Bob suggested I write up a set of Q & A for an advice column on PTSD
and try and sell it to a newspaper or something. It is really what I
love to do, but do I have the energy? It would be easy if someone else
came up with the questions...
I have a blog at PatienceMason.blogspot.com http://www.patiencepress.com/pat…/PTSD_Help-For_Spouses.html and two other facebook pages, Patience H C Mason, Author and Recovering From the War.
Last Year in June (PTSD Month) I posted everyday here and cross posted to all of them. I think it helped some people.
I keep directing people on some of the groups I belong to to http://www.patiencepress.com/pat…/PTSD_Help-For_Spouses.html
which also links to the stuff for kids, the Gazettes and various
essays. I have written so much on this subject and few people know, but
I
really think my non-professional take on PTSD is way more helpful than
the way professionals look at it as a random collection of symptoms with
no rhyme or reason.
I see it as survivor skills built into your brain
which are rapidly/instantly activated by war or abuse and which play out
in a logical order, hyperalertness and rapid adaptation leading to numbing and then avoidance, ending up with re-experiencing symptoms like
nightmares, intrusive thoughts, flashbacks, anniversary reactions to
incidents you may or may not remember, one of the commonest causes for a
resurgence of PTSD symptoms.
The other common cause for a resurgence is
a new stressor which, having been to war, may not seem like it ought to
bother you, but suddenly you are keyed up, angry etc.
I'd be glad for suggestions or inspiration.
Friday, May 15, 2015
Thursday, May 7, 2015
To my Congressman about marijuana
When Bob got back from Vietnam
anyone who had problems was treated badly at the local VA where they were rude and dismissive. The diagnosis of PTSD did not exist. There was no treatment except valium, and he was told to take all he wanted since it was the new wonder drug. He also drank heavily. The students at UF introduced him to pot.
Bob survived BECAUSE he had these three drugs to use. Not because he got help at the VA. Not because I helped him. Because drinking, smoking pot and taking lots of valium just kept him down to WIRED. He could not sleep. Sleeping pills kept him awake. He was irritable and angry a lot, numb a lot, but whatever he was, the pot HELPED.
It helped him and it helped me because it calmed him down.
I think it should be available to every veteran.
What I wrote Ted Yoho, a supposedly pro-vet Congressman in Florida:
'I happen to live with a vet who has PTSD and who has suffered a lot as a result. I have written a book called Recovering From The War and have a website on recovering from PTSD, which involves different things for different people. http://www.patiencepress.com/patien…/PTSD_Help-Gazettes.html
I believe that with so many veterans killing themselves or hurting their families with outbursts of anger etc, they should be provided with something which will help them NOW, not after weeks of therapy, if they can even be seen in the VA or find a therapist who understands. Medications may help, but if they have bad side effects, most vets won't take them and won't say they are not. They give up. Pot just makes them feel better and it should be available. For years after Vietnam, it was the only thing that helped my husband and I was glad he had it.
I know you won't agree, but I wanted to let you know that you could have helped our veterans and you didn't.
It is not an ideal solution, but it is something that has helped many. "
I wrote this when I signed a letter to Representative Yoho about the fact that VA doctors can't even talk to vets about pot, thanks to a recent vote. The letter came through the Drug Policy Alliance
http://www.drugpolicy.org/
anyone who had problems was treated badly at the local VA where they were rude and dismissive. The diagnosis of PTSD did not exist. There was no treatment except valium, and he was told to take all he wanted since it was the new wonder drug. He also drank heavily. The students at UF introduced him to pot.
Bob survived BECAUSE he had these three drugs to use. Not because he got help at the VA. Not because I helped him. Because drinking, smoking pot and taking lots of valium just kept him down to WIRED. He could not sleep. Sleeping pills kept him awake. He was irritable and angry a lot, numb a lot, but whatever he was, the pot HELPED.
It helped him and it helped me because it calmed him down.
I think it should be available to every veteran.
What I wrote Ted Yoho, a supposedly pro-vet Congressman in Florida:
'I happen to live with a vet who has PTSD and who has suffered a lot as a result. I have written a book called Recovering From The War and have a website on recovering from PTSD, which involves different things for different people. http://www.patiencepress.com/patien…/PTSD_Help-Gazettes.html
I believe that with so many veterans killing themselves or hurting their families with outbursts of anger etc, they should be provided with something which will help them NOW, not after weeks of therapy, if they can even be seen in the VA or find a therapist who understands. Medications may help, but if they have bad side effects, most vets won't take them and won't say they are not. They give up. Pot just makes them feel better and it should be available. For years after Vietnam, it was the only thing that helped my husband and I was glad he had it.
I know you won't agree, but I wanted to let you know that you could have helped our veterans and you didn't.
It is not an ideal solution, but it is something that has helped many. "
I wrote this when I signed a letter to Representative Yoho about the fact that VA doctors can't even talk to vets about pot, thanks to a recent vote. The letter came through the Drug Policy Alliance
http://www.drugpolicy.org/
Friday, April 3, 2015
It is normal to be affected by what you live through!
Different people need different things to get better.
There is no pill for PTSD and no therapy that works for everyone (no matter how "evidence based").
The symptoms of PTSD all start in the primitive parts of the brain as brain based survival skills: attention to threat leads to hypervigilance; rapid adaptation to what's happening leads to numbing and then avoidance to stay numb (including alcoholism, drugs, and other addictive behaviors); and the brain's better safe than sorry system, which does not speak English and can't tell time (except when anniversaries roll around) tries to keep you aware that the universe is a dangerous place with intrusive thoughts, flashbacks, nightmares, and anniversary reactions.
NORMAL, people! Not weak! Not weird! We are made to survive if possible.
Having PTSD is evidence that you have been through traumatic events and also evidence of strength, courage, speed, luck, etc, and survival! I am glad you lived through it and made it home.
Monday, January 19, 2015
Do you still think of Vietnam by Kerry "Doc" Pardue,
This is a beautiful essay!
Do you still think of Vietnam?
2013/11/01 - OPINIONS / SUPPORT OUR TROOPS
by Kerry “Doc” Pardue A couple of years ago someone asked me if I still thought about Vietnam. I nearly laughed in their face. How do you stop thinking about it? Every day for the past forty years, I wake up with it- I go to bed with it. This was my response:
“Yeah, I think about it. I can’t stop thinking about it. I never will. But, . I’ve also learned to live with it. I’m comfortable with the memories. I’ve learned to stop trying to forget and learned to embrace it. It just doesn’t scare me anymore.”
A lot of my “brothers” haven’t been so lucky. For them the memories are too painful, their sense of loss too great. My sister told me of a friend she has whose husband was in the Nam. She asks this guy when he was there.
Here’s what he said, “Just last night.” It took my sister a while to figure out what he was talking about. Just Last Night. Yeah, I was in the Nam. When? Just last night, before I went to sleep, on my way to work this morning, and over my lunch hour. Yeah, I was there
My sister says I’m not the same brother who went to Vietnam. My wife says I won’t let people get close to me, not even her.They are probably both right. Ask a vet about making friends in Nam. It was risky. Why? Because we were in the business of death, and death was with us all the time. It wasn’t the death of, “If I die before I wake.” This was the real thing. The kind boys scream for their mothers. The kind that lingers in your mind and becomes more real each time you cheat it. You don’t want to make a lot of friends when the possibility of dying is that real, that close. When you do, friends become a liability.
A guy named Bob Flanigan was my friend. Bob Flanigan is dead. I put him in a body bag one sunny day, April 29, 1969. We’d been talking, only a few minutes before he was shot, about what we were going to do when we got back to the world. Now, this was a guy who had come in country the same time as me. A guy who was loveable and generous. He had blue eyes and sandy blond hair.
When he talked, it was with a soft drawl. I loved this guy like the brother I never had. But, I screwed up. I got too close to him. I broke one of the unwritten rules of war. DON”T GET CLOSE TO PEOPLE WHO ARE GOING TO DIE. You hear vets use the term “buddy” when they refer to a guy they spent the war with. “Me and this buddy of mine.”
Friend sounds too intimate, doesn’t it? “Friend” calls up images of being close. If he’s a friend, then you are going to be hurt if he dies, and war hurts enough without adding to the pain. Get close; get hurt. It’s as simple as that. In war you learn to keep people at that distance my wife talks about. You become good at it, that forty years after the war, you still do it without thinking. You won’t allow yourself to be vulnerable again.
My wife knows two people who can get into the soft spots inside me-my daughters. I know it bothers her that they can do this.It’s not that I don’t love my wife. I do. She’s put up with a lot from me.She’ll tell you that when she signed for better or worse, she had no idea there was going to be so much of the latter. But with my daughters it’s different. My girls are mine. They’ll always be my kids. Not marriage, not distance, not even death can change that.They are something on this earth that can never be taken away from me. I belong to them. Nothing can change that. I can have an ex-wife; but my girls can never have an ex-father. There’s the differance. I can still see the faces, though they all seem to have the same eyes. When I think of us, I always see a line of “dirty grunts”sitting on a paddy dike. We’re caught in the first gray silver between darkness and light. That first moment when we know we’ve survived another night, and the business of staying alive for one more day is about to begin. There was so much hope in that brief space of time. It’s what we used to pray for. “One more day, God. One more day.”
