PTSD & Anger, Part 3: The Physiological Side of Anger

Yesterday, a man wrote me how much he enjoys the blog, even though anger is not his problem, even though he's only depressed. So let’s pause for a moment to remember: Depression is anger turned inward. And since anger can be a positive survival mechanism, let’s not be so quick to dismiss it or want to deny we feel it. Yesterday’s post made the point that anger can be helpful to survivors, so come with me over the next couple of days. Building on the first anger post I’m going someplace we all can go, regardless of how your anger manifests itself.

Today I want to continue the exploration of anger in physiological terms and here’s why: Anger has many physical effects, so if we don’t find a way to deal, diffuse and direct it we’re only adding to the problems we already have. Let’s begin with more from Dr. Harry Mills who writes in his article ‘Physiology of Anger’, “Like other emotions, anger is experienced in our bodies as well as in our minds. In fact, there is a complex series of physiological (body) events that occurs as we become angry.”

In her excellent and informative article on the physiology of anger Christina Boerma builds on Mills’ statement with an important reminder when she writes, “Anger hurts the angry person more than the object of its anger.” How does it do that, you ask? Let me count the ways in this partial list of how anger physically manifests:

1 - Muscles that are needed to fight or flee become very tight, causing an “uptight” feeling.

2 - Chemicals known as catecholamines are released causing us to experience a burst of energy (which causes a sugar deficiency, so that an angry person may “shake from anger”).

3 - Heart rate accelerates: Because of our anger, the usual (average) heart rate of 80 climbs to 180 beats per minute.

4 - Blood pressure rises: An average blood pressure of 120 over 80 suddenly soars to 220 over 130, sometimes even higher.

5 - As the body prepares for survival, it safeguards itself against injury and bleeding. Likewise, an angry person's body releases chemicals to coagulate (clot) the blood, creating a situation that's potentially dangerous. Although there is no physical injury, the clot is formed, which can travel through the blood vessels to the brain or heart.

6 - Rate of breathing increases to get more oxygen into the body.

7 - Increased blood flow enters our limbs and extremities.

8 - Attention narrows.

9 - Hormones (adrenaline and noradrenaline) are released which trigger a lasting state of arousal.

The problem with all of this, as Dr. Mills points out is that:

"If anger has a physiological preparation phase during which our resources are mobilized for a fight, it also has a wind-down phase as well. We start to relax back towards our resting state when the target of our anger is no longer accessible or an immediate threat. However, it is difficult to relax from an angry state. The adrenaline-caused arousal that occurs during anger lasts a very long time (many hours, sometimes days), and lowers our anger threshold, making it easier for us to get angry again later on. Though we do calm down, it takes a very long time for us to return to our resting state. During this slow cool-down period we are more likely to get very angry in response to minor irritations that normally would not bother us…. High levels of arousal (such as are present when we are angry) significantly decrease your ability to concentrate."

Which means, the naturally hyperaroused, hypervigilant, brain fog state in which we already exist is only exacerbated by anger. We need to consider this. We need to see ourselves. We need to make a change.

Our bodies are already stressed, tensed and on edge any normal day. Why make it worse by not controlling our anger? It is, after all, an emotion that is within our capability to focus, modulate and contain. There are tons of anger management techniques. We can also begin easing anger's effects by learning simple relaxation techniques. Which, come to think of it, wouldn't be bad for any of us, even when we're not angry -- even when we're only depressed.

(Photo: Eva8*)

PTSD & Anger, Part 2: Why Are We So Angry?

( First off, let me say for those of you who have not scrolled down and found the picture of me, this picture here is NOT me!)

Getting to today's topic: This idea of anger has captivated my attention. Mostly, because I lived with it for so long and never thought twice about it. In my world… well, that’s the state I was so often in; it seemed normal to be frustrated and angry -- when I couldn’t control my environment, when others got in my head space, when someone would say, for example, “Can’t you just let go of the past?” To which I would reply (often inside my head but sometimes very outloud), "Um… NO!"


Feeling isolated in my symptoms and experience only made me more irritable. Anger became a general daily sensation.

And now I’m no longer angry and I’m amazed by what a different world it is when I’m not feeling like a combination of The Grinch, The Wicked Witch of the West and Darth Vader every day.

This morning I started looking around for anger info to better understand why it’s such a common PTSD symptom. You might find the reasons, and how anger functions on our behalf, pretty interesting:

What is Anger?

Well, we have to begin somewhere; may as well start with the source. In this great article by Harry Mills, Ph.D. he explains that

Anger is a basic human emotion that is experienced by all people. Typically triggered by an emotional hurt, anger is usually experienced as an unpleasant feeling that occurs when we think we have been injured, mistreated, opposed in our long-held views, or when we are faced with obstacles that keep us from attaining personal goals…. At its roots, anger is a signal to you that something in your environment isn’t right. It captures your attention and motivates you to take action to correct that wrong thing.

So this can potentially be a good thing! After trauma we are sensing something’s wrong and we should be motivated to take a corrective action. Unfortunately, the psychological unraveling after trauma gets in the way. We are overwhelmed, and so we don’t immediately take positive steps. But I mean, really, how could we when you consider the role of anger in trauma…:

Anger & Trauma

Initially, anger is a really useful tool for us. Theories suggest that high levels of anger are actually related to a natural survival instinct. Take heart, depending on how we use it and how we perceive it anger could be viewed as a healthy emotion: We survive and are bolstered in our efforts by this driving internal force. (Remember this for later: We have a healthy, instinctive driving internal source for survival.)

This great @health.com 'Anger and Trauma' article offers this explanation of the role of anger in trauma:

Anger is usually a central feature of a survivor's response to trauma because it is a core component of the survival response in humans. Anger helps people cope with life's adversities by providing us with increased energy to persist in the face of obstacles. However, uncontrolled anger can lead to a continued sense of being out of control of oneself and can create multiple problems in the personal lives of those who suffer from PTSD.

(This article also offers a guide to finding relief, so you may want to take some time reading through the entire page.)

Adding to the mix in explaining the post-trauma emotional environment, take a look at this article about ‘Common Reactions to Trauma’ on the National Center for PTSD web site.

As in everything with PTSD, anger is another one of those coping/survival mechanisms that gets out of control. What began as something to help us cope and keep us safe outlives its usefulness, but we’re so far gone emotionally we don’t stop to consider what’s happening or how we can stop it.

Or, as I did, the aberration of who we are becomes so familiar and recognizable – and who we were before trauma becomes so far away and unfamiliar – we don’t even realize we’re living in an altered state. We accept this is who we are now. After my trauma I knew I had been changed and I accepted that. But that was wrong! Yes, of course, we are changed, but those effects do not have to mean negatively and dysfunctionally forever. We can be changed in good ways: we can have experienced something that taught us things about ourselves those who don’t suffer never know. Things like 1) our large capacity for inner strength, 2) our survival tools, 3) our deep reserve of will, 4) our incredible amount of courage, 5) our ability to face fear and transcend.

