Search This Blog

Sunday, December 19, 2010

A Pill to Prevent PTSD

I have to laugh when I read this kind of stuff. Are they gonna give a pill after every firefight and every IED? After every time a pedophile molests a kid whom he or she has picked because the parents won't know or won't believe? After every time a battered wife is battered?
This morning, I was thinking about the brain-based survival skills that are activated by danger. We all have them. They are built into us. Attention to threat, the ability to rapidly adapt to whatever is going on (i.e. numbing) and the capacity to pour on the adrenaline to move before thought and do whatever it takes to survive don't reside in the forebrain where we think, use words, use logic, plan. These abilities are built into what they called the reptile brain when I was in high school biology, a part of the brain that doesn't speak English, and can't tell time, so it can't tell something is over. It is also a better safe than sorry system, so it keeps reminding the survivor that the world is not safe.
And they are going to disable this with a pill? Don't they think this system is what has kept the human race alive?
If you jump at a cat, you see the same system in action. Move, adapt, live!
There's a book about meditation, Don't Just Do Something, Sit There. People with PTSD don't need a pill, they need training in techniques that allow them to choose when to be numb (it can have certain advantages when dealing with bureaucracy) and when to feel, when to let hyperalertness take over and when to be calm, when to remember and when to step away from the memories. Meditation is one way to learn how to do this. So is yoga. Somatic therapies developed by Pat Ogden and Babette Rothschild also work. So do the exercises taught in Dialectical Behavioral Therapy developed by Marsha Linehan.
They also need to process what happened to them, moving the non-verbal memories which keep activating symptoms into the forebrain by using words, writing or talking about what happened. It hurts, but then they have already lived through the pain of the actual events.
Avoidance perpetuates PTSD.
Is this pill a form of avoidance? Who knows? I don't, and they don't, but I just can't imagine soldiers taking a pill after every firefight. Would they lose their edge? Who will volunteer to find that out or are we just going to blindly do it like they are now doing with sending soldiers back who have PTSD, on drugs that are un-tested in randomized clinical combat trials?

Tuesday, December 14, 2010

Does it ever change?

I found this Time Magazine article while trying to find information on the VA Hospital in Rutland Heights, Massachusetts, where I grew up and my dad was chief surgeon. We moved there after the time of the article, and probably they wanted my Dad because he had been a thoracic surgeon in WWII in Europe so he was a good surgeon and a vet, too.
What I find so surprising is that this article was written after the big one, the good war. Apparently the greatest generation was not the greatest generation when they got home. I think they probably had to fight to get good treatment just as Vietnam vets and OIF/OEF vets are having to do.
Most VA's these days have excellent medical care, but they are overwhelmed because during the previous administration, the VA budget was cut. This was an unfortunate but not unexpected result of a war begun by people who had never been to war. They had never seen the physical damage war does to people, so they failed to plan for the wounded. And like most foolish war planners through out history, they thought the war would be over in a few months.
They also believed the right-wing propaganda that real men are not bothered by war and PTSD is a left wing conspiracy against our troops, so they started attacking the diagnosis.
The actual left-or-right-wing conspiracy against our troops took place during the Vietnam War when DSM II came out (1968) and dropped all mention of post-traumatic reactions from the list of available diagnoses.
At the bottom of the article if you look closely there is a footnote that says:
"Veterans' Hospitals are of three types: general, neuropsychiatric, tuberculosis. More than half the patients are neuropsychiatric cases."

Saturday, December 11, 2010

Facebook Page and Holiday helps

I started a Facebook page, Patience H C Mason, Author, which is the business kind of page so it comes with a discussion board (the link to the title of this post) to make it easier for people to ask questions and find help. I have three discussions started including two begun with two different articles I wrote on the holiday season, PTSD and Holidays and one called "Can't you just be normal for one day?"
These are also available at if you want to print them out. This time of year is hard on veterans and other trauma survivors so I am hoping these will be of help to some of you.
Anyone is welcome to friend me on Facebook, but if you do, please add a note to your friend request saying how I may know you, or what the connection is...
Meanwhile, Happy Holidays!

Wednesday, December 8, 2010

Women Veterans

Two things have happened recently that got me started on thinking about women veterans. One, I saw Lioness the film, which totally blew me away. Second, I got an email from a VA therapist working with OIF/OEF veterans asking me to rewrite Why Is Mommy Like She Is? for the new women veterans, which I have done. You can order it at my website.
Today Anonymous posted on one of my posts, Do you have anything for women veterans? My reply to her is let me know what you need and I will try to write it.
Some thoughts:
War changes people.
We, as women, are supposed to take care of other people's emotional and physical needs. Even today, in a household where both people work, the wife still does most of the housework and child care after work, while the guy watches TV. Is this fair? No. Is it right? NO. Is it common? Yes.
I'm not sure how quickly this expectation is laid on our women veterans when they get home: the housework and the parenting. From my own experience when Bob got home from Vietnam, I suspect it is hard to get back into giving a sh*t about laundry and dishwashing... and even the kids... your husband...
No matter how much you may want to be the same, war has changed you, and it will take time, and sometimes therapy, to let go of some of the pain and altered priorities and become who you prefer to be. One of the things war will do for you is to get you thinking about how you were and if you want to be that person...
When Bob went to Vietnam, he smoked. When he got home, he'd been living in a tent and sometimes sleeping in the helicopter for a year, so he'd just flick his butts on the floor. I laughed. He was raised by a much better housekeeper than me, so he would apologize and say he'd been living in this tent, and they all did it. He got so he didn't do it after he'd been back about a month.
At that time, I don't think I was even aware enough to realize he had been living in a separate reality in which all the priorities were different, but I hated housework so I thought it was really funny... I think that was good for our marriage, because if I had taken it personally and felt insulted or any of a million other common thoughtless reactions ("Don't you have any manners," to a WWII combat vet who hadn't eaten at a table for YEARS.), I think our problems would have been greater.
Things happen in war that change a person's priorities.
Another thing that was pretty evident, looking back, was that Bob's physiology and emotional life were changed by the experience. These were the normal results of his brain trying to keep him alive: hyperalertness demonstrated by an utter inablilty to sleep and leaping up over and over in the night, emotional numbing which caused me to feel unloved because I had no idea that in war you have to put away your emotions to rapidly adapt to what is going on around you so you can do your job, despite bullets, rockets, IED's or whatever. He began to drink to get to sleep, another common way of dealing with the changes war creates in the brain.
At the time, most psychiatrists were telling veterans who said war had changed them, that they were wrong, but now we know it does change you, your brain chemistry, your reaction times, etc.
I think this would be harder to accept for a woman because we are supposed to be feeling, emoting, caring people, so If you feel like you don't give a sh*t, be aware that it is a normal protective device of your brain, not some kind of moral defect. It is evidence that you lived through something that killed others, so it is a good thing. It can become a bad thing over time, but right after you come home, give yourself a break and don't expect yourself to be the same.
War changes people. If you understand the changes, it makes them easier to accept. If you don't like them, you can work on unlearning what you have learned under the hammer of war. My "Veterans Day and I'm mad" post has a very detailed explanation of the changes, if you would like to read that.
Meanwhile, whatever happened to you, whatever you did or didn't do, you deserve to recover.
My email is on my profile, so please email me with any questions you have or topics you would like covered.

