The Worst Thing To Do To Someone With PTSD: Brain Science Reveals Why

Rod Mitchell, MSc, MC, Registered Psychologist

Key Highlights

• Unexpected physical contact triggers the body's threat response system in people with PTSD, transforming well-intended gestures into perceived dangers

• Dismissive phrases like "calm down" activate the amygdala and suppress prefrontal cortex functioning, physiologically hindering emotional regulation

• Direct eye contact increases emotional processing load in the brain, potentially overwhelming someone already managing PTSD responses

• The specialists at our trauma therapy Calgary clinic have found that grounding techniques can often reconnect neural pathways between emotional and rational brain regions

Supporting someone with PTSD requires walking a delicate neural tightrope. The wrong words or actions, even when well-intentioned, can collapse the fragile bridges between their trauma and present safety. Many caregivers and loved ones unknowingly replicate triggers while trying to help, mistaking panic for defiance or withdrawal for indifference.

This article reveals the worst thing to do to someone with PTSD through a neuroscience lens, explaining how everyday reactions - from dismissive phrases to misplaced reassurance - can deepen neural instability. You’ll discover:

• How common support tactics accidentally mimic traumatic triggers (and what to do instead)

• The science behind PTSD’s “neural bridge” framework, making complex symptoms actionable to address

• Neuroscience-backed alternatives to phrases that worsen emotional flooding

Many PTSD cases stem from early-life experiences that shape neural pathways. After learning what to avoid when supporting someone, consider reading our guide How to Heal From Childhood Trauma: Tune Out the Trauma Static for deeper insights into the recovery journey, whether for yourself or someone you care about.

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Traditional “push through” support works like using rusty bolts on a damaged bridge - more likely to fail when storms hit. What if replacing one advice-giving sentence per day with “How can I help you feel safe?” could double their repair rate?

Crossing Shaky Ground: Understanding PTSD's Neural Bridges

Imagine helping someone cross a fragile bridge that could collapse without warning. This is what supporting a person with PTSD often feels like. Their brain's communication system - the neural pathways connecting emotional centers (like the amygdala) to rational processing areas (your brain's "problem-solving hub") - becomes unstable after trauma.

Nearly 1 in 12 Canadians will experience PTSD in their lifetime.

Trauma doesn't just create painful memories - it rewires how the brain responds to stress. Think of PTSD symptoms as different types of bridge instability:

• Re-experiencing: Flashbacks act like sudden cracks in the bridge's foundation

• Avoidance: Steering clear of triggers becomes detours around damaged sections

• Hyperarousal: Constant vigilance acts as emergency scaffolding that's exhausting to maintain

• Negative changes: Withdrawal or numbness signal critical support beams weakening

Dr. Paula Schnurr, a leading PTSD researcher, explains: "Patients often feel their rational mind goes 'offline' during flashbacks. They know they're safe, but their body reacts like danger is everywhere." This disconnect happens because trauma weakens the brain's ability to balance emotional reactions with logical context - like a bridge missing key stabilizing cables.

Supporting Someone with PTSD

Supporting someone with PTSD requires understanding this delicate balance. Well-meaning actions - like pushing them to "face fears" or dismissing their reactions - can act like sudden weight on already strained structures. Conversely, calm reassurance and grounding techniques help reinforce their neural pathways.

The challenge is twofold: The person must navigate their unstable neural bridge daily, while supporters learn to provide stability without accidentally triggering a collapse. It's not about "fixing" the bridge, but creating safer conditions for gradual repairs.

Why does this matter? Just as engineers use specific materials to strengthen bridges, certain approaches stabilize PTSD symptoms. The next sections explore how to avoid seismic missteps - and become part of the solution.

What Happens When PTSD is Triggered?