When we get lost in anger we fail to appreciate our survival. We see only the bad that happened to us, and we lose sight of the fact that WE ARE SURVIVORS, and surviving means more than just struggling through the trauma and the aftermath. Literally, surviving means we ‘outlive’ an event. But in feeding our anger what part of us lives? Not all the good, the possible, the amazing. In feeding anger we keep the trauma alive, which means the trauma wins. Now that’s something to be angry about!

(Photo: Jeneyepher)

PTSD & Anger, Part 4: The Psychology of Anger

In my own experience I've found two dominant sides to the psychology of anger coin: Fear, and motivation.

First, I have to apologize to my mother. I do apologize to my mother, often now that I’m healed, for all of the abuse she absorbed during my PTSD years. She is an amazing, strong and wonderful woman; if it weren’t for her love, patience and understanding we would have stopped speaking 20 years ago because there were many days, weeks, months I couldn’t be around her without snickering, snarling and sneering.

If you’ve scrolled down and viewed the ‘Faces of Joy’ you’ve seen that my mother looks eminently fun, happy and approachable. But that’s not how I saw her when I was PTSD suffering. Instead, she was the villain and I the victim of her ‘Let’s get you some help’ anthem. She saw me struggling and wanted to talk – all the time. She saw me hurting and wanted to reach out – endlessly. She was tireless in her desire to find some way to lead me to peace. And for that I hated her. For that altruistic goal I unleashed upon her all my fury.

Why? Because the pain in which I lived was intense, and I only wanted to be left alone in it. I did not want to share, explore or study it. I was afraid doing any of those things would tip the delicate balance I had constructed and everything would fall to pieces. I was afraid going into those dark places, ideas and moments would suck me in and I’d be lost forever. I was afraid I’d be overwhelmed by the pain and the memories. I was afraid the process of healing would make me weak. I was afraid the trauma would win if I lifted it up and exposed it to light. (I was wrong about each of these things, by the way.) In order to insulate and preserve myself, I lashed out at anyone who tried to get into the trenches and help me. Most often, that was Mom.

When we research the psychology of anger, however, this behavior becomes completely understandable. Our good friend Dr. Harry Mills in his article ‘Psychology of Anger’explains that one of the functions of anger (after its use to respond to perceived pain) is as a substitute emotion. He writes, “By this we mean that sometimes people make themselves angry so that they don't have to feel pain. People change their feelings of pain into anger because it feels better to be angry than it does to be in pain. This changing of pain into anger may be done consciously or unconsciously.”

Perfect. Because of course, I didn’t sit down one day and decide to be angry at Eileen. But all of her wanting to help and suggestions of things to do threatened the security of how I felt I was coping, and so, rather than become vulnerable, I became enraged. It makes so much sense when Mills explains, “Being angry rather than simply in pain has a number of advantages, primarily among them distraction…Part of the transmutation of pain into anger involves an attention shift – from self-focus to other-focus. Anger thus temporarily protects people from having to recognize and deal with their painful real feelings; you get to worry about getting back at the people you're angry with instead. Making yourself angry can help you to hide the reality that you find a situation frightening or that you feel vulnerable.” Ahhhh, Yes.

The flip side of this negative anger perspective, however, is quite positive. In his article ‘Motivational Effects of Anger’ Mills writes, “On the positive side, anger creates a sense of power and control in a situation where prior to anger these positive, motivating feelings did not exist.” Bingo! That’s exactly how we can use the anger we feel. That is, ultimately, how I used my anger.

Two years ago I was so sick of myself, my memories, my PTSD, my trauma – EVERYTHING. I got angry at all of that, instead of the usual suspects. I got angry my life was passing by in this horrible fog of pain. I got angry the trauma was winning. And so I took all of that angry energy and unleashed it on the trauma and PTSD themselves. I took all of that ferocious focus and channeled it into a vengeful pursuit of joy, and healing. We all know how powerful anger feels; imagine using it to create a new future instead of to lash out at the past or destroy the present.

I’m not the only one who used my anger to good effect. Tomorrow I’ll introduce you to another survivor, Kellie Greene, founder of Speaking Out About Rape (SOAR). Kellie has a strong and dynamic perspective. In our interview earlier this week we discussed anger and its uses, and also, the importance of self-perception. I’ll leave you with this one idea, which includes not only Kellie’s self-empowering thought process, but also a very good reason not to let the negative side of anger – its supposed protecting us from vulnerability – to be our guiding light:

I prefer to be called a victim and not a survivor because it all has to do with when you say it. ‘I am a survivor’ means you’re still there, you haven’t moved on. But to say ‘I was a victim’, past tense, you’ve moved on from it. There’s nothing wrong with being a victim and I think we shouldn’t be so ashamed to say, ‘I was a victim’, because in the cases of violent crimes, criminals are looking for the most vulnerable opportunity and there are people who have been through extensive self-defense training that are victimized as well. Criminals are looking for the opportunity to prey on someone who is vulnerable and you can’t live life without being vulnerable. You miss out on a lot of joy, a lot of happiness, relationships. You have to allow yourself to be vulnerable, there’s nothing wrong with that.

(Photo: dem vadda sen john)

Survivors Speak: Forgiveness & Abuse

A few months ago I stumbled upon Nancy Richard's blog, Heal and Forgive, and was immediately taken in by this statement in her bio:

"When I finally mustered the courage to buck societal expectations; not to forgive; and to put my own healing and well-being first, I achieved a level of healing that I never thought was possible."

Don't you need to hear more from this person? I know I did. And now, I'm really delighted she's written a guest post just for us. Her views on what comes first, forgiveness or healing, might surprise you. Or, you might agree it's something you've suspected all along...

At some point in most abuse survivor’s healing journey, he or she faces the question of forgiveness. Are there some abuses too atrocious to forgive? Is it possible, or even healthy, to forgive someone who has never asked to be forgiven, someone who has never acknowledged any wrongdoing, and someone who continues to practice the same abusive behaviors?

All too often, well-intentioned people ask us to forgive and forget. For decades, I heard from friends, relatives, therapists, and fellow Christians, that I needed to forgive my abusers in order to heal. This advice - and the attempts I made to forgive before I'd learned to exercise personal boundaries - left me open to further injury and damaged me deeply. When I finally mustered the courage to buck societal expectations; not to forgive; and to put my own healing and well-being first, I achieved a level of healing that I never thought was possible. My period of not forgiving created the space necessary to achieve the greatest emotional growth of my life. Wow!

Sometimes it is necessary to place a moratorium on forgiveness until healing has taken place. This affords us the opportunity to 1) validate our stories with sympathetic listeners, 2) express our anger in appropriate ways, 3) mourn our losses, and 4) protect others and ourselves from re-injury.

After many years of militantly not forgiving, I was both shocked and surprised to find that the unintentional by-product of this healing was - ironically – forgiveness.

At that time, I realized that the old adage, "Forgive and Heal," was backwards. For me, it was "Heal and Forgive!" If I only knew *then* that adequate healing had to come first, it would have saved me a great deal of time and pain. So, now I shout it from the roof tops "Heal first, THEN Forgive!"

How then do we heal?