Monday, November 22, 2010

War veteran barred from CCBC campus for frank words on killing

I hate this kind of story.
People are allowed to be where they are at!
Imagine! A veteran who loves to kill! Is this a surprise to anyone? People are different. Some people won't hunt or kill anything after they get back from war. Some people love it. Love what we ask them to do in our name.
The human brain is designed to keep you alive, so when you are fighting for your life and win, your body reacts with joy (See On Killing by Dave Grossman). Your brain is also designed to rapidly adapt to whatever is going on, so the first killing is upsetting, but a few killings later it is just everyday, or maybe even fun.
One of my Vietnam vet friends won an argument with the guys he was with and got to be the one to kill the VC they had caught. That was the best thing that could happen in that day , and isn't that a comment on the reality of war. This is not unusual although it is not talked about much, because most people are ashamed of the pleasure they find in that ultimate win, killing.
Another vet told me that when they went on missions to bomb or drop napalm, and the mission failed, they dropped it anywhere in Vietnam on the way back to the airbase. It was SOP.
General James Mattis got in trouble for saying, “ "You go into Afghanistan, you got guys who slap women around for five years because they didn't wear a veil. You know, guys like that ain't got no manhood left anyway. So it's a hell of a lot of fun to shoot them. Actually, it's a lot of fun to fight. You know, it's a hell of a hoot. It's fun to shoot some people. I'll be right upfront with you, I like brawling."
Isn't that what you want in a soldier?
Later on, as they get older, some people are horrified by things they did, which seemed normal, everyday stuff to them at the time. They need help, not condemnation.
I notice that Charles Whittington says in his essay that "We train and train for combat, and then when we actually go to war, it is reality and worse than what we have trained for." There is no training that makes you ready for what will happen to you in combat.
Every person who goes through that is changed by it. Charles Whittington is getting help with his reactions and being honest about the cost of war for him. I admire his honesty.
When I was young and Vietnam was going on, I used to think, very self-righteously, that I would never do any of the bad things we were hearing about. Then I talked to a lot of vets when I got older, writing Recovering from the War, and I realized that at 18 or 19, I was a black and white thinker, and I would have killed any one I was told to, and any one who got in my way, or killed my buddies, or didn't warn us about booby traps... It was quite humbling.
Only something like 10 % of people won't follow orders like the German soldiers in WWII or the American soldiers at My Lai, and I was not one of them. Most of us are not.
I hope I am one of those 10% today.

Wednesday, November 17, 2010

More rant

I followed link after link to see if there were a way to find out why I could not contact Military Onesource, and got to a place on the DOD website where I could ask a question. Here is the email I got back:

Thank you for contacting the Department of Defense. We have received
your message. We read every message and will take the appropriate
actions in response to your question or comment.
We are the Office of Public Communication, a part of the Office of the
Assistant Secretary of Defense for Public Affairs
If the answer below does not resolve your query, please update your
question at
Question Reference #101117-000054
Summary: the book Recovering From the War
Category Level 1: Other Issues Not Listed Above
Date Created: 11/17/2010 01:00 PM
Last Updated: 11/17/2010 01:00 PM
Status: Unresolved
Discussion Thread
Customer (Patience Mason) - 11/17/2010 01:00 PM
Why is it not listed on Military Onesource as a resource for families? Why can't I contact Military Onesource myself to find out why?
There is a disclaimer that they can't connect to commercial websites, but the do list a number of books, including one for adolescents. I have also written a couple of childrens books: Why Is Daddy Like He Is? and Why Is Mommy Like She Is? in a new edition for the new women vets.
These are resources used by VA's and Vet Centers and I can't even get to email Military Onesource that they EXIST. I couldn't even find PTSD resources on there without hunting for them. Denial is not just a river in Egypt.
Auto-Response - 11/17/2010 01:00 PM
Title: Locating Service Members or Getting a Mailing Address
Title: Felony Waiver Report for Military Recruits
Title: Overseas Bases - Congressional Commision and the DoD Response

Man, I am so relieved and reassured.

A rant from Belleruth and me

Belleruth Naparstek has the same problem I have, no one can get her stuff onto Military Onesource. see her rant
She has people who work for her. I am a single person business and years ago, when I first heard of Military Onesource, I tried to get added, but since I am just a wife and not a professional or a big business, I had no luck, so I gave up.
They do list books, five of them. Not mine, Recovering from the War, not the new one by Cynthia Orange from Hazleden, Shock Waves: A Practical Guide to Living with a Loved One's PTSD, not Edward Tick's War and the Soul: Healing Our Nation's Veterans from Post-Traumatic Stress Disorder, not Belleruth's CD's and her book Invisible Heroes.
To say I am pissed is an understatement. There is also no easy way to contact them and ask to be included. Why not add a button for authors, veterans, etc to get in touch and suggest resources? Do they give a sh*t? Apparently not.
Whoever is looking out for our soldiers and veterans is not looking very hard for stuff that actually helps. Better to have a big expensive website, Military Onesource, run by a big corporation making billions of dollars that doesn't even list PTSD as something you might need help with. It also has a what appeared to me to be totally worthless find function which brings up page after page of links to the same posts on the supposed discussion list about having a husband with PTSD, but no information.
So if you are an active duty vet or family member looking for something to read or listen to that might help you deal with PTSD, I invite you to come to my website, Patience Press, where there are free articles, or read the rest of my rants, or try Belleruth's guided meditations (see link above).

Monday, November 15, 2010


I just found out I have been listed in this website as one of the top fifty bloggers on PTSD!
It says my website is good for seniors, and I wish it didn't because I am also trying to communicate with the new vets and their wives and get them to my website where they can get a different perspective on PTSD as survival skills that later become your biggest problem.
In case you just found this blog, I have written a book too, Recovering from the War, which was a Viking/Penguin in 1990. After it went out I print, I became a publisher and publish it as Patience Press, along with two children's books (Why is Daddy Like He Is? ditto for Mommy) and three patient education pamphlets, After the War: For the Wives of all Veterans, An Explanation of PTSD for Twelve Steppers: When I Get Sober I Feel Crazy, and The War at Home. There are also 13 free articles at Patience Press which I want all vets and other trauma survivors to have.
However, to say I am pleased at being included is an understatement. Writing is a lonely occupation and I have no idea if I am being read or not, so this is quite happifying! (Hey, I'm an English major. I get to make up words!)

