From: ephemeral@ephemeralfic.org Date: 17 Apr 2001 08:58:38 -0000 Subject: POST TRAUMATIC STRESS by mulderache Source: direct Reply To: tgw080160@aol.com TITLE: POST TRAUMATIC STRESS DISCLAIMER: THEY DO NOT BELONG TO ME BECAUSE IF THEY DID THEY WOULD BE DOING MORE THAN JUST HOLDING HANDS. THYE DO BELONG TO THE GREAT CHRIS CARTER AND 1013 PRODUCTIONS. THANKS: TO MY BETA READER WHO IS GETTING READY TO TAKE EXAM.SHE IS GOING TO BE A NURSE! GREAT PROFESSION! SHE IS THE BEST! THIS IS POST THREE WORDS. He could not talk to anyone about what had happened to him on that God forsaken ship. He had been having flashbacks since he was alert enough to be fed by Scully. He could not talk about it though. It had been a very painful, humiliating experience. He felt numb and cold. Sometimes it was hard for him to get warm. The memory of the cold stone chair and all the metal attached to his naked body was hard to endure. He was hurting inside and he felt so alone. He sat on the hospital issue chair remembering the most painful moments of his captivity when he heard the door open. Closing his eyes and hoping that it was a nurse or aide but he recognized the click of the heels against the linoleum floor. "Mulder. Are you okay?" The strength to stand and walk across the room was exhausting but he listened to Scully's and Dr. Lem's good news and as best he could he answered with a stunning," Wow." It was as flat as his affect and as sad as his voice. He had tried to appear cheerful but it was very difficult. He just wanted to be alone again and attempt to get through some more of the painful memories. Hopefully he could start processing some of the things that had happened to him in the past few months. He could not deal with other problems at the present, including his partner's pregnancy. When the door shut his body almost collapsed in exhaustion. He found it more difficult to pretend to be fine than to be actually not fine. He pushed back the blankets and slid underneath and fluffed up the pillow under his head. He wanted to sleep. Sleep was the best escape right now except for when the dreams would come and wake him up. He closed his eyes and wandered if sanity would ever be his again. He didn't want anyone around and it took a lot of self-control not to lose control when others tried to get him to talk about his experience. He just wanted to be left alone. A FEW HOURS LATER The nurses had given him another intravenous dose of the antivirals. The medicine always made him nauseated. He would make his way to the bathroom soon and vomit up his lunch, his nurses would never know. He lay in the bed as long as he could and then he pushed himself up on unsteady feet and made his way to the bathroom. He found himself retching longer than usual and when he looked up a very worried Scully was looking down at him. She reached for a washcloth and held it to his forehead. "Mulder, are you finished?" she asked as if this was not a new development. He nodded and she assisted him to his feet but he quickly shrugged her off and made his way back to bed. He did not want human touch or pity. He was use to the pain and the loneliness. He would be fine. She sat down in silence in the chair that sat by his bed. She did not question him about the vomiting or the desire not to be touched. She seemed to understand that he needed some space. That he needed to do some things on his own and if he needed to be helped that he would ask. She sat quietly in the semi-dark room, only the sounds of her steady breaths filled the room. She would be there if he needed her but she would also respect his need to be left alone too. He was a psychologist. He went to Oxford and studied with the best and had the best teachers. He knew that he was suffering from post-traumatic stress syndrome. He was classic as far as clinical symptoms. Post traumatic stress syndrome was a reaction to deeply shocking and disturbing experience. Boy did he ever fit the definition. Being held captive and being tortured definitely fit that category. Also being placed in a coffin and put into the cold ground for three months. He was fitting every category of the DSM-IV. How else should he feel? He was a victim, he had felt helpless and had been in great fear of his life. Hell, he had even died in actuality. Now he relived that horror every day and every night. He hated his life and he hated being alive. He turned over in the bed to face the wall. He did not feel like seeing anybody right now. She was just a reminder that life had went on without him. A reminder that they had grieved his death then went on living. They found a way to forget and move on with life. Damned be the man in the grave. At least he had not vomited anymore. He was almost asleep when a nurse entered the room with another round of food. Clear liquids and foul tasting medicine. He should be thrilled that they had decided against putting a feeding tube down his nose and throat but he still did not like feeding time. The sweet voice pulled him from his thoughts and he raised up in the bed and the tray was set in front of him. Evidently Scully had not told his secret or he would be getting a nasogastric tube instead of clear liquids. With a shaky and unsteady hand he lifted the spoon from the tray and tried to gather the orange jello up to spoon it to his mouth but his shaking kept throwing it to the floor. Then his frustration reached a peak and the food was toppled to the floor in one clean sweep. Scully did not give any remarks or reprimands. She slowly gathered some towels and cleaned up the mess. Afterwards she went to the nursing station and gathered enough food for another tray. She came back and sat the tray on the now clean table and spooned up the jello, not saying a word. She offered the food which he took willingly from the clean spoon. She was being patient and tolerant of his bad behavior. She knew that he was suffering from PSTD, she was a physician. She would allow him time to heal and she would be there for him until he was ready to share his experience. She understood. He would be going home soon and she would be there, she was always there. She was his Scully. THE END WHAT IS POST TRAUMATIC STRESS SYNDROME? Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normal reaction to an abnormal situation. WHAT IS A DSM IV? DSM-IV diagnostic criteria The diagnostic criteria for PTSD are defined in DSM-IV as follows: A. The person experiences a traumatic event in which both of the following were present: 1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others; 2. the person's response involved intense fear, helplessness, or horror. B. The traumatic event is persistently re-experienced in any of the following ways: 1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions; 2. recurrent distressing dreams of the event; 3. acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated); 4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event; 5. physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event. C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of: 1. efforts to avoid thoughts, feelings or conversations associated with the trauma; 2. efforts to avoid activities, places or people that arouse recollections of this trauma; 3. inability to recall an important aspect of the trauma; 4. markedly diminished interest or participation in significant activities; 5. feeling of detachment or estrangement from others; 6. restricted range of affect (eg unable to have loving feelings); 7. sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span). D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following: 1. difficulty falling or staying asleep; 2. irritability or outbursts of anger; 3. difficulty concentrating; 4. hypervigilance; 5. exaggerated startle response. E. The symptoms on Criteria B, C and D last for more than one month. F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. OKAY GUYS NOW LET'S FIT MULDER'S EXPERIENCE INTO THESE CATEGORIES AND WE SEE A TRUE CASE OF PTSD. THIS IS THE REASON IS HE IS HAVING A HARD TIME PROCESSING THINGS. HE WILL NEED TIME TO HEAL. HAVE A GREAT DAY!