Saturday, June 20, 2009

PTSD in the News: BIG NEWS DAY

Hello, Blog Friends!

PARASITES OF THE MIND no longer lives at this address.



To keep up with us on a daily basis, please update your bookmark.

See you in the new hood!

(Photo: peglatz)

Friday, June 19, 2009

Treating PTSD Symptoms: Is Your Therapist Right for You?, Part 1

For 8 years I was with a therapist I loved and adored and whom I thought hung the moon. Too bad he wasn't trauma trained. Yes, we made galaxies of progress, but by the end of 8 years that's all I could say. I'd made progress. I wasn't healed. I used to wail at him, "Henry, when will we ever be finished?" And Henry would sagely reply, "You'll know when you get there."

Not good enough.

We all know that according to research conducted by the American Medical Association psychotherapy only has about a 38% recovery rate and even that result takes about 11.5 years. If we're going to be in therapy -- and I really believe in it as a foundation for healing -- then we need to set some ground rules for ourselves. We need to make sure we're in the right therapy. If I knew then what I know now, here's what I would have been thinking:

#1 We need to evolve - If we become stagnant in the therapeutic relationship we're doomed.

#2 Therapists need to be creative - If they feel stumped we're doomed.

#3 We need to make progress that releases us - If we circle endlessly we're doomed.

#4 We need to feel someone's guiding the boat - If we feel unfocused we're doomed.

#5 There needs to be a plan - If there's no structure to our therapy we're doomed.

The bottomline of all of this is that we shouldn't be the ones running the show - we should be partners with someone who knows more and sees more clearly than we do. There were many times I felt Henry didn't give me the guidance I needed to move me toward resolution. It's nice to be able to go into therapy and be allowed to talk about whatever you want. But if you're there because you have nightmares every night - and instead of discussing the cause of them you want to discuss, oh, I don't know just about everything else under the sun - then what's the point?

If a therapist can't gently guide you back to the reason you're in there then what's going to become of your quest for healing? Of course, we don't always feel like diving into the deep. But if a therapist doesn't help us build a framework for doing just that then we can't ever hope to be free.

There's no science to therapy, but even in the hands of a professional we must consider whether or not he or she is the right professional for us. Just because someone has a degree or is highly recommended doesn't mean he or she will be our personal Messiah. Wecan't just sit back, relax and say, "Whatever you say, boss." WE are the boss. It's our lives and healing that are at stake. We can't sit on the sidelines.

Even if the relationship fit is comfortable and supportive we still need to ask ourselves: Is this therapist going to take me to the place I need to go? If you find yourself (as I did) despairing that you'll never be finished, or feeling you're not getting anywhere or feeling that the therapeutic relationship isn't moving you forward toward freedom then it may be time to assess if it's the right relationship for you where you are now. We are all on a continuum. What's right at one moment can change in the next and we need to be aware of those shifts, and also, when it may be time to seek new help -- not as a decision made on the fly but as the result of some careful thinking and assessing of where we were, where we are, and where we hope we're going.

What are your experiences in therapy? Did one therapist take you all the way from struggling to healing?

(Photo: Lauren Anabela)

Thursday, June 18, 2009

Meandering Michele's Mind: Recognizing the Role of the Obvious

From the day my trauma ended through all the 25 years I struggled with PTSD undiagnosed through the following years of my healing one thought was always bigger and more constant in my mind than any other. One thought followed me wherever I went, no matter whether I was having a good day or a bad, spiralling or healing -- it didn't make a difference. This one thought was there, more a part of me than my shadow. It constantly resonated in my head and drove every action, reaction and desire I had. It was the reason I got up in the morning and the reason I couldn't fall asleep at night. It was how I celebrated my survival and how I condemned myself for surviving at all. It defined who I was even as it stripped me of my identity completely.

And yet, it never occurred to me to discuss this thought in therapy. It had become as familiar as air, as involuntary as breathing, as unremarkable as a sigh. There were bigger, more terrifying thoughts and I spoke about them and cried and raged and carried on. And yet, I came to find out later, it was the one thought I never realized I should articulate that ended up being the very crux of my entire PTSD experience.

I have to make my survival worthwhile.

It wasn't enough that I survived; I had to be worthy of surviving. But I didn't feel worthy at all. Instead, I felt that my life having been saved was a waste if I didn't do something extraordinary with that life. Only problem was: I was too fractured to do anything, and didn't know what to do anyway.

So the years went by and this thought morphed and grew and became the monster behind my anorexia, insomnia, flashbacks, dissociation, rage, depression, anxiety and fear. It itself became a fear. Every day I put myself through tests to keep my body and my mind conditioned to survive again, and to ensure that I was worthy of another second chance. Every day a part of me melted into a pool of butter in the frustration of not knowing who or what or how to be a survivor who was worthy of saving.

Still, I never told anyone about this idea. In therapy I spoke about my fears of my body and the horrific elements of my trauma. I vented about what went on in my head and my body that could not be explained, contained or managed. I cried that I was too weak to heal. But I never told my therapist I didn't believe I was worthy of surviving much less healing. A small detail that really might have helped us both make more progress more quickly.

When I finally did admit this thought - because I'd eradicted all the others and it was the only one left! - it was because I'd progressed my healing to a place that I could see that this was a thought operating all on its own, independent of me and harming me each day. It was the reason my PTSD stress was so bad my hair fell out. It was the reason the nightmares came night after night. I was the reason I couldn't 'let it go'.

And then I let it go and the whole world changed. I sleep at night. Not just a solid, dependable 7 straight hours but deep, peaceful and rejuvenating sleep. I see the world as open possibilities instead of a pressure cloud sitting on my head. I feel a resonance in myself because I am no longer critical of my right to be here in my self, in my body, in this life.

I'm wondering today how many of us, when we seek help, forget to mention the most important, most obvious things. It's so much easier to talk about the big, universal PTSD symptoms. How often do we forget to hear our inner dialogue and say, 'Forget all that other stuff, here's what's really driving me crazy.' How often do we even recognize what's at the root of our PTSD experience because it's become so familiar we accept it as normal? How often do we accept what we shouldn't?

How often does our healing stall because we forget to mention one not-so-tiny critical detail?

(Photo: Stallard Images)

Wednesday, June 17, 2009

Healing PTSD Symptoms: Our Stigma Against Seeking Help

Why does it take so long for us to accept the fact that we need help?

Why don't we know and admit immediately that we're living a life that's not exactly whole?

For years and years I existed in a sort of psychological bumper cars, accepting the constant full-body crash of the PTSD symptoms insomnia, rage, hyperarousal, hypervigilance, emotional numbing, dissociation, intrusive thoughts and flashbacks -- as if that's all in the course of a regular day, for everybody.

I look back on those years now and....

  • I'm struck by the sadness I thought my life was meant to be.

  • I'm in awe it didn't occur to me that I needed help.

  • I'm shocked I didn't think specific help existed for survivors, or that our situations absolutely require it.

  • I'm amazed I believed trauma could be self-contained.

  • I'm proud I was tough;

  • Not so proud I forced myself to suffer.

  • I'm impressed I determined to cope alone;

  • Not so impressed I never recognized that idea wasn't the greatest I'd ever had.

  • I'm a little annoyed that my Ego -- so determined to keep me isolated --ran the show for so long;

  • Not so annoyed that I don't appreciate how it helped me survive survival by propping me up.

  • I'm stunned by the all-encompassing idea that if you survive trauma you must be strong enough to survive what comes afterward;

  • Not so stunned I perceived 'help' as admission of weakness.
Our psyches are designed to do whatever they can to protect us. Dissociation, for example, in all of its forms, is a coping mechanism - a survival mechanism - that kicks in whenever events threaten to overwhelm us. Not such a leap that that very same protective part of us steps in and starts directing traffic on our road to recovery. Healing is rife with jack-knifed tractor trailors of our emotions and memories. The psyche polices it all so that we feel safe.

But as in most instances of the PTSD puzzle, this overprotection actually hurts us more than it helps. It provides us with limiting beliefs about ourselves, recovery and how we're going to live. For a long time my own erroneous ideas about 'help' stopped me from moving toward wellness.

It took many, many (metaphorical) head-banging years for me to understand: NOT seeking, finding, accepting, receiving help is the WEAKNESS. The ultimate strength is not surviving or coping and managing symptoms but commiting to overcoming PTSD so that it does not rule our lives.