Thursday, November 11, 2010

Veterans Day and I'm mad!

copyright 2010, Patience Mason.
I just listened to some idiot (didn't catch his name) on The Diane Rhem Show (a show I love, by the way) tell the usual lies about how only 10 % of vets get PTSD, and a new and amazing lie, that DSM II came out in the forties, and after that until 1982, I think he said, no one could get help for PTSD because of DSM II.
DSM I came out in 1952. It was an attempt to standardize diagnoses. It contained "Gross Stress Reaction" for survivors of traumas like combat or a concentration camp.
Contrary to what that idiot said, in 1968, DSM II was published during the Vietnam War: it actually went on sale during the TET Offensive. It dropped all stress reactions except for "transient situational disturbance" which could only last up to 6 months... Otherwise you were screwed up before you went to the war and got a diagnosis of personality disorder and no help from the VA since Personality Disorders were pre-existing conditions.... Was this aimed at Vietnam vets? I can't say, but it is quite a coincidence.
People who work for the VA often do not know the history... They don't know the facts... They speak for the VA, not for veterans.
It is the same problem when you get military psychiatrists. They speak for the military, not for the soldiers. They usually don't know the facts, either. Their job is to keep people going back to the war, so they have a conflict of interest with their patients.
They all say they can fix or prevent PTSD.
Maybe they can but there is no proof of that. NO PROOF.
A four year follow up on some 12 week or 12 month treatment is not proof that a lifetime condition has been fixed. (We'll give you insulin for a 12 week course and then you won't be diabetic. No one would say that.) And that's at a VA that uses "evidence based therapy," or some sort of therapy or treatment. Some of them just give drugs, and let me tell you, if the drugs make the vet feel weird, he or she won't take them and won't tell the doctor either.
Each VA is a feifdom. The doctors do what they believe in, and none of them use all the therapies and techniques which are available today and each of which helps some people... It 's like if you want help, fit into our theory. This is wrong. Vets need a variety of therapies because people are different and need different things. Some people need long term help. The government took them long term, perhaps for the rest of their life, and they should be willing to help them long term.
Statistics can always be manipulated so only 10 or 12 or 17 % of people get PTSD. In the National Vietnam Veterans Readjustment Study, of people who had had "high war zone stress" (multiple traumatic incidents) 66% of them had diagnosable PTSD at some time after the war and 33% still did, twenty years after. That means it is a normal reaction to multiple tours and multiple traumatic stressors. The guy today said 10%. The technical term for that is bullsh*t.
It is enough to make me tear out my hair.
I want to help people understand their PTSD.
I want them to know it is normal.
I want them to know there are four basic causes of PTSD, only one of which is the traumatic stress you have endured. The traumatic stressors you may have endured include serious threat to your life or physical integrity, serious threat or harm to spouse, kids, close relatives or friends (i.e. your buddies to whom you are probably closer than anyone), sudden destruction of home or community, and seeing anyone who is or has been recently seriously injured or killed. Traumatic stress is cumulative, it is worse when it is caused by human cruelty, neglect, error or betrayal, worse when you are young, and worse when part of the cause is a person or institution which is supposed to take care of you.
If you have PTSD think about how many of these traumatic stressors did you have? One a day? Ten a day?
The other three causes are that your brain is designed to keep you alive so all the symptoms of PTSD start out as brain based survivor-skills, that you care about other people no matter how numb you feel now, and third, that you lived. Dead people don't get PTSD...
Having lived means you are fast, smart, courageous, ingenious, and lucky. PTSD is proof of survival. It is not weak or weird. Normal people are affected by what they live through. Some psychiatrists know so little about human nature as to deny this. They seem to write the diagnostic criteria as some sort of numbing ritual entirely divorced from the reality of trauma. One of my friends is a lawyer and he says this is good, but I think it makes it easier for them to avoid the reality of war and other traumatic events and think, "I wouldn't be affected."
To psychiatrists, PTSD is a problem. To me the problem is war (or rape, incest, battering, industrial accidents, fires, etc,). PTSD symptoms are a wonderful solution to surviving war (or any other trauma) physically and mentally. They are evidence of courage, initiative, endurance, speed, luck, and caring. You wouldn't have to get numb if you didn't care. The same things that get you through the trauma alive can also become your biggest problem over time.
Post means it can happen any time after the war, right after or sixty years later. Most people have all the symptoms right after a traumatic event (Critical Stress Response, what guys who break down in combat have, not PTSD, although it probably does become PTSD) and some people seem to heal, we don't know why, so it is a disorder of healing.
Some people also appear to heal, but in fact they are using behaviors (work, sex, gambling, tv watching) and/or substances (alcohol, drugs, food, adrenaline) to hide their problems. This is as bad for their families as living with the PTSD would be, but it looks better to the outside world. "My dad never talked about WW II" is actually evidence of PTSD, not that it didn't bother him...
I want every one to know that the symptoms of PTSD begin as evolution-based or god-given survival skills, built into our brains. The symptoms come in three clusters which often overlap and reinforce each other.
The diagnosis of PTSD in DSM, whatever edition, always begins with re-experiencing. This is because psychiatrists had to stop denying PTSD's existence when vets were having flashbacks in the halls of the VA. That is when they noticed PTSD, so they describe it as weird re-experiencing disorder with associated problems.
I look at it differently: what would keep you alive when someone is trying to kill you?
Your brain is designed to keep you alive and a big part of this is paying attention to threats. Moreover, your body is provided with abilities that get you moving long before you actually think I should move out of the way of that bullet. DUCK! Move fast. Action. Action before thought. That is why some of us think somatic therapy should be offered along with talk therapy. Your body retains hyperarousal, and it does not speak English, nor can it tell time in the sense that your fore brain can. It does not know it is over.
The basic built in capacities of your body are usually described as fight or flight, but freeze is also an option the body can take, even against your will, if it thinks that is the only way to survive. Your body will do, is designed to do, whatever it takes to survive. Your brain also has a tremendous need to be in control of things, so it keeps repeating what works.
These reactions, once triggered lead to constant wariness (hypervigilance) one of the PTSD hyperarousal symptoms. Another symptom which the shrinks call "exaggerated startle response," I call effective startle response (You're alive!). Inability to concentrate is actually the inability to concentrate on everyday stuff, because you are concentrating on survival information, who is in the room, how will you get out, where the ambush or IED might be, etc. Irritability or outbursts of anger? Maybe it is normal to get pissed when people are trying to kill you and have killed your buddies. Plus people are so rude (Did you kill anyone? Aren't you over it yet?) and so full of dumb problems (Who cares what color the curtains are?)... Maybe anger makes you feel powerful so you can fight for your life or endure the privations of war and the need to kill people. Inability to fall or stay asleep keeps you alert at all times, keeps you from being killed in your sleep. They all make sense when viewed like this.
Numbing and avoidance probably develop at the same time as the hyperarousal symptoms. Your brain has an incredible capacity to rapidly adapt to situations. Rapid adaptation means that something that is horrifying quickly becomes everyday: emotional numbing. After that it takes a lot of adrenaline to get an emotion out of you. This means you may only feel alive when angry, doing something dangerous, or screwing around, because your emotions have been buried by the need to be in control combined with the need to do whatever it takes to survive and do your job and help others survive. People can do things under these conditions which are hard to look back on later. Feeling detached and estranged from others is reality. War changes you. People can't understand what you have been through, no matter how understanding they want to be. I realized this when my husband Bob and I came out of the movie Platoon, and I was upset by one of the wounded guys, the one with the shredded arm. Bob looked at me like I was nuts and said, "It's worse when it's real." I was starting to think I understood war because of all the interviews I was doing for Recovering from the War, but when he said that it hit me. I will never understand the reality. It is a separate reality. This is also self protective because of the stupid things people say to vets and trauma survivors. Having a sense of a foreshortened future is also realistic and self protective. You see other people dying all around you: why get your hopes up? Live for today because you may be dead tomorrow. (This can be annoying to your spouse...) Inability to recall parts of the trauma is a brain based protective device. The actual events are not recorded in narrative memory (and then, and then...) because it happened too fast and was too overwhelming for you to take it all in. This ties in with the reexperiencing because these unprocessed bits of memory seem to intrude and they are upsetting, so you begin the process of avoidance. You may avoid thoughts, feelings, situations, places, people, and activities that remind you of the trauma. If you were happy with your buddies and got ambushed you may decide never to be happy again. It is not conscious, and often is is done by staying drunk, or drugged, or high on adrenaline. Maybe you feel a mistake on your part got someone killed, so you are never going to be wrong again. Most of these are unconscious decisions, and you may not know you have made them. Avoidance is self protective and helps you avoid triggers, but it also perpetuates PTSD. Being really numb can lead to depression and to outbursts when your emotions erupt and scare every one around you. You may also lose interest in significant activities which helps you avoid triggers. What activities? Sex (losing control), hunting (no more killing), parties (crowds), family gatherings (people who wonder why you're not over it yet), cookouts (burning flesh) among other things.
Finally we get to reexperiencing, where the psychiatrists start the diagnosis. I think your brain keeps you alive by doing better safe than sorry. Primitive parts of the brain can't speak English and can't tell time, so they don't know it is over and you are home. Bits of experience, sights, sounds, smells, emotions, physical feelings like a thump on the head, all bring back the trauma in full living color. These are non-verbal memories, like your dog has when it sees a ball, only they are painful and upsetting. You may have the opposite of avoidance, and be constantly tormented with intrusive recollections of the war or trauma. You may also have nightmares about it, symbolic or actual repetitions of some awful events. You may suddenly act or feel like you are back in the war (flashbacks). You get upset by stuff that resembles or symbolizes the trauma. This includes anniversaries of holidays and of personal events including ones you don't remember! And you can have a physiologial reaction to things that remind you of the trauma. (Heart rate goes sky high when you see a car parked by the road, or hear a helicopter, etc.) You can also have second and third generation triggers. You get triggered by a car backfiring while you are eating a hot dog and watching children play, and after a while you can't stand hot dogs or the sound of kids playing... and you think you are nuts or a bad person, instead of realizing this is from the war.
Reexperiencing symptoms are probably what brings most people in for help, because they feel pretty nuts.
It appears that moving your non-verbal memories from what they called the reptile brain into your fore brain and encoding them as narrative memories is probably the most important healing device. This is called therapy when done with a therapist, writing when done with a typewriter (like Bob in Chickenhawk) or a pen in your journal or your fourth step in a 12 step program. It is the basis of cognitive therapy and narrative therapy and talk therapy, of EMDR, TIR, and other alphabet therapies.
If remembering is too upsetting, you need something like the skills you learn in Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, meditation, or the HEALS technique developed by Steven Stosny, Ph. D., so you can tolerate painful feelings in order to heal them.
Whatever you have done or not done, witnessed or ignored, you did not deserve to be traumatized, even if everyone says you deserve what you got. You do deserve to recover, and I hope looking at PTSD through my eyes will help you find the courage to get help. It is not fair that it hurts to recover. It is just reality. And since you made it through your war or traumas, you can probably make it through the work it takes to recover.
I also have seen people recycle PTSD symptoms when a new war starts or another traumatic event happens, and I think this is probably normal too. That's why I don't like the term "cured." "In remission," seems more realistic and more accurate to me. If your symptoms do come back, what worked before will work again. Don't give up. Get more help. You deserve to recover.

