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.
Wednesday, December 11, 2013
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.
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
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.
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
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.
Saturday, June 29, 2013
4th of July
Here is a wonderful article on PTSD and The 4th of July: https://www.facebook.com/veteransptsdproject
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!
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.
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.
Tuesday, March 19, 2013
Story from a vet
I just got this wonderful story from a FB friend:
Craig Latham
Craig Latham
Hello,
Pardon me for sending this to you, but I was diagnosed with PTSD in the late 80s. This helped me and I wanted to share with you.
My Time At The Wall
by Craig Latham
It had been twenty-five years since I left Vietnam. My brother-in-law and I had just finished a weekend at Bristol, Tennesee, where we watched our first Nascar race in person. We still had to go to Virginia Beach for a couple of days and then on to Washington D.C.
We arrived at the wall just about 6am as the sun was coming up. It was gonna be another hot day in August. This is when I realized it had been exactly twenty-five years to the day that I left the hot sun of Vietnam and boarded the "Freedom Bird" home. The heat in the United States was nothing, compared to the humid heat of the jungle. Sometimes you would sit in the sun to cool off because you were constantly hot and wet in the jungle.
Anyway, back to D.C. We got to the wall just as the sun was coming up and only one other couple was there. They had been there many times before. He had made this pilgrimage there every year for the past ten years. He told us it was part of his healing process. I asked him what he did in Vietnam and he said he had been a "grunt". We chatted for a few minutes, "Welcomed" each other home, and then he told us how to find what we were looking for.
My brother-in-law, Bob, had been in Vietnam about two years before me. I looked down the shiny black wall and noticed Bob was down on one knee. I didn't know if he was praying, crying, or a little bit of both. I didn't ask. This was his private time with someone he knew a long time ago.
I had a list of names of people I wanted to look up, too. Most were people from my home county (Coshocton, Ohio). I found them all, and made etchings of each. They had all been in Vietnam before me. Some were "Grunts", "Medic", "Crew Chief", "Door Gunner", and "Pilots".
The last one I looked for was my friend Andy B. He had been a "Door Gunner" for the 2nd Brigade Hq. in the 101St Airborne Division (Ambl) in Phu Bai, S. Vietnam. Andy was short, (not in stature, but in time left in Vietnam). He and his pilot were on their way back to Phu Bai when they heard a unit in trouble and went to see if they could be of any help. They were shot down. Both killed. Andy and I were gonna have a couple of beers that evening when he got back, but I drank alone that night. The next day, I had to go out with an infantry unit and wouldn't get back to Phu Bai for a week. I missed his "Memorial Service". I felt bad.
I had my own "Memorial Service" for Andy that day at the wall. Something happened that day. I found Andy's name on the wall and as I reached out to touch his name, all I could see was a hand (actually my reflection) coming at me from the blackness. As I touched the "Wall" and the hand, it felt as if something was stripped from my body. A weight of twenty-five years was gone. It was as if the hand belonged to Andy and he was saying, "It's over now. It's time to let go." That day, something happened. From that day forward, the night sweats slowly subsided. The waking up in the middle of the night screaming, stopped.
"The Wall" has healing powers and no one can tell me any different.
The ride home from D.C. with my brother-in-law was a quiet one. Each of us was reflecting on our past, present and probably our future.
Welcome home, all "Vietnam Veterans".
Craig Latham
Combat Writer/Photographer
1970-1971
34th Public Information Detachment (34th PID)
2nd Brigade/101st Airborne Division (Ambl)
Phu Bai, S. Vietnam
Pardon me for sending this to you, but I was diagnosed with PTSD in the late 80s. This helped me and I wanted to share with you.
My Time At The Wall
by Craig Latham
It had been twenty-five years since I left Vietnam. My brother-in-law and I had just finished a weekend at Bristol, Tennesee, where we watched our first Nascar race in person. We still had to go to Virginia Beach for a couple of days and then on to Washington D.C.
We arrived at the wall just about 6am as the sun was coming up. It was gonna be another hot day in August. This is when I realized it had been exactly twenty-five years to the day that I left the hot sun of Vietnam and boarded the "Freedom Bird" home. The heat in the United States was nothing, compared to the humid heat of the jungle. Sometimes you would sit in the sun to cool off because you were constantly hot and wet in the jungle.
Anyway, back to D.C. We got to the wall just as the sun was coming up and only one other couple was there. They had been there many times before. He had made this pilgrimage there every year for the past ten years. He told us it was part of his healing process. I asked him what he did in Vietnam and he said he had been a "grunt". We chatted for a few minutes, "Welcomed" each other home, and then he told us how to find what we were looking for.
