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Tuesday, July 1, 2014

I will post on ptsd here at patiencemason.blogspot.com and at the Facebook page Recovering from the War a few times a month from now on. Hope some of you will be following the stuff I write. If you have questions you would like answered, post them in the comments.

Monday, June 30, 2014

Day 30 of National PTSD Awareness Month:
So here we are. I have explained my take on PTSD and why I think it is a more helpful way of looking at it. I have talked about most of the symptoms and how they can save your life and make it painful later for you and your family.
If you want more about that there is a free pamphlet at patiencepress.com "The War at Home." It started out as a talk for a retreat the National Conference of Vietnam Veteran Ministers gave for couples. At the end of what I thought was so obvious, everyone cheered. You don't usually get cheers at a spiritual retreat. So I made it into a pamphlet.
I have also talked about types of help and why it is important to look for extra things that help you. I found the 12 steps helpful especially in accepting and sitting with painful emotion. Bob learned that from meditation. It is a skill you learn in many kinds of therapy and it is essential for recovery, because you can't heal what you can't feel.
So no matter where you are in the journey to recovery, I wish you well. It is not easy to change and grow. It is not fair that after all the shit you survived, you have also to do the painful work of recovery. The only thing I can say is that it will be worth it.
When I wake up in the morning, sometimes I  forget and give Bob some advice. Instead of getting mad like he did in the old days when I thought everything I said was RIGHT, he just grins. I go, "Oh, sorry. Doing it again." He gets this ridiculous meek look on his face and says, "Don't worry, honey, I'm used to it." We both laugh like crazy. Then, since it is irresistible, I say, "Well if you need any more shit, let me know, because I have plenty." More laughter.
I love him more every day. And he, oddly enough, loves me!
Every change I made in myself gave him room to change. Since I was only able to make very small changes, I know that is how people change. Every time he makes a little change, I know how hard that is so I appreciate the effort. I used to not notice because I was so wrapped up in how messed up he was.
It is not easy living with PTSD for either of us. I was just kidding him today because occasionally our PBS station messes up. One of those round TV signals that used to come on when the station went off the air comes on. Bob used to sit and watch that and then the snow after that went off. After I said "You used to watch that and the snow," it hit me. I realized and said, "You were in such hell." He looked up at me and I could see it had been hell. But it isn't now most of the time. For that I am glad.
Our suffering has been transformed.
We have been able to help others.
That is a blessing.

Sunday, June 29, 2014

Day 29 of National PTSD Awareness Month
When Bob got home from Vietnam in August 1966, he weighed 119lbs. He's 5'11". The first night he was home, a loud smack woke me. Bob was a few feet up in the air. I could see between him and the bed. He made way less noise when he landed. I was impressed, but I had no idea what it meant.
He flicked cigarette butts everywhere, too, in the house. He'd look shocked and say, "Sorry! I've been living in a tent." I thought it was pretty funny.
One day a big palmetto bug was inside and I started shreiking "Kill it! Kill it!" Bob picked it up and put it outside, and said to me, "Patience, I've seen enough things killed." It really made me think.
I still had no idea what he had endured. He mostly told funny stories about Vietnam, Mo'fuck the mongoose biting him when he wouldn't share his coffee and flying on missions with them. Stealing things from the R&U compound so the his unit had stuff to trade, the ambulance full of ladies of the night, his buddy, Jerry, getting stuck overnight in a whore house...
It wasn't till he was writing Chickenhawk that I learned details of what he had lived through. That was why I decided to write my book, Recovering, so other women could give their vets some slack if they knew what they had been through.
My plan was to help women understand and fix their vets, but luckily I found out about 12 step programs by accident. One nurse I interviewed who was running a Vet Center said the Alanon pattern of detaching with love would help.
Then I saw a Hazelden daily meditation book for Adult Children of Alcoholics, Days of Healing, Days of Joy, by Earnie Larsen and Carol Hegarty Larsen. Wow! I thought. I have got to check this out. So many vets are drunks. This will help their kids. So I looked into more ACoA books.
There was a list of ACoA characteristics which started with "Adult Children of Alcoholics do not know what normal is." I almost fell over because adult wives of vets with PTSD do not know what normal is either. I can't tell you how many times I wondered if it was normal to want your husband to say I love you. Was it normal to want hugs? I really couldn't tell anymore. That is what got me going to an independent ACoA meeting.
That was in 1987.
At the time I could not go 100 yards in the car with Bob without telling him how to drive. I believed that he drove the way he did to intentionally piss me off. Everything was about me. I personalized everything and I misunderstood everything. I was always pissed off or depressed. If something good happened it was about f-ing time and it wasn't going to last so why be happy?
I know I was hard to live with, but I thought I was fine (haha) and Bob was f*cked up, so I often told him so, because I thought he's want to know! I found help in the 12 steps. Other women have found other kinds of help, but I think one of the most important parts of recovery for the family and veteran is to focus on yourself. If you're the vet, get help, work on you. That's your job and your duty. If you're the spouse find help and support, so he can be in pain without you trying to fix it, and work on yourself. That's your job and your duty. Sometimes it does not work out, but often if you work at it, your marriage can turn from a battleground into a sanctuary, not a quiet cold sanctuary, either, but one that is also filled with laughter and hope, like ours is.
Tomorrow will be my last post of the month. I will try to post once a week from now on. If you go to patiencemason dot blogspot dot com you will be able to follow my posts by email, since I finally found out how to add that to my blog.