Wednesday, September 22, 2010

It is not your fault

When I was a young wife struggling with a husband who had problems, like emotional numbing, angry outbursts, and inability to sleep, I thought it was all my fault. Everyone knew that if you were a good wife, your husband and family would have no problems. This is a myth, but I believed it.
At that time, there was no diagnosis of PTSD and we had no idea for years that any of it was related to flying into a hail of bullets over and over again as a slick pilot in Vietnam in the 1st Cav, 1965-66.
Bob thought most of his problems were my fault, too. What did he know about the effects of combat?
So I thought if I could just lose a little weight, keep the house cleaner, keep our son Jack a little quieter, and be more responsive to his needs, Bob would be nicer to me and not get mad or cold or whatever.
In fact, coldness (emotional numbing) is often a response to an anniversary, and the veteran may not know that. Bob seemed to turn into an iceman several times a year and when he wrote Chickenhawk, I realized why: Ia Drang, Happy Valley, Bong Son, and the last month flying heavy lifts when they had promised ass and trash (mail and passengers). One vet friend of mine tried to kill himself three times at the same time of year, a few years apart. His counselor suggested looking up the reports on his unit, and they found that a bunch of guys had been killed in a big firefight. He did not even remember. So there can be anniversaries that even the veteran does not know about.
Unfortunately most of us do not know anything about the symptoms of PTSD or we think they are defects instead of survival skills. We misunderstand. We take it personally, when often these behaviors have nothing to do with us.
I used to think that the things I did depressed Bob instead of understanding that the deaths he saw and the things he endured combined with the lack of care when he got home depressed him. He was called a murderer. When he was training new helicopter pilots and saw the standards lowered because they needed bodies. He had combat fatigue and was grounded when all he had ever wanted to do was to fly. And I thought I was the cause and could control and correct all his feelings.
If you are going through a rough time with a veteran, please read the rest of my posts and the free articles at Patience Press.
It is not your fault.
You didn't cause it although you may be thinking that, and he/she may too...
You can't control it by being the best little woman, or the best husband, in the world, although she or he may be telling you that if you only did this, that, or the other, he/she would have no problems.
You can't cure them either.
The hard and painful work of recovering is something they have to do, even though it is not fair.
This will be extremely hard for you, because tolerating someone else's pain is very hard. We want to help. We want to fix, but we can't and if we try to cheer them up and tell them to put it behind them and forget, we will perpetuate it.
If we tell them they are screwed up and to go get help, that can perpetuate it too.
They need to regain a sense of being in charge of what happens to them, so not following our directions is a healthy choice for them. They don't need directions, but suggestions can be helpful if done with a light touch. That's why I tell people to leave my articles in the bathroom instead of giving them to someone with PTSD. People don't like being told they are screwed up.
Get some support for yourself. One place is Living with PTSD. Another can be Alanon, where you can learn to detach with love.
Just remember: It is not your fault!