My brother-in-law, Bob, had been in Vietnam about two years before me. I looked down the shiny black wall and noticed Bob was down on one knee. I didn't know if he was praying, crying, or a little bit of both. I didn't ask. This was his private time with someone he knew a long time ago.
I had a list of names of people I wanted to look up, too. Most were people from my home county (Coshocton, Ohio). I found them all, and made etchings of each. They had all been in Vietnam before me. Some were "Grunts", "Medic", "Crew Chief", "Door Gunner", and "Pilots".
The last one I looked for was my friend Andy B. He had been a "Door Gunner" for the 2nd Brigade Hq. in the 101St Airborne Division (Ambl) in Phu Bai, S. Vietnam. Andy was short, (not in stature, but in time left in Vietnam). He and his pilot were on their way back to Phu Bai when they heard a unit in trouble and went to see if they could be of any help. They were shot down. Both killed. Andy and I were gonna have a couple of beers that evening when he got back, but I drank alone that night. The next day, I had to go out with an infantry unit and wouldn't get back to Phu Bai for a week. I missed his "Memorial Service". I felt bad.
I had my own "Memorial Service" for Andy that day at the wall. Something happened that day. I found Andy's name on the wall and as I reached out to touch his name, all I could see was a hand (actually my reflection) coming at me from the blackness. As I touched the "Wall" and the hand, it felt as if something was stripped from my body. A weight of twenty-five years was gone. It was as if the hand belonged to Andy and he was saying, "It's over now. It's time to let go." That day, something happened. From that day forward, the night sweats slowly subsided. The waking up in the middle of the night screaming, stopped.
"The Wall" has healing powers and no one can tell me any different.
The ride home from D.C. with my brother-in-law was a quiet one. Each of us was reflecting on our past, present and probably our future.
Welcome home, all "Vietnam Veterans".
Craig Latham
Combat Writer/Photographer
1970-1971
34th Public Information Detachment (34th PID)
2nd Brigade/101st Airborne Division (Ambl)
Phu Bai, S. Vietnam
Thursday, March 14, 2013
Report on Army Mishandling of PTSD
On March 8th the News Tribune published an AP report on the Army's Mishandling of PTSD which confirms what most of us already know. It is not good!
As I have said before, there is an inherent conflict of interest in being a military psychiatrist, especially one who decides who does and doesn't have PTSD. The military does not want them to have PTSD. That's why they have stigma and resilience training: two attitudes which are very human but not particularly aware of human nature!
Since the begining of history, people have had PTSD symptoms. With most wars it is recognized, perhaps with another name, nostalgia, soldier's heart, shell shock, combat fatigue, combat neurosis, post-Vietnam syndrome (along with post-rape syndrome, and other post-syndromes). Between wars the elite intellectuals who become doctors, psychiatrists, and psychologists for the most part try to prove that PTSD doesn't exist. The women's movement helped put a stop to that after Vietnam, because rape survivors and battered wives were no longer going to shut up and be good. They combined with the Vietnam vets who also were not willing to shut up and be good to get the diagnosis of PTSD added to DSMIII (Diagnostic and Statistical Manual of the American Psychiatric Association) in 1980. The first edition, published during the Korean War, had Gross Stress Reaction (gross meaning big, like a concentration camp or combat). The second, which came out in 1968, during the TET Offensive, pretended that if you had a problem with the war for more than 6 months after you got back, you'd been screwed up before you went. They liked giving PTSD vets personality disorders and other wrong diagnoses.
For a while, veterans could actually get help in the Vet Centers and some VA Hospitals, eventually many VA Hospitals.
Still after Somalia, and incredibly stupid paper was published by specialists in the PTSD field in which, when the soldiers who had PTSD reported worse experiences four years after their first interview, their conclusion was that they were making it up, instead of that they didn't tell the worst to a bunch of guys in white coats right after they got back. (Young cocky soldiers, right!)
Then we saw Sally Satel and her ilk trying to pretend PTSD was overdiagnosed and wouldn't be a problem in Iraq and Afghanistan. (Bangs head on desk.)
Now we have manualized 12 week treatments for PTSD and a thirty page questionnaire to fill out.
I swear to God, these people are entirely without compassion or the slightest conception of how this appears to the people they might be trying to help. Tell some mother who lost a kid in Iraq that you are going to cure her grief in 12 weeks... These people have lost their friends and seen horrors, and some of them have done things they can't look back on easily. They need to be listened to, not fixed like they were cars or something.