And I can hear our conversations as if they’d only just been spoken I still hear the way we sounded. The hard cynical jokes, our morbid senses of humor. We were scared to death of dying, and tried our best not to show it.
I recall the smells, too. Like the way cordite hangs on the air after a fire-fight. Or the pungent odor of rice paddy mud. So different from the black dirt of Iowa. The mud of Nam smells ancient, somehow. Like it’s always been there. And I’ll never forget the way blood smells, sticky and drying on my hands. I spent a long night that way once. The memory isn’t going anywhere.
I remember how the night jungle appears almost dreamlike as pilot of a Cessna buzzez overhead, dropping parachute flares until morning. That artificial sun would flicker and make shadows run through the jungle. It was worse than not being able to see what was out there sometimes. I remember once looking at the man next to me as a flare floated overhead. The shadows around his eyes were so deep that it looked like his eyes were gone. I reached over and touched him on the arm; without looking at me he touched my hand. “I know man. I know.” That’s what he said. It was a human moment. Two guys a long way from home and scared to death.
God, I loved those guys. I hurt every time one of them died. We all did. Despite our posturing. Despite our desire to stay disconnected, we couldn’t help ourselves. I know why Tim O’ Brien writes his stories. I know what gives Bruce Weigle the words to create poems so honest I cry at their horrible beauty. It’s love. Love for those guys we shared the experience with.
We did our jobs like good soldiers, and we tried our best not to become as hard as our surroundings.You want to know what is frightening. It’s a nineteen-year-old-boy who’s had a sip of that power over life and death that war gives you. It’s a boy who, despite all the things he’s been taught,knows that he likes it. It’s a nineteen-year-old who’s just lost a friend, and is angry and scared and, determined that, “some*@#*s gonna pay”.To this day, the thought of that boy can wake me from a sound sleep and leave me staring at the ceiling.
As I write this, I have a picture in front of me. It’s of two young men. On their laps are tablets. One is smoking a cigarette. Both stare without expression at the camera. They’re writing letters. Staying in touch with places they rather be. Places and people they hope to see again. The picture shares space in a frame with one of my wife.. She doesn’t mind. She knows she’s been included in special company. She knows I’ll always love those guys who shared that part of my life, a part she never can. And she understands how I feel about the ones I know are out there yet. The ones who still answer the question, “When were you in Vietnam?”
“Hey, man. I was there just last night.”
~Kerry “Doc” Pardue
Sunday, December 7, 2014
Holiday stuff from the Post-Traumatic Gazette
For anyone who is having a hard time at this time of year, here are all my holiday articles:
http://www.patiencepress.com/doc…/V3N4PTSDand%20Holidays.pdf
http://www.patiencepress.com/documents/V4N4Normal.pdf
http://www.patiencepress.com/docume…/V6N4Holidays%20Hurt.pdf
and on on New Years Resolutions which is not the headline article
http://www.patiencepress.com/do…/V5N4%2828%29%20Physical.pdf
http://www.patiencepress.com/doc…/V3N4PTSDand%20Holidays.pdf
http://www.patiencepress.com/documents/V4N4Normal.pdf
http://www.patiencepress.com/docume…/V6N4Holidays%20Hurt.pdf
and on on New Years Resolutions which is not the headline article
http://www.patiencepress.com/do…/V5N4%2828%29%20Physical.pdf
Wednesday, November 26, 2014
Holidays
Stress and the Holidays
This is basically good advice from the Department of Defense, along with a bunch of apps for keeping calm.
I left a comment with links to PTSD and Holidays, Can't You Just Be Normal for One Day? and When Holidays Hurt.
When I sent out the first PTSD and Holidays I didn't even think of it as a major topic. The issue was on Anger and the holiday article was on page 5. It was shorter than the one I linked to above, but I got a letter from a VA social worker who told me her WWII combat veterans had had their first good Christmas since the war after they read that.
Maybe it will help you too!
When I was doing the PT Gazette, it was subscribed to by a bunch of good therapists who used it for topics in group.
BTW, I checked back with the DOD blog and they did not accept my comment. Why do I feel slighted? Why am I surprised. I have experience. They have theory...
Tuesday, November 11, 2014
Veterans Day
When I look over at Bob every morning, I am so grateful he survived
Vietnam, that we managed to stick together through the worst days of
undiagnosed (because there was no such diagnosis) untreated PTSD, and
that we are still together and happy.
I look at him and I see the costs of war when he was a wild man, drinking, smoking pot and taking valium which just kept him down to WIRED. He could not have survived without those things so I am glad he had them, even though at the time they pissed me off.
I see him not able to sleep during an anniversary period last year and how they jerked him around at the VA because he went in and asked for Valium. That made him a junkie in their stupid eyes, although they could have checked his medical records and seen he hadn't had or needed it since 1995. They tried every other thing for 12 days on the weird ward (as Bob calls it), even an elephant tranquilizer, and finally sent him home with a dangerous cousin of Valium that you're not supposed to give to old people, and then told him to go to the ER when he called to talk to the psychiatrist about how drugged it made him feel. Like saying "F*ck you!"
I also look at him and think how grateful I am for his new VA psychiatrist who treats him like he is a valuable human being instead of a veteran shaped blob. She has helped him more than any psychiatrist he's had at the VA, and he's had some doozies.
I see him immersed in learning new things. I see him sometimes totally disconnected from me, and I know that is part of the price of war. I used to think it meant he didn't love me. Now I know it is the anniversary of something, some time when he flew into a hail of bullets because it was his job and then later went back to pull out wounded or bring ammo because he and his fellow Vietnam helicopter pilots would do anything for the grunts.
Sometimes he grins and says it's all gravy, that he never expected to live this long. I laugh, but I am so grateful that I get to live with this brave, strong, smart, funny, sarcastic, wonderful man.
To all the veterans out there: I am glad you made it back. I hope your life is good. If it is not, you deserve to heal your wounds and find how you can have a good life. Believe me, it is not in a bottle or a pipe or on TV, although you may need those things sometimes just to stay alive. If you need help, please go ask for it at a Vet Center or wherever you can find it. And if you don't think you need help, but people are nagging you about it, maybe you can pause and ask yourself what you would say to some younger guy who was acting like you? Would you think he could use some help?
Veterans Day is about the living as well as the dead. Alive, but feel dead? That is PTSD and there is help.
I look at him and I see the costs of war when he was a wild man, drinking, smoking pot and taking valium which just kept him down to WIRED. He could not have survived without those things so I am glad he had them, even though at the time they pissed me off.
I see him not able to sleep during an anniversary period last year and how they jerked him around at the VA because he went in and asked for Valium. That made him a junkie in their stupid eyes, although they could have checked his medical records and seen he hadn't had or needed it since 1995. They tried every other thing for 12 days on the weird ward (as Bob calls it), even an elephant tranquilizer, and finally sent him home with a dangerous cousin of Valium that you're not supposed to give to old people, and then told him to go to the ER when he called to talk to the psychiatrist about how drugged it made him feel. Like saying "F*ck you!"
I also look at him and think how grateful I am for his new VA psychiatrist who treats him like he is a valuable human being instead of a veteran shaped blob. She has helped him more than any psychiatrist he's had at the VA, and he's had some doozies.
I see him immersed in learning new things. I see him sometimes totally disconnected from me, and I know that is part of the price of war. I used to think it meant he didn't love me. Now I know it is the anniversary of something, some time when he flew into a hail of bullets because it was his job and then later went back to pull out wounded or bring ammo because he and his fellow Vietnam helicopter pilots would do anything for the grunts.
Sometimes he grins and says it's all gravy, that he never expected to live this long. I laugh, but I am so grateful that I get to live with this brave, strong, smart, funny, sarcastic, wonderful man.
To all the veterans out there: I am glad you made it back. I hope your life is good. If it is not, you deserve to heal your wounds and find how you can have a good life. Believe me, it is not in a bottle or a pipe or on TV, although you may need those things sometimes just to stay alive. If you need help, please go ask for it at a Vet Center or wherever you can find it. And if you don't think you need help, but people are nagging you about it, maybe you can pause and ask yourself what you would say to some younger guy who was acting like you? Would you think he could use some help?
Veterans Day is about the living as well as the dead. Alive, but feel dead? That is PTSD and there is help.
For all vets
To all veterans of every war, thanks and welcome home.
Just found this letter I sent to a soldier a few years ago who wrote me he was feeling worthless, cutting himself and questioning why he was alive. We are still friends. This is what would like to say to all vets:
I hear your pain. I wish I could help.
I wish you had never had to go through the things you went through.
I wish you were healed, and you can be.
You are doing the right things, asking for help and writing about what you feel, but healing takes time and it is painful. I'm sure you realize this from the pain when your cuts heal.
Pain is a sign of healing.
Pain is also a sign that you are a good man, no matter what you did, didn't do, or saw, because if you were not innately good, it would not bother you.
Writing is a good way to get this stuff out of your head onto the page.
Please write me and tell me what happened to trigger this.
Please think about what the cutting is doing for you, and how you could meet that need in another way.
Please have compassion for yourself. You have been through a hell you did not create, nor did you deserve it, and coming out on the other side is a slow process. You've taken the first step-looking for help, but it is a process, and progress not perfection is a good motto.
I'm sure you'd rather be fixed in two days...I know I would,
Instantaneous gratification is too slow!