Those of you in various stages of healing know what I mean when I say, healing is much tougher than living with PTSD. Living emotionally numb is a picnic compared to enduring the excruciatingly slow peel of the onion that, for example, allows emotions to gradually return. Living in a dissociated state is so incredibly easy compared to the (initially) magnified intensity of being present in every moment.

We have to be tough. We have to have courage. It's takes guts to seek help because that can be the beginning of the end of PTSD and that means redefining a whole self to live in an entirely new way.

Our stigmas against seeking help may be designed to make us feel safe, but it is our actions against them that are the heroic acts we take that eventually bring us to a place of emancipated security.

It's so very much easier to live in the darkness than to force our eyes to adjust to recovery's blinding light. In order to heal we have to get over our own stigmas about seeking, asking for and finding help. We have to stand, that little bit on our own, and say/shout/scream/mutter/whisper - to ourselves first of all! - those three magic words: I NEED HELP.


At every stage of the healing process there are times we resist help. From before we admit there's a problem, through our 5th or 6th or 7th year of therapy we hit blocks that stop us from saying, "I need help". We can't move forward until we identify these moments, recognize what they're about, and commit to getting around the natural blocks our psyche puts in our way.

Today, consider where you are on your healing journey -- beginning, middle, near the end? Sit very still and allow any resistance to the process to come up and make itself known. Say hello to it; and then book it with mug shot and fingerprints. Our aversions to getting help are the criminals running around the neighborhood of our recovery. They've got to be apprehended and sentenced to life. In order for our lives to progress we've got to eliminate the stigmas, ideas and misconceptions that keep us from seeking the help we need, both from new people and those already in place.

Wherever you are in the healing continuum, there's going to be resistance. Think about where you are in the process. What ambivalence do you feel? What ideas are you chafing at?

What remains your biggest fear about healing?

What's holding you back from seeking (more) help from new or already existing relationships?

Get control of all this stuff swirling around. Write it out:

1. Make a list of 5 things stopping you from asking for help.
2. For each item on the list, write an explanation about why you're feeling this resistance.
3. Determine one action you can take to override that resistance.

(Photo: digitalgopher)

Tuesday, June 16, 2009

Dr. Alex Pattakos & I: Bridging the Gap Between Trauma and Meaning

So today I spoke with the one and only Dr. Alex Pattakos (that's Dr. Meaning, to you!) and he had some very interesting things to say about how the search for meaning applies to trauma healing.

A quick overview:

Logotherapy - This is the psychiatric core of Pattakos' theories. 'Logo' = Greek for meaning, soul, spirit.

Logotherapy is the spiritualization of psychotherapy.

Inherent in each of us is the desire to find, feel and live a meaningful life; the pursuit and achievement of this enables us to transcend trauma.

Without meaning we feel hollow. Finding meaning elevates the human spirit.

Core principles of Pattakos' book, Prisoners of our Thoughts:

  • We are free to choose our attitude.
  • We can realize our will to meaning by making a conscious commitment to meaningful values and goals.
  • We can find meaning in all of life's moments
  • We can learn to see how we work against ourselves
  • We can look at ourselves from a distance and gain insight and perspective
  • We can shift our focus of attention when coping with difficult situations
  • We can reach out beyond ourselves and make a difference in the world

Existential digging in relation to trauma -- 4 questions to ponder after an event:

  1. How did I respond?
  2. How did I feel in the situation?
  3. What did I learn cognitively?
  4. How do I grow and develop because of what I learned?

Dr. Pattakos had a lot of interesting things to say, and great examples of how his ideas have been applied to large scale trauma response. To hear our entire conversation, follow this link:


(Photo: topgold)

Survivors Speak: Poetry of Vietnam

I met Gary Jacobson in the phenomenal Yahoo! Group: Combat Vets with PTSD. I love this group. They are a terrific community of vets and significant others all of whom are dedicated to a healing path that nurtures education, connection, comaraderie, compassion, knowledge and proaction. It’s a group of people all over this continent who support each other and work together to figure out how to navigate not only the VA system but also the emotional and physical circuitry of Combat PTSD.

Gary is a Vietnam vet who also happens to be a poet. I asked if I could interview him about the intersection of PTSD, healing and poems. He agreed and has been extremely generous in illuminating the path of a healing vet. Over the next month or two Gary’s interview will appear as a series of posts, each one answering one of my questions.

For today’s post: Gary’s introduction of himself and a brief answer about how he first came to poetry as a medium, followed by his poem, ‘One Tin Soldier.’ And now I give you, Gary Jacobson….

Let me first introduce myself: This is Gary Jacobson. I was sent by my rich uncle to work in his vineyards in a land all white and ready to harvest ~ Vietnam. I served with B Co 2nd/7th 1st Air Cavalry ‘66 - ‘67, as a combat infantryman … we called ourselves “Grunts,” operating out of LZ Betty near beautiful downtown Phan Thiet, Vietnam. Mine was the same unit depicted in the Mel Gibson movie, “We Were Soldiers,” only one year later.

Vietnam changed us all indelibly and forever. I’m now on 100% disability rating with an extra hole in my head, covered by a 3X4 inch plate, shrapnel the size of a quarter currently imbedded three inches into my brain … this all compliments of a trip wire booby trap that triggered a grenade, that in turn detonated an artillery round … and in the process completely ruined my whole day … April, 22, 1967, during combat operation in the boonies near Phan Rang, Vietnam.

What, if any, relation did you have to poetry before using it as a therapeutic method?

I graduated with a BA from Brigham Young University in Communications, Journalism, Advertising, Public Relations, and Broadcasting. I also attended the University of Utah, Oklahoma University, Southern Utah University along the way … my education delayed by serving as a church representative in England for two years, and then by Vietnam.

I toyed with poetry in several classes, but never really took to it, or really never did well in it at that time. It is strange to me, totally shocking even, that when I started to write and reveal myself about Vietnam, I chose the medium of poetry … really, I sincerely feel it chose me. It almost came unbidden, almost like automatic writing.

One Tin Soldier

One tin soldier
American warrior
Left his valley of milk and honey
Abundant life so rich and sunny
To bring peace unto the world
Spread before him in great vastness unfurled.

He wanted naught but mankind to help
This freshborn naïve whelp
Still abiding in carefree callow youth
Drawn unknowing into war’s violence uncouth
Innocent to horrors, life and death on the line
Intrinsic values in spiraling decline.

One tin soldierMarched to be his country’s savior
Taken far, far away
Thrust headlong into battle’s heated fray
Facing men preoccupied with killing, handed a gun
Killing was at first indeed no fun.

Some soon became addicted to the killing
Some could not live without its fever thrilling]
Losing the love once held so essential
To being’s essence now grown dysfunctional
Reborn into a hard corps fighting machine
Most efficient warriors the world’s ever seen.

Lost forever was the young boy’s naiveté
He forgot how to pray
Only living to survive
Fighting so he and buddies might stay alive
To make it back to the world
To find again his lost peace like gold.

Now the man-boy at last comes home
Looking for his soul to atone
The war aching in his belly like a stone.
He had lost himself
In war’s treacherous gulf
His ideals long abandoned on a shelf.

He was to others, himself included, adversarial
Hostile with only one thing in mind antisocial
Humanity a bartered credential
Lost was the boy in shadowy forest lair
Hot home of the Vietcong who dare
Dare these but callow youth to venture there.

Still he sees enemies smirking
Their eyes red coals burning
There waiting to kill in every crowd
Wartime adrenaline talking overly proud, too loud
Finding it hard again to trust
Trust lost in mud, blood and dust.

Beaucoup violence now become a learned way of life
Dinky dau antagonisms gained in the warrior’s strife
Drinking too hard to quell nagging memories
Giving no peace to these wounded in spirit ambulatories
Visited at night by flash-back-stories
Rife with anxious anxieties cruel war’s depositories.

He’s afraid to make friends, because they too will die
He’s lost the connection he once had on high
Now visited nightly by brothers who died
Painfully, bloodily, swept up in war’s tide
Seeing one-by-one grinning faces grown grotesque
Statuesque men he killed in macabre war burlesque
Oceans of tears belie a war once thought humoresque
Bound forever to remember his walk in the park picturesque.