Today on NPR I heard a soldier (male) who was raped by his NCO and told not to report it, but he did, so he was sent to a psychiatrist who conveniently diagnosed him with a personality disorder.
I used to think nothing like Vietnam and the mistreatment of vets would ever happen again. I was wrong.
There are people out there who listen to vets, who care about vets, who help vets. I hope our vets can find them.
As I have said before, there is an inherent conflict of interest in being a military psychiatrist, especially one who decides who does and doesn't have PTSD. The military does not want them to have PTSD. That's why they have stigma and resilience training: two attitudes which are very human but not particularly aware of human nature!
Since the begining of history, people have had PTSD symptoms. With most wars it is recognized, perhaps with another name, nostalgia, soldier's heart, shell shock, combat fatigue, combat neurosis, post-Vietnam syndrome (along with post-rape syndrome, and other post-syndromes). Between wars the elite intellectuals who become doctors, psychiatrists, and psychologists for the most part try to prove that PTSD doesn't exist. The women's movement helped put a stop to that after Vietnam, because rape survivors and battered wives were no longer going to shut up and be good. They combined with the Vietnam vets who also were not willing to shut up and be good to get the diagnosis of PTSD added to DSMIII (Diagnostic and Statistical Manual of the American Psychiatric Association) in 1980. The first edition, published during the Korean War, had Gross Stress Reaction (gross meaning big, like a concentration camp or combat). The second, which came out in 1968, during the TET Offensive, pretended that if you had a problem with the war for more than 6 months after you got back, you'd been screwed up before you went. They liked giving PTSD vets personality disorders and other wrong diagnoses.
For a while, veterans could actually get help in the Vet Centers and some VA Hospitals, eventually many VA Hospitals.
Still after Somalia, and incredibly stupid paper was published by specialists in the PTSD field in which, when the soldiers who had PTSD reported worse experiences four years after their first interview, their conclusion was that they were making it up, instead of that they didn't tell the worst to a bunch of guys in white coats right after they got back. (Young cocky soldiers, right!)
Then we saw Sally Satel and her ilk trying to pretend PTSD was overdiagnosed and wouldn't be a problem in Iraq and Afghanistan. (Bangs head on desk.)
Now we have manualized 12 week treatments for PTSD and a thirty page questionnaire to fill out.
I swear to God, these people are entirely without compassion or the slightest conception of how this appears to the people they might be trying to help. Tell some mother who lost a kid in Iraq that you are going to cure her grief in 12 weeks... These people have lost their friends and seen horrors, and some of them have done things they can't look back on easily. They need to be listened to, not fixed like they were cars or something.
Today on NPR I heard a soldier (male) who was raped by his NCO and told not to report it, but he did, so he was sent to a psychiatrist who conveniently diagnosed him with a personality disorder.
I used to think nothing like Vietnam and the mistreatment of vets would ever happen again. I was wrong.
There are people out there who listen to vets, who care about vets, who help vets. I hope our vets can find them.
Do's and Do Not's for Spouses and Partners of Combat Veterans
This article is reprinted with permission from Ray Scurfield
“The Do’s and Do Not’s for Spouses and Partners of Combat Veterans”
By Ray Scurfield
The Do Not's
• Do not say, “I understand,” or “I know you feel.” No, you don’t. If you were not in war, you
don’t understand. Period. However, you may well understand from your own life
experience how it feels to not want to talk to anyone, or how it is to feel that no one can
understand about something you have experienced. You may know what it's like to hope
that if you could just ignore something festering inside you that it would eventually go
away.Seek help if you are hurting, whether or not your veteran partner does.
• Do not push or insist that your vet talk about the war if he/she does not want to. It is too sacred
a subject to attempt to pry the details out of someone. Remember, you are trampling on
hallowed ground.
• Do not say, “Did you kill anybody?” Or, “How did it feel to kill someone?” If the vet wants to
share this, the vet will share it. Otherwise, this is perceived as an invasive and unwanted
demand for the most extremely personal of information.
• Don’t take it personally when your veteran does not want to talk about it. Part of it is because
you are not a combat veteran. Your veteran partner will probably be far comfortable
talking about the war experiences in any detail with another combat veteran. It is crucial
to remember that the vast majority of war veterans feel that no one but other combat
veterans could possibly understand.
Side note: Also, the veteran may be very concerned about “taking the lid off” of all the pent-up
feelings and memories about war that have been buried. The fear is, “If I open the lid (of the
memories, emotions, trauma) I may not be able to put it back on again.” This reluctance is why
there are a number of other war veterans who just don’t want to talk much to anybody, not even to
other vets. As one such Vietnam veteran told me: "When I got back from Nam, the only people I
could relate to were other Vietnam vets---and they were the last ones I wanted to be around."