Take care of that wounded soldier within you. He needs you
Love
Patience
Just found this letter I sent to a soldier a few years ago who wrote me he was feeling worthless, cutting himself and questioning why he was alive. We are still friends. This is what would like to say to all vets:
I hear your pain. I wish I could help.
I wish you had never had to go through the things you went through.
I wish you were healed, and you can be.
You are doing the right things, asking for help and writing about what you feel, but healing takes time and it is painful. I'm sure you realize this from the pain when your cuts heal.
Pain is a sign of healing.
Pain is also a sign that you are a good man, no matter what you did, didn't do, or saw, because if you were not innately good, it would not bother you.
Writing is a good way to get this stuff out of your head onto the page.
Please write me and tell me what happened to trigger this.
Please think about what the cutting is doing for you, and how you could meet that need in another way.
Please have compassion for yourself. You have been through a hell you did not create, nor did you deserve it, and coming out on the other side is a slow process. You've taken the first step-looking for help, but it is a process, and progress not perfection is a good motto.
I'm sure you'd rather be fixed in two days...I know I would,
Instantaneous gratification is too slow!
Take care of that wounded soldier within you. He needs you
Love
Patience
Tuesday, July 1, 2014
Monday, June 30, 2014
Day 30 of National PTSD Awareness Month:
So here we are. I have explained my take on PTSD and why I think it is a more helpful way of looking at it. I have talked about most of the symptoms and how they can save your life and make it painful later for you and your family.
If you want more about that there is a free pamphlet at patiencepress.com "The War at Home." It started out as a talk for a retreat the National Conference of Vietnam Veteran Ministers gave for couples. At the end of what I thought was so obvious, everyone cheered. You don't usually get cheers at a spiritual retreat. So I made it into a pamphlet.
I have also talked about types of help and why it is important to look for extra things that help you. I found the 12 steps helpful especially in accepting and sitting with painful emotion. Bob learned that from meditation. It is a skill you learn in many kinds of therapy and it is essential for recovery, because you can't heal what you can't feel.
So no matter where you are in the journey to recovery, I wish you well. It is not easy to change and grow. It is not fair that after all the shit you survived, you have also to do the painful work of recovery. The only thing I can say is that it will be worth it.
When I wake up in the morning, sometimes I forget and give Bob some advice. Instead of getting mad like he did in the old days when I thought everything I said was RIGHT, he just grins. I go, "Oh, sorry. Doing it again." He gets this ridiculous meek look on his face and says, "Don't worry, honey, I'm used to it." We both laugh like crazy. Then, since it is irresistible, I say, "Well if you need any more shit, let me know, because I have plenty." More laughter.
I love him more every day. And he, oddly enough, loves me!
Every change I made in myself gave him room to change. Since I was only able to make very small changes, I know that is how people change. Every time he makes a little change, I know how hard that is so I appreciate the effort. I used to not notice because I was so wrapped up in how messed up he was.
It is not easy living with PTSD for either of us. I was just kidding him today because occasionally our PBS station messes up. One of those round TV signals that used to come on when the station went off the air comes on. Bob used to sit and watch that and then the snow after that went off. After I said "You used to watch that and the snow," it hit me. I realized and said, "You were in such hell." He looked up at me and I could see it had been hell. But it isn't now most of the time. For that I am glad.
Our suffering has been transformed.
We have been able to help others.
That is a blessing.
So here we are. I have explained my take on PTSD and why I think it is a more helpful way of looking at it. I have talked about most of the symptoms and how they can save your life and make it painful later for you and your family.
If you want more about that there is a free pamphlet at patiencepress.com "The War at Home." It started out as a talk for a retreat the National Conference of Vietnam Veteran Ministers gave for couples. At the end of what I thought was so obvious, everyone cheered. You don't usually get cheers at a spiritual retreat. So I made it into a pamphlet.
I have also talked about types of help and why it is important to look for extra things that help you. I found the 12 steps helpful especially in accepting and sitting with painful emotion. Bob learned that from meditation. It is a skill you learn in many kinds of therapy and it is essential for recovery, because you can't heal what you can't feel.
So no matter where you are in the journey to recovery, I wish you well. It is not easy to change and grow. It is not fair that after all the shit you survived, you have also to do the painful work of recovery. The only thing I can say is that it will be worth it.
When I wake up in the morning, sometimes I forget and give Bob some advice. Instead of getting mad like he did in the old days when I thought everything I said was RIGHT, he just grins. I go, "Oh, sorry. Doing it again." He gets this ridiculous meek look on his face and says, "Don't worry, honey, I'm used to it." We both laugh like crazy. Then, since it is irresistible, I say, "Well if you need any more shit, let me know, because I have plenty." More laughter.
I love him more every day. And he, oddly enough, loves me!
Every change I made in myself gave him room to change. Since I was only able to make very small changes, I know that is how people change. Every time he makes a little change, I know how hard that is so I appreciate the effort. I used to not notice because I was so wrapped up in how messed up he was.
It is not easy living with PTSD for either of us. I was just kidding him today because occasionally our PBS station messes up. One of those round TV signals that used to come on when the station went off the air comes on. Bob used to sit and watch that and then the snow after that went off. After I said "You used to watch that and the snow," it hit me. I realized and said, "You were in such hell." He looked up at me and I could see it had been hell. But it isn't now most of the time. For that I am glad.
Our suffering has been transformed.
We have been able to help others.
That is a blessing.
Sunday, June 29, 2014
Day 29 of National PTSD Awareness Month
When Bob got home from Vietnam in August 1966, he weighed 119lbs. He's 5'11". The first night he was home, a loud smack woke me. Bob was a few feet up in the air. I could see between him and the bed. He made way less noise when he landed. I was impressed, but I had no idea what it meant.
He flicked cigarette butts everywhere, too, in the house. He'd look shocked and say, "Sorry! I've been living in a tent." I thought it was pretty funny.
One day a big palmetto bug was inside and I started shreiking "Kill it! Kill it!" Bob picked it up and put it outside, and said to me, "Patience, I've seen enough things killed." It really made me think.
I still had no idea what he had endured. He mostly told funny stories about Vietnam, Mo'fuck the mongoose biting him when he wouldn't share his coffee and flying on missions with them. Stealing things from the R&U compound so the his unit had stuff to trade, the ambulance full of ladies of the night, his buddy, Jerry, getting stuck overnight in a whore house...
It wasn't till he was writing Chickenhawk that I learned details of what he had lived through. That was why I decided to write my book, Recovering, so other women could give their vets some slack if they knew what they had been through.
My plan was to help women understand and fix their vets, but luckily I found out about 12 step programs by accident. One nurse I interviewed who was running a Vet Center said the Alanon pattern of detaching with love would help.
Then I saw a Hazelden daily meditation book for Adult Children of Alcoholics, Days of Healing, Days of Joy, by Earnie Larsen and Carol Hegarty Larsen. Wow! I thought. I have got to check this out. So many vets are drunks. This will help their kids. So I looked into more ACoA books.
There was a list of ACoA characteristics which started with "Adult Children of Alcoholics do not know what normal is." I almost fell over because adult wives of vets with PTSD do not know what normal is either. I can't tell you how many times I wondered if it was normal to want your husband to say I love you. Was it normal to want hugs? I really couldn't tell anymore. That is what got me going to an independent ACoA meeting.
That was in 1987.
At the time I could not go 100 yards in the car with Bob without telling him how to drive. I believed that he drove the way he did to intentionally piss me off. Everything was about me. I personalized everything and I misunderstood everything. I was always pissed off or depressed. If something good happened it was about f-ing time and it wasn't going to last so why be happy?
I know I was hard to live with, but I thought I was fine (haha) and Bob was f*cked up, so I often told him so, because I thought he's want to know! I found help in the 12 steps. Other women have found other kinds of help, but I think one of the most important parts of recovery for the family and veteran is to focus on yourself. If you're the vet, get help, work on you. That's your job and your duty. If you're the spouse find help and support, so he can be in pain without you trying to fix it, and work on yourself. That's your job and your duty. Sometimes it does not work out, but often if you work at it, your marriage can turn from a battleground into a sanctuary, not a quiet cold sanctuary, either, but one that is also filled with laughter and hope, like ours is.
Tomorrow will be my last post of the month. I will try to post once a week from now on. If you go to patiencemason dot blogspot dot com you will be able to follow my posts by email, since I finally found out how to add that to my blog.
When Bob got home from Vietnam in August 1966, he weighed 119lbs. He's 5'11". The first night he was home, a loud smack woke me. Bob was a few feet up in the air. I could see between him and the bed. He made way less noise when he landed. I was impressed, but I had no idea what it meant.
He flicked cigarette butts everywhere, too, in the house. He'd look shocked and say, "Sorry! I've been living in a tent." I thought it was pretty funny.
One day a big palmetto bug was inside and I started shreiking "Kill it! Kill it!" Bob picked it up and put it outside, and said to me, "Patience, I've seen enough things killed." It really made me think.
I still had no idea what he had endured. He mostly told funny stories about Vietnam, Mo'fuck the mongoose biting him when he wouldn't share his coffee and flying on missions with them. Stealing things from the R&U compound so the his unit had stuff to trade, the ambulance full of ladies of the night, his buddy, Jerry, getting stuck overnight in a whore house...