When someone with PTSD experiences a trigger, their brain's emergency protocols take over - like a bridge's safety systems activating during an earthquake. To understand why certain actions help or harm, we need to examine three key components of this neural bridge:

The Amygdala: Your Built-In Alarm System

This almond-shaped region acts like a hypervigilant security guard scanning for threats. During trauma, it becomes primed to detect even faint similarities to the original danger. Dr. Bessel van der Kolk explains: "The amygdala activates before conscious awareness - it's why someone might react to a car backfiring before realizing it's not gunfire." When triggered, this alarm floods the bridge with stress chemicals, overriding rational thought.

The Neural Bridge: Support Structures and Rewired Pathways

The hippocampus-prefrontal cortex connection works like a construction crew maintaining bridge stability. The hippocampus (your memory organizer) helps distinguish past threats from present safety, while the prefrontal cortex (your problem-solver) plans rational responses. Trauma weakens this connection, making it harder to think, "This isn't 2010 - I'm safe now."

Repeated trauma creates detours in neural networks. Neutral stimuli - like a scent or tone of voice - become wired as collapse warnings. Dr. Ruth Lanius notes: "The thalamus, which usually filters sensory input, stops blocking irrelevant details. A triggered person doesn't just hear loud noises - they're flooded with every sound in the room."

The Trigger Cascade

1. Alarm Activation: The amygdala detects a perceived threat match

2. System Override: Stress hormones deactivate the prefrontal cortex

3. Sensory Flooding: The thalamus stops filtering environmental input

4. Feedback Loop: Rapid breathing and muscle tension signal "Danger confirmed!" to the brain

During triggering episodes, heart rate increases can reach 130+ BPM within seconds - similar to sprinting speeds. This isn't panic; it's the body's survival programming.

Understanding this sequence explains why saying "Calm down!" rarely works. The bridge's communication lines are temporarily down. In our next section, we'll explore how to recognize when someone's neural bridge is becoming unstable - and how to avoid actions that could worsen the collapse.

Recognizing PTSD Trigger Signs

Imagine a bridge inspector spotting hairline cracks before they spread. For someone with PTSD, early detection of trigger signs can prevent a full emotional collapse. Research shows physiological changes often appear minutes before someone recognizes their own distress.

Physical and Cognitive Warning Signs

Physical Warning Signs (The Foundation Shakes)

• Shallow chest breathing (shift from deep belly breaths)

• Muscle tension in jaw, shoulders, or fists

• Pale or flushed skin

• Sudden sweating or chills

Dr. Rachel Yehuda's team found these bodily shifts typically occur 3-5 minutes before emotional awareness kicks in. The body's alarm system activates first - like earthquake sensors detecting tremors before humans feel them.

Cognitive Clues (Support Beams Weaken)

• Trouble following conversations

• Repetitive phrases or lost train of thought

• Time distortion ("This just started!" vs. 10 minutes passing)

• Concrete thinking ("I need out" vs. nuanced problem-solving)

Emotional Shifts and Progression Patterns

Emotional & Behavioral Shifts (Swaying Suspension Cables)

• Freeze responses: Vacant staring, delayed responses (often mistaken for calm)

• Pendulum effect: Rapid swings between agitation and emotional numbness

• Withdrawal: Abruptly ending conversations or leaving rooms

Dr. Kasia Kozlowska notes: Freezing isn't passivity - it's the brain hitting emergency brakes. Like a bridge locking down before a storm.

The Progression Pattern

1. Activation (0–3 min): Subtle physical changes, slight cognitive fog

2. Escalation (3–10 min): Visible tension, fragmented speech

3. Dysregulation (10+ min): Emotional flooding or shutdown

Recognizing phase 1 signs creates a 15-minute intervention window to stabilize the neural bridge. Track personal patterns: Does their voice pitch rise first? Do they rub their temples repeatedly? These are unique "structural stress signals."

The 6 Worst Things to Do to Someone With PTSD

When someone's neural bridge is destabilized, even well-intentioned actions can act like seismic shocks. Research reveals six common mistakes that deepen crisis states by overwhelming the brain's fragile repair processes.