Thursday, May 13, 2010

Medal of Honor Recipients Launch Post-Traumatic Stress Public Service Announcements

I just went and looked at the website Medal of Honor Speakout and I cried.
Then I began looking more closely at the message, which seems to be a script written by a military PR guy, and they all say the same thing, some with compassion and conviction and some like... Well go see for yourself.
I sent the website the following email:
I have played several of your videos and so far, none of the Medal of Honor recipients says that he had problems after he got home, although Audie Murphy said he did and fought with the VA during Vietnam to get help for combat veterans. Audie Murphy was sleeping in a bedroom he had built in his garage with the lights on all night and a gun under his pillow, and having a recurring nightmare. (50th Anniversary Issue of Esquire, article by Thomas Morgan, I believe). I suspect some of the others may have had similar experiences. Talking about them will have more of an effect than this impersonal stay strong message.
This "stay strong" message does not cut it. Unless some of these guys say that they needed help, it will simply keep our current veterans thinking that these guys did not need help because they were stronger!
Please reconsider the message. Drop the " stay strong," and say "get help. I did." Or "I lost three families before I realized it had affected me," or something like that. The idea that you don't want to let the enemy win is good.
Please forward this message to the Medal of Honor guys and let them decide.
I am the wife of a Vietnam veteran helicopter pilot, Robert Mason, who wrote the memoir, Chickenhawk, and we lived with PTSD when it didn't have a name and was not supposed to exist. Bob thought he was a loser, and I thought I was a bad wife or he would not be having problems. If we had known anyone who said they had problems too, it would have helped.

Patience Mason, Editor and Publisher
Patience Press
P O Box 2757
High Springs, FL 32655
Publisher of information on recovering from PTSD
The International Society for Traumatic Stress Studies
American Academy of Experts in Traumatic Stress
" Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed." --Dwight D. Eisenhower

Monday, May 10, 2010

Belleruth Naparstek:Note to Colleagues: Please Stop Saying Post-Traumatic Stress Is Incurabel

If this were anyone but Belleruth, I would be going nuts, saying it's bullshit, but I know Belleruth.
She worked with one of the most effective and innovative PTSD programs in the country, (which of course the VA defunded and closed).
Transcend was a twelve week residential joint PTSD and Substance Abuse treatment program at the Brecksville VA in Ohio. There was a workshop on the Transcend Program at the International Society for Traumatic Stress Studies, probably in 1995, which I went to, and believe me these people, Beverly Donovan PhD and Edgardo Padin-Rivera had the right attitude, and so does Belleruth!
I reviewed the Transcend Treatment Manual and their Workbook for Veterans in the Post-Traumatic Gazette (V1N3, free online at near the bottom of the page. One of Belleruth's CD's is reviewed in V5, N2 of the Post-Traumatic Gazette).
Edgardo and Bev asked Belleruth to make them a guided imagery tape for the guys in the Transcend program. She did. It worked. It helped them. Now that one tape has blossomed into three pages of CD's that can help you heal from PTSD, (
Guided imagery reaches deep into the primitive areas of the brain, the parts that don't really speak English and can't tell time, so they don't know it is over. Those areas are where your non-verbal memories of the trauma are stored, triggering you over and over and over. If you can access them in talk therapy or write about them as Bob did, it turns them into regular narrative memories in your frontal lobes and they are much less distressing. I agree with her that often this is not enough. It can be going at the problem from the wrong end. Get your body calmed down and things will go better in life, and in therapy if you choose to pursue it.
If you can't talk about it (yet), as a lot of vets can't, do yourself a favor and read Belleruth's article and try some of her suggestions. They are working for veterans right now.
And when some future trauma comes along, if you find your symptoms coming back, don't think it didn't work: think it worked once and it will work again, and get more help.
That is my only problem when people say PTSD has been "cured." I know it can be radically improved by various therapies and treatments, but will it come back? Maybe. We don't know. Trauma is cumulative. So instead of saying it will never come back, tell them if it does, get more of what works! Because otherwise the vets just think they failed and they can't be helped.
BTW, eventually there is always a study saying that some good therapy or technique don't work, and when it comes out you can be sure that the treatment was applied in a rote way by VA staff who didn't believe in it and didn't want to do the work or for the treatment to work and probably thought all vets were whiners. That is why some really excellent treatments work at one VA and not so well at another one.

