Search This Blog

Monday, April 30, 2012

Vietnam and All Veterans Reunion

Due to a mistake, no one knew I was speaking on Saturday afternoon because it wasn't in the program they were handing out. So I did my usual talk, Recovering from the War, to three people. Kind of disappointing, but I can say that what I said helped those three so it was worth it to me.
Bob got really mad when I called and told him and said I should never go again, that they don't respect or appreciate me. I was really down in the dumps, thinking he was right.
The next day, my talk was in the program, but it usually overlaps with the service by John Steer, so once again I gave the talk, The War at Home, to just a few people. Luckily they got a lot out of it and laughed at all my jokes. When I said it was probably my last visit, one couple who come every year got really upset. I was talking to a Korean War and Vietnam vet and to a really lovely Donut Dolly and a Navy nurse and a Special Forces guy and his wife, when the upset couple disappeared.
As I was packing up the free handouts I'd brought and my books, the treasurer of Vietnam Veterans of Brevard, Ralph, showed up with the upset couple to personally apologize and ask what they could do to get me to keep coming.
I suggested they announce my talks on the main stage and do some PR. He offered to put up posters if I could mail them down so they would be up before I get there next year. He suggested that the talk on Sunday should be at noon so it wouldn't be interfered with by the church service. He also said he'd write Bob and apologize. I hope he does.
I did a talk for VVB a few years ago, just so they would know what I was saying over there at the wall pavilion while they are busy running the reunion, and he remembered it and said it was so helpful. So maybe I will be there next year. I do love giving the talks and talking to vets and their families afterwards and Donut Dollies.
One of my pet peeves is that the Red Cross claims the Donut Dollies weren't employees and weren't in danger (yeah, right! like no one ever rocketed or mortared every place they could in Vietnam) so it denies them help with PTSD treatment.
So it was an interesting lesson in how little control I have over events and how perhaps my speaking up will lead to a better result next year.

Tuesday, April 24, 2012

Link to the readio show

Here is the link for the  radio talk. http://www.wbobradio.com/wp-content/uploads/2012/04/DMS-042112.mp3. I just listened to it and am pretty happy with it except for the guy who wanted to help me by letting me know PTSD is not caused by war but by chemical stuff. I am only on for the first hour, but I have no idea how to only link to the first hour.

Saturday, April 21, 2012

Radio Talk

I just spent an hour on the Donnie Moses Show on WBOB AM 600 in Jacksonville, FL, with Bill Carter, talking about PTSD. Within a week the podcast should be available at http://www.wbobradio.com/wbob-archives/podcasts/ scroll down to Donnie Moses show and click on today's date, 4/21/12. It looks like they only keep them online for a couple of months. You can either listen or download. Download if you want to keep it. That's what I plan to do and hope to put it on my website.
One guy called in to help us with PTSD by saying it was caused by chemical exposures and if we just read his book and went to these special doctors (because the VA doesn't treat it) we would all be fine. I tried to be polite, but I told him that PTSD is caused by traumatic events and in soldiers it is caused by hundreds if not thousands of traumatic events. Then Bill, who was a helicopter pilot in the 1st of the 9th Cav, a unit that went looking for bad guys all the time, told him an abrupt goodbye. The rest of the broadcast was about PTSD and I got to say most of what I think is important, that it is normal to be affected by what you live through, that the symptoms of PTSD start out as survival skills built into the "reptile brain" which doesn't speak English or tell time, so that part of you does not know it is over, and that avoidance perpetuates it, which is why writing and talking about it help you heal. I also talked a bit about triggers in the family and how we can misunderstand and personalize things which leads to a lot of fighting and disharmony.
I thought it went well.

