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Tuesday, December 5, 2006

The Realities of PTSD

I'm starting a blog to talk about the multiple realities of PTSD: The biological basis of PTSD, the brain and body based keys to human survival which we all have, the historical reality of PTSD in literature, the separate reality of trauma (war, abuse, natural disaster), the reality of having PTSD, the reality of living with someone who has it, the reality of denial by survivors and society, the physical reality (depleted cortisol, changes in amygdala and hippocampus, stress related diseases, early death), the reality of how hard it is to get help, especially good help.
I'm inspired partly by a story on NPR yesterday about soldiers saying the Army is not treating PTSD, (see This story includes many of the elements which make life hard for people with PTSD. Denial by those in charge (they're faking it) when the likelihood is that those in charge are either REMF's (rear echelon bad word bad word) or so numbed out themselves in order to cope with the trauma of war (usually enabled by alcohol or workaholism or some other addiction) that they think they are fine and it didn't affect them. One sergeant actually said that in the story. I see that as evidence of PTSD, like the mother of a molested child saying, "I don't know why she's making such a fuss. I was molested for years and it didn't affect me." Except to destroy your natural human capacity to care. I think people get this numb because they do care and caring is too painful and utterly unsupported in this society. Been there, done that, being one of the numbing rituals we hear a lot.
Poor treatment. We've all heard the Army, Marines, and VA claim that they are treating and preventing PTSD this time. I always laugh when I hear that. First of all, most guys have to be in extremis to ask for help. Second of all, being in a group with a psychologist is not debriefing, one of the things that does help (see for more information). Critical Incident Stress Debriefing is peer-to-peer, not shrink to clients... The military is not doing that. Third of all, you can't change human nature. We all do our best to survive in war and other traumatic situations. Then we all do our best not to feel the pain. The same things that help us survive: hyperalertness, so we can pay attention to threats and move fast; numbing, rapidly adapting to the situations in order to remain in control and do whatever it takes to survive and keep others alive; and re-experiencing, our brain's better-safe-than-sorry warning system, all can become our biggest problems if the trauma is not addressed. So trying to pretend that 17 soldiers and a shrink is debriefing, and that a suicidal, not-doing-his-job drunken or drug-using combat vet is simply a slacker who should be thrown out of the military will leave us with the same problems we had after the Civil War, First World War, Second World War, Korea, Vietnam, Somalia, The Gulf War, Panama, Beruit, etc.
For interesting reads on the effects of war on family life try Even Dogs Go Home to Die by Linda St John, It's All Over But the Shouting by Rick Bragg, or Change Me Into Zeus's Daughter by Barbara Robinette Ross, none of whom had ever heard of PTSD when they were growing up.
I gotta stop here. As you can see, I have a lot to say.


  1. Hello Patience,
    Thank you for sharing the realities of ptsd. I'm the wife of a combat ptsd Vietnam vet. I also suffer from ptsd due to the war in our home, as do our two children. We had "Help" that only served to retraumatize us in the aftermath of war." The most healing resource I have found in my life, is you.
    A very intelligent lady once said to me:
    "Dear Chris,
    You find such wonderful articles!
    I agree with you that PTSD can't be prevented, but I don't object to people trying to prevent it. I do object if they announce the are preventing it with a six month study... You really cannot say someone did not get PTSD until they are dead, because the post in PTSD can come anytime in the rest of your life. So working to prevent it is not preventing it.
    People who get PTSD have the greatest exposure (most traumatic events), the greatest losses, the least support, and the fewest resources (resources being stuff like knowing it's okay to feel, having seen other people process feelings, knowing you don't have to be perfect, all the stuff you learn in a non-PTSD family, plus emotional support, good relationships, etc.).
    Once they have PTSD, although the symptoms can be brought under control and become no longer crippling or debilitating with good therapy, they often come back when there is further trauma, so you have to be aware that this can happen and get further help. Then there are the bad world holes like your former therapist, Olga, who retraumatize their clients... It is hard to get the right help!!!"
    That intelligent lady was you my dear friend. The validation you gave me was so helpful and healing, I will always cherish you for that. When the therapist revealed a confidence I had shared privately with another member of group, deliberated trigged me, and blocked the escape route, then threw me out of group for having a normal reaction, she cut all my resources, said I have to be perfect, etc. All the things you talked about learning in a non ptsd family. I experienced a sudden loss of community, and she cut the emotional support and good relationships I had formed with other wives striving to cope in the aftermath of war. You taught me how dysfunctional the therapist was, and how her group modeled the life I live at home with ptsd. "Don't talk,don't think, don't feel." Given my life experience, sights and sounds of family violence would be a normal trigger. I was taking healthy steps to cope with it when she violated my rights and punished me for being affected by trauma. You've been the most respectful person in my life to validate that experience, and to lead me in the direction of healing. The resources you have provided have been a God send to me, and in turn, to my family.
    When my vet heard you speak about the war at home, for the first time in his life since Vietnam, he was filled with hope for healing. The bad word holes at A&W psychology stole that hope from him at the very next session when he talked about you. For the first time in his life since Vietnam, he felt normal. Not weak, or defective, or crazy.
    He gave on on therapy altogether after they retraumatized him. Thank you for saying "It's hard to find the right help." Because of you, I do have the right help today. And I know that when new stressors crop up, and my symptoms come back, I need to practice the things that worked in the past again. My wonderful help practices CBT, and he really knows how to listen and validate my experiences. The other help didn't know how to do that, they blamed me for being affected by trauma, and basically said I was weak, defective, or crazy. (calling triggers "issues" LOL) It's all you're fault! is what I heard from them. Thanks to you, I can laugh about it today. A lot of therapists are codependent. Following codependent orders is NOT healing. Survivors need to establish and maintain control of their own recovery.
    You my friend, are the true expert in ptsd. Those who have born the battle usually are. We learn from life experience. In a ptsd home, the fear our soldiers suffer of making a mistake, (because in a war zone they could get you killed), tends to prevent family members from making them, and learning from them. I've learned so much from you Patience. The most valuable lesson was that survivors need to be heard, to be listened to, and understood, in order to heal. I can never thank you enough for validating my life experiences in the aftermath of war. I love you madly and the most my dear friend and mentor. Thank you for using your precious life experience to help others. By helping others, we are helping ourselves. Bless your heart my sister. Big healing hugs and all my love, Chris