Friday, May 7, 2010

Feeling Warehoused in Army Trauma Care Units

I just found out about this. Read the article by clicking on the link.
Fort Carson was originally cited in 2006 as the place where soldiers with PTSD were mistreated, and guess what, they are still doing it! Imagine my surprise.
The fact is that Army psychiatrists, Army doctors, and Army officers and NCO's have a conflict of interest in dealing with PTSD. They want drugs and discipline, so they can send people back to combat. The conflict of interest is that the medical personnel should first do no harm, and sending someone with PTSD back will only make it worse. This was illegal in Vietnam and World War II. Once you had combat fatigue, you could not be sent back to a combat zone. Of course in World War I they sent guys with shell-shock induced paralysis, blindness, etc back to the front after connecting them up to an electrical apparatus and cranking it till, as the report states, the blind see, and the dumb speak and the paralyzed move. I wonder if they have thought of that at Ft Carson? Maybe I shouldn't give them the idea.
There are no randomized clinical trials of whether sending guys back on drugs, who already have PTSD, is even safe. Israeli studies of veterans of several wars show that people with PTSD get it faster and worse in subsequent wars... But you know, they are foreigners...
From the article, it seems that the medical staff are being ignored and exploited by the chain of command. Their recommendations are not being followed. I believe this is because it is not designated a hospital where the medical staff would be in charge, not the brass. This needs to be changed.
To get back to my original idea, that those in charge have a conflict of interest: the Army, as represented by the officers and NCO's, is in loco parentis to the soldiers, in the place of a parent. There are abusive parents we all know, but the Army doesn't advertise "We'll use you and then screw you over." They say we'll give you a future. They say join us and be a hero, not that we'll make your life hell if you have a normal reaction to too much combat trauma.
The people who get PTSD have the most traumatic events (including childhood events), the biggest losses (severe wounds, friends, belief in God and country or that the Army will take care of them, their sense of self), the least social support (so these Trauma Care Units, intended to be social support, but staffed with ignorant abusive NCO's simply make PTSD WORSE), the fewest resources (not just money, also emotional skill in dealing with painful events, relationship skills in dealing with friends and family, etc.). Human cruelty and neglect make PTSD worse. So instead of helping these soldiers, what they are doing makes it worse.
Of course, the NCO's who are doing this, are probably acting out their own PTSD, emotional numbing, irritability and outbursts of anger, feeling like these losers just don't understand being a real man/soldier like me, unable to concentrate on information about PTSD because they are concentrating on their own (survival) priorities: getting these bums in line. Can I keep my job if I can't keep them in line. It's a heads you win/tails I lose situation for everyone.
I am so depressed by this that I can't even rant.

Thursday, May 6, 2010

PTSD: Get tougher soldier

I came upon this letter by a WWII veteran who called Iraq and Afghanistan "so called wars." I could not believe it. I know there were WWII vets who said Vietnam wasn't a real war. Of course they didn't know that the one year tour often meant the Vietnam combat vet was in combat more than they were because they had long periods of retraining after the big battles.
Italy was hell. So this man went through hell. But why is he so incapable of thought and empathy? Well those are symptoms of PTSD. I'm not saying he has it, just that he has a few of the symptoms.
If you don't think, you can't see what might be worse in this war: Not knowing who the enemy is so you can never relax. Multiple tours. IED's. Horrible wounds which are survived. Remember, they don't just heal and then the person is pain free. The pain continues forever in many cases in phantom limbs and body parts.
This man had uniformed enemies and rules of war. They were welcomed as liberators, not attacked as invaders.
It is worth reading all the comments especially the one by pdxbohica about Audie Murphy and others, and of course, you might want to read my rant at the end of the comments.

Wednesday, May 5, 2010

First Coast veteran’s fall from grace showcases need for PTSD care

This is one of those "heads I win, tails you lose" dilemmas that face veterans and their families. The criminal justice system is rarely interested in the problems of returning veterans.
They need treatment not prison.
We all remember Kojack, the TV detective, saying "Round up all the recently discharged Vietnam veterans," whenever there was a murder. People who were having flashbacks and doing what they were trained to do wound up in prison like Nathan did. And the prosecutor would say to the judge, "This man is a trained killer and a danger to society." One study I read showed that they got longer sentences for the same crimes.
The police didn't know how to deal with veterans in flashbacks or rages, either. Some of them got shot. Some succeeded in committing suicide by cop.
One group, Nam Vets of Alachua County was formed after the cops shot a Vietnam vet who had PTSD. The cops had tried to get help from our local VA Hospital but were told that no one could come talk to him. It was illegal for them to go. Of course, I asked my mother, Constance G. Hartwell, MD, a psychiatrist at the Boston VA Outpatient Clinic, and she said that in Boston they would and could go. Each VA is a feifdom, however, and ours had a bad attitude at the time and the worst PTSD program in the country.
The guys in Nam Vets went out on calls whenever asked. Some of them, and me, took training at the local Crisis Center and worked on the suicide hot line. We need more of that kind of activism.
You can read more about Veteran's Courts here and here
We need to work to make changes that allow for the problems of our returning veterans instead of forgetting about them. Years ago I was at a trauma conference and heard William Mahedy, Vietnam vet, priest, and author of Out of the Night told us that in 1972, they did a survey of the bums on skid row in LA, and 75 percent of them were WWII combat vets. Those are the members of the greatest generation you don't hear about. Today we would call them homeless, not bums. We have a chance to intervene and keep them in homes and out of jail and off skid row.

Sunday, May 2, 2010

If there are three phonies and 30,000 with real claims...

Click on my title to see the stupid AP article.
In one of the stupider articles I have ever read, Alan G Breed makes it clear how little he understands about the VA Claims process. He tracked down three assholes who suckered the system. Did he track down three guys who had had legitimate claims denied, or thirty, or three thousand, or any of the 391,257 claims that are now waiting adjudication? Apparently not, although he does mention one guy whose legitimate VA claim has been repeatedly denied.
I guess denied legitimate claims are just not that interesting.
My experience of the VA claims process is that the compensation system is not on the veterans side. It is slow. It is ponderous. It is full of psychiatrists running veterans through compensation exams in a few minutes, when it should take hours. They get paid the same no matter how long or short the exam is. So the ten minute exam in which the MD asked Bob how he was, and Bob said "about the same" and then the doctor asked him about flying (as a preliminary to put him at ease, Bob thought ) and then said goodbye, got the psychiatrist the same money as a real exam would have. The doctor's write up of this was "the patient reports no problems." Not "I didn't ask him about his problems because I just chit-chatted with him for ten minutes."
I went with Bob to his last compensation exam, with a tape recorder. The woman psychiatrist pointed out to Bob his original diagnosis was for "nervousness." I said "Look at the date!" 1968. "What difference does that make?" she said. She was totally ignorant that in 1968, the American Psychiatric Association came out with the Diagnostic and Statistical Manual II in which PTSD did not appear in any form.
DSMII dropped the category of Gross Stress Reaction (if you had been through a gross [big] enough stress–combat, concentration camp, POW–it could affect you for the rest of your life) and replaced it with "transient situational disturbance" meaning if a trauma like war affected you for more than six months, you were screwed up before you went. This change was not based on any scientific evidence and no one has ever admitted to being responsible for it. A study of WWII combat veterans, Archibald & Tuddenham, Archives of General Psychiatry, 1965, had just reported that twenty years after the war, combat vets were still experiencing startle responses, wake ups, anxiety, difficulties in memory, etc. This was completely ignored. The men who wrote the DSMII, those completely self-centered REMF psychiatrists, turned their narcissistic theories about how war wouldn't have affected them into a reality which would cause problems for a generation of combat vets and other trauma survivors.
May they rot in hell.
Oh, sorry. I guess I got carried away. But having lived through that era, I don't put too much stock in the current brain-imbalance theory of psychiatry in which pills rule.
Then there was the veteran of Hamburger Hill who called me. He was very upset because the VA compensation psychiatrist (this is not the treating psychiatrist but someone hired by the compensation system to do compensation exams) said to him, "Oh, I saw the movie. It couldn't have been as bad as that," thereby ending the exam. (It's worse when it's real," Bob said to me when I was upset about the wounded in Platoon.) This kind of total lack of information and understanding causes people who actually have PTSD to lose their ability to pursue the claim. It triggers them into painful scary reactions as well as makes them feel disrespected, devalued and hopeless, which is what the VA compensation system wants.
One of the guys in my book (Recovering from the War) was told by the St Petersburg VA Regional Office that although he had been shot at a lot and had found his CO in the jungle with his head cut off by the enemy, it wasn't "outside the range of usual human experience" for an infantryman, so he didn't have a traumatic stressor. (Totally false interpretation of the criteria). Of course the St Pete VARO was famous for fucking over veterans.
I'd love to see Mr. Breed do a story on some of our 300.000 plus veterans who are not getting what they fought for (and in many cases nearly died for) instead of one on three crooks.
Perhaps it would be too much effort.

