Seemingly Irrelevant Decisions in PTSD

A seemingly irrelevant decision is a decision or choice a person makes that may appear unimportant or insignificant on the surface but that actually increases the likelihood that he or she will be placed in a high-risk situation that can cause a relapse.

A person may ignore, deny or explain away the importance of these decisions/choices.

The identification of seemingly irrelevant decisions is an important part of the relapse prevention-focused treatment for people with addictive behaviors devised by Drs. Marlatt and Gordon.

Seemingly irrelevant decisions are often associated with posttraumatic stress disorder (PTSD), a mental health condition that's is set in motion by a traumatic event. The person either experiences the event or witnesses it. Many people who go through traumatic events may have trouble coping for some time but they don't have PTSD. With time and treatment, they usually improve. But if the symptoms get worse or last for months or years and disrupt day-to-day activities, you may have PTSD.

According to the Mayo Clinic, PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

Symptoms of intrusive memories may include:

• Recurrent, unwanted distressing memories of the traumatic event
• Reliving the traumatic event as if it were happening again (flashbacks)
• Upsetting dreams about the traumatic event
• Severe emotional distress or physical reactions to something that reminds you of the event

Symptoms of avoidance may include:

• Trying to avoid thinking or talking about the traumatic event
• Avoiding places, activities or people that remind you of the traumatic event

Symptoms of negative changes in thinking and mood may include:

• Negative feelings about yourself or other people
• Inability to experience positive emotions
• Feeling emotionally numb
• Lack of interest in activities you once enjoyed
• Hopelessness about the future
• Memory problems, including not remembering important aspects of the traumatic event
• Difficulty maintaining close relationships

Symptoms of changes in emotional reactions (also called arousal symptoms) may include:

• Irritability, angry outbursts or aggressive behavior
• Always being on guard for danger
• Overwhelming guilt or shame
• Self-destructive behavior, such as drinking too much or driving too fast
• Trouble concentrating
• Trouble sleeping
• Being easily startled or frightened

An alcoholic in early recovery may make the seemingly irrelevant decision to go to parties where alcohol is being served or allow himself to become overly stressed out by not practicing self-care or using healthy coping strategies. In actuality, however, such decisions would harm his recovery efforts. Increasing awareness of seemingly irrelevant decisions can reduce your risk for alcohol abuse.