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Thursday, February 13, 2014

This is a good infographic on PTSD, which I believe is an epidemic.
It is not a government production so it is not full of bull about how most people will not be affected. You can twist statistics and the military and government specialize in it where PTSD is concerned. http://www.onlinemilitaryeducation.org/ptsd/

Wednesday, December 11, 2013

PTSD AND HOLIDAYS
Reprinted from Vol. 3, No. 4 of the Post-Traumatic Gazette. © 1997 by Patience H. C. Mason.
I give permission to copy and distribute this exactly as it is to anyone it might help.
P O Box 2757, High Springs, FL 32655-2757, 352-215-9251, www.patiencepress.com

Most people do not realize that people with PTSD have anniversary reactions. Holidays may also be anniversaries of trauma and bring up a lot of pain. This is one of the most distressing forms of reexperiencing for survivors and their families.
If the survivor doesn’t recognize that this  is one of the symptoms of PTSD, he or she may feel like Scrooge instead of like a normal human being who went through hell at that time of the year.
If the family doesn’t understand that this is a PTSD anniversary reaction, they may be very angry at the survivor. “What is wrong with you?” is a heart-rending, humiliating question when the survivor doesn’t know why s/he reacts like this.
If your veteran spent a particularly horrible Christmas seeing villagers lose all they had, seeing friends die, seeing the fat cats in the rear partying while the troops were suffering, he may have a hard time with Christmas. If your abusive father tore up the Christmas tree every year, if your uncle molested you at the family get together when you were eight, if you got mugged while out Christmas shopping, or date raped after an office party, or if your violent family pretended nothing was wrong during the holidays, these upcoming holidays may be a hard time for you. This is a normal reaction.
Holidays are also a really stressful time for many trauma survivors because they seem to reinforce the outsiderness of being a survivor of trauma. Everyone else seems so happy while your guts are twisted into knots as you think about past events. For veterans and other survivors, this pain can be compounded by grief for lost friends and their families who now face the holidays without those loved ones who didn’t survive. Guilt may also rear its painful head. Why did I survive?
The financial difficulties many trauma  survivors experience are highlighted by the commercialization of the holidays. There are a lot of pressures to conform.
One of my first healthy actions in my  marriage was to decide that Bob didn’t have to celebrate Christmas after he came back from Vietnam. I loved it so I should celebrate it and let him be him. I have no idea where that idea came from but it saved me a lot of fights. Today I look back on it as a miracle, accepting Bob as he was, and detaching in a healthy way. I think this is an important point for all trauma survivors and their families: Let the people who love the holiday celebrate it, and the people for whom it brings pain don’t have to. This may cause problems with the extended family or the kids, but treating the survivor with respect is one healing way to frame it: “We have to respect other people’s feelings and limits,” can be a healthy way to put it.
We can also create our own ways of  celebrating the holidays. We don’t have to conform to a rigid commercial stereotype of piles of expensive gifts and big gatherings. As a matter of fact one thing that trauma can bring you face to face with is the value of people as opposed to things. We’re starting a tradition in our crowd this year (a number of whom are trauma survivors and veterans) of homemade, recycled, or under $5 gifts. Ingenuity and fun!
Many survivors are not comfortable in  crowds or at parties, but a quiet meaningful celebration, say singing carols in the living room with just the tree lights on, may be something they can participate in. They may not want to trim the tree, but going out to cut it down or pick it out may be okay. I am mentioning Christmas traditions here because that is what I grew up with, but I’m sure that Hanukkah and Kwanzaa celebrations can be as low-keyed and spiritual as the
survivor needs them to be.
Survivors may need to create new rituals  to help in their healing. For instance a veteran who lost friends in combat on Christmas may want to feed the homeless (many of whom are combat veterans) instead of participating in a big family dinner with people who may or may not appreciate his service. He may need to go to a special place and tell his lost buddies how much he misses them and wishes they had lived. Someone else may want to help provide Christmas presents for children of poor families or for other survivors of trauma. The range of possibilities is limited only by the imagination.
If all you want to do is stay drunk or  stoned through the holidays, it might be good to find help instead. No one wants to be providing traumatic memories for the next generation. What you do while drunk or stoned can be pretty unpleasant for others, and especially painful for family members of both the spouse variety and the small-fry variety. 12 step meetings happen even on holidays like Christmas and New Year’s. I’m going to be at my ACOA meeting Christmas Eve. Sobriety is better than big presents. Harder, too.
Crass commercialization and shop till you  drop take the fun out of the holiday for me. So does having religion shoved down my throat, but I find that I can celebrate the birth of a child who represents all children to me and use it as an opportunity for me to do good in the world. Perhaps you and your family can do the same.
Holiday Helps:
Asking for input and creating  family traditions:
As I mentioned before, when Jack was a  kid, he and I had our own Christmas without making Bob participate. This is called politeness, although my principal reason was selfishness, wanting my kind of Christmas. Selfishness created a healthy boundary in that case. Something I didn’t think of at the time was asking for input, which is also polite.