Validation

Our greatest opportunity for healing comes from the offender. When the person who harmed us is willing to offer restitution, we are truly blessed. This means the wrongdoer must be willing to acknowledge the harm he or she caused us, offer a genuine apology, demonstrate a willingness to restore what was taken and change abusive behavior. However, because of the chronic nature of abuse, most victims do not have their abuse acknowledged by the offender.

Still, validation is key. When we do not receive acknowledgment from the person who harmed us we need to have our abuse acknowledged by other individuals, so we feel as if justice has been served.

For me, justice came in the form of supportive friends, a therapist, and support groups who stood by me during my 14 year estrangement from my family. Each time someone validated my experiences, I became stronger and clearer about what happened to me and the effect it had on my life. For most survivors, abuse is our only reality. Even if we are aware of our childhood abuse, we often live in denial about the effect the abuse had on us until another party bears witness to our trauma. Support and validation from others, dissolved my isolation and gave me the necessary strength to journey forward to the life I deserved.

Anger

Forgive and forget. Anger corrodes. Only through forgiveness can you heal. These often heard statements usually instill within us a sense of urgency that implies we must forgive immediately. Yet, healing and forgiveness are a process.

It is important to note that for most survivors, it isn’t anger that holds us back from forgiving - it is fear. I was afraid that if I forgave, I would be hurt again.

Anger has its place. We can’t deal with our fear until we deal with our suppressed anger.

It wasn't until I received validation from other people that I found appropriate ways to discharge my rage. I gave myself permission to be constructively angry - to use my anger as an aid in moving forward - until the hurt no longer felt present. Expressing anger in the company of trusted confidantes gave me the sense of not being alone, and validated that I had a right to my anger.

There is an important distinction between - a) perpetuating anger by raging at the individuals who harmed us, and - b) releasing pent up anger in safe environments apart from the individuals who caused the harm. Bringing my injuries "into the light" and acknowledging my anger in the safety of supportive individuals brought me the emotional freedom necessary to find a measure of peace.

Mourning

Discharging my anger freed me to honor my pain and mourn my substantial losses.

Protection

An important and often overlooked aspect to healing is that of protecting others and ourselves from further harm. In order to heal, we must be free from the anxiety of re-injury. Boundaries issues are common in abusive family systems. When a child’s body, heart, and soul are routinely violated, her life is constructed in the absence of boundaries. Forgiveness must go hand in hand with learning to set and maintain clear, respectful boundaries.

Each survivor has her own individual time-table that must be honored. As long as I carried unhealed wounds – forgiveness would have to wait. Healing requires a great deal of time, self-examination, hard work, and pain. Yet, I have learned that once an adequate amount of healing has been accomplished, forgiveness becomes a viable opportunity.

Forgiveness doesn’t mean that we “excuse” offensive behavior; it doesn’t mean forgetting or even trusting the person who harmed us. Nor does it require us to “let go” of our safety. Rather, for me, forgiveness meant healing enough to let go of resentment and find peace.

Nancy Richards is an adult survivor of childhood abuse. She is the author of "Heal and Forgive: Forgiveness in the Face of Abuse," "Heal and Forgive II: The Journey from Abuse and Estrangement to Reconciliation" and co-author of "101 Great Ways to Improve Your Life, Volume 2."

Copyright © Nancy Richards. All Rights Reserved.

'Survivors Speak' is a weekly feature written by or interviewing a survivor and 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 @ yahoo.com.

(Photo: Nancy Richards)

PTSD & Anger, Part 1: When We Hate Happy People

There’s been a big debate in one of the PTSD online support groups in which I participate. It all started around the Thanksgiving holiday. It began like this: S. asked,

Has anyone been through this? I mean, seeing everyone happier than ever (of course, it doesn't mean they are) while you are struggling at ground zero.
I've been through minor but several traumatic life events which accumulated to a greater sum and my coping mechanisms failed after the last event. It's been now more than a year and my soul is still not at rest.

It just seems to me like everyone around me is achieving everything they want and ask for contrary to me who lost almost everything. Is this jealousy normal? It is extremely painful and instead of concentrating on myself I examine other's lives and can't take myself out of it. And seeing people happy makes me misarable and leaves me with the unanswerable question, "Why?" I believe maybe it is a way of keeping myself out of the original problems, I don't know.

There ensued a lot of agreement from the group that, yes, they do feel jealous of people who do not have PTSD, and they are angry at others for not suffering, and angry for the things others have achieved and angry for… the list went on and on and on. The discussion became heated as people vented their frustration in increasingly vehement @$&%! terms.

And it got me thinking, what if everyone took that angry energy and used it for something positive? What if, instead of railing against those ‘happy’ people (or, as I used to do, the unfairness of fate), we harnassed that energy and used it for our own good? When we manifest pure anger all we do is drain ourselves of good energy, literally.

I started researching this whole idea of anger and found an interesting article by Kathy Wilson. Entitled, ‘Anger: The Greatest Motivator of All’ she talks about ways to channel angry energy. Actually, what she says is,

When you experience the emotion of anger, you create one of the most extremely powerful energies that we humans have been given to work with.

Although powerful, the energy of anger isn't bad or good. It simply exists as energy. What you choose to do with it determines if it's bad or good. As with any energy, you can choose to use it in harmful ways or in beneficial ways.

This idea perfectly illustrates the point I made in the group, which was this:

What about looking at the whole topic another way? Instead of being angry, how about thinking about how much we deserve to be as happy as they are? How about getting angry that we aren't happy and deciding to fight as hard as we need to in order to achieve a happier, healthier life?

I used to be angry at my own PTSD suffering. I used to be angry my trauma happened in the first place; no one shielded me from harm; no one could stop the horrific event from continuing over a period of weeks.

On a bad day, I could add to my already deep depression with a powerful dose of anger and then -- watch out! I was really a sight to behold. That depressive anger I usually turned inward came out with a ferocity that flayed anyone around me. I feel sorry for the people I directed it at, particularly my family.

But two years ago this new year's eve I decided to take that angry energy and use it in a positive way: I decided to pursue joy and ... it worked! All of that antsy angry energy spilled onto the dance floor and out of me. I became more peaceful, more tolerant; less angry, more... well... happy.

Being jealous of others is useless. Being angry at them is a total waste of time and energy - time and energy that we really need to be channeling toward healing. Using that energy on ourselves can bring relief, so we shouldn't so easily give it away. Don't you agree?

(Photo: Amir el Mayordomo)

PTSD & Anger, Part 5: How To Make Anger Work For You

So, it's been a good week. I've learned a lot about anger I didn't know. More importantly, I've thought a lot about my own anger so that I understand how it hindered me, and also how it helped me to heal. When we can see ourselves, recognize what's going wrong and understand why, then we can find the path to changing behavior and moving forward. Not a bad way to make some daily progress!