It wasn't till he was writing Chickenhawk that I learned details of what he had lived through. That was why I decided to write my book, Recovering, so other women could give their vets some slack if they knew what they had been through.
My plan was to help women understand and fix their vets, but luckily I found out about 12 step programs by accident. One nurse I interviewed who was running a Vet Center said the Alanon pattern of detaching with love would help.
Then I saw a Hazelden daily meditation book for Adult Children of Alcoholics, Days of Healing, Days of Joy, by Earnie Larsen and Carol Hegarty Larsen. Wow! I thought. I have got to check this out. So many vets are drunks. This will help their kids. So I looked into more ACoA books.
There was a list of ACoA characteristics which started with "Adult Children of Alcoholics do not know what normal is." I almost fell over because adult wives of vets with PTSD do not know what normal is either. I can't tell you how many times I wondered if it was normal to want your husband to say I love you. Was it normal to want hugs? I really couldn't tell anymore. That is what got me going to an independent ACoA meeting.
That was in 1987.
At the time I could not go 100 yards in the car with Bob without telling him how to drive. I believed that he drove the way he did to intentionally piss me off. Everything was about me. I personalized everything and I misunderstood everything. I was always pissed off or depressed. If something good happened it was about f-ing time and it wasn't going to last so why be happy?
I know I was hard to live with, but I thought I was fine (haha) and Bob was f*cked up, so I often told him so, because I thought he's want to know! I found help in the 12 steps. Other women have found other kinds of help, but I think one of the most important parts of recovery for the family and veteran is to focus on yourself. If you're the vet, get help, work on you. That's your job and your duty. If you're the spouse find help and support, so he can be in pain without you trying to fix it, and work on yourself. That's your job and your duty. Sometimes it does not work out, but often if you work at it, your marriage can turn from a battleground into a sanctuary, not a quiet cold sanctuary, either, but one that is also filled with laughter and hope, like ours is.
Tomorrow will be my last post of the month. I will try to post once a week from now on. If you go to patiencemason dot blogspot dot com you will be able to follow my posts by email, since I finally found out how to add that to my blog.
Saturday, June 28, 2014
Day 28 of National PTSD Awareness Month.
Traumatic events happen so fast they don't get incorporated into narrative memory which resides in your forebrain, that big lump of brain that gives us high foreheads. It is where the words are.
If the story isn't put together in your mind in words. I think this is one reason for intrusive thoughts and if onlies. It is like when you are trying to figure out the first point in the movie where there was a clue to what was coming. Your mind picks at it and picks at your war experience, trying to have a better past.
If I did this, it wouldn't have happened. If I did that...
This is the main reason that therapy is effective if you have an effective therapist. You get to tell the story. It will probably change during the therapy as you remember more details and feel the emotions you didn't have time for. This is hard for people who are not used to welcoming their emotions. We call them Americans, although I suspect it is common all over the world.
One thing that really hangs people up is guilt. You felt great when you killed that gook/raghead/dink. No one tells you that killing someone is a basic biological high because you lived and every bone in your body rejoices. This even happens when a fellow soldier is killed, because it wasn't you. In Chickenhawk, Bob wrote about the weird smile that possessed his face when he was telling his buddies about someone who was killed. People have thanked him for that because it happened to them and they thought it was only them. A lot of people hate themselves for that and can't even talk about it.
If you are doing therapy and don't get relief, maybe there is something you feel so guilty about you can't even admit it happened.
I wrote this prayer for people in 12 step groups when I realized a lot of them had been traumatized:
Prayer for People with PTSD
Higher Power,
I know that it’s not within the harmony of the universe that I be healed from the trauma of remembering ____________________________ without pain.
Help me through the pain. Surround me with the golden light of healing, fill me with the white light of peace and love. Help me to bear the pain as I go through these memories. Help me to cry. Help me to remember. Help me to love myself no matter what happened to me or what I did to survive. Amen.
A few meetings later someone told me about being raped, having therapy, and still reliving the rape every day. When she read the prayer she remembered something she had never told the therapist or anyone else because she was so ashamed of it. When she remembered it, after reading "no matter what I did to survive," the whole thing went away.
I used to be invited to VA's to give talks on PTSD and Bob would come along if he could talk about writing. One time, he was giving a workshop and one of the vets told about getting an F on his first journal because it wasn't personal enough. Being a Vietnam vet, he said "F her. I'll write one of my nightmares." He did. She handed it back with corrections. He rewrote it several times for her, then several more times for himself, and then he realized he wasn't having the nightmare any more! That night Bob said to me, "I haven't had nightmares since I wrote Chickenhawk, and I didn't notice.' We had a good laugh over that.
Therapy is about debriefing and finding support. The way I described PTSD yesterday, the two clusters of symptoms which start way before reexperiencing (hypervigilance and numbing/avoidance) explain one of the mysterious things about PTSD. Everyone has most of the symptoms right after the trauma (Critical Stress Response) but if it lasts more than a month it is considered PTSD. But some people don't seem to get PTSD which means it is a disorder of healing.
How do you heal? Talk and find support. Some people have someone who listens. Most people don't. Most people can't listen for more than 30 seconds. Trained therapists can listen unless they have been trained to think they know all the answers, but if you go for help, you will know quickly if you can talk to the person. This also means that you can talk to someone who wasn't there as long as they are interested in learning from you what it was like for you there. I think that is why so many guys talked to me about Vietnam for the book. I was interested and they could tell.
Group therapy will help you find support, but sometimes it is difficult to be around people who didn't go through as much as you did or who went through more. That is when my mother's saying is good: comparisons are odious. That means they stink. Each person in the group has been through the worst thing they have been through. If you've been through more, remember how it was when you first got shot at or saw wounded or lost a friend. How rapidly you adapted to sudden death. And if you are feeling guilty because your war was not as hellish, you still have been through your own hell and have a right to be there. Don't compare. Share and support each other. It will be worth it.
More tomorrow.
Traumatic events happen so fast they don't get incorporated into narrative memory which resides in your forebrain, that big lump of brain that gives us high foreheads. It is where the words are.
If the story isn't put together in your mind in words. I think this is one reason for intrusive thoughts and if onlies. It is like when you are trying to figure out the first point in the movie where there was a clue to what was coming. Your mind picks at it and picks at your war experience, trying to have a better past.
If I did this, it wouldn't have happened. If I did that...
This is the main reason that therapy is effective if you have an effective therapist. You get to tell the story. It will probably change during the therapy as you remember more details and feel the emotions you didn't have time for. This is hard for people who are not used to welcoming their emotions. We call them Americans, although I suspect it is common all over the world.
One thing that really hangs people up is guilt. You felt great when you killed that gook/raghead/dink. No one tells you that killing someone is a basic biological high because you lived and every bone in your body rejoices. This even happens when a fellow soldier is killed, because it wasn't you. In Chickenhawk, Bob wrote about the weird smile that possessed his face when he was telling his buddies about someone who was killed. People have thanked him for that because it happened to them and they thought it was only them. A lot of people hate themselves for that and can't even talk about it.
If you are doing therapy and don't get relief, maybe there is something you feel so guilty about you can't even admit it happened.
I wrote this prayer for people in 12 step groups when I realized a lot of them had been traumatized:
Prayer for People with PTSD
Higher Power,
I know that it’s not within the harmony of the universe that I be healed from the trauma of remembering ____________________________ without pain.
Help me through the pain. Surround me with the golden light of healing, fill me with the white light of peace and love. Help me to bear the pain as I go through these memories. Help me to cry. Help me to remember. Help me to love myself no matter what happened to me or what I did to survive. Amen.
A few meetings later someone told me about being raped, having therapy, and still reliving the rape every day. When she read the prayer she remembered something she had never told the therapist or anyone else because she was so ashamed of it. When she remembered it, after reading "no matter what I did to survive," the whole thing went away.
I used to be invited to VA's to give talks on PTSD and Bob would come along if he could talk about writing. One time, he was giving a workshop and one of the vets told about getting an F on his first journal because it wasn't personal enough. Being a Vietnam vet, he said "F her. I'll write one of my nightmares." He did. She handed it back with corrections. He rewrote it several times for her, then several more times for himself, and then he realized he wasn't having the nightmare any more! That night Bob said to me, "I haven't had nightmares since I wrote Chickenhawk, and I didn't notice.' We had a good laugh over that.
Therapy is about debriefing and finding support. The way I described PTSD yesterday, the two clusters of symptoms which start way before reexperiencing (hypervigilance and numbing/avoidance) explain one of the mysterious things about PTSD. Everyone has most of the symptoms right after the trauma (Critical Stress Response) but if it lasts more than a month it is considered PTSD. But some people don't seem to get PTSD which means it is a disorder of healing.
How do you heal? Talk and find support. Some people have someone who listens. Most people don't. Most people can't listen for more than 30 seconds. Trained therapists can listen unless they have been trained to think they know all the answers, but if you go for help, you will know quickly if you can talk to the person. This also means that you can talk to someone who wasn't there as long as they are interested in learning from you what it was like for you there. I think that is why so many guys talked to me about Vietnam for the book. I was interested and they could tell.