Gary Jacobson is the webmaster of “Vietnam Picture Tour,” pictures with a story of a walk in “the park” grunts called Vietnam, with the 1st Air Cavalry on combat patrol, and welcome your visit there. Experience chilling reality with beaucoup combat action pictures and poignant poetry to leave the sweet and sour taste of “the Nam” pungent on your tongue, the smell of “the Nam” acrid in your nostrils, and textures of “the Nam” imbedded in you as though you walked beside him in combat. His personal pictures are all in this “Vietnam Picture Tour“. His Poignant Poems Index contains combat action pictures, artwork, and stirring music, each portraying an aspect of life in the Vietnam war he feels heavily embedded on his soul, entangled in him, and around he, the average American boy-next-door at war…

‘Survivors Speak’ is a weekly feature written by or interviewing a survivor/PTSD experiencer about some positive aspect of healing. If you would like to participate in the series (anonymously if you prefer), please email thoughts, ideas, and topic suggestions to Michele: parasitesof.themind @

(Photo: Gary Jacobson)

Monday, June 15, 2009

Meet Dr. Meaning a/k/a Alex Pattakos; BTR Interview on 6/16

Dear Fellow PTSDers, it is with great excitement and honor that I'm announcing my interview with Dr. Alex Pattakos, on Tuesday, June 16 at 11:30am EST.

Known around the world as 'Dr. Meaning', Pattakos is the protege of Vicktor Frankl, the trauma survivor who developed the therapeutic system of Logotherapy.

Pattakos is the author of the internationally celebrated book, Prisoners of our Thoughts, and the founder at Center for Meaning and Principal of Innovation Group.

Join us while Dr. Meaning and I discuss
Are We Prisoners of our Thoughts: Healing Trauma through the Search for Meaning

The interview will take place here, on BlogTalk Radio.
11:30am EST

Tuesday, June 16th

If you have questions for Dr. Pattakos and I you can join the interview by calling 347-637-1847.

Treating PTSD Symptoms: Being Present in the Search for Therapy

When we enter into the therapeutic relationship, how focused are we? If you’re anything like me, not very. I was a mess. Such a mess (and so against being in therapy) that I didn’t actually choose, seek out, or decide upon my therapist. I hit rock bottom; splatted against a wall of depression and powerlessness, and then let someone else push the pieces together and into my therapist’s office. Sometimes, that’s just the way it has to be done. Sometimes this is the only way for us to make the decision to seek help — by not making a decision at all.

This isn’t, of course, the most self-empowering way to go about healing. No matter how difficult it is, we need to force ourselves to be present, just for a few minutes each day, to make determinations and decisions about how to help ourselves. For a few minutes we need to use all our energy to push the symptoms aside and ask the right questions. For example, Am I in the right place?

At first glance, my therapist, Henry, seemed perfect. He was kind, soft-spoken, intelligent, compassionate, the head of a psychopathic institute. I felt comfortable with him. I could speak easily and freely. He knew all about different therapy modalities, including CBT, EMDR, TAT, EFT, and TFT. We used them all. And we made progress. So, what was wrong?

Henry didn’t know anything about PTSD.

OK, to be fair, even I didn’t know I had PTSD at the time I began therapy. All we knew collectively was that I was one emotionally unstable girl with a slew of mysterious, undiagnosable and debilitating physical symptoms. But right there is the reason why we need to make sure we’re in the right place. The right therapist would have immediately been able to put the pieces of the puzzle together. If you have trauma in your past make sure you have a trauma trained therapist in your present. PTSD diagnosis or not, trauma training will be useful!

I spent 8 years on and off with Henry. I made great strides. I went from being unemployable because of my PTSD symptoms to holding a job, going through a post-graduate degree program, and falling in love (at the age of 33) for the first time. Good progress for someone who began therapy thoroughly depleted in both emotional and physical realms.

The problem was that even as I got better, I wasn’t getting better. My PTSD symptoms were still incredibly prevalent and my physical state continued to evolve and decline. While I found the strength to push through and refused to be bedridden again, what was happening in my body was frightening and extreme. By the time I moved from New York City to Florida I was on the verge of quitting yet another job because I just could not keep pushing my body to do so much when organs weren’t properly functioning.

The question is, why didn’t Henry make the PTSD-symptoms connection? Why didn’t he recognize there was a name - and so a protocol - for treating what ailed me? Why, indeed.

The simple answer: he wasn’t trained to. Henry specialized in spirituality and psychotherapy — a great combo when I started, not so great for healing the underlying cause of all my problems.
After 8 years and a big relocation and the gnawing feeling that something was still very wrong with me and so it required research, I led myself to my PTSD diagnosis, all alone.

My journey to a new therapist and PTSD began with my decision to research my trauma. For so many years I’d been avoiding learning about the details of my illness. Toxic Epidermal Necrolysis Syndrome (TENS) is very rare. I’d never met anyone else who’d suffered from it or had even heard of it. I decided to educate myself. I decided to speak to and connect with other survivors.

As I read everything I could about TENS an interesting thing happened: the words ‘trauma’ and ‘traumatized’ popped up a lot in the literature. Naturally, I began reading about trauma. In the trauma literature, the words ‘posttraumatic stress disorder’ frequently appeared. I looked up the definition. I took the self-administered quiz. I was shocked to find I had all the symptoms. Even more shocked that Henry had never mentioned PTSD. In our next session I asked what he knew about PTSD. He confessed he didn’t.

I decided I needed another opinion; I decided to find a trauma therapist. This decision is what led me to Holly, who was able to explain how dissociation worked and why I was using it so much just to get through each day. She was able to set me straight about trauma and how we get so lost in the vortex. She was able to support my own efforts and let me know the path I’d been defining for myself - of education, integration and proaction - was a good one.

I didn’t stay with Holly for very long. I’d already been through all the therapeutic modalities and was frustrated with the process. I didn’t want to do it again, even if it was going to be more properly directed this time around. I abandoned therapy and struck out on my own on a quest to do two things: integrate my traumatic memories and construct a post-trauma identity.

My conversations with Holly, however, gave me an invaluable gift: as a trained trauma professional she helped me build a framework and perspective for what I was experiencing now instead of only working with what happened then.

Sometimes, just a little perspective adjustment makes all the difference.


Time to take stock of the help you’re receiving. Is your therapist trained to help you? We can love our therapists, but if they don’t have the training to take us to the end of the PTSD road - or if we don’t connect with them in a way that facilitates progress - then we can’t remain with them. Separating can be difficult and tumultuous, but we owe it to ourselves to have the proper care.

In future posts we’ll cover how to choose the right therapist. Today, just consider your relationship with your therapist. Do you feel you’re making progress? Become aware of your attitude and interaction. Are you frustrated, stagnant or moving forward? Do you feel safe, in good hands, directed or lost? How do you feel about your therapeutic experience?

Our attitude is everything. If we don’t have the right one in and about therapy there’s a fundamental problem in the foundation of our healing.

Have you switched therapists? How did you realize a change was necessary?

(Photo: jswolfsberg)

Sunday, June 14, 2009

Professional Perspective: Dialectical Behavior Therapy & PTSD, Part 1

I met Laura Burlingame-Lee when I stumbled upon her blog, The Other Side of the Couch. I immediately liked her personable voice and her incredibly educated and knowledgeable approach to communicating with those of us on, well, the other side of the couch!

One of her posts referenced Dialectical Behavior Therapy (DBT), something I'd never heard of before. I wrote asking for details and voila! In the spirit of spreading the healing word Dr. Burlingame-Lee wrote this guest post, just for 'Parasites of the Mind'. In the way that DBT combines skills training with therapy I think it's a very interesting approach to healing. Today, Part 1 of a two-part series giving us an overview of DBT - what it is, how to use it, how to develop its skills and how to incorporate it into your recovery process.


Dialectical Behavior Therapy (DBT) is a specific type of behavioral therapy that was developed to treat Borderline Personality Disorder (BPD), a condition where the person involved has chronic feelings of depression, anxiety and suicidality in addition to volatile personal relationships and trouble regulating emotions and mood. The overall goal of DBT is pretty straightforward: to help you create a life worth living.

Ok - a lot of this sounds pretty technical, doesn't it? I have to say, I really hate, despise and abhor the term "personality disorder" because it implies that there is something fundamentally wrong with the person. So, how does this relate to PTSD? There are some mental health professionals and researchers who believe that BPD is actually a chronic, severe form of PTSD. Many, many people diagnosed with BPD have severe and/or chronic trauma in their past and really don't know how to cope with stress, anxiety and/or anger along with ups and downs in relationships. Marsha Linehan, the psychologist who developed DBT, once said that the person with BPD was like a person with 3rd degree burns - extremely sensitive and very easily irritated; the difference was that the problem here was emotional rather than physical.
Some of you, even without BPD, may have or do feel overly sensitive on occasion. PTSD involves its own set of overwhelming, frightening, and anxiety-producing symptoms that DBT skills can help.