Saturday, June 28, 2014

Day 28 of National PTSD Awareness Month.
Traumatic events happen so fast they don't get incorporated into narrative memory which resides in your forebrain, that big lump of brain that gives us high foreheads. It is where the words are.
If the story isn't put together in your mind in words. I think this is one reason for intrusive thoughts and if onlies. It is like when you are trying to figure out the first point in the movie where there was a clue to what was coming. Your mind picks at it and picks at your war experience, trying to have a better past.
If I did this, it wouldn't have happened. If I did that...
This is the main reason that therapy is effective if you have an effective therapist. You get to tell the story. It will probably change during the therapy as you remember more details and feel the emotions you didn't have time for. This is hard for people who are not used to welcoming their emotions. We call them Americans, although I suspect it is common all over the world.
One thing that really hangs people up is guilt. You felt great when you killed that gook/raghead/dink. No one tells you that killing someone is a basic biological high because you lived and every bone in your body rejoices. This even happens when a fellow soldier is killed, because it wasn't you. In Chickenhawk, Bob wrote about the weird smile that possessed his face when he was telling his buddies about someone who was killed. People have thanked him for that because it happened to them and they thought it was only them. A lot of people hate themselves for that and can't even talk about it.
If you are doing therapy and don't get relief, maybe there is something you feel so guilty about you can't even admit it happened.
I wrote this prayer for people in 12 step groups when I realized a lot of them had been traumatized:

Prayer for People with PTSD
Higher Power,
I know that it’s not within the harmony of the universe that I be healed from the trauma of remembering ____________________________ without pain.
Help me through the pain. Surround me with the golden light of healing, fill me with the white light of peace and love. Help me to bear the pain as I go through these memories. Help me to cry. Help me to remember. Help me to love myself no matter what happened to me or what I did to survive. Amen.

A few meetings later someone told me about being raped, having therapy, and still reliving the rape every day. When she read the prayer she remembered something she had never told the therapist or anyone else because she was so ashamed of it. When she remembered it, after reading "no matter what I did to survive," the whole thing went away.
I used to be invited to VA's to give talks on PTSD and Bob would come along if he could talk about writing. One time, he was giving a workshop and one of the vets told about getting an F on his first journal because it wasn't personal enough. Being a Vietnam vet, he said "F her. I'll write one of my nightmares." He did. She handed it back with corrections. He rewrote it several times for her, then several more times for himself, and then he realized he wasn't having the nightmare any more! That night Bob said to me, "I haven't had nightmares since I wrote Chickenhawk, and I didn't notice.' We had a good laugh over that.
Therapy is about debriefing and finding support. The way I described PTSD yesterday, the two clusters of symptoms which start way before reexperiencing (hypervigilance and numbing/avoidance) explain one of the mysterious things about PTSD. Everyone has most of the symptoms right after the trauma (Critical Stress Response) but if it lasts more than a month it is considered PTSD. But some people don't seem to get PTSD which means it is a disorder of healing.
How do you heal? Talk and find support. Some people have someone who listens. Most people don't. Most people can't listen for more than 30 seconds. Trained therapists can listen unless they have been trained to think they know all the answers, but if you go for help, you will know quickly if you can talk to the person. This also means that you can talk to someone who wasn't there as long as they are interested in learning from you what it was like for you there. I think that is why so many guys talked to me about Vietnam for the book. I was interested and they could tell.
Group therapy will help you find support, but sometimes it is difficult to be around people who didn't go through as much as you did or who went through more. That is when my mother's saying is good: comparisons are odious. That means they stink. Each person in the group has been through the worst thing they have been through. If you've been through more, remember how it was when you first got shot at or saw wounded or lost a friend. How rapidly you adapted to sudden death. And if you are feeling guilty because your war was not as hellish, you still have been through your own hell and have a right to be there. Don't compare. Share and support each other. It will be worth it.
More tomorrow.