Rituals For Our Times, by Evan Imber-Black  and Janine Roberts has a wonderful chapter on holidays and a whole section called “Making Meaningful Rituals.” Among other things, they suggest that planning, discussing and getting input from family members can prevent disappointments. Planning small changes in existing family traditions instead of trying to change everything at once is also easier. Sometimes family traditions are out of balance and only please one side of the family or one spouse or whatever. To fix this,  ask what the other person would like to do for the holidays. Say something like: “Maybe we could figure out some new things we could do that we would all like and could do together. Then the kids and I could do the stuff we like without pushing you to be involved.” Your spouse may never have thought about what he or she would like to do. I suggest not expecting an answer right away—maybe not even till next year. Just let him or her know you are interested in discussing it and open to change. People resist doing things they haven’t been involved in. Planning or contributing to an event can give them a sense of being valued and having some control.
One final point, without them being  aware of it, some traditional activities may clash with issues of safety for survivors. For instance, if Vince Veteran never puts up the Christmas lights despite endless nagging, perhaps it is because in Vietnam the night belonged to Charlie. By lighting up the house at night, he is attracting attention to his nearest and dearest, the kind of attention that could get you killed in Vietnam. Bringing this to consciousness—the need to keep the family safe—may help him get such a natural need met in a more appropriate way—like buying new tires for the car or better locks for the doors. Examining your traditions with that in mind can be rewarding.
Let go of outdated traditions or modify  them to suit today:
With our without the  help of your survivor, you can sit down with whoever else in the family wants to celebrate. Have each person list what is fun for him or her. Do the things everyone likes doing. Let go of what has become a burden or what you think others should do or you should do. You can always go back to doing something if you miss it! Example: I like filling stockings for everyone and I thought they should fill mine. Now I get my own stocking stuffers. It is a lot of fun getting a stocking full of stuff I really like instead of an empty one full of hard feelings. I’ve also dropped creamed onions, cornbread dressing and mince pie! Discussing what the family might like to do can be empowering for your children because it gives them a chance to move on to more age appropriate activities as they grow up. This may be hard for the parents, but I suggest that you can hang your own stockings or have your own quiet holiday dinner.
Some new family traditions you might try:
Looking up at the stars can be a beautiful  experience of the glory of nature. Get out of the house: Making snow angels is one of my favorite pastimes. There is nothing that helps me recreate the feeling of being a happy kid again like falling over backwards into the snow and waving my arms and legs. Too bad it never snows in Florida! Snow men, snowball fights (no ice balls, please), snow forts, snowy walks, cross country skiing, sledding, ice skating all can be family fun activities. In the south, walks in the woods, canoeing, kayaking, fishing, bicycle rides are still options.
Decorating with natural materials is  another thing I like to do. Grapevine wreaths with gold or silver pinecones, magnolia cones, acorns, berries and any weird seed pods I can find give me a sense of satisfaction no store bought wreath ever brought. Look around and be inventive. I also have a wreath made of rusty barbwire which my friend Marci gave me. As a survivor, she feels a little Scroogey at Christmas. I like it! Recycled and home made decorations (and gifts) bring family members together, minimize the wastage of natural resources, and increase our own resourcefulness and independence in a healthy creative way. For some of us it is important not to contribute to corporate profits. Paper chains and pomanders (oranges covered with cloves) are great home made decorations. Buying cloves in bulk at an oriental grocery store or a health food store makes pomanders affordable. They smell great!
Doing stuff for others. One veteran I  know has been feeding the homeless for the last nine years on holidays. I buy books to contribute to the local newspaper’s Christmas book giving program for disadvantaged kids. This is a living amends to a poor little girl to whom Jack wanted to give one of his books when he was 5. I wouldn’t let him. Battered women’s shelters always need stuff as do homeless shelters, nursing homes, hospitals and churches. You can adopt a family if you are well off, or contribute a few cans of food or a toy if you are not. Whatever you give will benefit you as well as those you help. Altruistic people actually are healthier than those who are not! You can do any of these as a memorial to someone who was lost or abused.
Doing stuff for yourself: Provide  yourself with something you didn’t get that you needed. Maybe this is a grown woman buying her inner child a Barbie doll, maybe it is a veteran presenting himseof with a certificate of thanks for his service. Look inside. People who love you would like to do this for you, too. Let them know if they can help somehow.
Ask people what you could get them  within your price range. Tell people what you want. Talking about presents is hard for some of us. I thought I should be able to find the perfect present with no input. Now I ask. I used to expect Bob to know what I liked and wanted. Now I give him guidelines.
Our crowd is having a homemade, recycled or under $5.00 Christmas again. We gave each other some really funny presents last year. If someone has given you something expensive you hated, this year you can recycle it to someone who might like it. I get wonderful containers at garage sales and fill them with cookies or rum balls or spiced pecans so it is homemade and recycled!
Talk to each other: Go for the quiet evening  at home together. Many of us never sit down and talk because we are so swept away in the demands of daily living. Make a date and simply talk. What about? About what the holidays and/or the family means to you.
 Accept the fact that kids are naturally self-centered and needy but can develop great kindness. A parents job is not to suppress these natural characteristics, but to encourage awareness of others and empathy. People used to think small children were little demons, but they are actually very kind and willing to give of themselves and help others. One great family tradition is to tell them that some little kids need toys and help them weed out ones they want to give away.
Give each child something that will give  him or her a feeling of specialness. It needn’t be expensive. Magic markers and a pad of paper gave Jack many wonderful hours of fun. I still treasure his creations.