DBT is a system that's designed to help a person deal with overwhelming emotions (anger, rage, fear, panic) and urges (self-harm, suicide, harming others) and to increase quality of life by strengthening relationships and increasing the person's ability to cope in general. DBT in its full form includes individual therapy with a DBT-trained therapist and a skills-training group. We'll focus more on the skills training group in most of the post, but I'll give you an overview of the individual therapy as well.


In DBT, individual therapy is more oriented like traditional Cognitive Behavioral Therapy (CBT - we've got a LOT of acronyms here, don't we? J). Individual therapy looks pretty similar to a lot of other types of therapy, with the exception that the individual therapist will work with you on both accepting you as you are and helping you work for change. That sounds a little weird, doesn't it? Like trying to find the balance between two ends of a see-saw, where it seems like both goals are pretty opposite each other. That's what a dialectic is - a situation where you have two things that seem opposite but are both true.

Individual therapy works on this dialectic because nonjudgmentally accepting you as you are is crucial for developing a good relationship, and because working on change is the goal - changing so that you can reduce the things getting in the way of creating a life worth living. The bottom line is that your individual therapist will help you reduce the stuff that's getting in the way of healing and living the life you want, and also help you increase your ability to cope by reinforcing the skills taught in the group and by helping you process the experiences you have in using these skills.


Before you understand what skills training is, it's helpful to know what it's not. DBT skills training is NOT a group designed to explore traumas, examine and process the past, or come to terms with the traumatizing event(s) - this is done with your individual therapist. (This is also why DBT works best when you also work with an individual therapist and/or psychiatrist who is trained in DBT and other supported therapies like CBT.) Ideally, someone with PTSD would use DBT to help her or him cope with the overwhelming emotions and self-harm urges that often accompany PTSD while also working in individual therapy to help understand, come to terms with, and process/heal from the trauma. A combination of DBT skills training groups and a CBT/DBT therapist works really well.

Another misunderstanding of DBT is that it's a quick and easy way to fix symptoms - most of you, I'm sure, know first-hand that dealing with PTSD and its symptoms is practically a full-time job (and I'm NOT saying that in jest - it takes a lot of energy and strength to cope and even more to progress and heal. I have tremendous admiration and respect for all of you who work so hard to overcome what's hurt you. That takes guts!) DBT was designed, believe it or not, to be a long-term therapy - Linehan had her clients sign a two-year contract!

To learn more about practicing DBT skills, why skills training is so effective and what comes after training, check back here next Sunday for Part 2 of Laura's professional perspective.

Laura Burlingame-Lee, Ph.D. is a recent graduate who obtained her doctoral degree in counseling psychology from Colorado State University. She is currently pursuing licensure in this field, and is available to answer questions concerning DBT and a variety of other topics. Laura has had personal and professional experience in dealing with PTSD, Depression, and Anxiety, in addition to extensive clinical training and experience in treating Borderline Personality Disorder and other chronic and severe emotional issues. She completed her internship at the Colorado Mental Health Institute at Ft. Logan in Denver, Colorado and is looking forward to beginning her practice as DBT-trained therapist. She generally works with CBT and DBT, but also brings in mindfulness and spirituality as well as other aspects in order to work holistically with her clients. She can be reached via email at: theothersideofthecouch @

(Photo: Laura Burlingame-Lee)

Saturday, June 13, 2009

PTSD in the News: Weekly Roundup

Back in the News saddle after a week of trauma conference coverage and other bumpy life things.

This afternoon I hosted a BTR show: ‘Bridging the Gap Between PTSD and The People Who Love Us’ — fabulous interview with my mom and Deb Vaughan, two people who have gone to great lengths to support survivors in recovery. For tips about how to facilitate communication and proactive healing, listen to the archived show here.

In the PTSD spotlight lately:

Civilian PTSD

Study: Female Police Officers May Hold the Key to Understanding Gender Differences in PTSD - Gender differences in the intensity and frequency of posttraumatic stress disorder (PTSD) may not relate to biology as much as psychology, according to a new study of nearly 300 females - civilians and police officers.

AIG Balks at Claims from US Airways Jet Ditched in the Hudson River - Ms. Sosa said Sophia “remembers everything. I just want her to walk away from this knowing that we did everything we could to make it make sense.” A.I.G. agents have told her that for therapy she should use her own health insurance, but it has a $3,000 deductible for mental health care.

EMDR Helps Jewish Family and Children’s Services - ‘EMDR doesn’t erase the memory,’ says Barbra Quade, director of child and adolescent traumatic stress services at JFCS. ‘What it does is help people deal with their trauma so that it isn’t so troubling to think about.’

Childbirth Can Trigger PTSD - When you think of post-traumatic stress disorder, chances are you think of soldiers returning from Iraq or victims of sexual abuse. However, few people realize it can also be triggered by a long, complicated childbirth. Now, moms and medical experts want to spread the word.

Lifespan Integration Therapy - “Lifespan Integration is a new therapy that facilitates rapid healing in adults who suffered abuse and/or neglect while growing up. LI connects a current problem to a past memory and uses imagery to re-visit that past memory and resolve what happened.” Familton says. “One of the best aspects about LI is that clients do not have to talk about or sit in the difficult memories or emotions of past trauma.”

Emotional Freedom Technique: Forgive, Release, Let Go, Move On! - Although Rich had a difficult time believing that these rather strange procedures would work for him, he was open to giving them a try. After practicing EFT for 15 minutes, his height phobia went away. Then, after applying EFT to a few of his intense war memories, in about one hour they were neutralized.

Heroes & Healthcare - Reggie took her kids and moved to Oklahoma City in September of 2002. Because of the OKC bombing in 1995, Reggie believed doctors there knew enough to treat her children who were also suffering, along with their mom, from Post Traumatic Stress Disorder (PTSD).

Black Women Bear the Burden of Domestic Violence - Poor health ratings are far greater among African American battered women than for non-Hispanic white women or that of the general female population; post traumatic stress disorder is considerably higher.

Combat PTSD

Purple Heart Veterans Help New Generataion of Wounded - Older vets encouraging new veterans to seek treatment for Post Traumatic Stress Disorder.

Why Army Suicides Continued to Rise in May, And What We Can Do - The news gets more and more troubling when it comes to Army suicides, which continue on a record pace, according to the latest report. March and April saw 13 suicides each. May saw 17 suicides. The Army is taking the issue much more seriously, trying to stop the trend.

Battlefield Accupuncture - It was recently announced that the U.S. Air Force will begin training physicians being deployed to Iraq and Afghanistan in battlefield acupuncture.

U.S. Military Uses Alternative Medicine - The U.S. military is known for using super secret codes to identify sensitive projects. The key word here is sensitive. Who would have thought that the US military has a softer side? Project code name: iRest, short for Integrative Restoration, a code name for yoga nidra.

Education Key To PTSD Related Issues - ”Ignorance always feeds the fear of mental health injuries, and if you empower the people with the knowledge, it will definitely work in your favour to reduce the stigma,” Doucette said Wednesday.

Awareness is Key As Soldiers Return Home - Of the 1.5 million soldiers deployed to Afghanistan and Iraq since 2001, an estimated 5 to 10 percent have mild traumatic brain injury, and up to 60 percent of those also have post-traumatic stress disorder.

Homeless Vets Does Not = PTSD - Combat-related post-traumatic stress disorder (PTSD), has been found not to have a direct relationship with homelessness. Further, it has also been found that homeless combat veterans were no more likely to be diagnosed with PTSD than combat veterans who were not homeless.

Wounded Warrior Program Offers Massage & Facial Therapies - Massage, facial and related treatments are part of the recovery regimen at the Wounded Warrior Transition unit at Ft. Belvoir.

Pentagon Investigate Pill-Popping PTSD Prevention
- The Pentagon’s advanced research arm is hoping that a combination of neuroscience, psychology, and creative pill-popping can stop battlefield stress before it even starts. Darpa is hosting a one-day information session to solicit proposals for “Enabling Stress Resistance” among troops. They’re hoping to harness advances in molecular biology (the science of cell-to-cell interaction) and neuroscience that would short-circuit the brain’s stress response.