Group therapy will help you find support, but sometimes it is difficult to be around people who didn't go through as much as you did or who went through more. That is when my mother's saying is good: comparisons are odious. That means they stink. Each person in the group has been through the worst thing they have been through. If you've been through more, remember how it was when you first got shot at or saw wounded or lost a friend. How rapidly you adapted to sudden death. And if you are feeling guilty because your war was not as hellish, you still have been through your own hell and have a right to be there. Don't compare. Share and support each other. It will be worth it.
More tomorrow.
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
patiencemason.blogspot.com
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 patiencepress.com.
Three more days in the month, so more tomorrow.
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 patiencepress.com.
Three more days in the month, so more tomorrow.
Thursday, June 26, 2014
Denial is a reality where PTSD is concerned. The four traumatic stressors of DSMIII and IIIR were pretty well laid out: 1. serious threat to your life or physical integrity, 2. serious threat or harm to children, spouse, or other close relatives or friends (and no one is closer than battle buddies), 3. sudden loss or destruction of home or community (like being medevacked), 4. seeing another person who has been seriously injured or killed (including the enemy).
This series of relatively descriptive terms has been replaced in the newer DSM's with a numbing ritual (like "It don't mean nothin'" in Vietnam) which goes something like this: "The person has experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others."
Read that over a few times.
What does it MEAN?
How can some kid in a white coat, no matter how good his or her motives, with his or her brand new MD or PhD know about blood and shit and burning flesh, or the agony of gang rape, or the devastation of losing your best friend from that bit of repetitious sleep inducing drivel, I mean prose?
Being put to sleep helps with denial.
Another reality of PTSD is simply the reality of having it. No one knows it is normal to be affected by what you live through. The statistics conveniently make you feel like it is not common and you won't get it. If you get it you feel like you shouldn't, and like you should be over it. You feel like you are nuts but you are not telling anyone, so you get grumpy and spend a lot of energy and effort trying to appear normal. Your spouse complains and the war at home starts. Sometimes this leads to divorce and isolation. It is not easy. It is not fun. Nobody does it for the money.
There is also the reality for families. A veteran's numbness leads to the discounting of our everyday problems which makes us feel unimportant and worthless. If the vet blows up a lot we are afraid and we feel worthless, because if our nearest and dearest treat us like dirt, we must be dirt, right? If the vet can't concentrate and doesn't seem to listen to anything we say, more proof of our lack of value. It is a losing battle to feel good about yourself when your vet is saying if you just were thinner, or kept the house cleaner, he'd have no problems. (I am sure husbands of PTSD vets get parallel crap.) It can turn into a downward spiral. Bob and I were on it from 1967 to about 1980 when we found out what PTSD was and that we weren't the only nut jobs. It was such a relief.
Another reality is that there is help. It is not easy to get it because the VA is overwhelmed. There are Vet Centers. There are Veterans Service Officers to help with claims. Be sure to use one and keep appealing. There are other services for vets provided by all sorts of organizations. Use Google. Service dogs, yoga, meditation, all sorts of things can help you calm down and have a pause button.
The pause button is what we all need when dealing with PTSD so we can make our relationships a sanctuary instead of a battleground. If someone like me, who used to scream and sulk and rescue and rant, and I didn't even have PTSD, can change, so can you, whether you are a vet or spouse. It is not easy, but it is your job, to change yourself to be the kind of person you want to be. It is a choice: self-righteous or compassionate? Right or happy? Kind or cruel? Like I said, it is not easy. Change is not fast. Small changes are more effective in the long run than a giant leap forward. I wrote 42 plus articles on that which are available at patiencepress.com.
More tomorrow.
This series of relatively descriptive terms has been replaced in the newer DSM's with a numbing ritual (like "It don't mean nothin'" in Vietnam) which goes something like this: "The person has experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others."
Read that over a few times.
What does it MEAN?
How can some kid in a white coat, no matter how good his or her motives, with his or her brand new MD or PhD know about blood and shit and burning flesh, or the agony of gang rape, or the devastation of losing your best friend from that bit of repetitious sleep inducing drivel, I mean prose?
Being put to sleep helps with denial.
Another reality of PTSD is simply the reality of having it. No one knows it is normal to be affected by what you live through. The statistics conveniently make you feel like it is not common and you won't get it. If you get it you feel like you shouldn't, and like you should be over it. You feel like you are nuts but you are not telling anyone, so you get grumpy and spend a lot of energy and effort trying to appear normal. Your spouse complains and the war at home starts. Sometimes this leads to divorce and isolation. It is not easy. It is not fun. Nobody does it for the money.
There is also the reality for families. A veteran's numbness leads to the discounting of our everyday problems which makes us feel unimportant and worthless. If the vet blows up a lot we are afraid and we feel worthless, because if our nearest and dearest treat us like dirt, we must be dirt, right? If the vet can't concentrate and doesn't seem to listen to anything we say, more proof of our lack of value. It is a losing battle to feel good about yourself when your vet is saying if you just were thinner, or kept the house cleaner, he'd have no problems. (I am sure husbands of PTSD vets get parallel crap.) It can turn into a downward spiral. Bob and I were on it from 1967 to about 1980 when we found out what PTSD was and that we weren't the only nut jobs. It was such a relief.
Another reality is that there is help. It is not easy to get it because the VA is overwhelmed. There are Vet Centers. There are Veterans Service Officers to help with claims. Be sure to use one and keep appealing. There are other services for vets provided by all sorts of organizations. Use Google. Service dogs, yoga, meditation, all sorts of things can help you calm down and have a pause button.
The pause button is what we all need when dealing with PTSD so we can make our relationships a sanctuary instead of a battleground. If someone like me, who used to scream and sulk and rescue and rant, and I didn't even have PTSD, can change, so can you, whether you are a vet or spouse. It is not easy, but it is your job, to change yourself to be the kind of person you want to be. It is a choice: self-righteous or compassionate? Right or happy? Kind or cruel? Like I said, it is not easy. Change is not fast. Small changes are more effective in the long run than a giant leap forward. I wrote 42 plus articles on that which are available at patiencepress.com.
More tomorrow.
Wednesday, June 25, 2014
Ranting away: Day 25 of National PTSD Awareness Month.
Denial in the professional community.
Wow! Still!
I had to stop writing yesterday because I was so mad, and since then I have had comments from vets and spouses about professionals not believing in PTSD, saying PTSD can be easily cured, and encouraging women to leave their PTSD vets because they are just a-holes and PTSD doesn't exist.
NICE.
Makes me very angry. I hate trendy shit, and this is simply another trend in the struggle to understand and treat PTSD.
In 1968, the trend was suddenly combat fatigue and gross stress reaction (PTSD) didn't exist. In 1980, PTSD was put into the DSM III but most psychiatrists thought it was made up for Vietnam vets, despite the fact that Holocaust survivors, WWII vets and POW's, flood, fire, tsunami, hurricane and other natural disaster survivors, battered women and children, rape and incest survivors and survivors of industrial accidents and fires all had it. People see what they want to see.
In the 90's it was all "lets fix it with drugs" which did not work. It still doesn't work. Drugs can help but they do not cure.
Then psychologists started getting smart, so if they developed a treatment, they did follow-up studies and some of the new treatments do actually lower PTSD symptoms. Is it a cure? Does it last forever? In 50 years we'll know.
Most of these studies are on sexual abuse (rape) survivors but a few have been done on combat vets. The "evidence based" therapies do work for some. So do a lot of other therapies as long as someone who cares is listening.
Many, many therapists, social workers, psychiatrists, and other mental health people work hard and long to help our vets in the VA system. If you get someone you can talk to, hang on to them.
Then there are the smugly self-righteous. They know the new ways are the best ways. They are going to change the world and human nature.
They have no idea how lethal they can be, especially when they tell you you don't have PTSD, or that you can't be helped, or they can cure you quite quickly.
I call this a profound and pervasive narcissistic sense of entitlement, a phrase I read in a paper about Vietnam vets with PTSD, which really pissed me off. Society makes a deal with soldiers. You go do our dirty work, and it is dirty work in every sense of the word, and we will respect you, and honor you, and take care of you. So vets who felt they were owed something were narcissists. NOT.
But someone with a PhD or MD who thinks they know everything and can fix everyone if they just listen to MEEE. Yep. Narcissistic sense of entitlement.
PTSD has been around since the beginning of writing, if not before. When Saul (who had killed his thousands) was troubled by an evil spirit of the lord (PTSD), they sent for the harpist, David, to soothe him. Saul tried to spear him to the wall twice. I was at a National Conference Of Viet Nam Veteran Ministers (NCVNVM.org) retreat when I first heard this. I laughed. It sounded just like Bob. Most women can identify.
The PTSD psalm, the 137th, starts out with the captors saying forgeddaboutit, just like everyone says to vets.
Be happy. Sing! Yeah, right!
The vets feel they will betray their friends (If I forget thee, oh Jerusalem) if they forget so they don't (and can't).
The last bit isn't usually read in church: happy are they who take the children of the enemy and dash their heads against the rocks. People with PTSD are angry. We all have an innate sense of justice. We know that what happened to us was not right, whether it is people trying to kill us or surviving rape or losing everything in a fire. That is why "irritability and outbursts of anger" are part of the diagnostic criteria.