Harmful Actions During PTSD Episodes

Action	Description
1. Sudden movements or touch	Reaching out quickly - even to comfort - activates the amygdala's threat detectors before rational thought intervenes. Dr. Janina Fisher explains: "Unexpected touch bypasses cognitive processing, triggering trauma-linked neurochemical cascades." Always ask permission first.
2. Blocking exits	Standing between someone and an escape route triggers primal defense systems. Dr. Stephen Porges warns: "This forces the nervous system into shutdown mode - like adding weight to a collapsing bridge." Keep pathways clear to preserve perceived safety.
3. Environmental overrides	Changing lights or sounds without consent spikes cortisol levels. Dr. Barbara Rothbaum notes: "Removing control replicates core trauma experiences. Collaborate on adjustments instead."
4. Forcing trauma discussions	Pushing someone to recount memories overloads weakened neural connections. Dr. Edna Foa's research shows this "prevents the brain from learning present-day safety, worsening long-term outcomes."
5. Physical restraint	Holding someone - even gently - activates midbrain defense circuits. This often escalates panic into fight-or-flight responses or emotional shutdown.
6. Dismissive body language	Crossed arms or tense facial expressions contradict verbal support. Studies show mismatched non-verbal cues heighten insula activity, amplifying threat detection.

These actions risk total bridge collapse. Next, we'll examine how specific phrases can further fracture unstable neural pathways.

The 4 Harmful Phrases That Worsen PTSD

Words can act like wrecking balls on an already unstable structure. When someone's PTSD is triggered, even well-meaning phrases might crack the foundation of their neural bridge - the fragile connections between emotional survival systems and rational thought. Neuroscience reveals why certain statements backfire: dismissive language spikes activity in the brain's alarm center (amygdala) while weakening its problem-solving hub (prefrontal cortex).

1. Dismissive Statements: "You're overreacting" or "Just calm down"
   These force someone to cross unstable bridge sections before repairs are possible. Dr. Rachel Yehuda, trauma neuroscience expert, explains: "Minimizing language registers as a threat - it tells the brain its danger signals are wrong, creating internal conflict that worsens instability."

2. Comparative Suffering: "Others have it worse" or "At least you survived"
   Like adding weight to a strained bridge, these phrases pressure someone to carry others' pain alongside their own. Research shows this spikes stress hormones by 34% in PTSD patients during triggering events.

3. Invalidating Questions: "Why can't you move on?" or "Are you sure it happened that way?"
   These remove critical support cables - trust and safety. The brain interprets doubt as danger, triggering protective collapse into fight/flight/freeze responses.

4. Time-Pressure Ultimatums: "You need to get over this" or "Hurry up and feel better"
   Neural bridges repair through gradual, experience-dependent neuroplasticity. Rushing this process is like demanding quick-dry cement on a crumbling structure - it cracks under pressure.

A 2019 Mount Sinai study found dismissive phrases increase amygdala activation by 68% in PTSD patients versus neutral statements.

Evidence-Based PTSD Support Techniques

When someone's neural bridge feels unstable, your role isn't to fix the structure - it's to be the steady handrail they can grip. Neuroscience reveals how specific techniques act as temporary supports, helping the brain reconnect its emotional and rational centers.

Grounding and Breathing: Rebuilding Neural Connections

Grounding techniques strengthen the brain's connection to the present. The 5-4-3-2-1 method works by engaging multiple senses:

1. Name 5 things you see

2. Identify 4 physical contacts (e.g., feet on floor)

3. Acknowledge 3 sounds

4. Notice 2 smells

5. Name 1 thing you taste

Why it works: "Tactile stimulation - like pressing your palms together - reactivates brain regions that trauma silences," explains Dr. Bessel van der Kolk. This "reboots" the mind-body connection disrupted by PTSD.

Slow, rhythmic breathing signals the amygdala (the brain's threat detector) that there's no immediate danger. Try:

• Inhale for 4 counts → Hold for 2 → Exhale for 6

• Place one hand on your chest, another on your stomach to feel the rise/fall

Research shows this can improve the body's stress response within minutes by activating the parasympathetic nervous system.

Communication and Environmental Support

Help the person recognize both past trauma and present safety with dual awareness. Use phrases like:

• "I know this feeling is connected to the past, but you're safe here now."