Understanding Post-Traumatic Stress - As well as PTSD being far less common than many believe, the former lieutenant colonel, who served in the Balkans and Rwanda during his 25-year Army career, emphasised that sufferers could nearly always be returned to full health: “The worse the traumatic event, the greater the possibility of troublesome symptoms but the overwhelming majority of PTSD cases respond well to treatment,” he said. “It is simply not the case that it is incurable.”
(Photo: birdfarm)

BTR Show Today

Today at 2:30pm (EST) I will host a radio show on BlogTalkRadio:

Bridging the Gap Between PTSD and the People Who Love Us: What Every PTSDer Needs to Know About the View From the Other Side

Guests for the show will be my mom, Eileen Rosenthal, who stuck by and did not abandon me (despite all the reasons I gave her to do so!) through 25 years of undiagnosed PTSD hell.

And Deb Vaughan, who runs the 'I Love Someone With PTSD And I'm Not Alone' group on Facebook. A few things to know about Deb and her PTSD mission:

  • Making a difference has always been important to me. I became involved in service organizations in high school.

  • My work with PTSD is personal. My partner has PTSD and I have friends who struggle with it as well.

  • I think it's important to erase the stigma, increase awareness, and dispel myths. Until we do these things psychiatric programs will never get the funding they need.

Topics will include:

  • How supporters feel in the midst of the PTSD struggle before diagnosis.

  • The most difficult thing about watching someone struggle with PTSD.

  • How to communicate with someone who has PTSD.

  • Advice for anyone supporting a loved one with PTSD.

To listen to the show live click here. Afterward, the show will be archived on the BTR site here.

If you'd like to participate in the interview, feel free to call in with comments and suggestions at (347) 637-1847 .

Friday, June 12, 2009

Getting Rid of PTSD Symptoms: Seeking a New Kind of Help

Can't help myself from looking back over the past week and recognizing how important it is to revamp our ideas of who to consider when we're seeking help. It's easy to get stuck in the rut of thinking only clinicians, therapists or trained practitioners can help us. But there's a whole world out there! Help can come in many different forms and from many different sources, from neuroscientists to dance instructors. We have the opportunity to seek help openly or privately in just about any area, aspect or outlet we can think of.

Which means we need to think. We need to approach healing not only from a clinical, DSM IV viewpoint but from the creative view of the whole person. We are more - so much more! - than our PTSD. Developing other areas of ourselves empowers the healing process. It reconnects us to ourselves outside of trauma; it helps us develop a post-trauma identity which gives us the strength we need to eschew the past. Sometimes, seeking help means finding a new therapist. And sometimes, it means finding another perspective from a source that doesn't know our story.

David's answer to my question about our own ability to heal our minds means we are not doomed to live with an imbalance between amygdalic and hippocampal activity. The neural pathways can, without a doubt, be shifted, rerouted and rewired - not because we are more or less damaged than someone else, but because that's the way the brain is programmed to perform. And also, because we have the power to use our minds for this.

I sought help for understanding a concept and received a Get Out of Jail Free card: PTSD is a creation of the power of the mind, which means we can use that power to create healing, too. If our psychological experiences can affect our healing, then we need to consider how we can create experiences that fill us with joy and thereby balance out, reverse, and negate the effects of trauma. (Who can help you do that? What friend, expert, regular person has experience that can help you evolve as a person outside of your trauma? What have you always wanted to do that would bring you pleasure; who can help or teach you to do this?)

Neurofeedback seeks to retrain the brain by activating and exercising specific areas; experience can do that, too. We must take an active role in creating our present and our future - in helping to rewire the brains we find so draining.

It all boils down to this: when we reach out and seek help - in the form of education, experience or therapy - with and from the right people with the right sources, experience or proper training - we learn things that impact our perceptions and lead to new thoughts, ideas, healing possibilities, actions and eventually, healing itself. Even where I am on the healing spectrum I have questions about my experience. Even for me, seeking help in understanding and framing my journey is a useful exercise.

David gave me the gift of knowledge - a gift, like all on the healing path, I would not have gotten had I not sought it out. As survivors there's the impulse to accept PTSD because we don't have the will or the means to counteract it. But that's an enormous error on our part. We all have to participate. We need to engage. We need to ask the questions. We need to seek the help. We need to move through the fog with a hand outstretched and our voices echoing.

Identify one person outside the clinical realm you could approach for help in combatting PTSD. Always wanted to learn guitar? Find a teacher. Want to become a stellar quilter? Find someone who runs a quilting group who can hook you into the community.

The goal is to find someone who can give you what you need beyond therapy. What person can you engage in an exploratory conversation? Who can you sign up with to develop a new skill that will reconnect your body and your mind, or distract you enough to get out of your looping mind for a while? Choose a non-clinical person to approach for help, then start plotting how to introduce yourself.

[Note: This can be an entirely private activity. As I did with my dance instructor, you do not have to tell anyone why you are seeking the help you do. I told Bill I simply wanted to learn to dance. Only I knew that by learning to dance I was making a desparate attempt to save myself from a life of PTSD.]

(Photo: shmilebliK)

Thursday, June 11, 2009

Meandering Michele's Mind: In Memorium -- Bill Hering

For those of you who've been following this blog for a while, you know I'm a dancer and how much dance had to do with my PTSD recovery. When all therapies failed me I decided to pursue joy as a way to overthrow trauma's vicelike grip and to habituate myself to something outside of my trauma addiction, and to reconnect to my pure and innocent and untraumatised self, which I believed still existed despite the daily evidence that might have suggested otherwise.

I was a freestyle dancer with no background in partner dancing when I walked into The Ritz Ballroom and said, "Teach me." It was a rocky road at first. My mind and body were so used to being separate they did not speak the same language, nor did they want to. And I, so used to processing in the PTSD fog and dissociative state, found the present, in-the-moment, connected-to-your-partner aspects of dance incredibly difficult to sustain.

But I knew when I danced I felt joy, and when I felt joy I was transcendant, and when I was transcendant trauma and the past ceased to exist and for a little while I was free. I've already written about dance and how it impacted the evolution of my healing. I haven't written much about the man who taught me to dance, my instructor, Bill Hering.

As we're talking about seeking help this month, his portrait (above with dance partner/wife, Sylvie) becomes very relevant in its suggestion of how we can seek help in new, out of the box ways and find more help than we ever expected. I went to the dance studio Bill owned just wanting to dance, and what happened was that I discovered a whole new self, not just from the hours I spent in private lessons with Bill, but from the community he had built at the studio, the other teachers he employed, the dance parties he hosted and the classes he designed.

A few months after taking the dancing plunge (and dancing 7 nights a week because I wanted to develop a joy habit and once I began to feel joy it became addictive -- I wanted to feel that way every day!) an unexpected thing happened: the nightmares ceased. I began to sleep. The anxiety lessened. I became more open. My body and mind slowly renegotiated their connection. I became comfortable in the moment. I became comfortable in my body. I was flooded with good feelings instead of bad. I dissociated less. I began to laugh more. Good things came from my dance odyssey and Bill, for one hour twice a week and as a presence every other moment in the studio, was a big part of that.

Last Thursday while I was in Boston for the trauma conference Bill lost his year long fight with cancer. Our dance community has suffered a great loss. The funeral on Monday was difficult for all of the usual reasons but also because Bill is so entwined with my recovery. He was only 50, way too young for us to lose him.

In recovery we have to have a spirit of adventure. We have to imagine the impossible. We have to not get stuck in the rut of our own thoughts but seek help in new and unsual places. We have to think about who we are and who we want to be and how we can make the transition. We have to think about who can help us make that dream come true.

We think things through. We commit to the desire to heal. We educate ourselves. We educate those around us. And then we're left with the task of finding a way to make the fantasy reality. Help doesn't always come from the most predictable places -- sometimes, you simply pursue joy and a guide emerges to help you do so.

To heal, sometimes you just have to put on a pair of suede soled shoes, step onto the floor, give in to the music, and dance. And if you've searched hard enough you'll find someone with the patience to lead you through.

Wednesday, June 10, 2009

Self-Empowered Healing: Audio Notes From NAMI

A double post day because:

Last night I spoke at the local meeting of the National Alliance on Mental Illness. The topic:

Are You Participating in Your Recovery?
5 Tips to Supplement Therapy with Self-Empowered Healing

Today, in my ever-increasing tech evolution: a slimmed down audio version (15 minutes) of last night's hourlong presentation.

Comments? Thoughts? Things you would add?

(Photo: maraculio)

Healing PTSD: What We Learn from Seeking Help

Continuing from Monday's post...