Today’s post I’m going to turn over to the voice of Kellie Greene, rape survivor and now activist and founder of Speaking Out About Rape (SOAR). Kellie has been National Spokesperson for the Pfizer/YWCA "Moving Past Trauma PTSD Community Outreach Program". In 1999, she founded SOAR, a nonprofit organization dedicated to protecting the rights of victims of sexual assault. SOAR is committed to raising awareness about rape and its consequences, including PTSD. Kellie also coauthored Florida's "Sexual Predator Prosecution Act of 2000". The law mandates consecutive sentences, rather than simultaneous sentences, for any repeat sexual offenders. In addition, Kellie helped pass Florida legislation that prohibits hospitals from charging rape victims for forensic teams. As a result of her efforts, Kellie earned the Survivor Activist Award from the Florida Council Against Sexual Violence.

What I find so inspiring about Kellie is that she went through all of the phases of trauma – shock, grief, anger, healing – and came out swinging. Kellie’s ultimate reaction to a brutal attack shows just how we can survive and then define a new self that is more powerful and bigger and better than ever.

Here are a few excerpts from our interview, ones I found particularly interesting as they showed Kellie's psychological process in the aftermath of trauma, and then how she constructed a new, post-trauma identity that led her to healing and a new life.

What were your initial reactions to trauma?

I had all of the usual symptoms: nightmares, insomnia, flashbacks. This is all the brain’s way of processing what’s happened to you. Kind of like back in the days when we had vinyl records and you would get a scratch on it and the needle would get stuck and it wouldn’t come out of it and it would just keep playing that one word over and over again. When you get PTSD that’s kind of like what it is: you can’t move past the thought of the trauma. So even though within 6 weeks I had started therapy after 6 months I realized I wasn’t moving forward. I was stuck in the sense that I started to isolate myself from friends and family because it was easier to be alone because I was tired of hearing myself talk about the trauma over and over again. I was afraid to go outside, and afraid to be out in the dark. Just making simple decisions was difficult. It all started to prohibit me from functioning on a daily basis.

On another level though, my initial reaction to the trauma was that I was determined not to let the rapist ruin my life or change who I was. I was adamant about getting back to my daily routine. Not appearing to be frightened. Not giving him control and power beyond the 45 minutes of my life he had taken during the attack. But in doing that I didn’t accept at the beginning that I had changed. I was ignorant to the fact that something that impactful couldn’t not change my life, either good or bad. I had this sense that I had to appear strong because I wanted to bet it. But you have to validate that you have changed, and unless you incorporate both the strength and the change I think it takes a little bit longer to get to where we are today.

What did you do to cope with all of this, to bring yourself to such a place of proactive strength?

In the beginning I was a mess. It was very difficult for my mother and boyfriend to be around me. They had to walk on eggshells. And I became very manipulative. I used ‘victim’ to my advantage. Any time something wasn’t going my way I would say, ‘I was raped.’ I would play that victim role and then everyone was forced to give in. I could even do that with counselors until I found the right counselor that would call me on it and I was stuck in a room and had to sit there to the end. It was my mom and my boyfriend who got me into the counseling and it was the best thing that they did because I was so out of control with wanting to be in control that I was out of control.

What made you decide to go into counseling?

My boyfriend actually had to track me down and take me there, and he did that for the first 2-3 months because otherwise I wouldn’t go. I was really frightened of counseling. I thought it meant I was weak. I thought I was better than this, I wasn’t going to let it affect me, I could deal with it until I thought if I had to go to counseling and ask for help it meant I wasn’t beating it, which was the wrong way of looking at it. Plus, I’m such a perfectionist. I don’t want to fail. I want to excel at everything I do and I didn’t want to fail at counseling. So, all of those things were really making it difficult for me to let go and say that I needed help to help me process what was going on in my head to actually start making sense of it.

I went through a handful of therapists before I began working with one who was calling me on the manipulation and was forcing me to talk about why I was actually there. Once I was working with her I started getting a little better, but then I reached that plateau where I wasn’t and that’s when things got really difficult and I knew that I needed more help and it was 6 months after the attack. I’d been working with this counselor for 3 months and I felt myself getting worse and worse with flashbacks and nightmares, not being able to make decisions – simple decisions, like in the morning not being able to figure out what to wear. It kept snowballing and everything was getting worse and I thought I was going crazy because I’d never heard or read about anyone being raped experiencing those types of problems, like also, crying all the time, or trying to read – at that point I couldn’t even get past one page. Maybe ½ an hour had gone by and I’d read 2 paragraphs, but I hadn’t understood what I’d just read. So, I thought I was going crazy, losing my mind. I didn’t tell anybody because I was really afraid of that. About six months afterward I was in the shower and broke through in these terrible, terrible sobs. I sat on the bottom of the tub in the fetal position rocking back and forth.

Finally I found a counselor and he read back to me from a book everything that I told him and he said. “You have PTSD”; he gave it a name. And he said, “This is what we’re going to do…” And at that point I could just let out this exhale. I had some hope because, one: I’m not alone. It’s in a book. Other people have had it, too, and they’ve studied it. And obviously there’s some sort of treatment for it because it’s in the book. And he laid out the treatment with me and I worked with him for about 6 months and I was able to recover from the PTSD pretty quickly and then go back to the rape crisis counselor and begin working on the aftereffects of the rape. All in all I was in counseling for about 3 years.

What in your PTSD process worked for you?

He got me to look at everything in a different way. To really examine everything that had happened in a different way. To get out of that mindset that I wasn’t going to let it change me to… One of the greatest things he said to me was that we all change. Every day we are changed by things we come in contact with. And to say that we don’t change kind of cuts us short of evolving as people. So, once I realized that it was okay to change, that it was okay that this affected me, that it didn’t necessarily have to affect who I was going to become, or who I was going to be in a negative way, I was able to look at it and say, ‘Yeah, that was a bad thing that happened, but it’s okay that it’s changed me because I can decide how it’s going to change me now. I am the one who has control over whether or not I’m going to let it control me for the rest of my life.”

Mostly we did talk therapy. The breathing exercises were great because they would keep my mind focused on breathing and not on what I was remembering, so it really quieted the mind for me so that I could actually work the counseling. And then he also said I was discovering some really great things about myself, because I had discovered that I was able to get up and speak in front of groups, which was always something I had feared. That I had a voice, and that I was pretty powerful with that voice and making positive changes for others and I should celebrate that, and I should embrace the counseling experience because I could go in and examine everything about my life from the beginning to where I was at that point, and it was an opportunity for me to keep pieces that I really liked, discard the ones I don’t like, and work on the ones that I could improve. So, it was an opportunity and once he presented it to me as an opportunity, then it was a little bit easier to swallow, as opposed to the rapist forced me into counseling.

When did you get to the point that you realized you could channel your anger into something positive?

That was from the very beginning. I owe that to my mom because my mom realized at the very beginning that if I were to fall into self-pity I would never have gotten out of it, or it would have taken a long, long time to get out of it. So, she wanted to keep me mad, as ticked off at the rapist as she possibly could. And that’s what she did! Whenever she would hear me feeling sorry for myself she would say, “Do you think the rapist is sitting around feeling sorry for you right now?” And I answered, ‘Hell no! Why should I? He’s probably not even thinking about me!” So, by helping me stay angry I was able to find different channels for that anger. One of them was I joined the Raped Abused and Incest National Center, which is RAIN. I joined their speakers bureau and started doing presentations for universities. I worked with the Attorney General in the state of Florida in passing new legislation. I also worked with the Attorney General in training law enforcement in dealing with victims of sexual crime.