• Don’t make ultimatums or threats that have severe consequences and deadlines attached to
them unless you are absolutely at your wits end. An example of an ultimatum: “You need
to get it together now, it’s been ___weeks or ___months of being withdrawn, moping
around, etc. If you don’t go see a counselor this week, I’m going to leave you.” Big
mistake. Most combat vets do not respond very positively to threats. This is not a poker
game where bluffing and deception go hand-in-hand with winning.
• Don’t lay a guilt trip on your vet, or present it as a test of your relationship. For example: “If
you really loved me, you would share more with me” Or: "If you really loved me, you
would understand what’s going on inside me.” Your veteran partner may already be
feeling guilty about what he/she did or did not do in the war, or about the hardships you
and the family may have gone through while he/she was deployed.
• Do not ignore warning signs in your vet that there may be potentially serious problems, such as
excessive drinking, isolating, a deep-seated rage, mood swings, anxiety and sleep
disturbance. You need to point such things out, but not dwell on them, depending on how
severe the symptoms are.
• Do not ignore your own needs and wants. You have the right to have your needs and wants
met, no matter how troubled your veteran partner is. And so do your children.
• Do not ever allow your veteran partner to treat you meanly, disrespectfully, or in a threatening
way. This includes screaming, yelling and threatening behaviors. And do not EVER
tolerate your veteran partner hurting you or your family. Violence in war is one thing.
But to bring it back into the home is quite another. It is NEVER excusable. If you can’t
protect yourself or your family, then immediately go talk to someone who can help you.
The Do’s
• Do remember to reach down deep within and stay in touch with the love you have for your
veteran - even if it is more of a love for how he or she was before deployment than how
he or she is behaving right now.
• Do remember that your relationship that should be at least as important as the individual needs
and wants of each of you. Think about what is best for your relationship right now, not
what is best for you or what is best for your veteran partner.
• Do hold hands and look each other in the eyes. Try this: if you and your partner are having a
serious argument or harsh words, both of you stop. Be silent for a moment, compose
yourselves, stand in front of each other, hold hands, look in each other’s eyes, and start
talking to each other this way. You almost surely will calm down and start relating to
each other rather than talking meanly at each other.
• Do put yourself out there. Ask: "Do you want to talk a little with me about the war? Are you
willing to share with me some of the good times, some of the bad times? If not now,
possibly later?" And say, "I need to be able to ask you these same questions again at
another time, because otherwise you may never come to me first and start talking about
it. Tell me the best way to approach you."
• Do tell your vet partner about the warning signs and triggers about post traumatic stress and
combat stress that remind you of him or her. If you don’t know the signs, get some
literature ASAP from a military family support agency, a partner support group, a VA
Vet Center or a Veteran’s Service Organization.
• Do recognize that your veteran partner may well be very resistant to talking to anyone,
including you, about what is going on. The veteran may not respond positively to your
suggestions today or tomorrow or next week, and so you have to be both persistent and
diplomatic/gentle in continuing to bring up your concerns.
• Do say, "I know I can’t fully (or perhaps at all) understand what is going on with you, because
I wasn’t there in the war."
• Do say (if you genuinely mean it), "I really do want to better understand, and request that you
help me better understand. If you don’t tell me anything, then you are shutting me out and
it will be impossible for me to ever really understand. Please don’t shut me out
completely."
• Do ask your vet, "Are there any books, articles or other readings about war, or any
movies/songs/music that are personally meaningful that you could recommend to me that
could give me a better understanding of what it was all about, about what was so
meaningful for you? And then I would like to talk with you a little about it." Many vets
will be much more comfortable with you learning in this way, rather than you expecting
your veteran partner to talk in great detail.
• Do say, "Please let me know when it feels like I am trying to invade into your most deep and
personal feelings and issues. I really want you to tell me that gently, in a respectful
way. And that goes both ways. I am going to let you know when you may say something
offensive to me, or that hurts me, or when it feels like you’re trying to invade my most
deep and personal feelings and issues. I want to tell you that gently, in a respectful way."
• Do say, "I’m here for you. And I want you to be here for me, even if you can’t be here for me
as much right now as I want you to. Because I am in this for the long haul." However, if
you are having serious doubts that you still committed to this relationship, then that is
another matter entirely that requires immediate attention.