Friday, June 27, 2014

Today is National PTSD Awareness Day. This is also National PTSD Awareness Month and I have been posting on various aspects of PTSD all month, here at Recovering from the War on Facebook and at patiencemason.blogspot.com
Today, if you take nothing else away from this post, take away the idea that PTSD is NORMAL. It is normal to be affected by what we live through. It is not weak. It is not weird. It probably feels pretty nuts if you have it, so you probably try to hide it or deny that you have it, which takes a lot of time and effort and is usually pretty ineffective.
In the medical model, PTSD means there is something wrong with you. Having PTSD is painful and debilitating and annoying and it brings a lot of disorder into your life.
To me having PTSD proves something is right with you. You are alive. Dead people do not get PTSD, so it is proof of survival. You lived through something, probably many somethings if you are a vet, where others died. You did whatever it took to survive using the God-given or evoloutionary based survival capacities you were born with.
PTSD is not a defect, bus a set of survival mechanisms and therefore wonderful. Unfortunately there is a paradox. These survival skills, which bring you out alive, can, and usually do, become your biggest problems over time.
The medical model thinks PTSD is the problem.
I think WAR is the problem and PTSD is a solution to the problems of surviving war, physically and mentally.
PTSD symptoms are evidence of courage, caring, initiative, endurance, speed, skill, and luck.
If you are currently numb as a stump, you may not see the caring part, but why would you have to be numb if you didn't care? It is a protection God or nature has granted you so you can keep on the the face of a level of pain and fear and exhaustion and guilt and despair and rage most people never have to face.
The post in Post-Traumatic Stress Disorder means it can happen right after the trauma or 50 years later. Further stress or traumatic events can trigger a new round of symptoms even if you have had good therapy. And if you've been dealing with your hidden PTSD with workaholism, that invisible addiciton usually called resilience (how I hate the word), it will seem to the medical model that you just got it. I'd like to talk to your wife and kids before I believe that.
In the medical model, a person with PTSD looks mighty peculiar: flashbacks and nightmares with associated rages and lack of affect (feelings).
I hate this mis-arrangement of symptoms which is based on the fact that psychiatrists didn't notice PTSD till vets were having flashbacks in the beds of the hospitals.
My husband came back from Vietnam in 1966 with PTSD (read about his tour in his memoir, Chickenhawk) and I knew this was not how he was when he left. Eventually we found out about PTSD and I decided to write the book I wished I had had when he got home.
The first part is interviews with vets.
The second part was everything known in 1989 about PTSD, but I kept having the idea that these symptoms had to have a purpose.
Hyperalertness seemed like it should be the first symptom cluster. I bet when the first bullet whizzes past you get plenty alert. I bet you aren't going to be sleeping soundly when you could wake up dead. Makes sense. Your brain is designed to pay attention to threat, way down in the more primitive areas which don't speak English and can't tell time. This set of symptoms is what has to happen if you are to stay alive. In a war, each symptom is pounded into you. I call the "exaggerated" startle response an effective startle response. Outbursts of anger? Most people get pissed if someone tries to kill them. I'd call that a normal reaction. "Difficulty concentrating" seems to be another misnomer. Vets are concentrating on who might have a gun or a bomb and how they will get out of the room, survival information, not whatever some wife (who is not a threat) or clerk, or doctor is saying. They concentrate, just not on you! (So insulting...not really).
Your brain rapidly adapts to stuff, so the first death is horrifying but a few on, it is just everyday and don't mean nothin'. That is another survival skill. You can't sit down in combat and cry... Numbness keeps you able to do your job. Avoidance grows out of numbness, because the losses and pain of combat veterans are so great that it would be illegal to feel that in America, the land of "Aren't you over that yet?"
So in my version reexperiencing comes along last, after you have actually experienced the trauma, lost the friends, been blown up or shot, bobbed and weaved enough not to get shot and feel guilty about that... whatever.
I also included what was known at the time about the effects of having a PTSD vet in the family. Families were depressed, felt different, and developed problems, too. I know I did. I didn't know what the problem was, so I thought Bob was my problem and I set out to fix him. It was pretty awful for us both. When I was writing the book I went to him and said, "I think I might have been (notice the hedging) a bit hard to live with." The look on his face still makes me laugh when I think of it. A vet can't be driving you nuts, without you becoming a little bit nuts. I was.
The last part of my book is about how to begin to recover, and although it is written to the spouse, there is a lot in there aimed at vets. It has a lot of funny stories about my progress because things got better in my family when I stopped trying to change Bob and started working on me. We mostly get along great these days, but if he is having a hard day, I listen and apply compassion and kindness instead of advice.
After the book came out I wrote a book about PTSD for kids of vets, several pamphlets, and The Post-Traumatic Gazette for 7 years, 6 times a year, on ways to recover, reframe, rethink, and work towards your own healing for vets, family members and survivors of other traumas. That is all free at patiencepress.com.
Three more days in the month, so more tomorrow.