Did the outreach help lessen your feelings of anger, or help you deal with them better?

As time went on I lost the anger toward the rapist because I started to be thankful for the direction that my life had gone in. Before the rape I really didn’t have any goals in life, I didn’t really have any direction. I was happy, I loved my life and I was living it very well and I was doing very well, but I didn’t really have a sense of purpose and I would say within 6 months to a year after the rape I knew what I wanted to do. I knew I wanted to educate the world about the aftermath of rape. Of what it’s really like. It’s not like in the movies, it’s not like in the soap operas… And that was what I wanted to do. So, I just started to channel all of that anger, that energy that I had from the anger into making this the reality and I honestly think that it was my chosen path and that it was my true chosen path because I remained true to it. I try not to question the direction I’m going in now because somehow these opportunities, these amazing opportunities keep presenting themselves to me, so I know that I’m on the right path and I’m doing what I’m supposed to be doing and that this is my purpose in life. And I wouldn’t go back and change anything that happened in my life, including the rape, because it’s brought me to who I am and what I’m doing today and I love both.

(Photo: Glenn Loos-Austin)

PTSD Healing: Prepare To Speak Part 1

In his book Youth and Identity Erik Erikson states, “… the ‘I’ is all-conscious… we are truly conscious only insofar as we can say I and mean it.” Can you say ‘I’ and mean it??

In order to survive the aftermath of my trauma, ‘I’ was a word that conjured too much fear and confusion for me to say. What slowly emerged as my post-trauma self was a girl who denied everything, beginning with the need or right to speak and extending to everything that might have been good or pleasurable. Joy was denied. And happiness. Religion. Trust. Faith. Medicine. Love. I believed in nothing, not peace or gladness. Neither glory nor pride. Everything became suspect. Everything became a potential trap into which I might fall and the result would be an overwhelming blight of emotion, an empty vortex of disillusionment, a catastrophic event.

Nothing seemed safe, so I never achieved a major step of the healing process: I didn’t “acknowledge the harm … [of] experience and discharge … feelings of grief, anger and despair.” Fear ruled me, and regardless of how often my mother offered to talk (which she did since the day of my hospital release) regardless of how often she suggested I might feel better if I did, I raged in anger at the idea until she, too, fell silent. And so, rather than move through denial and depression and anger toward a new understanding of myself, over the years I sank deeper into a definition against rather than of the new 'I'. Plus, I sank deeper into an internal silence until finally, there was no voice at all.

I was 13 when my trauma occurred. I was 17 when I first spoke about it. In the intervening 4 years I couldn’t come anywhere near the subject.

And then something broke inside of me and what gushed out one impromptu day was something I don’t even remember. All I remember was that my mother and I were out to lunch and the next thing I knew I was sobbing and she was holding my hand and it was the first time I admitted to myself that I was struggling with the past.

It would be another 20 years before I realized I could be healed; before I made the choice to become healed and do whatever it takes to make that be so.

What I do vividly remember from that day with my mother, as we lunched at a local diner and then drove to New York City for the afternoon, was the huge feeling of release. The feeling that I was no longer carrying around a secret – from myself and everyone else. It would be years before I spoke about it again, but I still remember the tremendous feeling of a weight being lifted. And also, my surprise that it could be lifted just by my attempting to talk.

For the past 3 weeks we’ve been building up to the moment that you share your trauma with someone else. Over the weekend, I posted the voices of other survivors who are finding the words. Now, it’s your turn.


BRIDGE THE GAP EXERCISE:

Your mission this week is to determine one family member, friend, or professional practitioner with whom to share your story. Make a list of the possible candidates in each area.

Carry the list with you; refer to it during the day. If you do not immediately know whom you wish to open up to, let your inner voice guide the way. When you randomly look at the list you will feel a reaction to the names on it. Which name has a positive reaction associated with it?

[Note: If you have already accomplished this step of speaking to family, friend and practitioner, your focus should be on whom you will tell the secrets you still keep. I went through years of therapy without admitting to my therapist what the real driving force was behind my PTSD. I talked about the horror of my illness, but I didn’t mention my continual flashbacks about leaving my body or how those flashbacks were driving the day to day life I was trying to lead. When I finally did tell him this, it brought me to a new level of healing. We cannot fully heal if we keep secrets. Now’s the time for you to get comfortable with the idea of letting out the last bits of information you’ve kept to yourself.]

Some points to think about:

1- The goal is not to go around telling our suffering to unspecified people who may or may not want to hear it. The plan is to reach out appropriately by developing the ability to have a dialogue with a support network: specifically chosen family, friends and practitioners.

2- Anyone to whom we tell the story should be in the position to have chosen to hear it and indicate how much detail he/she desires to know. Be up front about the nature of what you wish to share.

3 - In choosing to whom you will talk, consider the qualities that person possesses. For example, is he/she kind, empathetic, compassionate, respectful, understanding, supportive? You do not need to share with someone who does not have the characteristics to understand the courage it takes to do what you’re doing, and the conscience to know what the right response will be.

4 – Do not feel shy about your right to speak. One of the effects of PTSD is our detachment from the world. This is a major impediment to healing. If we are suffering without support, then telling the story is not a self-indulgence; it is a necessity. Healing cannot occur if we are all alone with our thoughts.

(photo:Elephant Soap)

Survivors Speak: Art As A Positive Channel

Tina is a survivor who knows how to cope. Unable to work - and then forced by economic reasons to leave her friends, family and doctors to relocate to a more affordable city - she is not only exploring art as therapy but building a business out of it!

Survivors never cease to amaze me. In the midst of our PTSD issues each of us continues to find the most amazing reserve of resiliency.


1. What, if any, relation did you have to folk art, craft work or cake design before using it as a therapeutic method?

I had no desire to do any art or craft before using it as a therapeutic method. Therapy, I thought, was not for me. I had a very negative view of therapy. I believed my life was always going to be bad and that suffering with PTSD was to be a permanent condition.

2. What first inspired you to explore your trauma/PTSD experience in art form?

I was unable to work and found myself having to relocate to a different city to find affordable accommodation. I did not know anyone in the new city and all my support networks including health care providers were in my original home town.

Anger set in and I deliberately did not leave the house or associate with anyone in the new city. I shut myself off from everyone and was determined not to accept being forced to change my location and being so far from all my family and friends. As a result, my doctor thought it would be a good idea if I could find something to get me out of the house as well as an interest that would redirect my thoughts and anger.

3. In what way do you feel using artistic expression has furthered your healing?

Firstly, in learning folk art I was able to channel my thoughts to something new and exciting. I was able to concentrate on something that didn’t involve too much energy. It was terribly difficult to focus on anything other than peripheral things, so artistic endeavours seemed to be ideal.

Secondly, art allowed me to start to feel positive about myself. Instead of focusing on the things I couldn’t do (for example, work, reading, concentrating, etc.), I was able to do little things like painting coasters, place mats, boxes, tins, small paintings.