• Do put on your oxygen mask first. This is the bottom line do or don’t - to first take care of
yourself. As we all know, the proper procedure on an airplane when the oxygen masks
drop down is to put your oxygen mask on first; otherwise you will be in no position to
help anyone else. The same principle applies to you at home. Seek help if you are
hurting, whether or not your veteran partner does and whether or not your veteran partner
wants you to. This is your right. And one of the most powerful sources of support and
understanding will be with and from other military spouses whose spouses who have
returned from deployment.
from Raymond Scurfield,
War Trauma. Lessons Unlearned From Vietnam to Iraq. Volume 3 of a Vietnam Trilogy, New York: Algora, 2006,
Chapter 4, "The Return Home and the Ricochet Effect on the Family" (pp. 77-106)
“The Do’s and Do Not’s for Spouses and Partners of Combat Veterans”
By Ray Scurfield
The Do Not's
• Do not say, “I understand,” or “I know you feel.” No, you don’t. If you were not in war, you
don’t understand. Period. However, you may well understand from your own life
experience how it feels to not want to talk to anyone, or how it is to feel that no one can
understand about something you have experienced. You may know what it's like to hope
that if you could just ignore something festering inside you that it would eventually go
away.Seek help if you are hurting, whether or not your veteran partner does.
• Do not push or insist that your vet talk about the war if he/she does not want to. It is too sacred
a subject to attempt to pry the details out of someone. Remember, you are trampling on
hallowed ground.
• Do not say, “Did you kill anybody?” Or, “How did it feel to kill someone?” If the vet wants to
share this, the vet will share it. Otherwise, this is perceived as an invasive and unwanted
demand for the most extremely personal of information.
• Don’t take it personally when your veteran does not want to talk about it. Part of it is because
you are not a combat veteran. Your veteran partner will probably be far comfortable
talking about the war experiences in any detail with another combat veteran. It is crucial
to remember that the vast majority of war veterans feel that no one but other combat
veterans could possibly understand.
Side note: Also, the veteran may be very concerned about “taking the lid off” of all the pent-up
feelings and memories about war that have been buried. The fear is, “If I open the lid (of the
memories, emotions, trauma) I may not be able to put it back on again.” This reluctance is why
there are a number of other war veterans who just don’t want to talk much to anybody, not even to
other vets. As one such Vietnam veteran told me: "When I got back from Nam, the only people I
could relate to were other Vietnam vets---and they were the last ones I wanted to be around."
• Don’t make ultimatums or threats that have severe consequences and deadlines attached to
them unless you are absolutely at your wits end. An example of an ultimatum: “You need
to get it together now, it’s been ___weeks or ___months of being withdrawn, moping
around, etc. If you don’t go see a counselor this week, I’m going to leave you.” Big
mistake. Most combat vets do not respond very positively to threats. This is not a poker
game where bluffing and deception go hand-in-hand with winning.
• Don’t lay a guilt trip on your vet, or present it as a test of your relationship. For example: “If
you really loved me, you would share more with me” Or: "If you really loved me, you
would understand what’s going on inside me.” Your veteran partner may already be
feeling guilty about what he/she did or did not do in the war, or about the hardships you
and the family may have gone through while he/she was deployed.
• Do not ignore warning signs in your vet that there may be potentially serious problems, such as
excessive drinking, isolating, a deep-seated rage, mood swings, anxiety and sleep
disturbance. You need to point such things out, but not dwell on them, depending on how
severe the symptoms are.
• Do not ignore your own needs and wants. You have the right to have your needs and wants
met, no matter how troubled your veteran partner is. And so do your children.
• Do not ever allow your veteran partner to treat you meanly, disrespectfully, or in a threatening
way. This includes screaming, yelling and threatening behaviors. And do not EVER
tolerate your veteran partner hurting you or your family. Violence in war is one thing.
But to bring it back into the home is quite another. It is NEVER excusable. If you can’t
protect yourself or your family, then immediately go talk to someone who can help you.
The Do’s
• Do remember to reach down deep within and stay in touch with the love you have for your
veteran - even if it is more of a love for how he or she was before deployment than how
he or she is behaving right now.
• Do remember that your relationship that should be at least as important as the individual needs
and wants of each of you. Think about what is best for your relationship right now, not
what is best for you or what is best for your veteran partner.
• Do hold hands and look each other in the eyes. Try this: if you and your partner are having a
serious argument or harsh words, both of you stop. Be silent for a moment, compose
yourselves, stand in front of each other, hold hands, look in each other’s eyes, and start
talking to each other this way. You almost surely will calm down and start relating to
each other rather than talking meanly at each other.
• Do put yourself out there. Ask: "Do you want to talk a little with me about the war? Are you
willing to share with me some of the good times, some of the bad times? If not now,
possibly later?" And say, "I need to be able to ask you these same questions again at
another time, because otherwise you may never come to me first and start talking about
it. Tell me the best way to approach you."