Monday, April 9, 2012

Infants Possess a Sense of Justice: How this affects anger in PTSD

This article reinforces one I read about monkeys also having a sense of justice (give one a banana and one a cucumber, and the cucumber monkey gets pissed). I believe that part of the root of PTSD is a sense of justice. People who are traumatized know it is not fair, even if they are told they deserve it by perpetrators or it is part of the job in the military. It's not fair and it's not right and on some level they know it and it makes them mad. It also makes them mad when people try to kill them or hurt them or their friends... so anger becomes a big problem.
Life isn't fair unfortunately and worse things happen quite often in war and other traumas than people are able to deal with. Finding someone who listens to your anger and doesn't tell you not to have it can be very healing.
Blowing up is the reverse of healing.
Most of what we think of as anger is dysfunctional and ineffective.
Here is my article from the Post Traumatic Gazette
Dealing with Anger in Effective Ways
One of the most terrifying things for trauma survivors is to fly into a rage without any warning. Family members friends and therapists can be terrified, too, although they may not show it. If you have read earlier issues of this newsletter, you know that irritability or outbursts of anger are one of the cluster of hyperalert symptoms that include not being able to sleep, lack of concentration, startle responses, etc. You may still be mystified or afraid that you will do something in a rage that you will regret for the rest of your life. And maybe you already have. I suggest using the pain from incidents you regret to motivate change.
The first task in dealing with anger is to distinguish between anger, which is an emotion, and violence, which is an action. Most people think they are the same thing.
Extreme startle responses can be violent. The violence occurs in nanoseconds when the person is surprised by something, way before the amount of time it takes to process something that pisses you off in your fore brain and get mad. Violent startle responses are very upsetting to the person who has them. Often the person goes from shame and despair (what is wrong with me?) straight into an eruption of anger at the victim of the violent startle response. In one sense it makes no difference to the person you are yelling at or hitting, but it can make a difference in how you handle the incident. Instead of erupting in anger, you can learn to say, “I am so sorry. That was a startle response. I am not angry except at myself for having it.”
Anger is based in thinking. One person is treated rudely by a clerk and thinks “She must be having a hard day.” Another person thinks, ”She cant treat me like I’m nobody,” and gets angry. Same behavior, one way of thinking results in compassion and the other in anger.
Anger is a signal that you have a problem to solve and you probably feel you are about to be harmed. The problem may be real (someone is hurting me) or it may be that what is going on today brings up feelings from the past (what is happening reminds me of my abuser or a traumatic event). Anger is an emotion, not an action like exploding into violence.
Anger can be managed if it is brought to awareness and feeling is separated from action. Boundaries and knowing about emotional reasoning can help here. Say to yourself, “I am over here. That person is over there. He or she has a whole history, feelings, thoughts of his/her own. I may feel pain but that does not mean that person is trying to hurt me (emotional reasoning, a cognitive distortion, says I feel it so it must be true). It may have nothing to do with me.” Just saying this much to yourself will help you pause. When you can pause, you can also learn to act in new ways instead of reacting in old ineffective dysfunctional ways that get you into trouble, ways you may have learned in childhood or in combat. You can learn new skills. It ain’t easy, but it can be done, one little bit at a time!
Several aspects of PTSD contribute to the problems trauma survivors have with anger.
Knowing you are angry: You may be so numb you can’t tell when you are beginning to get angry. It seems to explode out of you but there may be early warning signs that you could learn to detect. Regularly scanning your body for physical signs can help you become aware of this: are you clenching teeth or fists? Is your stomach churning, throat tight, lips turning into a thin blue line? Ask your family or associates how they can tell if you’re getting mad. You may start to twitch in a particular way that you are not aware of, moving your shoulders, drumming your fingers, rubbing one ear. If you know your own signs, you can walk away or calm yourself down.
Knowing why you are angry: Once you start to be aware of what is going on inside you, I’ve found that it helps me to identify other feelings I have numbed which lead me to anger. Most people learn to cover up painful or frightening feelings by getting angry. Anger causes a surge of adrenaline and a feeling of power which is more tolerable for most of us than feeling helpless, afraid, hopeless, needy, fearful, despairing, lost, abandoned, guilty, ashamed, or whatever.
If this is true for you, as it is for me, paying attention to your emotional state will help you deal with the primary feelings under the anger. I find that I do better if I just feel them, no matter how painful, for a while, maybe write down what I feel. The feeling passes and I am okay. “This too shall pass,” is a good slogan for me.