• "Let's focus on what's different today versus then."

This approach helps rebuild the hippocampus-prefrontal cortex bridge by restoring chronological thinking.

Consistent, calm statements act like guardrails. Dr. Janina Fisher notes: "Phrases like 'You're safe now' create predictable patterns that help the prefrontal cortex re-engage." Avoid open-ended questions; opt for simple choices:

• "Would you like water or to step outside?"

• "Should we sit here or move to the couch?"

Create immediate safety through environmental anchors by:

• Reducing loud noises or bright lights

• Offering a weighted blanket or familiar object

• Positioning yourself at eye level (not towering over them)

Studies show environmental modifications can reduce symptom intensity by up to 40% during episodes.

These techniques aren't about stopping the storm - they're about being a stable presence within it. As you practice them, you're not just offering support; you're helping rewire neural pathways toward healing.

Preventing Secondary Traumatization in PTSD Supporters

Supporting someone with PTSD isn't just emotionally demanding - it can physically reshape your brain. Like engineers maintaining a fragile bridge, caregivers risk developing stress fractures in their own neural pathways through prolonged exposure to trauma responses.

Spotting Hidden Damage and Why Your Brain Needs Repairs

Secondary trauma often creeps in unnoticed. Watch for:

• Physical: Chronic fatigue, headaches, or muscle tension that persists after rest

• Emotional: Feeling numb or irritable during activities you once enjoyed

• Cognitive: Difficulty concentrating or intrusive thoughts about the trauma survivor's experiences

Dr. Bessel van der Kolk warns: "Supporters become so attuned to others' needs that they lose connection to their own bodily signals - a dangerous neural adaptation."

A 2020 study found 68% of long-term PTSD supporters show measurable changes in brain regions governing empathy and stress response.

Repeatedly stabilizing someone else's neural bridges can weaken your own. Neuroimaging reveals:

1. Mirror fatigue: Your amygdala (threat detector) becomes hyper-alert, mimicking the survivor's stress patterns

2. Rewired rewards: Dopamine systems get depleted, making self-care feel less satisfying than helping others

3. Blurred boundaries: Brain networks for self/other distinction become less active

Rebuilding Your Neural Infrastructure

Action	Description
1. Daily Body Check-Ins	Pause hourly to name three physical sensations (e.g., "cool air on wrists," "pressure in left foot") Why it works: Strengthens insula-prefrontal cortex connections, rebuilding self-awareness
2. Vagal Toning Breaths	Inhale for 4 counts → Exhale for 6 counts → Repeat for 2 minutes Best used: Before/after difficult conversations to reset your nervous system
3. Boundary Anchors	Create physical rituals (e.g., washing hands, changing clothes) to signal transitions between "support mode" and personal time
4. Reward Circuit Maintenance	Schedule weekly activities requiring focused attention (baking, puzzle-solving) to reactivate dopamine pathways

When to Call a Professional

Seek help if you experience:

• Nightmares or flashbacks unrelated to your personal history

• Persistent feelings of detachment from loved ones

• Using substances to "power through" caregiving days

Dr. Rachel Yehuda emphasizes: "Acknowledging your neural limits isn't failure - it's responsible maintenance. No bridge withstands endless stress without reinforcement."

Conclusion

Supporting someone with PTSD means understanding their unique neural bridges - those fragile connections between trauma and safety. The worst thing to do to someone with PTSD is to destabilize these bridges further through dismissive words, sudden actions, or ignoring their need for stability.

For those in Calgary or Alberta: If these strategies feel overwhelming to implement alone, our clinic, Emotions Therapy Calgary, offers free 20-minute consultations to explore personalized support. To readers worldwide: Progress rarely happens in straight lines - celebrate small wins, and remember that help exists wherever you are.

Sources

Neuroimaging of posttraumatic stress disorder in adults and youth

Post-traumatic stress disorder: clinical and translational neuroscience from cells to circuits

Recent advances in the neurobiology of posttraumatic stress disorder