• Do tell your vet partner about the warning signs and triggers about post traumatic stress and
combat stress that remind you of him or her. If you don’t know the signs, get some
literature ASAP from a military family support agency, a partner support group, a VA
Vet Center or a Veteran’s Service Organization.
• Do recognize that your veteran partner may well be very resistant to talking to anyone,
including you, about what is going on. The veteran may not respond positively to your
suggestions today or tomorrow or next week, and so you have to be both persistent and
diplomatic/gentle in continuing to bring up your concerns.
• Do say, "I know I can’t fully (or perhaps at all) understand what is going on with you, because
I wasn’t there in the war."
• Do say (if you genuinely mean it), "I really do want to better understand, and request that you
help me better understand. If you don’t tell me anything, then you are shutting me out and
it will be impossible for me to ever really understand. Please don’t shut me out
completely."
• Do ask your vet, "Are there any books, articles or other readings about war, or any
movies/songs/music that are personally meaningful that you could recommend to me that
could give me a better understanding of what it was all about, about what was so
meaningful for you? And then I would like to talk with you a little about it." Many vets
will be much more comfortable with you learning in this way, rather than you expecting
your veteran partner to talk in great detail.
• Do say, "Please let me know when it feels like I am trying to invade into your most deep and
personal feelings and issues. I really want you to tell me that gently, in a respectful
way. And that goes both ways. I am going to let you know when you may say something
offensive to me, or that hurts me, or when it feels like you’re trying to invade my most
deep and personal feelings and issues. I want to tell you that gently, in a respectful way."
• Do say, "I’m here for you. And I want you to be here for me, even if you can’t be here for me
as much right now as I want you to. Because I am in this for the long haul." However, if
you are having serious doubts that you still committed to this relationship, then that is
another matter entirely that requires immediate attention.
• Do put on your oxygen mask first. This is the bottom line do or don’t - to first take care of
yourself. As we all know, the proper procedure on an airplane when the oxygen masks
drop down is to put your oxygen mask on first; otherwise you will be in no position to
help anyone else. The same principle applies to you at home. Seek help if you are
hurting, whether or not your veteran partner does and whether or not your veteran partner
wants you to. This is your right. And one of the most powerful sources of support and
understanding will be with and from other military spouses whose spouses who have
returned from deployment.
from Raymond Scurfield,
War Trauma. Lessons Unlearned From Vietnam to Iraq. Volume 3 of a Vietnam Trilogy, New York: Algora, 2006,
Chapter 4, "The Return Home and the Ricochet Effect on the Family" (pp. 77-106)
Thursday, March 7, 2013
Meditation and PTSD
The military is apparently trying out meditation for PTSD which I think is a good idea. Bob uses it. When he first told me he was going to try it, I thought it was silly and wouldn't work, but luckily since I am in recovery and trying to stop giving advice, I didn't say anything.
Man, was I surprised when it helped him a lot.
He used John Kabat Zinn's, Wherever You Go, There You Are, a very amusing book which answered the question he used to get enraged over: "Why can't I blank my mind?" It was a big relief to know that was not the point.
When I used to publish the Post-Traumatic Gazette, Bob wrote this for me for issue #25, PTSD and Spirituality:
Notes on Meditation by Robert Mason
A sign on my wall says, “Breathing is good for you.” It’s to remind me to focus on my breath for a moment. Why? Because once you are aware of your breath, you are in the present moment. And in the present moment, when you are aware of what you are actually saying or thinking or hearing or seeing, life is much more interesting and peaceful.
I’ve been reading about meditation for decades. I actually began doing it five years ago when I realized that to meditate is to practice being. Just being. I used to spend all my time in my mind, a very busy, chaotic, often scary place. Being alone with my thoughts was something I avoided because they were painful, so I diverted myself with drugs and adrenaline. That worked, more or less.
Meditation is better. I realized that when I meditate, I kind of step away from whatever stream of chaos happens to be splashing through my mind at the time, and look at it from outside. Sometimes I imagine I’m in a comfortable place under a waterfall of thoughts and ideas cascading overhead. I can be aware of the thoughts that come into my present, and then I can let them go. (Observe the thought, it is said, don’t be the thought.) When I discover I’ve been seduced by a thought (which happened constantly when I started), and have been involved with it for awhile, I just smile at the persistence of my mind trying to keep up its chatter, and return to my breath.
Ask a hundred people how to meditate, get a hundred answers. After read ing about the various methods, including a pricey Transcendental Meditation program, I decided to take Buddha’s advice to sit quietly and focus on my breathing.