Another PTSD symptom, hypervigilance, constantly scanning for danger out there, makes it hard to concentrate on your inner life and be aware of what you are feeling. This can compound the effect of numbing. Using an affirmation like: “I am safe. I am __years old and no longer in ______. I have more resources today than I did when I wasn’t safe,” can help remind you that hypervigilance may not be necessary today. Fill in the blank with your age and the place you were traumatized whether it was Vietnam, Iraq or Afghanistan, or your own home. Change the wording so that it works for you.
Other symptoms of PTSD can contribute to anger problems: lack of sleep makes you irritable. You may also carry an irritating residue of bad feelings from nightmares into the world of day. Trying to avoid feeling common feelings can be a constant irritation. Plus cultural conditioning says men can be angry; but they can’t cry about things they need to cry about, like losing friends. And women are never supposed to be angry so we tend to stuff and stuff till we blow up.
Changing: If you want to change, the first step is to identify what lies under the anger. Keeping a list of common feelings handy can help you learn to name them. List the beliefs you have which get you mad. A lot of them will have the word should in them. Stopping to identify feelings and beliefs turns out to be a good pause-button for those of us who tend to go off like a rocket.
Knowing your own history is important here, too. If you can identify why that clerk pissed you off so much (like the lifers in Vietnam or the teacher who humiliated you in front of the class), it is easier to go on with the thought “but this isn’t Vietnam. or school, and I’m older now and have more resources, one of which is to write a letter to his/her boss...” Taking a healing action is so much better than letting others push your buttons and jerk you around like a puppet.
When you want to yell, look inside for the feeling beneath the anger. Is it fear that your kid was dead when he stayed out late and didn’t call? It will be a lot more effective to tell him that than to rage. Is it feeling unloved and therefore unlovable because someone forgot something they said they’d do for you? If you can identify that you can be honest about it (I felt hurt when you forgot my sandwich/birthday) and you can also examine whether you are putting yourself in a position to be hurt over and over by relying on unreliable people or expecting someone human to be more than human. Then you can work on that pattern, too.
Much of anger comes from what are called “hot thoughts.” We see someone’s behavior as reflecting on us. I used to see my dog’s unwillingness to let go of the ball after she fetched it as proof that I was no good (Couldn’t even train my dog right!). It would enrage me. One day in the park, I found myself screaming at her, “This is not a game!” as I punched her for not dropping the ball! Me! Nice Patience! It got me to examine my rage and see what I was saying to myself about her natural playfulness vs. having the perfect dog. Today I try not to be perfect or have perfect dogs, plans, parties, newsletters, etc. It is a lot easier!.
Hot thoughts can be as simple as “she should have dinner ready when I get home.” If there is an emotional rush associated with a simple event, the uprush of emotion signals to me that this feeling is probably from a different time zone and I need to examine it. For me, often the intensity of the anger is a cue that my needs were not being met, whether that zone is a traumatic childhood, recent traumatic events, or Vietnam. It helps to remind myself that I have more resources today.
There are a lot of slogans and sayings which help to cool down hot thoughts. “Easy Does it,” is an old AA one. “This is not a life or death situation,” is one many veterans use. “I can handle this,” helps remind me that I have more resources today than I used to have. “Chill out! Cool down! Slow down and take a breath. What is the problem here that I need to solve?” all are helpful phrases.
Disputing your thoughts can help too. Whenever I think “I’m no good,” (which is an old pattern for me), due to the fact that I’ve been working at recovery for nine years, I almost instantly say to myself, “Wait a minute, I’m fine. I’m not perfect but who likes perfect people? I’m okay the way I am.” It really helps. You can learn to do it, too.
Letting go of unrealistic expectations that other people will put your needs first can help. I’ve found that most people can be trusted to be human and think of themselves first. It is okay. So do I most of the time.
In 12 Step programs, we use steps four through nine to free ourselves of anger: not to suppress anger but to become free of it. This involves self examination (the inventory), becoming willing to let go of old patterns which may have served us in the past but are ineffective today, asking for help from our higher power, listing people we have harmed, and making amends to them. (Sometimes it is human nature to be angriest at those we have hurt.)
Feeling vs. Action
I have come to believe that almost none of us sees anger used effectively in this society. And most of what we think of as anger are angry actions which are ineffective and dysfunctional. Yelling, hitting, throwing things, blowing up, hitting pillows, withering sarcasm, getting drunk to pay someone back, shopping till you drop, screwing someone because you were screwed either literally or figuratively are all ineffective actions. There may be a momentary feeling of power, but I don’t think it lasts very long. The effects of such actions usually do last.
The idea you should get anger out to get rid of it also seems to indicate that anger isn’t an acceptable feeling. It is to me. I am allowed to be angry. I prefer not to act in ineffective ways. I can “say what I mean but not say it mean.” I see a distinct difference between the feeling of anger and my old “let me tell you what is wrong with you!” shaming and blaming way of handling it. That was ineffective action. So today I try for the feeling, to sit with it, examine it, say what I need to to keep my side of the street clean (be honest).