In the Iliad we read about PTSD (read Jonathan Shay's Achilles in Vietnam) and homecoming in the Odyssey. Shakespeare mentions every symptom of PTSD in Lady Percy's description of her husband in Henry IV, Part I. There are lots of other examples if you look for them. I always do. Always glad to hear about them too.
The final thing I want to say today is the difference between a startle reaction (when a vet wakes up swinging or hits someone who has surprised him) and battering. Batterers go through a cycle: hit, sorry, honeymoon, slowly growing anger, and hit again. A startle reaction is completely different, and any therapist who doesn't know the difference should learn it. Most vets are not batterers and if they are, it is not from the war. It is learned at home and despite the conventional wisdom about battering, there is help for batterers and their wives: Compassionpower.com.
More tomorrow.
Wow! Still!
I had to stop writing yesterday because I was so mad, and since then I have had comments from vets and spouses about professionals not believing in PTSD, saying PTSD can be easily cured, and encouraging women to leave their PTSD vets because they are just a-holes and PTSD doesn't exist.
NICE.
Makes me very angry. I hate trendy shit, and this is simply another trend in the struggle to understand and treat PTSD.
In 1968, the trend was suddenly combat fatigue and gross stress reaction (PTSD) didn't exist. In 1980, PTSD was put into the DSM III but most psychiatrists thought it was made up for Vietnam vets, despite the fact that Holocaust survivors, WWII vets and POW's, flood, fire, tsunami, hurricane and other natural disaster survivors, battered women and children, rape and incest survivors and survivors of industrial accidents and fires all had it. People see what they want to see.
In the 90's it was all "lets fix it with drugs" which did not work. It still doesn't work. Drugs can help but they do not cure.
Then psychologists started getting smart, so if they developed a treatment, they did follow-up studies and some of the new treatments do actually lower PTSD symptoms. Is it a cure? Does it last forever? In 50 years we'll know.
Most of these studies are on sexual abuse (rape) survivors but a few have been done on combat vets. The "evidence based" therapies do work for some. So do a lot of other therapies as long as someone who cares is listening.
Many, many therapists, social workers, psychiatrists, and other mental health people work hard and long to help our vets in the VA system. If you get someone you can talk to, hang on to them.
Then there are the smugly self-righteous. They know the new ways are the best ways. They are going to change the world and human nature.
They have no idea how lethal they can be, especially when they tell you you don't have PTSD, or that you can't be helped, or they can cure you quite quickly.
I call this a profound and pervasive narcissistic sense of entitlement, a phrase I read in a paper about Vietnam vets with PTSD, which really pissed me off. Society makes a deal with soldiers. You go do our dirty work, and it is dirty work in every sense of the word, and we will respect you, and honor you, and take care of you. So vets who felt they were owed something were narcissists. NOT.
But someone with a PhD or MD who thinks they know everything and can fix everyone if they just listen to MEEE. Yep. Narcissistic sense of entitlement.
PTSD has been around since the beginning of writing, if not before. When Saul (who had killed his thousands) was troubled by an evil spirit of the lord (PTSD), they sent for the harpist, David, to soothe him. Saul tried to spear him to the wall twice. I was at a National Conference Of Viet Nam Veteran Ministers (NCVNVM.org) retreat when I first heard this. I laughed. It sounded just like Bob. Most women can identify.
The PTSD psalm, the 137th, starts out with the captors saying forgeddaboutit, just like everyone says to vets.
Be happy. Sing! Yeah, right!
The vets feel they will betray their friends (If I forget thee, oh Jerusalem) if they forget so they don't (and can't).
The last bit isn't usually read in church: happy are they who take the children of the enemy and dash their heads against the rocks. People with PTSD are angry. We all have an innate sense of justice. We know that what happened to us was not right, whether it is people trying to kill us or surviving rape or losing everything in a fire. That is why "irritability and outbursts of anger" are part of the diagnostic criteria.
In the Iliad we read about PTSD (read Jonathan Shay's Achilles in Vietnam) and homecoming in the Odyssey. Shakespeare mentions every symptom of PTSD in Lady Percy's description of her husband in Henry IV, Part I. There are lots of other examples if you look for them. I always do. Always glad to hear about them too.
The final thing I want to say today is the difference between a startle reaction (when a vet wakes up swinging or hits someone who has surprised him) and battering. Batterers go through a cycle: hit, sorry, honeymoon, slowly growing anger, and hit again. A startle reaction is completely different, and any therapist who doesn't know the difference should learn it. Most vets are not batterers and if they are, it is not from the war. It is learned at home and despite the conventional wisdom about battering, there is help for batterers and their wives: Compassionpower.com.
More tomorrow.
Tuesday, June 24, 2014
The reality of denial: Day 24 of National PTSD Awareness Month
Then
there is the reality of denial. It is not just a river in Egypt. Denial
is pervasive in veterans where it is protective, in families and in the
professional community, where it causes secondary traumatization to
people who have PTSD.
The funny thing is that the shrinks who denied PTSD from 1968-1980, (and some still do), were calling numb guys psychopaths because they could talk about horrible things with no emotion. Isn't that what psychiatrists do and call it professionalism?
Well, these guys are professional too, and numbness is required to do their job.
After 1980, when PTSD was forced into the Diagnostic and Statistical Manual despite the American Psychiatric Association's "it will cost too much money," many professionals thought it was a made up diagnosis for Vietnam vets and would not see it, despite the evidence in front of them. People see what they want to see.
There were studies on Vietnam Vets, some of which did not ask if the vet had even been in Vietnam or in combat, which conveniently found that 12 to 17% of vets were adversely affected. Hahaha! And guess what, the current crop of studies, run by the military and the VA, find similar percentages. One military shrink reporting on the unit he was in at an ISTSS meeting said he had to change the diagnostic criteria to get his percentage down to 17 from 28, and he did. NICE.
There has only been one completely observant study, the National Vietnam Veterans Readjustment Study, funded under Jimmy Carter and published under Ronald Reagan, who only allowed the Government Printing Office to print about 100 copies. In this study, which included talking to the veterans as well as standard diagnostic questionnaires, of the people who had been through the most war zone stress, combat, seeing a lot of wounded and dead, being shot at, etc, 66% of them had had diagnosable PTSD at one time, 33% still did.
Guys, that means it is normal. And no one can say a vet didn't get PTSD till after he's dead. There is always delayed onset...
I also found studies of WWII combat vets and POW's who were receiving treatment at VA's for medical reasons. Over 50 % had had PTSD at one time and about 30 % still did, undiagnosed, lying there in a bed in the VA!
WWII vets were not too modest to talk about it. They didn't talk about it because they couldn't. They had a good GI Bill and a good economy, too, so many of them dealt with their PTSD through workaholism and were considered "resilient," my least favorite word since it is code for workaholism, something doctors aren't likely to notice...
Acceptance of PTSD comes and goes in waves. WWI yes. In between, no. At the start of WWII they thought there wouldn't be any. When there was, they ascribed it to not getting along with your mom (I kid you not) and many other similar blame the survivor phrases until almost the end of the war. Then some people got help. Some of the help was pretty bad. They did lobotomies!
In 1965 Drs. Archibald and Tuddenham published an article on WWII combat vets who were still having nightmares, startle responses, etc. It was totally ignored.
I mentioned "Gross Stress Reaction" the term for PTSD in the first Diagnostic and Statistical Manual of the American Psychiatric Association, which was apparently based on observation and not theory. DSM II came out in 1968, actually in the bookstores during the Tet Offensive (so ironic), and on the basis of NOTHING, dropped GSR and substituted "Transitional Situational Disturbance." This is what I call the APA's denial and delusion period. Eventually, sanity prevailed and PTSD became the name of the diagnosis. There was actually quite a lot of good help there for a while. The Vet Centers were founded where you could get help without hassles.
At the VA's it was more like help with hassles, but it wasn't the PTSD staff that hassled, it was usually the VA Compensation Crooks.
Oh, did I say that? The people who delay and want more info and then give you 10% if you are 50% disabled and 50% if you are completely and totally unable to work but forgot and shaved before you came into be evaluated. I think I mentioned the young woman psychiatrist who told a veteran of Hamburger Hill that it "can't have been as bad as the movie." One of the guys in Recovering from the War was told in a letter from the St Pete Regional Office that since combat was not "Outside the range of human experience for an infantryman" that he did not have a traumatic stressor. This crap is still going on as I write.
Well, now I am too mad to write more, so more tomorrow.
The funny thing is that the shrinks who denied PTSD from 1968-1980, (and some still do), were calling numb guys psychopaths because they could talk about horrible things with no emotion. Isn't that what psychiatrists do and call it professionalism?
Well, these guys are professional too, and numbness is required to do their job.
After 1980, when PTSD was forced into the Diagnostic and Statistical Manual despite the American Psychiatric Association's "it will cost too much money," many professionals thought it was a made up diagnosis for Vietnam vets and would not see it, despite the evidence in front of them. People see what they want to see.
There were studies on Vietnam Vets, some of which did not ask if the vet had even been in Vietnam or in combat, which conveniently found that 12 to 17% of vets were adversely affected. Hahaha! And guess what, the current crop of studies, run by the military and the VA, find similar percentages. One military shrink reporting on the unit he was in at an ISTSS meeting said he had to change the diagnostic criteria to get his percentage down to 17 from 28, and he did. NICE.