Monday, November 4, 2013

Woohoo! Bob's second memoir has been out of print for years but we just made it available on kindle. It makes me look like a saint. He doesn't mention how I would never admit I was wrong in the first 25 years we were married. Our friend Mike Costello loved it and said "It is a litany of fuck-ups and a great read because  didn't do any of them..."
BTW, it is not a triumphant sequel. I think that must be the original publisher's words, but it is honest and unsparing and well written, even if I am bragging about my own true love.
It is a story about living with PTSD  before it had a name, back when it was not supposed to exist.

Monday, August 12, 2013

Compassion

Dealing with PTSD, whether you are veteran or spouse or family member requires lots of compassion: compassion for what your veteran has been through, compassion for his/her problems now, and compassion for yourself.
Living with PTSD is not easy for any of us. Bob has been having a worse time than usual this July. It is an anniversary of his worst month in Vietnam. I am practicing my compassion for him and for myself because my old habit of turning into a martyr was trying to sneak back, I had forgotten how to listen, and was starting to give him directions.
Whoops!
So I have to laugh at myself and be compassionate towards myself and him. It is difficult for him and for me, and I don't have to be perfect. And I do need compassion!

Here is what I wrote in the Gazette (#20) on Compassion vs the Cycle of Self-Pity and Self Criticism:
If you find it helpful the link to all of them is  http://www.patiencepress.com/patience_press/PTSD_Help-Gazettes.html
Compassion vs the Cycle of Self-Pity and Self Criticism