Here’s an example from recent experience. Someone yelled at me recently. It really pissed me off. I would have yelled back in the old days but I am really aware through experience of how ineffective that is. So I said to myself, yelling back is my old pattern. I need to use the principles of the 12 step program to find a new solution. She may not even know she is yelling. She also doesn’t know how I feel when she yells because I always act like it doesn’t bother me. In my mind I went from “Shut up, you _____! Don’t yell at me! You’re not perfect!” (my instinctive response) to thinking of saying “I know you don’t realize what an idiot you are being but blah blah blah.” Didn’t say that either because it was you-based and therefore blaming, not telling what I was feeling (not honest but defensive). I needed an I-statement. I ran through other possibilities in my head, shortening it each time. I wanted it to be short because I have a tendency to lecture (as you may have noticed if you read this newsletter). I wanted it to be honest. I did not want to argue the point she was making because, unfortunately, (and this really pissed me off) she was right. (And I had said she was right, but she went right on being mad!) I finally said simply, “I hate being yelled at.” That was honest. It was short. She didn’t like it. That was okay, too. She was allowed to be angry. I no longer want to control what other people feel (most of the time). After a while the yelling stopped. A few hours later she said to me she got carried away and hadn’t meant to yell, and I said “Thanks for saying that.”
Being yelled at is painful, but I can be in pain and survive. Part of the reason it isn’t intolerable anymore is because I know I don’t deserve it. I may have made a mistake, but that is okay. Someone else may be having a hard day, and that is okay too (healthy boundaries and letting go of having to be perfect— or having to have others be perfect).
Like I said, I try to feel my anger today. I don’t stuff and repress it but I also don’t scream and yell. Some studies indicate that geting-it-all-out escalates and reinforces anger. A recent report in the Mind/Body Health Newsletter said that men who blow up and men who repress anger both have significantly higher cholesterol levels than men who were flexible in dealing with anger. Since both those styles are characteristic of PTSD, as is having rigid reaction styles and doing the same thing over and over, it seems important.
Flexibility: So how do you become more flexible in dealing with things that make you angry? One way is working on becoming more flexible in everything. I’ve heard the suggestion of driving home from work a different way every day, a small action that can have far-reaching effects. It may not be the one that works for you, but you can find some small new action to take that fits you better.
I can also use the upsurge of adrenaline I get when I am angry to help me do something healthy (for me) and effective. It is nice to have a number of choices. Keep a list for those desperate moments when you can’t think. I can go for a walk, go outside and let the birds and trees remind me that I am part of the world, clean house, write a letter to my congresswoman, call someone who will understand, motivate myself towards self-examination or simply feel the pain. For instance, when Bob is right about something I haven’t done that I said I would, I can look at myself and see that I’m not perfect, but I can learn to do better one day at a time, starting now. I feel compassion for me, and it makes it a lot easier to be compassionate to others. Then I don’t get mad.
Using the HEALS exercise mentioned in issue #7 (Vol.2, No 1) has helped me develop compassion for myself and for others. Here’s how to do it:
Healing” comes into my mind in flashing letters.
Explain to myself what hurt I am feeling (disregarded, unimportant, guilty or mistrusted, devalued, rejected, powerless, unlovable) and feel it for a few seconds.
Apply self compassion (because I made a mistake doesn’t mean I’m worthless, because someone forgot me doesn’t mean I’m nothing...)
Love myself (It is okay if I’m not perfect. I’m fine the way I am. It is okay if someone forgot what I wanted. I am still lovable and I can love myself).
Solve the problem. (since I don’t have to blame, accuse or attack, I can use more of my brainpower to find a solution).
Another way to become flexible is developing a sense of humor about your self and your life. There is nothing funnier than the way all of us sometimes behave when we are mad. I think of myself swearing “I’m not angry,” as smoke was probably pouring out of my ears and I have to laugh. I didn’t know I was angry but those around me sure did.
And isn’t it sad that I thought a normal emotion, which I can use to signal that what’s happening is a problem for me, was so terrible I couldn’t admit to having it? So I’d lie to myself and to those around me until stuffing no longer was possible and then I’d blow up, all the time blaming their actions and not my own inability to see and use my anger effectively as a signal and a tool to change me.
Today I know I can’t change you, but today if I feel angry I can walk away, write a letter, speak up in a nice way, take my business my friendship or my love elsewhere. I do have options, but I couldn’t see them without self awareness.
Honesty about how anger affects us
Most people have no idea how scary they can be when they are mad, and I, at least, never used to mention it. Today I even try to be honest about that.
I find that I do best if I use my pause button before I try to be honest, keep it short, and I keep it in the “I.”