Thursday, June 26, 2014

Denial is a reality where PTSD is concerned. The four traumatic stressors of DSMIII and IIIR were pretty well laid out: 1. serious threat to your life or physical integrity, 2. serious threat or harm to children, spouse, or other close relatives or friends (and no one is closer than battle buddies), 3. sudden loss or destruction of home or community (like being medevacked), 4. seeing another person who has been seriously injured or killed (including the enemy).
This series of relatively descriptive terms has been replaced in the newer DSM's with a numbing ritual (like "It don't mean nothin'" in Vietnam) which goes something like this: "The person has experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others."
Read that over a few times.
What does it MEAN?
How can some kid in a white coat, no matter how good his or her motives, with his or her brand new MD or PhD know about blood and shit and burning flesh, or the agony of gang rape, or the devastation of losing your best friend from that bit of repetitious sleep inducing drivel, I mean prose?
Being put to sleep helps with denial.
Another reality of PTSD is simply the reality of having it. No one knows it is normal to be affected by what you live through. The statistics conveniently make you feel like it is not common and you won't get it. If you get it you feel like you shouldn't, and like you should be over it. You feel like you are nuts but you are not telling anyone, so you get grumpy and spend a lot of energy and effort trying to appear normal. Your spouse complains and the war at home starts. Sometimes this leads to divorce and isolation. It is not easy. It is not fun. Nobody does it for the money.
There is also the reality for families. A veteran's numbness leads to the discounting of our everyday problems which makes us feel unimportant and worthless. If the vet blows up a lot we are afraid and we feel worthless, because if our nearest and dearest treat us like dirt, we must be dirt, right? If the vet can't concentrate and doesn't seem to listen to anything we say, more proof of our lack of value. It is a losing battle to feel good about yourself when your vet is saying if you just were thinner, or kept the house cleaner, he'd have no problems. (I am sure husbands of PTSD vets get parallel crap.) It can turn into a downward spiral. Bob and I were on it from 1967 to about 1980 when we found out what PTSD was and that we weren't the only nut jobs. It was such a relief.
Another reality is that there is help. It is not easy to get it because the VA is overwhelmed. There are Vet Centers. There are Veterans Service Officers to help with claims. Be sure to use one and keep appealing. There are other services for vets provided by all sorts of organizations. Use Google. Service dogs, yoga, meditation, all sorts of things can help you calm down and have a pause button.
The pause button is what we all need when dealing with PTSD so we can make our relationships a sanctuary instead of a battleground. If someone like me, who used to scream and sulk and rescue and rant, and I didn't even have PTSD, can change, so can you, whether you are a vet or spouse. It is not easy, but it is your job, to change yourself to be the kind of person you want to be. It is a choice: self-righteous or compassionate? Right or happy? Kind or cruel? Like I said, it is not easy. Change is not fast. Small changes are more effective in the long run than a giant leap forward. I wrote 42 plus articles on that which are available at patiencepress.com.
More tomorrow.