Self-Pity is “pity for oneself, especially exaggerated or self-indulgent pity,” according to the American Heritage dictionary.
If you feel like a victim, are waiting to be “fixed” by time, a therapist, or God, or if you are waiting for it to magically stop hurting, you may be experiencing self-pity. Being stuck in the past, thinking  how unjust it was, or how “if only I had done this or that, it would have come out differently,” is another form of self-pity.
Self-pity originates in an innate sense of justice which we all have. Trauma is by its very nature unjust. No one deserves to be traumatized. No one. So the question, “Why me?” is understandable, but it is also unanswerable, or the answer is wrong. If you believe you did something wrong and it caused you to walk into the ambush, or caused your parents to beat you, or that guy to rape you, focusing on that will keep you stuck in “if onlies” forever.
Self-pity is contained in the words, “Why me?” It derives from two mistaken myths about life: if you are good and careful and hardworking enough, nothing bad will ever happen to you; and the other one: you should never feel bad.
You probably cycle from self-pity to self-criticism: “Why do I feel like this? What’s wrong with me? Why aren’t I over this?” These words bury the pain inside you, so it stays with you forever and eventually it starts to hurt again. That is the problem with self-pity. Over time it keeps you stuck in the past trying to change history. Self-pity becomes a bag of resentments dragged around and dragging you down. It becomes a rejection of reality; reality being that bad things do happen for no reason. Self-pity can also make you quite unkind to others (What are you whining about? I have real problems!).
Compassion, (“deep awareness of the suffering of another coupled with the wish to relieve it”) on the other hand, is rooted in reality and based in being real. Bad things happen. No one knows why. They hurt.
Compassion is a necessary emotion, one of the major survival adaptations of the species. It gets grownups running into burning buildings to save kids, gets men to run out under a hail of bullets to drag wounded buddies back to cover. It inspires nurses and doctors, medics and EMT’s, rape-crisis counselors, child-protective workers and the ordinary man and woman to do extraordinary things.
Compassion activates and motivates helping. As a trauma survivor, you need to help yourself so you will heal. Developing compassion for yourself will give you the power to do so.
First, it is important to acknowledge the usefulness of self-pity which kept alive the idea that I didn’t deserve this. The only realistic answer to “Why me?” is that trauma is a part of reality and can strike anyone anywhere. You don’t have to make a mistake to be traumatized. You were not bad, no matter how human you were or how many mistakes you made. You did not deserve to be traumatized.
You deserve to recover.
If you are mad at yourself for having been hurt and for not getting over it, if you alternate between poor me and lashing yourself for being affected, it is a pretty hard cycle to break. Self-lashing probably has served you in the past, helping you to act when you had no other skills. However, it costs a lot in emotional energy and self-esteem. Compassion is more effective and empowering. Emotional numbing may have repressed it, but compassion is a quality you can develop.
People who develop compassion for themselves and others become empowered. They respect themselves and their experiences and do not expect to be unaffected. Compassion for themselves gives them the power to act in their own behalf even when others (parents, the authorities, the military, the Veterans Administration) have not, or have let them down.
Self-pity seems to render people hopeless and helpless while they tear themselves up with the idea that it shouldn’t have happened (true) and they shouldn’t hurt (false).
How to move from self-pity to compassion?
Practice! What are some things you can practice to move from self-pity to compassion for yourself? How can you  enhance your capacity to heal?
HEALS: Steven Stosny, Ph. D., developed a technique called HEALS which is designed to help you develop compassion for yourself and others (See issues 7 and 12). HEALS causes changes at the core levels of your sense of self. This is where you experience being your true self. Trauma can obliterate your old values and tear apart your self concept. Compassion will increase your self esteem, your ability to nurture yourself, your feelings of being effective, and change how you see yourself in a positive direction. Dr Stosny suggests practicing HEALS 50 times a day. Here’s how:
H-When you find yourself trapped in self-pity say to yourself the word “Healing!” Picture it as a flashing neon sign. This moves your consciousness out of the pity-pot, just as it can move it out of the anger file (battering is what it was originally designed to heal).
E- Explain what is going on: Say to yourself: “I have been hurt. I’m feeling very natural pain for a trauma survivor. It is okay to hurt.” Identify the feeling. Is it the pain of losing your buddy (grief), or the pain of thinking you should have known it was an ambush (guilt) or both? Is it the pain of name-calling (shame) or the pain of beatings and/or sexual abuse (shame and fear)? It may be several of these. Name them all. It might be one of Stosny’s “core hurts: disregarded, unimportant, accused (guilty, untrustworthy, or distrusted), devalued, rejected, powerless, unlovable, or unfit for human contact.” Try to feel the actual pain for a couple of seconds.
A- Apply self compassion. Say to yourself: “I was hurt. I did not deserve to be hurt. Today I can be kind to myself instead of hurting myself more with questions of why or unrealistic self-criticism that I should be over it. I can feel the pain instead of stuffing it with anger or food or drugs or trying to fix people. I can heal. Healing takes time. I can ask for help. I can find support.”