We never know from where or when healing comes. We receive the gift of progress from unlikely places. This can happen even more frequently if we're openly seeking input and advice from people whose perspective we admire. My experience at the trauma conference last weekend is a perfect example. But first: bringing the story up to date in terms of my own history:

I got to a point in my healing that I was so bitter about the medical and psychiatric community that I refused to engage with it anymore and set about my own healing path alone. I stumbled, I fell, I felt worse; I crashed and burned and picked myself up out of the wreckage and tried again.

And now it's a few years later and I've succeeded; I'm PTSD-free and last weekend attended the 20th Annual Trauma Conference where I was surrounded by therapists and psychiatrists and scientists whose sole job and mission is to help people like us heal. Now, I'm wishing I'd had the ability to attend the conference years ago because by the end of the weekend I'd heard a lot of theories and ideas that could have helped me during my healing. I met a lot of men and women who are really devoted to participating in relieving our pain. I also wish I had attended years ago because I saw the value of seeking help up close and in person when David Kaiser, a neuroscientist from Rochester, New York, told me, as the conference ended and we were left chatting in the lobby of the World Trade Center Boston, one very important thing.

After all I'd learned about the brain over the weekend, and how it changes in response to trauma, and how those changes perpetuate themselves and how our biology, physiology and psychology team up and become entangled and make our lives miserable - and since many people can engage in the same experience and not all develop PTSD - which adds to the proof that PTSD comes from psychological perception - I had one question I really needed to hear answered. So I cornered David, who had presented at the conference, and I asked him this:

If neurological PTSD symptoms come about in response to a powerful psychological experience, is it possible to reverse those neurological changes by engaging in an equally powerful opposite experience?

"You mean, instead of experiencing trauma experiencing a powerful bliss?" David asked.

I nodded. "Yes."

David didn't even hesitate: "Yes. Definitely. If you could induce an equally powerful inverse experience it would impact the brain and cause neurological changes."

OK, I hear you all thinking, Michele, be serious! And I'm well aware that inducing bliss - without chemical help - isn't the easiest thing to do. But I submit to you this idea: joy is a powerful and transcendent experience. Each of us has something that brings us that feeling. And no, maybe doing that thing once will not have the powerful immediate effects of a single traumatic event, but we are habitual creatures. We are, as David explained in his presentation, responsive to operant conditioning, which means we do more and more of the behavior for which we are rewarded. Which means, the more joy we feel the more we want, the more we seek, the more we practice behaviors that engender it - which means we develop a joy habit which means the cumulative effects of all that joy can begin to replace the singular effect of trauma.

This is entirely possible. The outcome is scientifically available. It would take time but the goal is attainable. I have done it, so I can vouch for the idea. I can also say it's a much more fun way to progress healing than simply sitting in your therapist's office. An added benefit: through the pursuit of joy you further develop your post-trauma identity so that, as the depression lifts and the neurological changes slowly take place, you can be at the same time shifting your entire self-perspective away from survivor toward the new you; the untraumatized you that has gifts and aspirations and possibilities and most importantly, a definition outside of trauma.

I've wondered, since I decided alone to pursue joy as a way to heal, if it was a silly thing to do. Yes, it worked for me, but I had no idea how to factor my experience into the greater schema of PTSD literature. I don't believe I'm unique, so I do think my experience could be applicable to the general healing experience. And now here's David, answering my seeking by handing me the definitive answer that lets us all know we are not irrevocably damaged. Neuroplasticity is gaining public awareness and momentum. The implications it has on our own ability to heal are infinite.

Tuesday, June 9, 2009

Survivors Speak: Having A Survivors Instinct

I love to hear the strong, resilient voice of a survivor who's determined not to let fate get the best of her. Donna Allen has such a voice. The victim of child abuse - and then the survivor of a plane crash - Donna Allen's voice is clear, committed, proactive and full of self-determination and belief. Bravo!

When I was an abused teenager, I felt victimized, helpless, and overwhelmed and I shut down, got angry, and lashed out. When I was a young adult, my life was disrupted when I was paralyzed in an airplane crash. I wanted to be able to cope with disruptive change, tap into the will to survive, and gain strength from the adversity in my life. I wanted to have strong self-confidence, know what to do, and be in control. And something stopped me from regaining stability, gaining strength, and attaining what I desire.

I learned that some people are better survivors when they are born survivors. They have a natural coping ability . They are natural players in the game of life. Other people need to work consciously to develop their abilities. They have to work at learning to handle pressure, negative situations, and disruptive change. I learned that the best survivors are those who find ways to cope with adversity by reaching within themselves for answers. They succeed by gaining strength from their adversity. They are determined to walk through the fear of physically challenging conditions like polio, head injury, or cancer and life-disrupting events like abuse, job loss, and bankruptcy. I tap into the abusive life that I endured when I was a child to draw out the important life lessons that helped me to handle pressure, negative situations and disruptive change. I learned that if you learn something from an experience there can be no such thing as failure. It is the way that you cope with failure that shapes you, not the failure itself.

After escaping my childhood home of abuse at eighteen I never wanted to be in an abusive situation again. I had fear of being caught in a cycle of abuse and pain for the rest of my life and I was willing to do anything to avoid that outcome.

I was unhappy in my personal relationship with my mate, but I made excuses for staying, perhaps because of the baggage that I carried from my past. I was afraid to leave, afraid of what might happen if I had to depend on myself, afraid of what to do next, and afraid of being rejected by a new potential mate.

My own fear kept me from stretching beyond my comfort zone. As a child abuse/airplane crash survivor, I learned that I can allow myself to feel fear, but I don't have to allow fear to get in my way of attaining my dreams. I directed my attention toward my fear, started trusting my instincts and I walked through the fear to attain the personal success that I wanted.

All of the events in my life were being controlled by my inner mind which housed all of my memories, attitudes, emotions, beliefs and habits. These things had been impressed strongly in my inner mind and it formed the conditions and experiences of my entire life. Through the motivational books and audio recordings I studied, I cleared my mind of negative ideas and was able to make lasting, positive changes in my life.

After surviving the aircraft crash, I was told that I would never walk again. Yet coming out of the darkness of hopelessness and moving into the light of determination, I was able to turn my disaster into a gift; from pain and desperateness to happiness and personal success. Instead of reacting like a victim, I converted the disaster into one of the best things that has ever happened to me and I walked through my fear and overcame the resistance in my life.

I realized that my emotional disconnection had prevented me from finding my own personal strength to stand up for myself. It was about me compromising my own inner instincts. I realized that when I listened to my inner self, I was led down the right path. When I didn't listen, and instead, listened to someone else, I was led down the wrong path.

Yet coming from a place of hopelessness, I was able to transform my life of lack, limitations, and difficulties into one of courage and personal achievement. How? By listening to my instincts and walking through my fear.

For more Donna Allen insights, visit

Monday, June 8, 2009

National Alliance on Mental Illlness (NAMI)

For those of you in the Palm Beach County area:

Tuesday, June 9th

I'll be speaking at NAMI's monthly chapter meeting. I've been invited to present on the topic:

Are You Participating in Your Recovery?
How to Supplement Therapy With Self-Empowered Healing

6:30 - 7:30pm

Oakwood Center of the Palm Beaches
1041 45th Street
West Palm Beach

NAMI meetings are open to and free for the public.

Refreshments provided.

For further info call 561.588.3477.

Healing PTSD: Why We Don't Want to Seek Help

For the past 3 days I've been posting about my experience at the 20th Annual Trauma Conference in Boston. It's got me thinking about how we PTSDers view the professional clinical world, plus how we do and don't utilize it, and why we have a love/hate relationship with the people we should be relying on for help.

Let's go back 28 years. Before I even left the hospital after my trauma I had shut down to the perspective of the outside world. Sure, my parents made me speak to a shrink before my release; I ignored the poor woman and got nothing out of our encounter. When I got home, I focused on moving forward in space even while I looped backward in time.

Years went by. My PTSD symptoms kicked in big time. My mother took me to more therapists who didn’t recognize my symptoms as PTSD. These encounters pushed me further into my own isolation. I trusted professionals less and less. I fell into the dark abyss more and more.

When my PTSD symptoms became physical the situation was the same: no one recognized what was truly wrong with me and the collective inability of about 30 doctors and specialists to treat me forced me further and further into silence, despair, distrust and skepticism.

More years pass and I finally do get my PTSD diagnosis and what happens? I don’t want to seek anymore professional help. Why?

  • I don’t believe I can be helped.

  • I believe I can heal better on my own.

  • When things don’t go well, I begin to believe I can’t heal at all.

  • Since they failed me so often in the past, I don’t trust professionals in the present.