An added bonus was that I was able to do cheap presents for people on such a limited income (whether they liked my artistic endeavours is another story!). I started to form relationships in the new city and finally was able to come to terms with the relocation. I was then able to leave my home on a more regular basis, doing something pleasant, instead of all the horrible things that we, suffering PTSD, are used to doing, eg. like going to psych appointments, doctor’s appointments, and social services meetings. It was a relief to do something pleasant and non-taxing and positive.

Soon I was living a semi-normal life. Eventually I entertained the idea of cake decorating and was buoyed by my experiences in the realm of folk art. I have since started to try and earn a living from this enterprise. Cake art, although not an expressive art, is time consuming, artistic in nature and challenging. I enjoy seeing the end result and the happy faces on those celebrating their special day, whether it be a birthday, anniversary or wedding. I would never have thought that I would be calling myself artistic in a past life, but now it seems so normal.

4. What's the single most important benefit you've discovered from expressing your trauma this way?

My artistic endeavours have enabled me to recognise that I am more than the sum of my trauma.

5. What have you learned about healing by filtering it through art?

I treat art as a distraction that enables me to redirect my thoughts to something more positive. Whilst a distraction, art has also enabled me to see a different person, one I didn't know was there. Perhaps a person who can heal and get better, rather than the one that constantly feels healing is a struggle and not worth fighting for.

6. Do you have a single piece of work that you feel best embodies what you were trying to express? What elevates this piece above the others?

No piece embodies what I am trying to express. My art is simply decorative, enabling me to experience positive feelings of accomplishment and pride. I am not expressing myself to anyone else except me and therein lies the freedom.

7. What tip would you give someone who is interested in exploring the idea of addressing his/her own traumatic experience through any of your methods?

Do not underestimate art's healing properties. Art is subjective and not meant to put you into a pigeonhole. It is a medium that allows you - without judgement or condemnation - the freedom to explore a side of you that you may never have entertained. It is kind and forgiving and gentle; just what you need in a world that is shaken to its core by PTSD.

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

(Photo: cupcaketastic)

PTSD & Anger, Part 6: How To Heal

I love this fable. I don't know where it comes from, I don't know who to credit, but I love the symbolism and imagery and how it sums up our PTSD struggle in really simple terms.

*Two Wolves*

One evening an old Cherokee told his grandson about a battle that goes on inside people.

He said:

"My son, the battle is between two wolves inside us all. One is Evil. It is anger, envy, jealousy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.

The other is Good. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith."

The grandson thought about it for a minute, and then asked his grandfather, "Which wolf wins?"

The old Cherokee simply replied: "The one you feed."



Go feed your good wolf today -- the stronger we make him/her, the sooner we leave PTSD behind.


(Photo: Laenulfean)

PTSD Healing: Thinking Inside the Box

Getting back to Sarah and the black cloud she brought over me every time I was with her. I couldn’t help myself or stop myself from feeling the depression she exhibited. My own emotional boundaries were weak. And how could they not be? I lived in a perpetual brain fog where my emotions were uncontrollable and my clarity non-existent. I had no tools for erecting and maintaining a safe emotional space. If only I had known….

1 – The concept of emotional boundaries, as described here in this quote from coach Marcia Francois’ article ‘How To Set Healthy Boundaries’:

What is a boundary? In a physical sense, it is easy to understand that a boundary marks off where your property starts and where the neighbour's ends. You are responsible for your property but not for anything that happens on your neighbour's.

While not as easy to mark off, our emotional boundaries also mark off where our responsibilities start and end. Too many people feel out of control of their lives because they don't have good emotional boundaries.

Boundaries are like fences in that they keep bad things out and good things in. This means that you protect yourself from things or people that might hurt you and you nurture things or people that help you. Notice I said fences and not walls. A wall means that nothing gets through from either side whereas a fence allows flow.

Boundaries are limits or barriers that protect you, your time and your energy. When your boundaries are well-defined, they help to prevent conflict within your relationships. They are like your personal rules or policies. Laura Stack says it beautifully, "setting limits is a way of defining who you are and what you're all about, what you will do and what you won't; what's acceptable to you and what's not".

Setting boundaries means owning and taking responsibility for your personal choices and the consequences thereof. You make the choice, you take responsibility and you can make a different choice if you don't like the consequence. You can't control other people's behaviour but you can control the extent to which it affects you. In other words, control your exposure to people.

2 – Signs of my emotional boundary weakness: Since I always existed in a hyper-state of some kind I didn’t pay attention to the signs of my reaction to others and how these reactions indicated my boundaries were insufficient. But you can start listening to that small voice and being aware of these signs that your emotional boundaries are being breached:

- Knots in your stomach when you agree to do some things

- Anger and resentment

- Deep feeling of dread

- Feeling shocked or being appalled at something someone said or did

3 – How to set emotional boundaries: Marci suggests,

-Learn to say no.

-Remember if the reaction to your setting boundaries is not great (sulking, anger, etc), it's not about you - it's about them. That feeling belongs on their side of the "fence".

-Write these 4 sentences on a piece of paper and write out as many statements underneath each as you can think of:

a. People may not...

b. I have a right to ask for...

c. To protect my time and energy…

d. To feel safe while reaching out…

As you prepare to broaden your interaction with others (because you are, right, beginning to reach out??) it’s important to become aware of our reactions to those we meet, and also, to develop a method of maintaining our emotional boundaries. We can't heal if we get caught up in the wrong crowd or allow others to ooze all over us. It’s one thing to be compassionate and another to be used up by someone else’s needs. It’s one thing to want to reach out and another to get sucked in to an emotional energy that’s destructive.

When reaching out and finding your niche groups, these are some things I've learned:

In order to make boundary decisions you must become aware of how you feel around, about and because of the people you interact with;

You are in charge of your own emotions – you choose, decide and maintain the boundaries of how others impact upon you;

You decide how close to allow others (and their thoughts and opinions) to get;

You decide to be affected by others or to recognize and establish the distance you want between you and them;

It’s all about YOU, not about them.

In order to make the right decisions about emotional boundaries you must be willing to 1) recognize when you do not feel good about reaching out, 2) understand what’s making you feel badly, 3) do something about it.

There are so many places, ways and people with which to interact. If you don’t feel good, healthy, supported and respected in one place immediately remove yourself from that situation and continue your search for another. Don't get caught up in trying to figure out what's wrong or fighting with people. You don't feel good, that's all you need to know. Trust that little voice inside, it's thinking both in and out of the box.


(Photo: Raaid)

Fueling PTSD Recovery

So here we are, at the end of another month in the BRIGE THE GAP healing workshop. This month we covered a lot of great information in our search for PTSD Education. I think I’d have to say that PTSD U has been a success! We’ve studied the causes, symptoms, effects and several treatments for PTSD. We’ve heard from survivors healing and from professionals helping us on the path. As survivors, we’re really clear on what has happened to us after our trauma and what our options are to find relief. Education helps us reclaim our power. Are you feeling a little more powerful now??