Here’s what I recommend:
•Change your wake-up time to accommodate 10-30 minutes free time every morning. I meditate for 15-20 minutes.
•Find a quiet place where you can sit and not be disturbed. I’m immersed in bird calls in the morning, but that’s part of the environment, and it isn’t distracting.
•Sit. You can sit in a chair if you sit upright, not leaning back where you can fall asleep. You can sit cross-legged on a carpet, kneel in the Japanese tra dition, sit on pillows, whatever is comfortable for you.
•Set a timer or a clock to end the session. Close your eyes.
•Notice your breathing. Don’t change how you’re breathing. Just be aware of your breath coming in and going out. •When you breathe in, say to yourself “Breathing in.” When you breathe out say to yourself, “Breathing out.” Later, you can shorten this to simply “In” and “Out.” Eventually you won’t need the words at all. For now, the words help you to concentrate on the present moment. Your breath is your anchor. Whenever you lose your concentration, just refocus on your breath.
•Your breathing cycle has four distinct stages you can be aware of: 1) The beginning of breathing in. 2) The end of breathing in (pause). 3) The beginning of breathing out. 4) The end of breathing out.
•Notice whether you are breath ing fast or slow, but make no effort to consciously change that rate. Just notice what it is. Your breathing rate will naturally slow and quiet as you meditate.
•Do it every day for a few years and see how it works.
•Read about meditation to get other insights. My favorite books on the subject are Wherever You Go There You Are by Jon Kabat-Zinn and Walking Meditation by Thich Nhat Hanh.
Man, was I surprised when it helped him a lot.
He used John Kabat Zinn's, Wherever You Go, There You Are, a very amusing book which answered the question he used to get enraged over: "Why can't I blank my mind?" It was a big relief to know that was not the point.
When I used to publish the Post-Traumatic Gazette, Bob wrote this for me for issue #25, PTSD and Spirituality:
Notes on Meditation by Robert Mason
A sign on my wall says, “Breathing is good for you.” It’s to remind me to focus on my breath for a moment. Why? Because once you are aware of your breath, you are in the present moment. And in the present moment, when you are aware of what you are actually saying or thinking or hearing or seeing, life is much more interesting and peaceful.
I’ve been reading about meditation for decades. I actually began doing it five years ago when I realized that to meditate is to practice being. Just being. I used to spend all my time in my mind, a very busy, chaotic, often scary place. Being alone with my thoughts was something I avoided because they were painful, so I diverted myself with drugs and adrenaline. That worked, more or less.
Meditation is better. I realized that when I meditate, I kind of step away from whatever stream of chaos happens to be splashing through my mind at the time, and look at it from outside. Sometimes I imagine I’m in a comfortable place under a waterfall of thoughts and ideas cascading overhead. I can be aware of the thoughts that come into my present, and then I can let them go. (Observe the thought, it is said, don’t be the thought.) When I discover I’ve been seduced by a thought (which happened constantly when I started), and have been involved with it for awhile, I just smile at the persistence of my mind trying to keep up its chatter, and return to my breath.
Ask a hundred people how to meditate, get a hundred answers. After read ing about the various methods, including a pricey Transcendental Meditation program, I decided to take Buddha’s advice to sit quietly and focus on my breathing.
Here’s what I recommend:
•Change your wake-up time to accommodate 10-30 minutes free time every morning. I meditate for 15-20 minutes.
•Find a quiet place where you can sit and not be disturbed. I’m immersed in bird calls in the morning, but that’s part of the environment, and it isn’t distracting.
•Sit. You can sit in a chair if you sit upright, not leaning back where you can fall asleep. You can sit cross-legged on a carpet, kneel in the Japanese tra dition, sit on pillows, whatever is comfortable for you.
•Set a timer or a clock to end the session. Close your eyes.
•Notice your breathing. Don’t change how you’re breathing. Just be aware of your breath coming in and going out. •When you breathe in, say to yourself “Breathing in.” When you breathe out say to yourself, “Breathing out.” Later, you can shorten this to simply “In” and “Out.” Eventually you won’t need the words at all. For now, the words help you to concentrate on the present moment. Your breath is your anchor. Whenever you lose your concentration, just refocus on your breath.
•Your breathing cycle has four distinct stages you can be aware of: 1) The beginning of breathing in. 2) The end of breathing in (pause). 3) The beginning of breathing out. 4) The end of breathing out.
•Notice whether you are breath ing fast or slow, but make no effort to consciously change that rate. Just notice what it is. Your breathing rate will naturally slow and quiet as you meditate.