  • I don’t want to speak about what happened, is happening, or am afraid will happen.

  • I’m afraid I don’t have the words.

  • I’m afraid of how overwhelming the words will be.

  • I don’t want anyone else in my head.

  • I feel safer in my isolation than I feel in the exposure of connection.

  • I believe only I know the truth.

  • I believe only I know what’s right.

  • I believe only I can understand my experience.

  • I don’t believe anyone can say anything that will lighten my load.

Great. I have a lot of beliefs that keep me imprisoned in my own head and isolated in my pain. I decide to read and educate and inform myself about PTSD. My scientific absorption rate isn’t exactly that of a sponge. I read slowly. I’m in a fog. I have trouble concentrating. I can’t focus. I don’t understand all that I read, nor do I recognize the implications of what I read or how this information impacts healing. I learn more and more about what is wrong with me and less and less about how to fix it. I’m committed to going it alone and I’m in hell.

I look back on all that now and wish I’d had the clarity of mind (a PTSD oxymoron, for sure) to understand these things:

1 - all of the help I’d had before hadn’t been properly informed; I needed a trauma trained therapist and an internist who understood PTSD. It was my job as someone healing to doggedly seek these people out; to contact one and then another until I found the people appropriate to help me. If one or two people couldn’t help me that didn’t mean no one could, it just meant I hadn’t yet found the right person or combination of people.

2 - these people who can help do exist and deciding not to look for them severely inhibits the speed of our healing. Deciding to stay in my shell, holding onto my fear and anger, hurt no one but myself.

In my decision not to seek help I sentenced myself to far more pain and anguish than I needed to because:

To be continued in Wednesday’s post…

(Photo: Solea)

Sunday, June 7, 2009

20th Annual Trauma Conference: Final Notes

I love learning. If being a student was a profession it would have been the perfect one for me. Since I can't be a serial degree candidate, these sort of crash course weekends are really invigorating.

The trauma conference ended yesterday, but not until I learned about emergence, complex systems science, attachment theory, theater vs. therapy and somatic transference. And then I had a very, very illuminating chat with a neuroscientist, but I'll save that for tomorrow. Here's how the day went:

Complex Systems & Traumatic Stress- Glenn Saxe's theory in this lecture applied the complex systems of science model to PTSD. What does that mean? This: Complex Systems Science studies, identifies and unravels how diverse systems (i.e. flocks of birds, schools of fish, molecules) go from scattered individuals to organized systems. The answer is 'emergence' -- things organize from the bottom up, instead of from the top down. For example, there is no top bird in a flock or lead fish in a school. Each individual falls into a part of a pattern based on his relationship in space and timing to the other individuals around him.

What this means in terms of trauma: In this theoretic model patterns of traumatic response organize into complex systems that can be measured, put into a graph, and charted so that the most highly triggering actions can be pinpointed and treatment efficiently focused.

[In the collective opinion of myself and others sitting nearby: this is science gone a little ga-ga over itself. The primary example of this whole idea boiled down to how a traumatized child's world could be charted this way and so it be pinpointed that a major problem was the way his father treated him. But this father issue was apparent at the beginning presentation of the case -- we all immediately knew the father needed to be removed from the boy's presence. And so, while science takes its time observing, gathering data, inputing it, charting and graphing, the poor boy remains in harm's way when the rest of us would have just immediately suggested the father's visitation be restricted and monitored. Sometimes, common sense is better than science.]

Safety & Exploration for Trauma Resolution and Attachment Organization- Dan Hughes is a gifted therapist and a wonderful presenter. In this very clear, very organized and interactive lecture he disucussed attachment theory - "lasting psychological connectedness between human beings" - and applied it to the therapeutic relationship. He spoke of how important it is for therapists to make eye contact with clients, how they need to be present in their facial expressions, posture and tone of voice and most importantly, how vital it is for the therapist to experience the survivor's narrative so that his engagement deepens the survivors experience of his own retelling.

Using his own clinical experience as a model, Hughes showed us very compelling video about how he works in a session to read body cues and foster attachement between himself, his client, and the client's caregivers. In our survivor world this all comes down to this: in order for us to get the full measure of therapy we 1) must have a therapist willing to engage with us on a personal level (not one who has been trained to remain removed), 2) we need to be willing to allow a therapist to join us in the experience of our stories.

Developmental Trauma Disorder: Diagnosing the Impact of Trauma on the Developing Mind, Brain and Self- Bessel is bitter. Mr. van der Kolk has a bone to pick with the DSM V committee. The story goes like this: the clinical community daily sees the traumatic impact of child abuse and neglect. Studies have proven that early child abuse leads to such negative traits and habits as aggression, obesity, smoking, depression, etc. By the time these children are teens they end up with Type 2 Diabetes and other health issues, not to mention extreme psychological issues that involve such negative behaviors as aggression, cutting, suicide and drug addiction.

Bessel and many colleagues got together to propose to the DSM V committee the addition of a diagnosis that captures this segment of the PTSD population: Developmental Trauma Disorder. The DSM committe demanded data; Bessel et. al. complied with data compiled on over 10,000 kids from around the country.

Last week, the DSM rejected the petition saying there was not enough data. Bessel, in his own words, is "f*&%ing angry!" and speechless as well. Without this diagnosis and its deliberate criteria Bessel says kids will continue to be misdiagnosed with Bi-polar Disorder, doped up, and never treated for their real issues. A very sad state of affairs. The audience as a whole agreed to begin a grassroots movement to use this diagnosis on their own until the committee and insurance companies have no choice but to investigate acceptance.

Using Shakespeare's Words to Embody the Whole Self- Tina Packer looks like Dame Judi Dench and has almost as commanding a presence. She's magnetic and energetic and was the highlight of yesterday's conference -- at the end of her presentation she received a standing ovation.

Here's where the day started to get really interesting. We dropped the scientific proofs and got back to the humanity. It seems I'm not alone in feeling this aspect of the conference was important and missing. The entire auditorium was riveted as Tina showed us how her Shakespearean theater troupe works with traumatized teens to do a theater therapy that is extremely effective in helping kids find the words they need, reground themselves in their power, and evolve a physical, emotional, linguistic and mental strength.

First, Tina led all of us through a breathing exercise designed to teach how important it is to inhabit the body all the way from the top of the head through the bottom of the solar plexus - how this grounds us in feeling and emotion. Then, using Bessel and his assistant as volunteers, Tina worked them through an actor's warm up exercise where the two sit facing knee to knee, look into each other's eyes and repeat words from the text of MacBeth at Tina's bidding without losing eye contact. The focus for each actor individually was on the single or group of words Tina supplied. The words had to be said on the outgoing breath and the actors were told to be aware of what emotions and feelings arose during the exercise. It was interesting to see how the actors' voices, body language, breath, and tone changed according to their emotional resonance with the words. A short discussion of how they felt during the exercise followed.

The implications here for therapy are enormous, including how to gradually and directly/indirectly get a survivor back into a somatic experience at the same time as allowing associations, emotions and feelings to arise around a specific topic.

Dancing in the Dark: Somatic Transference in Trauma Treatment- Ellen Searle is a small woman with Big Ideas about how important the somatic experience is in healing trauma. 'Somatic transference' is all about emotions passing from the mind into the body, and how important feeling in the body is in the healing process. What I found really interesting about this presentation (which included a lot of our own somatic experience laced throughout) is how somatic work can ramp up feelings of safety and security and so progress healing by creating a space in which the words more easily flow. I thought of my own experience in healing: a large part of my dissociation came from my fear of my body, and my fear of being held hostage in my body. I didn't learn to address and heal this until my therapist taught me transcendental meditation, which allowed me a slow re-entry into my physical self. Dance, too, catapulted this process for me.

In Searle's presentation we danced and explored the use of our entire body through movement. We learned about the kinesphere (peripersonal space, or: the area around your body) and kinesthetic empathy (embodying the feelings and movements of another - the somatic version of Hughes' attachment theory). Quoting Jung, Searle taught us that "The symbols of the self arise in the depths of the body." Powerful, thought-provoking stuff. For a population for which the body has become a source or repository of terror, healing on this level is incredibly important to pave the way for healing in the mind.

In Friday's post I was frustrated by the divorce of science and humanity in this conference program. I wasn't wrong about that. The audience response to yesterday's program - especially the final two segments - proved I wasn't alone in wanting to bridge the gap between the scientific observations and their application in the real world of survivor healing. If only each day had been more balanced this way - science in the morning, humanity in the afternoon! I'm going to have to speak to Bessel about that....

