
Roger-Luc Chayer (Image: AI / Gay Globe)
Post-traumatic stress is not only a disorder affecting soldiers, first responders, or witnesses of severe and unusual events. It also affects a growing number of individuals from LGBT communities. In addition to frequently experiencing physical or verbal assaults, they must live with the deep traumas that result.
What are the possible causes of post-traumatic stress in LGBT individuals?
Post-traumatic stress in LGBT individuals can be caused by deeply impactful experiences related to discrimination, violence, or rejection due to their sexual orientation or gender identity. These experiences can include physical or verbal assaults, trauma related to homophobia or transphobia, as well as sexual violence—topics that are still too rarely discussed.
Family or social rejection, often when individuals decide to come out, can also cause a sense of abandonment and emotional danger. This is compounded by daily microaggressions, persistent stigma, and the stress of environments where they do not feel safe or accepted.
These experiences, whether cumulative or isolated, can disrupt a person’s basic sense of security, leading to enduring post-traumatic stress symptoms.
What are the symptoms?
It is important not to confuse post-traumatic stress with depression or anxiety, although these conditions are often associated. The symptoms of post-traumatic stress often manifest as intrusive and repetitive memories of the traumatic event, vivid nightmares, and intense flashbacks, as if the situation were happening again.
They often also involve avoiding places, people, or situations that remind them of the trauma, accompanied by emotional numbness and difficulty experiencing positive emotions.
Hypervigilance, characterized by exaggerated reactions to sudden noises or movements, is common, as is irritability and anger. Finally, sleep disturbances, difficulty concentrating, and persistent psychological distress related to the trauma’s memory are also disabling symptoms.
How is post-traumatic stress treated?
It is essential to consult a healthcare provider or any other health professional, such as a nurse or social worker, as soon as the first symptoms appear. Indeed, there are highly effective treatments and therapies for this condition, which, if left untreated, can lead to chronic disability.
In addition to traditional medications, which help manage anxiety and recurring memories, two new approaches deserve special attention. The first, which has shown excellent results, is currently being studied and even applied at the Douglas Hospital in Montreal. It involves the use of propranolol, a beta-blocker that has been available on the market for decades.
According to the Douglas Research Center website, an old memory must be reconsolidated to persist. There is a medication, propranolol, that partially blocks the reconsolidation process. Since the traumatized person suffers from ‘reminiscences’, reducing the emotional intensity of the traumatic memory without erasing it seems like an ideal therapeutic approach.
In current research projects, our research team is evaluating whether blocking the reconsolidation of traumatic memories is effective in treating PTSD. Propranolol is administered alongside a traumatic memory reactivation session to reduce the emotional intensity of the memory. Preliminary results are very encouraging.
EMDR (Eye Movement Desensitization and Reprocessing)
According to Inserm (French National Institute for Health and Medical Research), initially tested on people suffering from traumatic memories, such as Vietnam War veterans, this eye movement psychotherapy targets individuals’ traumatic memories. In other words, it aims to treat the psychological, physical, or relational consequences of psychological trauma.
This therapeutic approach aims to treat the consequences of psychological trauma by combining the patient’s mental recall of the traumatic memory with bilateral, alternating sensory stimulations (such as induced eye movements, for example, asking the patient to follow the therapist’s finger movements, or alternating tactile stimulations on the knees, or auditory stimulations).
The eye movements practiced in this way are meant to restore a natural management of painful memories and the restoration of self-esteem. Before starting EMDR therapy, preliminary sessions will help build a trusting relationship with the practitioner and establish the goals to be achieved.
A small linguistic point: the term « psychic trauma » is used here in the sense defined by the DSM-5, meaning a confrontation with a violent situation, a high fear for one’s life or the life of a loved one, a threat to one’s own integrity or that of a loved one.
Although the protocol used may seem somewhat extravagant to those unfamiliar with EMDR, numerous rigorous studies and meta-analyses have been published over the past 25 years to validate its effectiveness in treating post-traumatic stress disorders. So much so that in 2013, the World Health Organization mentioned EMDR as a valid alternative to more traditional cognitive-behavioral therapies.
Where to start?
The starting point for effective treatment is a consultation with a doctor, who will determine where to refer the patient so that they can access urgent care. In some cases, they may also prescribe medication to manage immediate crises and, occasionally, start treatment with propranolol or offer EMDR therapy if they are trained and specialized in these approaches.
The most important thing is to initiate treatment as soon as possible after the first signs of post-traumatic stress symptoms, in order to achieve the best results.