    The Aftermath of War
    We found a wounded veteran,
    And held him in our hearts.
    We've seen the bravest soldier,
    Break down and fall apart.
    Yet we love our heroes,
    Like no other has before.
    We're the wives of combat veterans,
    In the Aftermath of War.
    We had to learn the hard way,
    When coping with PTSD,
    That their war is never over,
    And freedom is never free.
    We bandage up their broken hearts,
    The best we can each day.
    We see the scars upon their souls,
    That never go away.
    Knowing we can't heal the wounds,
    That cut their very core.
    We're just trudging through the trenches,
    In the Aftermath of War.
    We've seen them lose their faith in God,
    And in the human race,
    As they try to hide the anguish,
    That's still written on their face.
    We've witnessed all the symptoms,
    That they're not willing to admit.
    We've dodged the screaming bullets,
    And been crawling in the Sh*t.
    We've felt the anger,
    guilt and blame,
    Of these men that we adore.
    As we stumble on the battlefield,
    In the Aftermath of War.
    Each day we share the horrors,
    Of a pain they can't forget,
    And we feel we lived through combat,
    Because we love a vet.
    But we are all survivors,
    And we're learning how to cope.
    Hanging on with all our might,
    Just holding onto hope.
    And our soldier's heart will cry out,
    That they couldn't love us more.
    Because we're sitting in their foxhole,
    In the Aftermath of War.

    By Chris Woolnough

    A special thank you to Patience and Bob Mason. The pioneers in "Recovering from the War" that blazed the trail of healing. I love you both!

  2. Thank you, Bob and Patience, for sharing your Aftermath of War!! If it weren't for you two very special people, I wouldn't be the sane (?) woman I am today. Matter of fact, I just got out of one the day before I joined AOW and you all made me realize that I am NOT crazy!! My discharge diagnosis: Your husband has PTSD. Ever since, I have been a Veterans' Advocate!! God bless them all!!


    Love, Kathy Dunn

  3. Patience
    In regards to your message on the first page. I'm a Nam Vet who was an FMF Corpsman with the USMC. For years I thought I was normal until many friends put pressure on me to go to the VA. I applied for a disability and after much BS I was granted 33% when we lived in Maryand. After moving to CA I went to a Vet Center and got some help and understanding. In turn they sent me to Loma Linda VA Hospital and was placed on meds. I then appealed and was granted 100% disability. I then reapplied for SS benies and after a long hard battle I got them. So my advice to others is to keep fighting the system. By the way my VA Vet Center Counselors and Hospital Docs are great.
    Mike Lerp

  4. Dear Patirnce;
    Your blog is very informative and important. As a combat vet, treat for PTSD from Viet Nam, I see new members at couseling. War is the same if it was Viet Nam, Irag, Korea, WW@ or WW1. Now VA wants to denie helping,,, it is a very sad epitaph on the future of defending this country. One day there will be a war, and no one will show up, if we treat our veterans this way. peace Rev. James Koshu Alonzo, Member-International Conference of War Veteran Ministers

  5. Patience! How wonderful to see you have a blog. I've bookmarked this and shared it with others. Glad to read it, you lifted my day. Thanks, friend!

    Joy Lemmons

  6. I am glad that you and your husband seem to have worked through the issues with PTSD. My husband has recently been diagnosed with it. He is seeing a counselor and on meds. Lately the violent incidents have become worse. It seems the most he can go is one day without having an outburst. I don't think he is being completely honest with his counselor or anyone he talks to about his issues. It seems that he is just going through the motions of getting help, but not committed to really changing. I am writing to seek advice. I don't know how much longer we have until he completely explodes. Any suggestions?