
Guilt, Tonic Immobility and PTSD
In the study published in the Journal of Traumatic Stress, researchers from the Veterans Administration and the Boston University School of Medicine used data drawn from 63 women to explore the connection between tonic immobility during trauma exposure, feelings of guilt in the aftermath of trauma exposure and the chances of developing post-traumatic stress disorder. All of these women had previously experienced a traumatic event or situation noted for its connection with the onset of PTSD. For each individual, the researchers sought to determine if tonic immobility occurred during such an event or situation. They also assessed any feelings of trauma-related guilt, the presence of any symptoms of PTSD and the severity of any noted PTSD symptoms. The researchers undertook this project, in part, in response to previous research efforts that pointed toward an undetermined link between trauma-induced tonic immobility and the eventual development of PTSD.
After analyzing all of the available information, the researchers concluded that, for women, there is a distinct connection between tonic immobility during trauma exposure, guilty reactions to experiencing a traumatic event or situation, the presence of PTSD symptoms and the severity of PTSD symptoms. Specifically, they concluded that a guilty reaction in the aftermath of tonic immobility accounts for roughly 35 percent of the PTSD-related risk in affected women.
The study’s findings indicate that guilt may be a major contributing factor to the ultimate onset of PTSD in women who experience tonic immobility-inducing fear while exposed to highly traumatic circumstances. They believe that discussion of the basically involuntary nature of tonic immobility may substantially alleviate the guilt of women who live through traumatic situations and events.