Say: “Does the fact that I was abused mean anything about me as a human being? No. I am a good person, worthy of good treatment. All it means is that I was unlucky. My abuser was the one with the problems. S/he hurt me. I didn’t deserve it, no matter what s/he said or did. I deserve to recover and I can recover.”
Say: “Does the fact that my war was a no-win situation and we didn’t get the support we expected at home mean there is something wrong with me? Of course not. There was something wrong with the politicians, the war, and the country, but I was a good person trying to do my duty. I was hurt, but I deserve to recover.”
Create a personal statement that applies to your situation.
L- Love yourself by feeling compassion for your pain. Tell yourself you are lovable, valuable, important and worthy of regard and you can give yourself these things. Even if you don’t believe them, say them anyway. Eventually you will believe.
S- Solve the problem that caused the self-pity/self-criticism, i.e. ask for the help you need, take that nap when you are tired, call the vet center or the rape crisis counselor or whatever you need. Do HEALS 50 times a day if you can!
Self-Talk: If you don’t want to use something as systematic as HEALS (although I highly recommend it), observing your “self-talk,” and working towards making it healing and helpful, instead of hurtful and impatient is another technique you can practice. Most of us rent out space in our heads to a lethal critic. It’s the voice that says, “You loser! Get your act together!” or “I can’t win for losing,” or some variation of that. Identifying when you are self-talking, what you are telling yourself (which isn’t easy to do at first because it seems so right and true to you, you’ve never even thought about questioning it), and then changing the messages you give yourself takes time. Doing it will help you develop compassion. Most of us do not identify how cruel we are to ourselves. We must stop if we are to develop genuine compassion and to recover. You can evaluate self-talk on the basis of whether it is true, rational, sensible or helpful. Harsh self-criticism or global catastrophizing are usually none of the above.
Compassionate self-talk: “I have been hurt. It takes time to heal. I can give myself time and attention. I can love myself. I can respect my experiences. I deserve to recover.”
Look around you for people the age you were when you were traumatized. We can often feel more compassion for others than we can for ourselves. Would you expect a young person to be unaffected by what you suffered at that age? Seeing how young you were can help you develop compassion for yourself. Visualize that inner child, inner vet, inner rape survivor or whomever and give him or her the same compassion you would give to another survivor today.
If you wouldn’t feel compassion for another survivor, it is evidence that you were traumatized at a young age. This is because to survive, children who are traumatized have to answer the question, “Why me?” with “I’m bad. I deserved it.” By believing that, they can hope to become good and earn better treatment. Without hope, they will die. Since children are by nature childish and self-centered, believing the trauma is their fault is pretty natural for them. Abusers reinforce this by blaming their victims. Sometimes a person who has experienced this develops a very hard shell and despises people who are hurt or who show pain. Compassion is one of the ways to dissolve that hard shell and heal.
Growing out of the belief that you caused the trauma is important for trauma survivors, especially since trauma can smash you back a few developmental stages. Under stress, you may find yourself acting or wanting to act as if you were the emotional age you were when traumatized or even younger.
Awareness: Any action which increases awareness will also increase the ability to be compassionate which is based on “the deep awareness of the suffering of others.” Even physical actions like mindful walking, running, dancing, martial arts, or singing can bring you to awareness of your feelings. They also empower you in a physical way, which can be very helpful in dealing with emotional pain. Various forms of meditation and prayer, and the “one-day-at-a-time” concept in 12-Step programs, also teach you to be here now, aware and living in this day, this hour, this minute. Once you can be aware of now, you can extend your awareness into your feelings and learn compassion. I find it very useful to do something my friend Katherine mentioned if I am in emotional pain when I meditate. I say to myself, “I am a good person,” and as I say it, I strike my chest. It really brings me into the moment and affirms my right to be in pain as well as my right to recover.
Another awareness technique which a therapist I admire teaches to her clients, (one of whom passed it on to me) is stop, drop, and breathe: When you notice a feeling, stop to identify the feeling, drop into the feeling, allow room for it inside you, and then breathe.
Remember it is okay to hurt. Genuine painful feelings are not self-pity. When bad feelings arise, remind yourself that it is normal to be affected by trauma.This too shall pass. It is painful. It is okay to be in pain. Reach out to that suffering person inside you as if he or she were a friend. Have compassion for yourself.
Small steps: “...the wish to relieve” suffering is the other half of the definition of compassion. What do you wish for to relieve your suffering? How can you break it down into small steps that can actually be accomplished instead of being overwhelmed by big unreachable goals ?
For example, suppose you wish to be happy. Break it down into a list of things that make you happy. Maybe you can do some of them today. To discover what makes you happy, you have to be aware enough to observe what actually does make you happy, instead of what’s supposed to make you happy.