Tuesday, April 27, 2010

PTSD and Sexuality

this article is from The Post-Traumatic Gazette #29, copyright Patience H. C. Mason, 2000.
What did you learn about sex and where did you learn it? Did you learn it through words, actions, or unspoken messages? Did you learn sex was dirty? That only “sluts” liked sex and nice women didn’t? (Words define the speaker, in my opinion). Did you learn sex was necessary for proper physical functioning and “shouldn’t” have emotional content? Or that only love justified sex? Did you learn sex is fun? Or duty? Or that you should do it every chance you get with anything that moves of the opposite sex? Did you learn that sex was a power game, that seducing or even forcing others is a sign of strength? Did you learn that men forced sex on women because they have “needs” and women don’t? Perhaps you learned a good wife always has to give her husband sex? Or that sex is only for marriage, so if you are married you must have sex? These are common misconceptions and stereotypes.
Some effects of trauma:
Child sexual abuse, no matter how gentle, has an impact on children which most grownups cannot comprehend. Children are not interested in having sex. Children want to play and explore and grow, not do the same not-very-interesting thing over and over and over. They are young, immature, with short attention spans, and even if they want to please and aren’t being hurt, it is still the same kind of torture as sitting still in church or being lectured by your mom. Children endure it. Child sexual abuse is often physically painful. When the grownup is also violent and physically abusive, the traumatic effects are even more intense.
Children are interested in love, affection, and attention. Wanting closeness, attention and interest from a grownup are not the same as wanting sex. The betrayal of child sexual abuse is a high price to pay for getting natural needs met. Betrayal intensifies the traumatic effect of the experience.
A woman who was sexually abused as a child or raped as an adult may not enjoy sex, or even be able to take part in it. Women who survive other traumas like war also have problems: Sharon Grant, a Vietnam nurse wrote “By the time I bedded a man/who didn’t smell like mud and burned flesh/ He made love and I made jokes.”
Male survivors of childhood sexual abuse or adult rape may be burdened by shame. It says on the National Organization on Male Sexual Victimization site “To be used as a sexual object by a more powerful person, male or female, is always abusive and often damaging.” see Only recently has it become possible to talk about it. The rape of men by men in prisons caused Stephen Donaldson to found Stop Prison Rape, Inc. He was gang raped in jail after a Quaker “pray in” at the White House in the 70’s. He wrote, “The catastrophic experience of sexual violence usually extends beyond a single incident, often becoming a daily assault...[some] become rapists, seeking to `regain their manhood’ through the same violent means by which they believe it was lost.” ( Men who were sexually abused may not be interested in sex or may use it addictively or abusively.
Although there can be other reasons including high blood pressure medications, diabetes, and alcohol abuse—which all may be related to PTSD—PTSD can cause a loss of interest in sex in men who are not survivors of sexual abuse. Perhaps it is an unacknowledged anniversary. Perhaps something triggered a reaction, but men tell themselves “It shouldn’t bother me” (a numbing ritual), and the numbness extends into sexuality. A man who lost control in combat (or in the streets) and hurt people may lose interest in sex because orgasm is like losing control and unconsciously, he’s afraid he’ll hurt someone. Feeling guilt over not saving someone, or over things done in the war zone, may cause him to deny himself the pleasures of sex and love.
People who put their life on the line can feel so alienated from even their nearest and dearest that connecting sexually is almost impossible. After moving a rotted corpse or seeing a decapitated car accident victim, love and sex are from another planet. In CopShock: Surviving Posttraumatic Stress Disorder by Allen R. Kates, one cop mentions “the sexual, sleep and other dysfunctions,” that keep cops from going home, and another talks about occasional bouts of impotence from being on steroids. (Neither appears in the index however.) The book is a terrific resource, however partly because it lists about a million PTSD and law-enforcement/stress sites and all kinds of other resources.
For survivors of other trauma, especially what is called “duty related” trauma, veterans, cops, peacekeepers, EMT’s, firefighters, sexual dysfunction is not discussed except in jokes. At a workshop on Critical Incident Stress Debriefing, one EMT told a joke about condoms. The six pack for Protestants (Monday, Tuesday, etc, but not Sunday), the eight-pack for Catholics, (Monday, Tuesday, etc,. and twice on Sunday) and then the new 12 pack condoms just for EMT’s: (January, February, March...) The audience (EMT’s) howled with laughter.
During the interviews for my book, Recovering From the War, quite a few of the combat veterans I interviewed said that after a year of combat, sex was “inconceivable” or “impossible” for a period after they came back.
The myth that a real man always wants sex can tear up a survivor and partner when he doesn’t. How does that affect the partner? She may feel unloved, undesirable and full of shame. Learning that this is a common reaction to trauma takes the pain of personal rejection out of it. Unfortunately if a survivor doesn’t know this is a common reaction, he may think or tell his partner she’s no longer sexy because he’s no longer reacting the way he once did and doesn’t know why. This can be an extremely painful and scary experience for a man. He may find himself turning to prostitutes, pornography, or a new sex partner who makes him feel like a “real” man again.
If a partner is perceived as demanding sex, people with PTSD may resist the demands because they need to regain a sense of control over their lives.
On the other hand, a person who is dealing with traumatic experiences may use frequent sex as a way of numbing or avoiding pain. The intense adrenaline rush of sex with a new partner, of cheating on someone, or being newly in love can also serve this function. Men and women can become sex and love addicts, looking for the perfect mate who will fix them, or simply drowning their sorrows in sexual activity.
Traumatic experiences may also affect attitudes towards others. Hating the opposite sex, feeling that all men or women are abusive, homophobia based on child sexual abuse (which is pedophilia not homosexuality) can affect sexuality. Who wants to fool around with the enemy?
People who were sexually abused may feel sex is all they have to offer. It can become the focus of a people-pleasing lifestyle that has nothing to do with the person’s real feelings about sex. When the survivor begins to deal with sexual abuse, he or she may need to set limits on sexuality. This is very hard on the spouse. If you are with a person with PTSD it is important to distinguish between sex and love. Sex can be an expression of love, but it isn’t the only one. Taking a vacation together from sex can be a very loving act by the partner of a survivor.