Next week we’ll move on to a really critical task in PTSD recovery: Educating those around us. How family members, friends and colleagues understand and perceive PTSD, plus our experience of it, drastically impacts our relationships, careers and healing. Beginning on Monday the workshop will spend the next month exploring the 5Ws of how to educate those around us about how we’re living and coping with – and healing – PTSD. If you have specific situations you’d like addressed, feel free to shoot me an email with suggestions.

The final topic in this month’s focus on education is one that (while I've written about it before) I, personally, have not experienced: group therapy. When I was initially diagnosed with PTSD I was too afraid to speak with other survivors. I was frightened that I was too weak in my own self to bear someone else’s pain or aberrant behavior. I was afraid I’d be sucked into someone else’s experience when the truth was, I could barely withstand my own. My whole perception of group therapy was that it would overwhelm me with too much emotion and crash my fragile coping house of cards. OK, so I was wrong about all of that.

Since then, I’ve learned a couple relevant things:

1 – when we practice erecting emotional boundaries we insulate ourselves from the pain drain.

2 – when we reach out to and interact with other survivors an amazing thing happens: we discover a meta-level of communication that’s all ours; we bridge the gap of our isolation in a very unique way. Connecting with survivors can be like coming home from traveling abroad and suddenly, you’re back in a country where everyone speaks your language.

The U.S. Dept. of Veterans Affairs describes group therapy this way:

In group therapy, you talk with a group of people who also have been through a trauma and who have PTSD. Sharing your story with others may help you feel more comfortable talking about your trauma. This can help you cope with your symptoms, memories, and other parts of your life.

Group therapy helps you build relationships with others who understand what you've been through. You learn to deal with emotions such as shame, guilt, anger, rage, and fear. Sharing with the group also can help you build self-confidence and trust. You'll learn to focus on your present life, rather than feeling overwhelmed by the past.

Sounds good, doesn’t it? By the time I realized all of this, I was healed, so I missed out on this possibly very positive experience. If I had to do it again, I’d find a group – and fast. Not only does the group lessen our experience of isolation, it’s also a very economical alternative to private therapy. An added benefit: listening to others speak can help us develop a voice, vocabulary and language of our own.

The disappointing thing (and one for which I intend to advocate change) is that PTSD support groups are not yet ubiquitous. In my county, for example, there are none outside of the VA system and those do not allow civilians. Which leaves us with these options:

1 – Ask your therapist for a PTSD group referral in your area.

3 – Ask your therapist to start a PTSD group!

3 – Join another existing group related to PTSD. For example, anxiety or anger management.

4 - We have to be careful with this one, but: start your own group on a site such as Meetup.com. In my zip code there is a waiting list for a PTSD group. (When dealing with strangers outside of a therapeutic environment we need to take precautions. I've worked with a local trauma therapist to develop a list of screening questions for group admission. I'm happy to share. Feel free to contact me for info.)

During healing PTSD education should be an ongoing activity, not only so that we learn more and more about ourselves, but also so that we continue to develop options for healing. We’re moving the pieces around in a healing puzzle here; the more we move the more we’ll find pieces that go together, fit, and snap into place so that a healed picture can eventually emerge.

Do you have experience with group therapy? Share your knowledge with everyone by leaving a comment.

(Photo: scottamus)

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.

WHAT IS DBT?

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.

HOW DBT WORKS

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.

DBT INDIVIDUAL THERAPY

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.

COMMON MISPERCEPTIONS AROUND SKILLS TRAINING GROUPS

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 @ live.com.

(Photo: Laura Burlingame-Lee)

Professional Perspective: How Forgiveness Helps Us Heal

Since forgiveness seems to be the dominant theme this week, it seems only fitting to include a professional take on the forgiveness question. Dr. Nancy Irwin has a winning approach to helping her clients. In her own words,

"As a therapeutic hypnotist and doctor of psychology, I know for a fact that we are all born to win. We learn to fail, and what we learn, we can un-learn. Therefore, I work to clear away the negative programming, undesirable habits, and limiting beliefs to free the inner winner in my clients."

A survivor herself, Dr. Irwin's words of experience and deep thought add great context to the forgiveness question.


THE HEALING POWER OF FORGIVENESS, by Dr. Nancy B. Irwin

"If we say that monsters [people who do terrible evil] are beyond forgiving, we give them a power they should never have...they are given the power to keep their evil alive in the hearts of those who suffered most. We give them power to condemn their victims to live forever with the hurting memory of their painful pasts. We give the monsters the last word." - Lewis Smedes

Why We Don't Forgive

For years I felt that it would be impossible to forgive my perpetrator (clergyman) of adolescent sexual abuse. I hopped up on my high horse pretty quickly when anyone even suggested I do so. He was WRONG and broke the LAW, yet year after year, I began to grow tired of living in my self-righteousness and superiority, rage, depression, deep sadness, and giving my power not only to the perpetrator, but to the past!

Forgiveness puts YOU in control, calling the shots over the trauma, allowing you to enjoy the now and your future. It frees you to create a happy ending for a movie that had a very scary scene.

Though not an overnight accomplishment, I had to learn to stop making the perpetrator "wrong." I had to see him as a flawed, emotionally arrested human being who operated with the only set of tools he had. Learning to shift my thinking from his being "wrong" to his being "inappropriate" opened up a whole new world for me. It was as if glacial shifts began occurring.....allowing me to settle into a more solid space.

I then had to forgive myself for all the years I lived in hatred and bitterness. I had to review what really happened, express all my feelings about the trauma and the abuser, all my feelings toward those I blamed for not rescuing me. I sorted all this out through therapy, through writing letters and finally through a confrontation. I let him know what his actions had cost me in life. Unfortunately, I was met with defensiveness and denial, yet I got to speak my peace and forgave him his denial, defensiveness, his ignorance, and his inappropriate actions. And almost overnight, 30-year-old symptoms began dissipating: fear of men (especially those who looked like him), my rapid startle reflex, fear of engulfment, fear of intimacy, and more.

What Forgiveness Gives to Us

Forgiving is the ultimate in standing in a place of acceptance and healing. Yes, the scar may remain, yet you are stronger in that place. As a survivor of traumatic experiences myself, I am a psychotherapist/clinical hypnotist specializing in trauma recovery, I have learned to abandon the "why me" questions that kept me trapped in my victimization. When I began asking "how could this experience help me or others" questions, I was able to reclaim my power. Trauma comes from Greek word "wound." As we all know, wounds can be healed. They may leave scars, yet scar tissue is tougher and allows the wounded area to be more resilient than before. I discovered that there was great meaning to my trauma; not that I'd wish it on anyone on the planet, of course, but it led me be the healer that I am.

Like the physical body, the psyche is designed for survival and protection, and is quite resilient. Trauma can leave marks on the psyche that act as warning signals for future similar dangers. This "default setting" may seem like that of a computer program; some are tougher to re-set than others. To avoid automatically reverting to the fear state that the original wound set up for you, there are ways to re-program that amazing computer of your subconscious mind: intervention, treatment, normalization, acceptance, and finally forgiveness. Forgiveness is NOT condoning deviant or criminal behavior. It gives you permission to move forward in your life with peace of mind. Further, you give the perpetrator permission to be accountable and responsible going forward. Staying in righteous mode (while the ego loves it!) disallows growth for all parties.