Heard at a 12 step meeting:
An expectation is a pre-meditated resentment.

Friday, April 6, 2012

The Hard Road Back

The New York Times is doing a series on wounded soldiers which has simply kicked my butt and made me cry. I am really glad they are doing this. It's video as well as print and it helps show that the war is never over for many people. Check it out.

Thursday, April 5, 2012

Giving a talk to a small group

I just came back from giving a talk to a local group of vets and their counselors. Not going to say exactly where for confidentiality reasons, but I really love giving vets my perspective on PTSD, because it is so different from the medical model with its random collection of weird symptoms and the current 8 week cures. One of the counselors said, and I agree completely, "These new therapists say they are going to cure these guys in 8 weeks. It is insulting. No one would tell the mother of someone killed in Iraq or Afghanistan that they were going to cure their grief in 8 weeks!"
Combat PTSD involves HUGE amounts of grief over friends, ideals, beliefs, and body parts lost. How do you cure that in 8 weeks?
Cognitive Behavioral Therapy of PTSD has a short track record and does not "cure" everyone, but only a percentage. The follow-up studies do not cover a lifetime. PTSD comes back with further trauma because it is a set of survival skills built into your brain, which are activated by war and other traumas. There is nothing a therapist can do to keep you from suffering further traumatic events. Life happens. Shit happens.
The CBT therapies were not developed using combat vets. I think they work on some people. But people need to find out what works for them, not what works for the therapist.
Of course it is easier to apply a manualized therapy and pretend that's it, but for our vets often that isn't it. They simply stop talking and looking for help.
This recently happened to a friend. He finally went to see someone at the VA about his depression, and this woman told him, "I just don't allow myself to become depressed." Well if he could do that, he wouldn't need her help. He felt insulted. Needless to say, he won't be going back.
At one VA I gave a talk at, they told me that the CBT therapist don't let them swear in group. How do you talk about war, real war, ugly, bloody, horrible experiences if you can't swear. It is like these therapists are so full of themselves they have absolutely no comprehension of what vets have been through. I wish they would read Recovering From The War, or some of the recent vet memoirs, and wake the fuck up!
One thing I love to see is a bunch of vets start to nod and sit up and look interested and hopeful as I explain how hyperalertness (attention to threat and the ability to move faster than thought) are built into the reptile brain. So is the ability to rapidly adapt to whatever is going on so you can be in control, which means you become numb so you can do whatever you need to survive and keep others alive.
The talk I gave, The War at Home, goes through each PTSD symptom, giving the vets an idea of what it did for them during the war, what it may be doing to them now, and how that may affect the family. Most of them have never heard anything like what I say before.
I love doing it.

Sunday, April 1, 2012

Book giveaway at Goodreads.com

I am giving away 5 copies of Recovering from the War at GoodReads.com. If you go to the website, you will see how to join.
Part of the reason I am doing this is that I am in the process of bringing out the book as an ebook which will have a new introduction for the new vets and a Mother's Introduction by the mother of one of our new vets. The printed version does not have these, but I think having a book, in my hands at least, is always a comfort. So if you'd like to enter to win, please visit the website and enter