Survivors of any kind of trauma may have to be in control to the extent that they can’t relax enough to enjoy sex or have an orgasm. Many survivors can’t feel loving or sexual feelings. Some, especially survivors of sexual abuse, can’t feel parts of their bodies during sex. They may be triggered by sexual activity, or triggered by specific words or actions during sex. This may lead them to avoid sex, or have scary reactions, flashbacks, crying and screaming, or trying to fight off their partner during sex. They may dissociate during sex, spacing out and not really being there.
Some people are aroused by acts or attitudes which turn out to be reenactments of childhood sexual abuse. Sex may be associated with power and control or pain. Love is pain.
A survivor’s life may be ruled by body image: The only thing I am is sexy, or I will hide my sexuality under layers of fat or huge clothes. Growing a layer of fat may signal to others, “I don’t have boundaries,” as can the big clothes. Skin tight clothes send the same message. Abusers pick up on it.
A survivor may also feel “I am not worthy so I’ll take anyone, no matter how badly they treat me. I deserve it.” If that is the message you are telling yourself, man or woman, I want you to know that you deserve to be treated by your nearest and dearest like a valued friend, with respect and consideration, in every area, but especially in lovemaking.
Solutions: I think it is impossible to find solutions to sexual problems until they are acknowledged and accepted as one of the common normal responses to trauma. The old idea of “shouldn’t be affected” tends to rear it’s ugly head here and combine with societal attitudes about sex as a contact sport so that it is difficult to see when fun becomes addiction. Sexual selectivity can veer into sexual anorexia, the person with no sexual interest at all. That is another signal that PTSD may be involved.
Sexual difficulties brought on by trauma can be a tremendous blow to a person, magnifying the trauma.
Sexual healing is difficult for those who have been sexually abused or violated. An experience which is by nature sensuous, sweet, and spontaneous has been affected by the perpetrator’s criminal behavior. God or evolution gave us sexual pleasure, so we were meant to be able to enjoy it. I consider sexuality a sacred part of being human. Sex can be a spiritual and emotional as well as a physical union. Enjoying all three aspects is the goal of sexual healing.
Many resources exist for survivors of sexual abuse and much of the information in them can be adapted for other trauma survivors. One excellent book is Wendy Maltz’ Healing Your Sexual Self which I just finished reading. Maltz has a web site at The book has inventories you can take and exercises to try which focus on being both safe and sensual. Taking your time and staying safe are emphasized.
Reading about sexual healing can be upsetting. If you become triggered, distraught, or have the urge to hurt yourself or others when you read about sexual healing, finding professional help is really important.
If you are triggered by sexual activity and want to heal, you can start by making a chart of safe, possibly safe, and unsafe sexual activities (see VOICES in Action Conference Report in Issue #25). One survivor whose safe list consisted of being touched on the right knee when she started therapy regained the capacity to feel safe and sexual one inch at a time, and you can, too.
Even if you were not sexually abused, making a chart of what is safe and not safe can help. If you use sex compulsively, and do things that endanger your life (unprotected sex), your freedom (illegal sex or having sex with drunken/drug-using partners, or pressuring people for sex), or a relationship you value (unfaithful sex) then they are not safe behaviors for you. What do these behaviors do for you? What are they doing to you? Are you becoming someone you dislike? If so where can you find help?
Perhaps you are not doing unsafe sex, but aren’t enjoying the sex you have. Another helpful idea is to listen to your body, which means being in your body, not off in your head or someone else’s head, worrying about what they might be thinking. This is called embodiment. In some senses it is like meditation. It takes practice and concentration to be fully present in your own body, focusing on what you physically feel. When you are embodied, you may also find yourself fully aware of what is pleasing to your partner, too. Awareness of these reactions may increase your pleasure.
Listen to your body. If you want to have sex but your sexual parts are not responding, what are they telling you? What are you trying to prove? Who are you trying to please? It is certainly not kindness or self care to force yourself to perform. On the other hand, as we age, sexual responses are slower. It takes more time and stimulation for older people of both sexes to get physically ready for sex, so more foreplay is helpful. The new anti-depressants can have sexual side effects as can blood pressure medications.
I suspect that as other PTSD issues resolve in therapy, some sexual problems may, too. Emotions that were unavailable to you when numbness prevented pain, like joy and closeness, return, improving sex. Talking and listening to your partner are important skills in any part of a relationship and even more important in this area where so much of our self-worth may be affected. As usual, I think using the word “I” is important. “I feel worthless when I don’t want to make love to you, and then I get angry,” is a lot harder to say than yelling “You don’t turn me on!” but it will probably have a more positive effect. “I feel sick when I smell liquor. It is like my step-father is crawling into bed with me all over again,” is better than “You pig!”
Al-Anon’s booklet Sexual Intimacy and the Alcoholic Relationship could be helpful couples dealing with PTSD. The New Male Sexuality by Bernie Zibergeld suggests ways of reconnecting both with your body and your partner. New books on sex come out all the time. Find one that helps you feel okay about yourself and leads you in the direction you want to go.
Acceptance (yes, trauma affected my sexuality, and that is normal for me) and time, combined with finding effective help, (therapy, books, groups) can heal this area of your life, too.
the end of the article.

To this I would add these resources: is a woman founded foundation which keeps a list of therapists for trauma survivors and publishes books and pamphlets.
In Gainesville Florida they have groups for sexual assault survivors at the local crisis center/victim services which are open to people no matter how long ago it happened.
If you want counseling, I recommend interviewing several counselors (free 15 minute interview, not a paid 55 minutes) and asking what experience they have had with sexual trauma survivors and how they proceed in therapy. When you find someone you fit with, then you proceed. It will hurt, but you survived the traumatic events and you can survive therapy.
Two relatively quick and non-intrusive therapies are EMDR and TIR (traumatic incident reduction) which you can google to find practitioners.
Please also go to and read the free handouts and check out the links.