If you wish to be able to go out socially without being triggered, break that down into manageable parts: spend time to identify your triggers (awareness), find places to go that don’t trigger you (research on what you like to do and what feels safe for you), and/or find therapy that helps you become less easily-triggered (ask other survivors for the names of therapists, call for introductory appointments, interview the therapist to see if he or she is someone you could work with, find out about his or her training, practices and beliefs).
If you wish for a healthy loving relationship, figure out the steps that might get you to your goal. Any plan you come up with will probably go through several revisions based on experience. It is okay to make mistakes. Try different approaches.
Asking yourself questions: In the American Heritage Dictionary, phrases defining synonyms for compassion include “sympathetic, kindly concern aroused by the misfortune...or suffering of another...a feeling of sorrow that inclines one to help or to show mercy...the expression of pity or sorrow:..the act of or capacity for sharing in the sorrows or troubles of another...a formal, conventional expression of pity...a vicarious identification with and understanding of another’s situation, feelings, and motives.”
Are you capable of “kindly concern” for yourself, or are you always flipping between “Poor me,” and Get over it!”? All-or-nothing thinking promotes self-pity.
Do you help yourself when you are having a hard time? Learning to identify emotions you’ve repressed or neglected will help you feel and release them. Even if they come back, you will handle them better each time.
Do you push yourself? If you do,  HALT is a good slogan. Don’t get too hungry, angry, lonely or tired.
Do you ask for help? Asking for help is another healing behavior especially if you ask early and often and before you are desperate. If you ask when you are desperate, it can appear to be a demand.
Do you have the capacity to share your sorrows with yourself or with a few trusted friends?
Do you give yourself formal expressions of sorrow and compassion for what happened to you?
Can you identify and understand your situation, feelings and motives? Everything a trauma survivor does is something he or she thinks will make him or her safe. Are your actions realistic? If not, maybe you can figure out how to make them more realistic. Do you feel safe? Is life the way you would like it to be?
How has this affected you? No one deserves to be traumatized, but if you were, realism suggests that it has affected you. It is time to change the question from, “Why me?” to “How has this affected me?” Most trauma survivors can give you a list. However, if you are a hard case, just barely beginning to realize you were even affected, this kind of self-awareness—examining yourself for symptoms—will give you a baseline for compassion for yourself. Every symptom started out as a survival skill that helped keep you alive.
Look at the adjective, compassionate: “Concerned with human welfare and the alleviation of suffering, charitable, humane, humanitarian, merciful.”
Are you merciful to yourself?
Are you working to alleviate your suffering? Looking out for your own welfare? Or are you abusing yourself with harsh judgments, unhealthy behaviors or substances?
How kind is your treatment of yourself? Do you have realistic expectations of yourself as a trauma survivor? Do you accept your natural, necessary pain or tell yourself to stop whining?
John Bradshaw in Healing the Shame That Binds You suggests saying, “I love myself. I will accept myself unconditionally,” out loud and often. This heals shame and develops self-love, which is an element of compassion.
If you also feel like you hate yourself or parts of yourself, that is okay. Bradshaw says we often dislike people we love, but it doesn’t mean we don’t still love them. The process of learning compassion includes learning to accept and love yourself as you are. It includes identifying your defenses and survival skills that are not very effective today so you can create the kind of life you want and find healthier happier ways to meet those needs. Bradshaw also recommends giving yourself time and attention, learning to be assertive, as opposed to either people-pleasing or aggressive behavior, and reframing mistakes. Everyone makes them. Self-pity leads you to think you are a mistake. Then you may try to become perfect, which will only make you hard to live with, not perfect! Mistakes serve a lot of useful purposes. They can be warnings. They can result from spontaneity and willingness to learn and play. They can be great teachers, if you are aware enough and flexible enough to learn from them. Bradshaw also recommends a commitment to becoming more aware of what you plan to do and what might come of it, using the experiences of the past and thinking through the likely consequences. This is a compassionate thing to do for yourself.
I’ve had a lot of experience with self-pity and self-criticism. I hated myself for not being perfect and treated myself harshly. I couldn’t figure out why I had problems, and I could never make them go away. It took me a long time to develop compassion for myself. It certainly wasn’t a concept I had ever thought about or felt that I needed, but I believe it has helped me heal more than almost any other quality I have developed (except for its twin, acceptance). Compassion is the kind of survival skill which never loses its usefulness. Compassion for yourself is essential for recovery. Once you have that, you will find you can say what it says in the Big Book, Alcoholics Anonymous: “...we will find that the people who wronged us were perhaps spiritually sick,” but the harm they did us will no longer be able to kill us or drive us to kill ourselves, slowly through addictions or swiftly through suicide. We are out of their power. Because we have self-compassion, we simply don’t take any more abuse. We have the energy to work toward healing and the capacity to be kind to ourselves in the process. Compassion means we also will not find ourselves inadvertently or intentionally hurting others. We can see their pain and reach out in fellowship, because we acknowledge and accept our own.