•Do it every day for a few years and see how it works.
•Read about meditation to get other insights. My favorite books on the subject are Wherever You Go There You Are by Jon Kabat-Zinn and Walking Meditation by Thich Nhat Hanh.
Thursday, February 7, 2013
Concerns about Suicide
I have been really concerned about the rising rate of suicide among military members and veterans of our latest wars.
I kept thinking what could cause it?
Multiple tours, yes. People get PTSD from high levels of war zone stress. In the National Vietnam Veterans Readjustment Study, among Vietnam vets with high levels of war zone stress, 66% of them had PTSD at some time after the war and 33% still did at the time of the study in the 80's! It is a statistic most professionals avoid, but I think it is VERY IMPORTANT. It means getting PTSD when you have been through hell is NORMAL.
So now we have professionals who say they are going to prevent it. No one was saying that during or after Vietnam. They were pretending it didn't exist. So here is another difference: resilience training.
When you look at PTSD from an organic/developmental sort of perspective, how can you prevent the survival skills built into your brain from kicking in. You can't. The part of our brain designed to look for danger and instantaneously prepare you to move without thinking doesn't speak English and can't tell time. The part of our brain that rapidly adapts to whatever is going on (and leads to emotional numbing which can be hard to look back on and gets perpetuated into avoidance) also. Re-experiencing is the reptile brain's way of trying to keep you safe by warning you constantly of danger
So how do you prevent these parts of the "reptile brain" from acting naturally. I don't know. I wanted to find just what resilience training consists of, but have not yet. I did see that it was designed to prevent PTSD, so knowing human nature, I know that people who took the training and still get PTSD are going to feel like they failed, not like the training failed...
So if you are feeling suicidal because of your reactions, please get help. Read stuff at Patience Press about how normal appropriate and effective PTSD symptoms are in war, and about how to begin to recover.
And if anyone tells you you are weak, remember PTSD is proof of survival.
And NORMAL. Normal people are affected by what they live through.
The people who are telling you they weren't affected have either been through less than you have (even if they were in the same outfit) or are handling it through workaholism, alcoholism, sex addiction, etc. Denial is another symptom and it is not just a river in Egypt. Don't believe. them. Don't compare your insides to someone else's outsides.
I am glad you survived and whatever you have been through, you deserve to recover.
Here are a few links to articles criticizing the resilience training program.
Health Experts Question
The Army's Flawed Resilience Training Study
The Dark Side of Comprehensive Soldier Fitness
I kept thinking what could cause it?
Multiple tours, yes. People get PTSD from high levels of war zone stress. In the National Vietnam Veterans Readjustment Study, among Vietnam vets with high levels of war zone stress, 66% of them had PTSD at some time after the war and 33% still did at the time of the study in the 80's! It is a statistic most professionals avoid, but I think it is VERY IMPORTANT. It means getting PTSD when you have been through hell is NORMAL.
So now we have professionals who say they are going to prevent it. No one was saying that during or after Vietnam. They were pretending it didn't exist. So here is another difference: resilience training.
When you look at PTSD from an organic/developmental sort of perspective, how can you prevent the survival skills built into your brain from kicking in. You can't. The part of our brain designed to look for danger and instantaneously prepare you to move without thinking doesn't speak English and can't tell time. The part of our brain that rapidly adapts to whatever is going on (and leads to emotional numbing which can be hard to look back on and gets perpetuated into avoidance) also. Re-experiencing is the reptile brain's way of trying to keep you safe by warning you constantly of danger
So how do you prevent these parts of the "reptile brain" from acting naturally. I don't know. I wanted to find just what resilience training consists of, but have not yet. I did see that it was designed to prevent PTSD, so knowing human nature, I know that people who took the training and still get PTSD are going to feel like they failed, not like the training failed...
So if you are feeling suicidal because of your reactions, please get help. Read stuff at Patience Press about how normal appropriate and effective PTSD symptoms are in war, and about how to begin to recover.
And if anyone tells you you are weak, remember PTSD is proof of survival.
And NORMAL. Normal people are affected by what they live through.
The people who are telling you they weren't affected have either been through less than you have (even if they were in the same outfit) or are handling it through workaholism, alcoholism, sex addiction, etc. Denial is another symptom and it is not just a river in Egypt. Don't believe. them. Don't compare your insides to someone else's outsides.
I am glad you survived and whatever you have been through, you deserve to recover.
Here are a few links to articles criticizing the resilience training program.
Health Experts Question
The Army's Flawed Resilience Training Study
The Dark Side of Comprehensive Soldier Fitness
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