There has only been one completely observant study, the National Vietnam Veterans Readjustment Study, funded under Jimmy Carter and published under Ronald Reagan, who only allowed the Government Printing Office to print about 100 copies. In this study, which included talking to the veterans as well as standard diagnostic questionnaires, of the people who had been through the most war zone stress, combat, seeing a lot of wounded and dead, being shot at, etc, 66% of them had had diagnosable PTSD at one time, 33% still did.
Guys, that means it is normal. And no one can say a vet didn't get PTSD till after he's dead. There is always delayed onset...
I also found studies of WWII combat vets and POW's who were receiving treatment at VA's for medical reasons. Over 50 % had had PTSD at one time and about 30 % still did, undiagnosed, lying there in a bed in the VA!
WWII vets were not too modest to talk about it. They didn't talk about it because they couldn't. They had a good GI Bill and a good economy, too, so many of them dealt with their PTSD through workaholism and were considered "resilient," my least favorite word since it is code for workaholism, something doctors aren't likely to notice...
Acceptance of PTSD comes and goes in waves. WWI yes. In between, no. At the start of WWII they thought there wouldn't be any. When there was, they ascribed it to not getting along with your mom (I kid you not) and many other similar blame the survivor phrases until almost the end of the war. Then some people got help. Some of the help was pretty bad. They did lobotomies!
In 1965 Drs. Archibald and Tuddenham published an article on WWII combat vets who were still having nightmares, startle responses, etc. It was totally ignored.
I mentioned "Gross Stress Reaction" the term for PTSD in the first Diagnostic and Statistical Manual of the American Psychiatric Association, which was apparently based on observation and not theory. DSM II came out in 1968, actually in the bookstores during the Tet Offensive (so ironic), and on the basis of NOTHING, dropped GSR and substituted "Transitional Situational Disturbance." This is what I call the APA's denial and delusion period. Eventually, sanity prevailed and PTSD became the name of the diagnosis. There was actually quite a lot of good help there for a while. The Vet Centers were founded where you could get help without hassles.
At the VA's it was more like help with hassles, but it wasn't the PTSD staff that hassled, it was usually the VA Compensation Crooks.
Oh, did I say that? The people who delay and want more info and then give you 10% if you are 50% disabled and 50% if you are completely and totally unable to work but forgot and shaved before you came into be evaluated. I think I mentioned the young woman psychiatrist who told a veteran of Hamburger Hill that it "can't have been as bad as the movie." One of the guys in Recovering from the War was told in a letter from the St Pete Regional Office that since combat was not "Outside the range of human experience for an infantryman" that he did not have a traumatic stressor. This crap is still going on as I write.
Well, now I am too mad to write more, so more tomorrow.
Monday, June 23, 2014
Realities of PTSD: Day 23 of National PTSD Awareness Month
I have covered a lot of different things that help people with PTSD.
I found out today that an inpatient treatment program somewhere in AZ uses my format for a 12 step group for trauma, and the people who are in there for addictions find the trauma group helpful too. I am so glad. Everything on patiencepress.com about PTSD is available for use and to give to people who might be helped.
Traumatic events are a separate reality which other people can't understand at a gut level. They may want to. They may try to, but the shot of adrenaline, the movement without thought, the terror, the rage, the changes in your metabolism... Those are a separate reality. Different people have different elements in their separate reality, like that quote yesterday from a WWI doctor pointed out.
There are a lot of other realities to PTSD.
How about the reality that most people want it to go away and wonder why you are not over it yet... This is really painful to the person who lived through it and will never be over it in the sense that those ignorant people want. This is the reality of societal attitudes. Then there are the scum who like to drop things behind combat vets to see them jump, or call them names to try to get them to fight.
How about the reality that getting diagnosed is really hard. The military, which claimed it would take care of you, is now trying to give you a bad conduct or personality disorder or adjustment disorder discharge, all of which mean no veterans benefits. Or the VA psychiatrist who just doesn't see your PTSD because you shaved when you came in for your C&P exam.
How about the reality that getting treatment tailored to you is hard. Many places have a focus: we do X, Y, or Z. It is even harder now at the VA's where people really care and are simply overwhelmed by the number of people who need help.
I'll talk about more realities of PTSD tomorrow.
I found out today that an inpatient treatment program somewhere in AZ uses my format for a 12 step group for trauma, and the people who are in there for addictions find the trauma group helpful too. I am so glad. Everything on patiencepress.com about PTSD is available for use and to give to people who might be helped.
Traumatic events are a separate reality which other people can't understand at a gut level. They may want to. They may try to, but the shot of adrenaline, the movement without thought, the terror, the rage, the changes in your metabolism... Those are a separate reality. Different people have different elements in their separate reality, like that quote yesterday from a WWI doctor pointed out.
There are a lot of other realities to PTSD.
How about the reality that most people want it to go away and wonder why you are not over it yet... This is really painful to the person who lived through it and will never be over it in the sense that those ignorant people want. This is the reality of societal attitudes. Then there are the scum who like to drop things behind combat vets to see them jump, or call them names to try to get them to fight.
How about the reality that getting diagnosed is really hard. The military, which claimed it would take care of you, is now trying to give you a bad conduct or personality disorder or adjustment disorder discharge, all of which mean no veterans benefits. Or the VA psychiatrist who just doesn't see your PTSD because you shaved when you came in for your C&P exam.
How about the reality that getting treatment tailored to you is hard. Many places have a focus: we do X, Y, or Z. It is even harder now at the VA's where people really care and are simply overwhelmed by the number of people who need help.
I'll talk about more realities of PTSD tomorrow.
Sunday, June 22, 2014
Yoga and other stuff: Day 22 of National PTSD Awareness Month.
If you Google PTSD and Yoga you will find a huge number of resources. I first heard of using Yoga with vets at a Ranger Reunion where I was giving a talk on PTSD years ago. MaryAnne Colledge, the wife of one of the Rangers, gave a yoga workshop for all of us. The next morning, one of the Rangers told her he has slept through the night for the first time in decades. It was amazing to him that something so simple could make that kind of difference. That is what I love about the search for the things that help YOU. You never know what will help.
Yoga involves stretching and breathing. You'd think that would have nothing to do with PTSD, but hyperarousal means tense coiled muscles which the vet may not even be aware of. The body develops amnesia about what a relaxed state is and how to breathe in a relaxed way.
Of course Yoga is not the only way that helps people. Other people get relief from running. Brian Castner's memoir, The Long Walk, talks about how running helped him. Some places provide traumatized vets with horses. Google PTSD and horses for more information.
Service dogs are another new aid to veterans with PTSD. I will put a link at the end of this article. BTW, there is a CYA article on the va.gov website saying they don't know if they really help. "Evidence based" therapy is better. Since a lot of the evidence for evidence-based therapy was gotten from civilians or very short term follow ups on vets who didn't drop out, and the drop out rates are huge, I don't think they have any evidence. Veterans need to be heard, not run through a program to fix them. They need to know they can come back if things get worse, and they need a wide variety of approaches because people are different!
Here is a quote from a book published in 1917, Shell Shock and Its Lessons, bu GE Smith and TH Pear, two British doctors.
"The patient must be approached without prejudice and the doctor who wishes to be of real help to him must make up his mind to examine and ponder over the sufferers mental wound with as much, nay, even more care and expenditure of time than would be given to physical injuries...the absolute necessity of obtaining and understanding the patient's past history, before and during the war. A dozen cases sent back from the front as shell-shock may prove to possess not a single feature in common..." In other words, pay attention to the person in front of you and forget your theories.
More tomorrow.
http://www.smithsonianmag.com/science-nature/how-dogs-can-help-veterans-overcome-ptsd-137582968/?no-ist
Yoga involves stretching and breathing. You'd think that would have nothing to do with PTSD, but hyperarousal means tense coiled muscles which the vet may not even be aware of. The body develops amnesia about what a relaxed state is and how to breathe in a relaxed way.
Of course Yoga is not the only way that helps people. Other people get relief from running. Brian Castner's memoir, The Long Walk, talks about how running helped him. Some places provide traumatized vets with horses. Google PTSD and horses for more information.
Service dogs are another new aid to veterans with PTSD. I will put a link at the end of this article. BTW, there is a CYA article on the va.gov website saying they don't know if they really help. "Evidence based" therapy is better. Since a lot of the evidence for evidence-based therapy was gotten from civilians or very short term follow ups on vets who didn't drop out, and the drop out rates are huge, I don't think they have any evidence. Veterans need to be heard, not run through a program to fix them. They need to know they can come back if things get worse, and they need a wide variety of approaches because people are different!
Here is a quote from a book published in 1917, Shell Shock and Its Lessons, bu GE Smith and TH Pear, two British doctors.
"The patient must be approached without prejudice and the doctor who wishes to be of real help to him must make up his mind to examine and ponder over the sufferers mental wound with as much, nay, even more care and expenditure of time than would be given to physical injuries...the absolute necessity of obtaining and understanding the patient's past history, before and during the war. A dozen cases sent back from the front as shell-shock may prove to possess not a single feature in common..." In other words, pay attention to the person in front of you and forget your theories.