Tuesday, March 26, 2013

Cleveland Plain Dealer articles

Series of good articles in the Cleveland Plain Dealer on Family issues with PTSD. I tried to get them to include my resources, but they didn't, so I left this comment:
More resources at patiencepress.com. I am the wife of a Vietnam vet and have written a lot of stuff from a non-professional perspective for other wives. There are pages of free pamphlets, articles, Post-Traumatic Gazettes, and some books for kids, all of which you can download, print, pass along. I suggest if you want your spouse to read something, print it and put it in the bathroom. PTSD people hate being given things to read that are supposed to help them... like all of us!
I also wrote a book, Recovering from the War, which is on Amazon and also a kindle.
If you are struggling, despairing and fed up, so was I. I share what worked for me (50 yrs next Dec.) and suggest a lot of things that have helped others, because you are different than me. 
If you are dealing with a lot of anger, I suggest Post-Traumatic Gazettes #10 and 22 and my blog post, Irritability and Outbursts of Anger and the pamphlet on the spouse page, The War at Home. Things can get better. They have for me!

Wednesday, March 20, 2013

What PTSD is by Myke Cole

I found another great blog post, this one by Myke Cole, veteran and writer and asked for permission to repost it, which he kindly gave.
One of my strongest beliefs is that we do not know all the causes and symptoms of PTSD. I believe, as he does, that most military PTSD is the result of a long period of days, not necessarily one super-traumatic event, and that by focusing on that, shrinks can miss a lot.
Here is a link to it followed by the text:
What PTSD is by Myke Cole

