From Fear and Horror to PTSD: What Determines the Longitudinal Course of Early Stress Responses

The drama of violent events captures the imagination of victims and helpers, often to the point of attributing the resulting psychological impairment mainly to the fact of exposure. Yet it is during the following and less heroic weeks that prolonged diseases of mind incubate. Drawing from experience with victims of terrors in Israel, this presentation outlines the composite picture of early responses and their eventual transformation into post-traumatic stress disorder. It is argued that exposure is but a trigger to a sequence of psychological events, each of which essentially adaptive and deeply embedded in bodies, minds and cultures, and all of which capable of going wrong. Such view clarifies the confusion - indeed the overlap - between 'normal' and 'abnormal' responses. Most importantly, it suggest that the road to recovery is widely open in the early aftermath of even the most horrendous events. Resources should be allocated to rescue survivors from the murky waters of subsequent loneliness, helplessness, depression, self-absorption and disease.