More tomorrow.
http://www.smithsonianmag.com/science-nature/how-dogs-can-help-veterans-overcome-ptsd-137582968/?no-ist
Saturday, June 21, 2014
Modulating arousal: Day 21 of National PTSD Awareness Month
When I
first saw Beverly Donovan and Edgardo Padin-Rivera present the
Transcend Program at an International Society for Traumatic Stress
Studies meeting, they told us their veterans used a guided meditation
tape (yes, this was the olden days: cassette tape) created for them by
Belleruth Naparstek. This was an amazingly innovative idea and it
worked. So one of the other helpful things I want to mention is listening to guided meditations for PTSD which are available at HealthJourneys.com.
Bob found meditation more helpful. He was always mad that he couldn't blank his mind till he read Wherever You Go, There You Are by John Kabat-Zinn which helped him a lot. Now Bob also uses a body scan CD from John Kabat-Zinn's The Mindful Way Through Depression (it has 3 other authors) which also helps him a lot.
At one ISTSS meeting we had someone present on the liberating effect of learning to use your voice. When people are traumatized, they often lose their voice, and singing lessons can be empowering. I will have to look for the paper, which is up in my office in some pile somewhere, but I just found an article: Music Therapy Helps Vets Control Symptoms of PTSD, which you can google. It is about a viola player, but the idea is the same. Different things help different people. Find what helps you to let go of anxiety and retrain yourself for peace.
I often say when I give talks on PTSD that vets need Basic Untraining so they can take care of themselves. They usually laugh a bit and look at me like I am nuts. I say, "Did the military teach you how to take care of yourself?" They nod. I say, "Oh, yeah? Did you ever say to your drill instructor that you couldn't do that right now because you needed to go take a nap?" Laughter.
But that is what self-care is. If you can't talk right now, if you can't go to that party, if you need space or quiet time, you need to be able to say it in a nice way without having to blow up. When you get mad, you need to remove yourself and learn ways you can learn to calm down without drugs or alcohol. The skills of peace are learnable, but often veterans don't even imagine such a thing since the skills they have (including a lot of PTSD symptoms) have kept them alive.
Other things that can modulate arousal are exercise, biofeedback, relaxation training, breathing training, Yoga and movement therapy. I will talk a bit more about Yoga tomorrow.
Bob found meditation more helpful. He was always mad that he couldn't blank his mind till he read Wherever You Go, There You Are by John Kabat-Zinn which helped him a lot. Now Bob also uses a body scan CD from John Kabat-Zinn's The Mindful Way Through Depression (it has 3 other authors) which also helps him a lot.
At one ISTSS meeting we had someone present on the liberating effect of learning to use your voice. When people are traumatized, they often lose their voice, and singing lessons can be empowering. I will have to look for the paper, which is up in my office in some pile somewhere, but I just found an article: Music Therapy Helps Vets Control Symptoms of PTSD, which you can google. It is about a viola player, but the idea is the same. Different things help different people. Find what helps you to let go of anxiety and retrain yourself for peace.
I often say when I give talks on PTSD that vets need Basic Untraining so they can take care of themselves. They usually laugh a bit and look at me like I am nuts. I say, "Did the military teach you how to take care of yourself?" They nod. I say, "Oh, yeah? Did you ever say to your drill instructor that you couldn't do that right now because you needed to go take a nap?" Laughter.
But that is what self-care is. If you can't talk right now, if you can't go to that party, if you need space or quiet time, you need to be able to say it in a nice way without having to blow up. When you get mad, you need to remove yourself and learn ways you can learn to calm down without drugs or alcohol. The skills of peace are learnable, but often veterans don't even imagine such a thing since the skills they have (including a lot of PTSD symptoms) have kept them alive.
Other things that can modulate arousal are exercise, biofeedback, relaxation training, breathing training, Yoga and movement therapy. I will talk a bit more about Yoga tomorrow.
Friday, June 20, 2014
The right attitude Day 20 of National PTSD Awareness month.
Some people have the right attitude for helping people with PTSD. They are effective.
The right attitude consists of respect, an understanding of human nature, the ability to listen and hear what is being said as well as what is not being said. They teach you skills that will help you have a better life if you use them, as opposed to "I can fix you." Willingness to use a wide variety of techniques is required because people are different and need different things. Acceptance of people where they are while encouraging change is another requirement.
What is not required is a Ph.D. and an attitude of I can fix you if you just do what I say.
People with PTSD have very sensitive control detectors. They also need to find what heals them, not follow directions that may or may not work. History shows that people with PTSD can get better, but also that PTSD symptoms come back with further trauma whether it is a new war, the losses of old age, or huge reminders, like 50th Anniversary celebrations which threw so many stoic WWII vets into the arms of the VA.
So any program that claims to "cure" PTSD is suspect from the beginning. Does it have 50 year follow-ups? I think not.
It is fair to say is we can help you with your symptoms and if they come back, we will help you again. I have seen people who seemed to be cured by one technique or another, but I have not seen fifty year followups.
Human nature means if someone is told they are cured and symptoms come back, that person is going to think they are defective, not that the cure isn't a cure, and they are unlikely to go for more help.
I have also met veterans who have been told that we have done all that can be done for you and you aren't going to get any better. I do not know of any VA Hospital or clinic that even uses all of the forms of therapy I mentioned yesterday. (It was not a complete list, just off the top of my head.) I did not mention all the available forms, and new ones are developed every day, so that is an outright lie.
Here is a quote from the Transcend Program's manual (a joint PTSD and Substance Abuse program which was so effective that the VA cancelled it) "developing a therapeutic alliance that gives responsibility to the client for change and to the therapist for guiding and supporting that change. Basic to this is developing in the client a feeling that taking responsibility for change will be worthwhile. The concept of self efficacy guides much of our general thinking....We work at instilling in clients the benefits of self-exploration, interpretation, and reframing of life experiences. Gentle tenacity is sometimes needed here in the face of resistance. However, we see resistance not solely as a client based problem, but also as an inability of the therapist to frame the issues and benefits of self-exploration in a way that can help the client overcome his fears."
Now that is the right attitude! They go on to say, "there is no real change without behavior change... We see our position as therapists not simply as facilitators of change, but promoters of a certain way to change. Teaching new skills, emphasizing the need to act on newly learned behaviors, assisting clients in generalizing behaviors...to other situations, and helping them maintain new skills by providing reinforcement... and also teaching them self-reinforcement skills..."
Most of what I mentioned yesterday was also developed by people with the right attitudes. I used to go to the International Society For Traumatic Stress Annual Meetings and go to the workshops, looking for people with the right attitudes. Many of the free Post-Traumatic Gazettes on my web page have reports on that. More tomorrow.
http://www.patiencepress.com/patience_press/PTSD_Help-Gazettes.html
The right attitude consists of respect, an understanding of human nature, the ability to listen and hear what is being said as well as what is not being said. They teach you skills that will help you have a better life if you use them, as opposed to "I can fix you." Willingness to use a wide variety of techniques is required because people are different and need different things. Acceptance of people where they are while encouraging change is another requirement.
What is not required is a Ph.D. and an attitude of I can fix you if you just do what I say.
People with PTSD have very sensitive control detectors. They also need to find what heals them, not follow directions that may or may not work. History shows that people with PTSD can get better, but also that PTSD symptoms come back with further trauma whether it is a new war, the losses of old age, or huge reminders, like 50th Anniversary celebrations which threw so many stoic WWII vets into the arms of the VA.
So any program that claims to "cure" PTSD is suspect from the beginning. Does it have 50 year follow-ups? I think not.
It is fair to say is we can help you with your symptoms and if they come back, we will help you again. I have seen people who seemed to be cured by one technique or another, but I have not seen fifty year followups.
Human nature means if someone is told they are cured and symptoms come back, that person is going to think they are defective, not that the cure isn't a cure, and they are unlikely to go for more help.
I have also met veterans who have been told that we have done all that can be done for you and you aren't going to get any better. I do not know of any VA Hospital or clinic that even uses all of the forms of therapy I mentioned yesterday. (It was not a complete list, just off the top of my head.) I did not mention all the available forms, and new ones are developed every day, so that is an outright lie.
Here is a quote from the Transcend Program's manual (a joint PTSD and Substance Abuse program which was so effective that the VA cancelled it) "developing a therapeutic alliance that gives responsibility to the client for change and to the therapist for guiding and supporting that change. Basic to this is developing in the client a feeling that taking responsibility for change will be worthwhile. The concept of self efficacy guides much of our general thinking....We work at instilling in clients the benefits of self-exploration, interpretation, and reframing of life experiences. Gentle tenacity is sometimes needed here in the face of resistance. However, we see resistance not solely as a client based problem, but also as an inability of the therapist to frame the issues and benefits of self-exploration in a way that can help the client overcome his fears."
Now that is the right attitude! They go on to say, "there is no real change without behavior change... We see our position as therapists not simply as facilitators of change, but promoters of a certain way to change. Teaching new skills, emphasizing the need to act on newly learned behaviors, assisting clients in generalizing behaviors...to other situations, and helping them maintain new skills by providing reinforcement... and also teaching them self-reinforcement skills..."
Most of what I mentioned yesterday was also developed by people with the right attitudes. I used to go to the International Society For Traumatic Stress Annual Meetings and go to the workshops, looking for people with the right attitudes. Many of the free Post-Traumatic Gazettes on my web page have reports on that. More tomorrow.
http://www.patiencepress.com/patience_press/PTSD_Help-Gazettes.html
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