**2.1 Epidemiology**

Studies conducted with large populations affected by the devastating earthquake, wars, and involvement in concentration camps found PTSD development risk between 20 and 50%. In one study conducted, data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71,083 respondents aged 18+ participated. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the traumaexposed [2].

The experience of trauma is by no means exceptional, with all of its disruptive, jarring, deeply traumatic, intolerable, and "extremely terrifying, helpless, or terrifying" qualities. Moreover, both the frequency of PTSD that develops after a traumatic

#### *New Diagnosis and Treatment Approaches to Post-Traumatic Stress Disorder DOI: http://dx.doi.org/10.5772/intechopen.104098*

event and the acute stress disorder that occurs immediately after the trauma is often closely related to the threat to the person's psychological integrity.

It does not seem possible to establish a relationship between the nature of the trauma and the developing pathological picture that would require us to refer to the importance and severity of the current trauma. Of course, we should also note that different psychopathological conditions, such as post-traumatic depression and substance abuse, can occur utterly independent of PTSD. So, when we consider all these, we need to argue that the non-traumatic factors that determine the emergence of PTSD are essential enough and need to be carefully investigated [3].

### **2.2 Existential dimension**

It is the ontological and cultural dimension that does not attract much attention from non-traumatic factors. Believing in and taking shelter in an unseen reality that knows everything, controlling the existence of belief in God when they feel helpless, powerless, and weak increases resilience to trauma. The conception of guardian angels, the Holy Spirit, or absolute monotheism (Tawhid) can be mental-sheltering. This approach, which changes our perceptions toward resilience, is also used in thirdwave psychotherapies (Mindfulness, Metacognitive therapies) [4].

When mainly dealing with why evil exists, the Theodicy discipline proposes that it is significant to attribute more positive meanings to evil instead of ascribing it as a punishment. For the Positive Psychology approach, perceptions can change in the direction of endurance. Philosophers develop more or less similar ideas. Epicurus alleges that the Gods do not interfere with the earth, so evil belongs to the Gods. The motivation to enjoy is a sufficient measure for man. Giving the example of his famous cave allegory, Plato declares that God is absolute good and this world is not real life. While Kant says that evil has nothing to do with God, Leibniz claims that evil is for the benefit of good. For Comte, if he cannot prevent evil, God is helpless.

Unlike all these thinkers mentioned above, existential philosophy accelerated ferocious competition with the proposition that "God does not exist or cannot be proven, man's purpose is to seek self-interest and freedom in the world, and he must be selfish." As a result, many scholars, such as Nietzsche, Sartre, Kierkegaard, and Dostoevsky, changed the purpose, meaning, and values of life formed by human values in the name of hedonism and freedom. They even found Hegel and Kant to be prescriptive. On the other hand, Karl Popper said that if there is no evidence in epistemology, falsification is required. That is, it cannot be proven that God does not exist. Analytical philosopher Alvin Plantinga, on the other hand, argued that evils are necessary not because God does not exist but because God gives free will.

Heidegger, in 1966, accepted "time" as the most fundamental ontological category in the philosophical field. Today, people emotionally become vulnerable to traumatic experiences when existentialist philosophers Camus and Sartre defend absurdism by saying there is no meaning in life. Positive psychology, for this reason, has tried to fill the gap of this meaninglessness and meet the need to search for meaning. Today, when metacognitive genes related to the search for the meaning of life are mentioned, evidence has been sought against the approach of absurdism that reduces resilience to trauma. Psychological well-being is discussed in subjective, relational, semantic and temporal, and existential dimensions. The positive psychology literature confirms the importance of psychological well-being for resilience, so ontological well-being should not be ignored [5].

Ontological well-being, apart from subjective well-being, is the evaluation of life. Here, one's own life as a project should be examined together within the contexts of "past," "future," and "present." The meaningful combination of past, present, and future is the main focus of the evaluation of life [6].

People feel the need for a solid belief. The statement, "I believe, therefore I am," has been an area in which neuroscientists present their evidence [7, 8]. Being able to connect to that feeling in situations that one cannot control and cannot afford is considered in trauma therapies. For this reason, knowing the ontological dimension in the protection and prevention of PTSD and providing resilience training are recommended by Seligman under the name of the PERMA model.
