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Sunday, May 6, 2007

Irritability and outbursts of anger

It can save your life to be able to go from fine into a killing rage in nanoseconds. The capacity is built into our brains. Anger is a normal response when people try to kill you and your friends. It is a normal response to the privations of war, the f*ck-ups by higher ups who are not risking thier lives, the job of killing, the fear of dying. Anger helps you feel powerful. It has a lot of survival value while you are at war.
Anger can become your biggest problem after you get home, driving away your friends and family, isolating you so you can't get the help you need to process what you have been through. It can make you dangerous and unreasonable self-righteous and cruel. If you develop chronic PTSD, your cortisol levels will be depleted so you can't calm down once you are angry, and while you are angry, your heartbeat may get above 175 beats per minute which means your brain is not operating either, so no one can reason with you.
If you have been to war and are now constantly angry, that is a symptom of PTSD. You may not like to hear that, but you have been, quite naturally, affected by the war. Many generations of veterans have lost family and friends because of this symptom, and it is not your family nor your friends fault. They could behave perfectly and you would still be pissed off. Nothing they do will prevent that, because this anger is welling up in you due to your experiences, and you need to process those experiences with an experienced therapist, or work a 4th step with a sponsor in AA/NA or some other 12 step program (In the 4th step you start by listing your resentments, the fun part, and then you look at your part...), or start meditating so you can see your anger as an emotion and not THE TRUTH about what is going on.
Handling your anger is your responsibility.
You need to learn to walk away, and your spouse needs to learn to let you. You need to learn how to let go of anger, seeing the emotion beneath it, like feeling disrespected, blamed, guilty, or afraid you won't get what you want. Steven Stosny's HEALS technique is the most effective antidote to anger that I know of. It is an acronym
Healing (see the letters flashing in neon, which takes you out of the angry space)
Explain (to yourself what the underlying feeling is, from disrespected down to worthless and feel that feeling for a few seconds-like an inocualtion, so you can tolerate the painful feeling without flying off the handle, which gets easier with practice)
Apply compassion to yourself: Of course it hurts to feel disrespected or worthless, so I need to have compassion for my pain, and to respect myself or value myself, give myself an antidote to the pain which fits the particular kind of pain I am feeling
Love yourself. If this sounds selfish, loving yourself means you will be able to love others and feel compassion for them too.
Solve the problem. Anything you say or do that does not involve yelling or other outbursts of anger is much more likely to solve the problem. When you are not angry, your thinking is clearer and your solutions are better.
Stosny has written a book for people in emotionally abusive situations, and blowing up at your nearest and dearest is emotional abuse, called You Don't Have To Take It Anymore which contains a boot camp for the person who is doing all the yelling and name calling and criticizing. If you are doing that, the book will help you.
You have to think about what kind of a partner and parent you want to be and commit to that. Was your plan to emotionally abuse your family and friends? Probably not. There is a type of therapy which is used at some VA hospitals called Acceptance and Committment Therapy (ACT). You accept that you have been affected by war (or if you have been diagnosed with PTSD, by that) and you commit to learning how to be the type of spouse and parent you always wanted to be. You learn basic un-training, which means how to take time for yourself so you are not blowing up all the time, how to handle your anger, how to let other people make mistakes (it is how they learn), be human, etc.
You have to commit to your own healing and to being fair to your family, even though what happened to you and your friends in war WAS NOT FAIR. None of them deserved to die. You don't deserve to have PTSD. That is the truth. But you do deserve to recover, no matter what you did or didn't do, saw or didn't see, you deserve to recover and to have a good life.


  1. Patience, glad you got back to your blog. You needed to for your own sake as a survivor of secondary PTSD.


    Bob Drury

  2. Dear Bob,
    I prefer the term "compassion fatigue" to secondary PTSD. By the time I found out what PTSD was, I was ready to strangle Bob and I felt like there was no hope for us. Of course, I had tried everything! Or so I thought...
    I didn't know what the problem was, nor did I know whose problem it was (Bob's) so of course nothing I had tried worked.
    After I learned to detach with love and work on me, things got better.
    BTW, for my other readers, Bob Drury was also a Vietnam helicopter pilot later in the war. We interviewed him at a Vietnam Helicopter Pilots Association meeting during the preliminary work on Flightline: The Army Helicopter Pilots of Vietnam, a documentary we did. As I listened to his story, I realized he went through hell, but he always went the extra mile for the guy on the ground. I have never forgotten his story. I admire him a lot. He also wrote a play about his experiences.

  3. Patience, I love your blog, please keep writing. I was Dxed a year ago, but lost my insurance after 1 EMDR session. So, I tried to stuff every thing back in I guess, which of course doesn't work, and now my marriage and very survival is at risk. I finally found out recently that I have to do the work to heal. My husband is completely non-supportive so I am now taking the steps I need to, alone or not. I am glad to have found your blog, there is much helpful information.
    Thank you for that. I am still learning.

  4. Hello,

    There is a very interesting blog entry that you will be interested in. It is written by Peter Sheehy, Ph.D. It discusses post traumatic stress disorder and the military's lack of support for its soldiers.

    The title of the entry is “A Debt that Haunts”. The link is:

    Here is an excerpt:
    “During his second night in Iraq in October of 2003, Sergeant Andreas Pogany witnessed an Iraqi man cut in half by a machine gun. Pogany vomited, shook for hours, and by his own confession, “couldn’t function.” Despite Pogany’s insistence that he was having panic attacks, he was denied proper therapeutic care and was eventually sent home. Before long, Pogany faced court-martial for cowardice, a charge the military had not pursued since the Vietnam war, and one that carries a maximum sentence of death.”

    Thank you,
    Adam Rosh, MD
    NYU/Bellevue Hospital

  5. PTSD and Street violence.

    I grew up in a violent neighborhood in Brooklyn, NY.

    For most of my life non of what transpired affected me... until
    I had children and noticed their child hood lives being vastly differnt from mine.

    I don't have anger outbursts, but sometimes have what can best be described as as "flashback" not hallucinations mind you... but sights, sounds smells of particular violent incidents in my youth remembered.

    3 stand out...
    1. Gang rape of my friends*
    2. Gunfight in a bodega (I was witness to)
    3. Blood on the streets seperating from plasma on hot day.

    * this is the one most disturbing... and walked out of "Kite Flier" during that scene.

    I am a WM.

    BTW I have read your husbands book.

    Not being military, leaves me no-where in this regards.


  6. Dear Anonymous,
    You don't have to be military to get help for PTSD. is the Crime Victim advocacy list in NY. is the National Center for Victims of Crime a national organization for victim and witness assisatnce.
    Hope these help.

  7. I'm a female Vet. Do you have any recommendations for female war Vets? I have lots of questions.

  8. Dear Anonymous,
    I hope you will check out for the free handouts and read the rest of this blog. You are welcome to email me at ptg at patiencepress dot com.
    I just rewrote Why Is Moomy Like She Is? for women veterans. It is a book for your kids. Let me know what else you need and perhaps I can write something new.