Andrew, thank-you for putting so much thought into a really comprehensive and candid reply.... It certainly has helped me understand it is 'expected' to be where I am and at last given me a resolve or certain level of peace about where I now need to go. In a way it is a relief to understand the way I am is still PTSD and to EVENTUALLY understand it is not a failure or 'cop-out' to accept this is 'the way it is'. For the first time I have realised my forced change of job / career (to caring for and schooling horses) will probably not be nearly as temporary as I thought. The one really insightful thing for me is the suggestion to face traumatic situations from a 'safe' base (i.e. a job not dealing with people, conflict and deadlines) - I had been doing the complete reverse i.e. trying to get 'better' so I could continue my career (for the 10 years leading up to PTSD my career was reporting directly to the CEO as a member of the top executive team of a company with 3500 employees) and, I have actively avoided anything that reminds me of the trauma. This in fact ends up hampering one's progress moving towards a 'new' career as your focus in on getting better (in a soft way) to return to this very demanding career, rather than closing the door and moving on with the focus on your new career. Up until now it was a complete mystery to me to have allegedly 'dealt' with the PTSD yet still not be able to deal with stress at all - and when faced with very stressful situations to literally feel as you explained (the intense feeling of wanting to kill yourself daily etc). Your suggestion of facing the trauma (and its associations) rather than avoiding it has answered another huge dilemna for me... I was so scared to face the trauma (and the associations I have with it in my mind)... I have faced it in bits and pieces but felt the 'dark hole' you describe so well would damage me permanently. I was scared if I went there again I might never be able to get out. However your explanation gives me hope that, although it will be very bad , there will be a 'long term' benefit. It is also sad for me that there seems to be so little understanding of PTSD especially in a significant percentage of the medical fraternity - this means the advice and comments you often receive does not explain what you have explained, hence your decisions and understanding are often completely flawed. I will certainly spend some time in the information section......