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Friday, June 27, 2014

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

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