I’ve talked before about genre writers who have been very open about per­sonal trials, par­tic­u­larly the kind of depression/anxiety con­di­tions that I feel are a nat­ural part of the uneven ter­rain all authors have to walk. I’ve always appre­ci­ated their will­ing­ness to go public with these issues, as the first (and false) thing that most people suf­fering from these sorts of things think is a.) that they’re alone and b.) the problem is unique to them. When your lit­erary heroes step into the spot­light and say, “hey, this is more normal than you think and you can figure out how to live with it,” well, let’s just say I wouldn’t be sur­prised if there are more than a few folks still pushing air past their teeth because of a blog post they read.
The thought of talking about what goes on in my head in any­thing but the most gen­eral terms in the public square takes me way out of my com­fort zone. But I reread the first para­graph of this post, espe­cially that last line. Some­times, you need to go out­side your com­fort zone, talk about a thing not because you need to get it off your chest, but because it might help others to hear it.
I was diag­nosed with PTSD in August of ’09, just after my third tour in Iraq. Of course my first con­cern (like everyone in my line of work) was losing my secu­rity clear­ance, and that kept me from going for help for a long time. But DoD did right by me, and I kept working for another 2 years before the book deal got me out of the business.
I had a hard time admit­ting it to myself. There was a cul­ture in my line of work, that PTSD was the province of the hard oper­a­tors, the door­kickers who got into 2–3 fire­fights every single day. Like most cul­tures, you bought into it silently, it was simply a thing that was, not worth ques­tioning any more than the law of gravity.
I mean, sure I’d sup­ported cer­tain spe­cial­ized units, sure I’d been to some funerals, sure there’d been some danger close indi­rect rounds. Sure I’d had some mis­giv­ings about what I was fighting for, what my actions were con­tributing to. But, I’d seen the ads on AFN, showing young men with gun­powder still on their hands, often fresh off the bat­tle­field, having trem­bling flash­backs of a fire­fight where their best friend went down right next to them. THAT was PTSD.
Except, it wasn’t.
I kept seeing non­profit TV spots, charity pieces and solemn psy­cho­an­a­lyt­ical essays. They all described a PTSD that I’d never seen in myself, and more impor­tantly, in anyone else I knew who suf­fered from it. I’ll never forget this one spot on AFN, where a sol­dier washes his hands, only to find blood pouring out of the faucet Stephen King’s Shining style. He hears gun­fire, looks into the mirror, the back­ground is a desert bat­tle­field strewn with corpses, glowing red.
I picked that apart with some friends for an hour. I’m not saying that there aren’t people out there for whom PTSD is like that, but it sure as hell wasn’t like that for any of us. As I thought about that spot, as I con­sid­ered the mounting reports of sui­cides, home­less vets, col­lapsing fam­i­lies, I began to get the uneasy feeling that PTSD is a lot like autism: A thing iden­ti­fied, but poorly under­stood. I read about the sup­posed symp­toms, the height­ened alert­ness, the re-experiencing of spe­cific trauma, the going numb. It was all true. Up to a point.
When James Lowder invited me to write an essay for BEYOND THE WALL, we started brain­storming what it would be about. After a few rounds of back and forth, I real­ized that I wanted to write about PTSD, and how I saw it man­i­festing in fan­tasy char­ac­ters. I used the Cooper Color System, talked about how living in the per­petual state of readi­ness known as “Con­di­tion Yellow,” both enfran­chised and hurt people. Con­stant vig­i­lance has its uses, but it is exhausting and, over time, transforming.
After the book was pub­lished I real­ized that I hadn’t gotten close enough to the issue. Arya Stark and Theon Greyjoy aren’t real people, and so addressing their PTSD was tack­ling the issue at a safe remove. It was a toe in the water. It wasn’t good enough.
Because the truth is, I’ve never heard anyone, med­ical pro­fes­sional, spir­i­tual leader or oth­er­wise describe the PTSD I know. What I see are people embracing a def­i­n­i­tion that explains PTSD using the vocab­u­lary of clas­sical pathology. It implies that, like a dis­ease, you can pre­scribe a course of treat­ment and fix it.
But, in my expe­ri­ence, PTSD doesn’t get fixed. That’s because it was never about get­ting shot at, or seeing people die. It was never the snap trauma, the quick moment of action that breaks a person. PTSD is the wages of a life spent in crisis, the slow, the­matic build that grad­u­ally changes the way the suf­ferer sees the world. You get boiled by heating the water one degree each hour. By the time you finally suc­cumb, you realize you had no idea it was get­ting hotter.
Because you kept adjusting.
Because PTSD isn’t a dis­ease, it’s a world view.
War, dis­aster response, police work, these things force a person to live in the spaces where trauma hap­pens, to spend most of their time there, until that world becomes yours, seeps through your skin and runs in your blood. Most of us in indus­tri­al­ized western soci­eties live with feeling that we are safe, that our lives are sin­gular, mean­ingful, that we are loved, that we matter. We know intel­lec­tu­ally that this may not be the case, but we don’t feel it.
PTSD is what hap­pens when all that is stripped away. It is the cur­tain pulled back, the deep and the­matic real­iza­tion that life is fun­gible, that death is capri­cious and sudden. That anyone’s life can be snuffed out or worse, ruined, in the space of a few sec­onds. It is the shaking real­iza­tion that love cannot pro­tect you, and even worse, that you cannot pro­tect those you love. It is the final sur­ren­dering of the myth that, if you are decent enough, eth­ical enough, skilled enough, you’ll be spared. The war­riors that the media ascribes so much power are the first to truly know pow­er­less­ness, as death becomes com­modi­tized, sta­tis­tics that you use to make an argu­ment for pro­mo­tion, or funding, or to score polit­ical points.
War­rior cults (and, heck, most reli­gions) were invented to give death meaning. Even if you look past the promise of immor­tality, they offer a tremor in the world, a ripple of sig­nif­i­cance in your passing. You do the right thing knowing that, some­where down the line, you have a mean­ingful death. PTSD is what hap­pens when you realize that you won’t, that your sur­vival will be deter­mined by some­thing as random as the moment you bent over to tie your shoelace.
Dis­eases are dis­crete things. But how do you treat a change in per­spec­tive? Joe Aber­crombie cap­tured it best in his descrip­tion of Ferro Maljinn’s final rev­e­la­tion of the world of demons just along­side our own. Once seen, the crea­tures cannot be unseen. When you’re quiet enough, you can hear them breathing.
Nobody talks about this. Nobody talks about the boredom, the impos­si­bility of finding meaning in 8 hours work in an air-conditioned office after you just spent months working 18 hours a day on a bat­tle­field where your touch altered his­tory. Nobody talks about the sur­real expe­ri­ence of trying to remember how you got excited about a book, or clothing, or even a car or house. On the bat­tle­field, in the burning building, the ground trem­bled, we felt our impact in every­thing we did, until the world seemed to ripple at our touch. Back home, or off shift, we are sud­denly the sub­ject of sym­pa­thetic glances, of silly, repet­i­tive ques­tions. The anonymity of the uni­form is nothing com­pared the anonymity of com­fort. We drown in it, cut off from what makes it worth­while for others, unable to carve out a piece of it for ourselves.
Time helps you to shift back, but you never shift back all the way. You develop the dreaded “cop’s eyes,” where you see the poten­tial threat around every corner, where you ask the waiter for the chair with its back to the wall. Where the trust essen­tial to build rela­tion­ships is com­pro­mised, because in the world you live in, every­body is trying to harm someone.
And this is why so many of us, even post diag­nosis, go back to work in the fields that exposed us to the trauma in the first place. Because the fear is bone deep, and the only thing that puts it to sleep is the thought that you can maybe patch a few of the holes in the swiss cheese net under the high wire. Because we are fright­ened from the moment we wake until the moment we sleep, and if we can stave that off for someone else, well, then maybe that’s some­thing to live for.
And that’s for those of us who get off easy. In the worst cases, people aren’t able to find meaning in a reg­ular job, or in wealth-building, or rela­tion­ships, or any of the things that modern soci­eties tell us charts the course of a life. These are the people that PTSD takes, as they flail their way into sui­cide, or crime, or insanity, des­per­ately trying to carve meaning out of a world where all the goal posts have sud­denly moved, where the giant ques­tion that no one can answer is, “why bother?”
The root of the treat­ment has to come from meeting those who suffer where they are. It isn’t just hard oper­a­tors. It’s clerks and phle­botomists and chem­ical engi­neers. It’s people who thought they were fine, only to wake up one morning and realize that the last few years have changed them in ways they don’t quite under­stand. It isn’t just sol­diers and cops and ER nurses. Life in poverty can bring on PTSD. An abu­sive parent can have the same effect.
We need to treat the fear, address the world view, acknowl­edging that these aren’t things you cure, maybe aren’t even things you change. We need to tip our hat to the trauma, and look instead at what the life after it looks like. We have to find a way to con­struct sig­nif­i­cance, to help a changed person forge a path in a world that hasn’t changed along with them.
And if you’re a vet, or an EMT, or a cop, or fire­fighter and you’re reading this, I want you to know that you can’t put the cur­tain back, but it’s pos­sible to build ways to move for­ward, to find alter­na­tives to the rush of crisis. There are ways you can matter. There is a way to rejoin the dust of the world, to find your own space on the dance floor.
I know this.
Because I did it, am still doing it, every day.
Don’t give up.