(Image: Witelson)

Saturday, June 6, 2009

20th Annual Trauma Conference: Notes from the Inside

Yesterday, a friend set me straight on my perspective about this conference. He explained to me: "Most people who get interested in the science are studying lab rats. It's unusual for the lab rats to be studying the science."

Once I understood that I am a rat at this conference, I got into the groove of the maze. As any good rat would, I adapted to the stimuli and made my way to find the cheese. Here it is, in bits and pieces:

Mothers, DNA and Psychological Trauma - Rats, actually, were the star of this lecture as Rachel Yehuda proved beyond scientific doubt that PTSD has epigenetic implications. That is, PTSD is passed from mothers to offspring through environmental effects that change the function of a gene while leaving its structure intact. Studies done with children of Holocaust survivors, 9/11 survivors pregnant on the day of the tragedy, and handled rats all were used to prove (largely through low levels of cortisol) that PTSD can be passed down through the maternal line.

Integrating the Past & Present: PTSD - An Information Processing Disorder- In this interesting lecture Alexander McFarlane included in the scientific data a large amount of artistic examples to discuss how and why we don't integrate trauma. A large problem he highlighted is the lack of language to effectively communicate traumatic impact. Using examples like the works of Auden, Picasso, Tolstoy, Nietzche and several other artists and theorists, McFarlane made the case that a big part of the PTSD problem is how small is our ability to communicate experience.

Neurofeedback- Larry Hirschberg, head of the NeuroDevelopment Center, spoke again today on the positive results of neurofeedback (NFB). Unfortunately, there is not enough data to support its effects in the PTSD population. However, I had a private conversation with Larry afterward in which he relayed to me his belief that it can be effective, although not necessarily as a tool all by itself. In PTSD cases he uses it largely in conjunction with clinical therapy. One way NFB is effective is in training the brain to reduce beta level activity (our hyper, active state) and induce more alpha activity (our at rest state). Stay tuned in the coming weeks for more from Larry; he's agreed to write a guest post just for Parasites of the Mind.

Working with Dissociated States- Fran Grossman deals a lot with patients who experienced early childhood trauma and who have developed fragmented parts. Her work, along the lines of Internal Family Systems, strives to address all the parts, help the survivor become aware of them, and then find a way to make the parts work together. The theory underneath it all: Pierre Janet's postulation that following trauma, systems of ideas can separate from the main personality and exist separately. In order to heal they must come back together. Grossman walked us through how she worked with one particular case to meet the different parts, explore their disturbances, and resolve their crises so that the survivor can work toward finding peace.

Chair Yoga and Mindfulness Techniques for Self-Regulation- Dana Moore is a young guy who works at the Trauma Center with Bessel van der Kolk. He has a deep meditation practice and a very calm, good-energy, peaceful aura. For 30 minutes he led us through a waking meditation that he uses with clients. In order to help them reground themselves in their bodies, he uses Mountain Pose, regulated breathing and awareness, plus muscle exercises to bring focus into the body in the present moment. For the final three minutes of the exercise he combines a counting and breathing technique - Mindful Counting Excercise - that, among other things, cultivates qualities of the Self in the Internal Family Systems. Lucky us, Dana has agreed to write a guest post on this topic, maybe two as I think it presents some very interesting tools that we can use to self-empower our healing.

The usual daily features on PARASITES OF THE MIND will be suspended until the end of the conference.

(Photo: lunawhimsy)

Friday, June 5, 2009

PTSD Symptom Word of the Day: Alexithymia

I'm in Boston at the 20th Annual Trauma Conference. I spent yesterday in a seminar with Bessel van der Kolk, Alexander McFarlane, Jim Hopper, Ruth Lanius and Rachel Yehuda on the topic of 'Reorganizing the Disorganized Brain', all about the neuroanatomy of trauma. I learned some interesting things about primary, secondary and tertiary dissociation, failed cortical inhibition, neural networks, the default state, the important roles of the prefrontal medial cortex and posterior cingulate cortex, self dysregulation, the positive healing effects of neurofeedback, and the anti-healing effect of alexithymia (the difficulty of identifying and labeling emotional states).

I admit, the science got a little unwieldy by the end of the day. Nevertheless, I came out of the seminar with some new ideas about trauma, PTSD, how and why we respond the way we do, and what all of this means in terms of healing.

One of the big questions all these bigwigs had is still one of the questions all we survivors have: How do we heal PTSD? And when someone does heal, how do they? Meaning, for this crowd, what are the neuroanatomical changes that take place?

The men and women gathered here are clinicians, trained psychiatrists and scientists. They like empirical evidence and strive to compose studies, research and publishable papers to quantify, qualify and certify the PTSD experience. But as a survivor - and in light of the question that still lingers despite all of this compiled data - I'm wondering: Do we need to know exactly why or how the fear vs. reward circuitry, amygdala vs. hippocampus activity changes the neuroanatomy of healing?

I know that perspective is the focus of the conference, but after looking at the problem through it all day yesterday, I'm not sure we do. Given the fact that each survivor is different; each healing path is individual; what works for and happens in me isn't necessarily your experience, I'm not sure we can empirically decide and/or define a healing method that will work exactly the same neuroanatomically speaking, for everyone. I'm not sure we can generalize healing down to that extremely specific scientific level. I'm not sure that's where our time and money should be spent.

I think each survivor still reserves the right to be unique in his journey and to defy science at any point. So I don't think the question should be how or why or what happens in the brain so much as the question should be who is this survivor in his soul? And then, how many methods can we devise, scientifically or otherwise, to try to woo that soul back to health. At one point everyone agreed yesterday that trauma is the murder of the soul. If that's true, is science the way to resusitate it?

When we get lost in the science it's easy to lose the humanity. Everyone becomes a statistic.

Everything becomes a computer generated model. By the end of the day I hadn't heard anything about how we are to deal with, accept, make peace with and reconceptualize memories. I heard a lot about PET scans, MRIs and brain mapping. I heard a lot about how we can determine what areas of the brain are functioning at too high or too low levels. I heard a lot about how to exercise and stimulate the brain to function differently, but I heard nothing about how to quell the tsunami of trauma's subconscious imprint - or how any of this science collaborates with that activity.

When I asked a noted neuroscientist about how to bridge the gap between science and the subconscious, she confessed she didn't know and that I should throw this question out to the entire seminar. When I asked the question to one of the speakers, she answered, "This afternoon we'll be talking about neurofeedback." Not really a satisfactory answer.

During a break I asked the questions to a miscellaneous woman standing near me. She replied,

"Oh, none of this stuff is meant to do any of that. It's just supposed to help survivors manage symptoms."

"So, these scientific ideas are meant to function like medication: to help survivors cope so that they have the strength and focus to do the rest of the therapeutic work."

"Exactly!" she said, and ran off to look at the vast trauma book display set up in the lobby of the World Trade Center.

I'm not sure she was entirely right. I'm not sure the professionals presenting about neurofeedback, the star of this year's conference, are seeing it in the same vein as medication. They are promoting it as the next big breakthrough in the science of healing PTSD. With caveats: "If neurofeedback doesn't help in 20 sessions at our center we keep treating for free until it does work." That doesn't sound very scientific to me. Which brings me back to the idea that science is a nice wing, but it's not really the leg that healing trauma stands on.

I think increasing and decreasing brain musculature is a great thing, but I'm still wondering, where's the person in any of this? I haven't yet heard anyone speak about how to integrate traumatic memories or personal perceptions or narrative or identity. I haven't heard anyone speak about how these scientific theories coallesce into a healing model that incorporates the less scientifically quantifiable areas of how we emotionally hold and handle trauma beyond the cognitive affective data in brain regions. There's been a lot of grouching about the DSM V and how important it is to get neuroscience into it. But as someone remarked today, the more neuroscience they put into the DSM, the more of the patient they take out of it.

Science and yesterday's intriguing seminar aside, I remain much more interested in the work that happens on the perceptual, subconscious level. We all agree there are changes in the brain. But since the changes came about through emotional reactions, can they be reverted by purely scientific actions? I don't know.... Science seems too black and white, too absolute. Healing is full of variables and a greyness that comes with the undulating planes of experience and perception.

Do you agree, or disagree? Anyone willing to offer a hypothesis on which is more important to healing - science or the soul?

The usual BRIDGE THE GAP healing workshop posts are suspended for the duration of the conference and will resume next week.

(Photo: Entity 6)