Wednesday, June 25, 2014

Ranting away: Day 25 of National PTSD Awareness Month.

Denial in the professional community.
Wow! Still!
I had to stop writing yesterday because I was so mad, and since then I have had comments from vets and spouses about professionals not believing in PTSD,  saying PTSD can be easily cured, and encouraging women to leave their PTSD vets because they are just a-holes and PTSD doesn't exist.
NICE.
Makes me very angry. I hate trendy shit, and this is simply another trend in the struggle to understand and treat PTSD.
In 1968, the trend was suddenly combat fatigue and gross stress reaction (PTSD) didn't exist. In 1980, PTSD was put into the DSM III but most psychiatrists thought it was made up for Vietnam vets, despite the fact that Holocaust survivors, WWII vets and POW's, flood, fire, tsunami, hurricane and other natural disaster survivors, battered women and children, rape and incest survivors and survivors of industrial accidents and fires all had it. People see what they want to see.
In the 90's it was all "lets fix it with drugs" which did not work. It still doesn't work. Drugs can help but they do not cure.
Then psychologists started getting smart, so if they developed a treatment, they did follow-up studies and some of the new treatments do actually lower PTSD symptoms. Is it a cure? Does it last forever? In 50 years we'll know.
Most of these studies are on sexual abuse (rape) survivors but a few have been done on combat vets. The "evidence based" therapies do work for some. So do a lot of other therapies as long as someone who cares is listening.
Many, many therapists, social workers, psychiatrists, and other mental health people work hard and long to help our vets in the VA system. If you get someone you can talk to, hang on to them.
Then there are the smugly self-righteous. They know the new ways are the best ways. They are going to change the world and human nature.
They have no idea how lethal they can be, especially when they tell you you don't have PTSD, or that you can't be helped, or they can cure you quite quickly.
I call this a profound and pervasive narcissistic sense of entitlement, a phrase I read in a paper about Vietnam vets with PTSD, which really pissed me off. Society makes a deal with soldiers. You go do our dirty work, and it is dirty work in every sense of the word, and we will respect you, and honor you, and take care of you. So vets who felt they were owed something were narcissists. NOT.
But someone with a PhD or MD who thinks they know everything and can fix everyone if they just listen to MEEE. Yep. Narcissistic sense of entitlement.
PTSD has been around since the beginning of writing, if not before. When Saul (who had killed his thousands) was troubled by an evil spirit of the lord (PTSD), they sent for the harpist, David, to soothe him. Saul tried to spear him to the wall twice. I was at a National Conference Of Viet Nam Veteran Ministers (NCVNVM.org) retreat when I first heard this. I laughed. It sounded just like Bob. Most women can identify.
The PTSD psalm, the 137th, starts out with the captors saying forgeddaboutit, just like everyone says to vets.
Be happy. Sing! Yeah, right!
The vets feel they will betray their friends (If I forget thee, oh Jerusalem) if they forget so they don't (and can't).
The last bit isn't usually read in church: happy are they who take the children of the enemy and dash their heads against the rocks. People with PTSD are angry. We all have an innate sense of justice. We know that what happened to us was not right, whether it is people trying to kill us or surviving rape or losing everything in a fire. That is why "irritability and outbursts of anger" are part of the diagnostic criteria.
In the Iliad we read about PTSD (read Jonathan Shay's Achilles in Vietnam) and homecoming in the Odyssey. Shakespeare mentions every symptom of PTSD in Lady Percy's description of her husband in Henry IV, Part I. There are lots of other examples if you look for them. I always do. Always glad to hear about them too.
The final thing I want to say today is the difference between a startle reaction (when a vet wakes up swinging or hits someone who has surprised him) and battering. Batterers go through a cycle: hit, sorry, honeymoon, slowly growing anger, and hit again. A startle reaction is completely different, and any therapist who doesn't know the difference should learn it. Most vets are not batterers and if they are, it is not from the war. It is learned at home and despite the conventional wisdom about battering, there is help for batterers and their wives: Compassionpower.com.
More tomorrow.