Things to Think About as We Move Forward

Everything and everyone has a positive intent. No one (including Mother Nature) does anything to be bad, stupid, wrong, or even evil. Even serial killers (and I'm certainly not defending them!) have a positive intent: to be in control or feel powerful. The goal in therapy is to find a healthy way to meet that need without harming others or the self. Just like your responses to trauma have a positive intent (protection, releasing and healing), so do the causes. In the case of natural disasters, the planet is shifting into a more settled position, or is releasing congestion and toxins from the atmosphere.

Many perpetrators are unable to forgive themselves for their behaviors. While it may be tempting to proclaim a resounding "Good! They SHOULD suffer!" this perpetuates the blame-shame cycle and no one is free. The best way to decrease further victims is to forgive the offender. Then, and perhaps only then, can future victims be spared. Yet forgiveness is for YOU.
We tend to have irrational beliefs such as "No harm should ever befall me" or "Others should always be appropriate" or "S--- never should happen to me." Until that Utopia exists, a more rational belief to operate from is: "While I hate the ignorance and inhumanity of others, I forgive the acts and find meaning from it to further my growth as a compassionate being."

If you have found a way to be at peace and in acceptance and do not need or want to forgive, I applaud you. Again, forgiveness is not essential to recovery. If my words here are offensive to you, or anger you, I honor your feelings. I can almost promise you that with the passage of time, the burden of anger will grow exponentially heavier than the trauma. When you forgive, you open the door to freedom.


Dr. Nancy Irwin graduated from the Hypnosis Motivation Institute in Tarzana, California with honors and the Director's Award. She is a member of the Hypnotists' Union, the California Psychological Association, the American Academy for Experts in Traumatic Stress, and the California Coalition on Sexual Offending (CCOSO).

Dr. Irwin is also a certified practitioner of Neurolinguistic Programming, Time Line Therapy and Emotion Free Therapy, combining these modalities with hypnosis to effect the most rapid change possible in her clients. While Dr. Irwin treats over 100 different issues, she is dedicated to treating victims of child sexual abuse as well as abusers.

In addition to earning a doctorate in psychology from Southern California University of Professional Studies, Nancy has a Master of Music degree in Opera Performance, and her background as an opera singer and stand-up comedian adds heart and humor to her healing. A popular keynote speaker she insists, "Change does not have to hurt!"

(Photo: Nancy Irwin)

PTSD Education: 8 Dos & Don'ts For Breaking the News

Let’s face it: While there are literally thousands of resources for how family members and friends can and should approach us about mental illness, there’s not a single resource for how we should approach them. Time to get creative and make a resource of our own.

I’m taking as my inspiration here one of my favorite (and the most fun) mental health bloggers, Alicia Sparks’ piece, ‘Don’t Avert Your Eyes: Know How To Talk About Mental Illness’. In this great piece (for people who don’t have any mental issues) Alicia outlines how family members should approach us about our problems. I’m going to turn the tables for a minute and use Alicia’s list to our advantage in how to approach family and friends to discuss our PTSD experience and diagnosis. Here are Alicia’s 8 dos and don’ts, from our PTSD point of view:

DO spark up a conversation
As difficult as it can be (and as stressful as it may be to think about doing) it really is necessary to speak to select family and friends about your PTSD diagnosis condition. Bad things grow when you hide; good things wither when you don’t take care. It’s so easy in the beautiful isolation of PTSD to just let familial and friend relationships fall into disrepair, but these are exactly the people who can turn out to be a part of the support system we need to build for health. Opening up to them is an important step and can be done simply by telling someone or the whole clan you’d like to discuss an important issue. Get their attention by letting them know something serious is at stake.

DON’T Be Aggressive
In the PTSD state we’re already so frustrated, annoyed, anxious and angry that it’s easy to take this out on family and friends when they don’t immediately understand or embrace what we’re saying and asking for. But let’s think about this from their perspective for a second: We’re telling them there’s something wrong with us – and they can’t do anything about it. Their own natural reaction could understandably be: frustration, annoyance, anxiety and anger. It won’t help the conversation if we don’t reign in our emotions, or don’t allow our audience to have emotions of their own. Getting angry will effectively shut down everyone on both sides. Before you spill the beans do some centering exercises (i.e. breathing, meditation, relaxation, yoga) so that your own core self is as calm as possible.

Do Show Concern For Them
As much as it feels like it, this conversation about your PTSD diagnosis is not all about you. Take a step back and realize that this news can be overwhelming to family and friends. Tell them you understand this, and that you’re willing to answer as many questions as you can so that they can better grasp the situation and what it means. If we set the stage for compassion it can more easily be returned to us.

DON’T Act Like It’s The End Of The World
This is a serious conversation, but it doesn’t have to feel like the earth is about to implode. PTSD is not exactly a mysterious, rare disease. Using facts about symptoms, stats, and causes, let your family know that PTSD is not unusual given the trauma you experienced. Outline for them the many treatment options you have and let them know that people can heal. Although it takes time, PTSD is not a death sentence; don’t present it as if it is.

DO Spend Time With Your Family & Friends
Even though all we really want to do is crawl under the bed and stay there, for our own sake and that of friends and family it’s better that we try to remain in touch. True, sometimes we just have to fake it when we’re out and the fog descends or panic sets in, but this is part of how we learn to cope and manage our symptoms. PTSD can mean we become hermits, or we can decide that we’ll go for a 2 hour dinner with family or friends and then scurry home. Especially after we explain our PTSD diagnosis, people will worry about us and want to reach out. Make it easy for them to remain in touch while continuing to maintain the boundaries you need to cope and get well. In everything there is a balance; strive to find it.

DON’T Smother Anyone
The tendency toward isolation can be overturned once we reach out: When we know people appreciate and understand our situation it is easy to then just fall apart all over them. Not a good idea. While we want, need and should have the support of family and friends, we still need to support ourselves. While we have every right to lean, we don’t have the right to assume anyone’s full-time job is now going to be taking our sobbing phone calls at all hours and running around the globe picking us up when we crumple. Sharing the facts of our situation doesn’t give us license to assume anyone now becomes our personal caretaker. This is still a battle to be won by our own acts of self recovery.

Do Keep It Light
Find the humor in your symptoms. When you’re dragging around exhausted from insomnia, let people know your subconscious was particularly chatty and kept you up all night. Personalize PTSD in a human way so that rather than being frightened of it friends and family can view it as its own (albeit unwanted) presence. You have a shadow; everyone should become friendly with it. The last thing you need is for anyone to add to your heaviness by lending some of their own.

DON’T Act Like It’s A Joke
While a little levity never hurts a situation, don’t use any humor that connotes something negative about you. Don’t say, Well, you know I’m nuts after all. You and PTSD are separate entities temporarily conjoined. You are not crazy. You are coping with symptoms. While you can make light of the symptoms, never demean or make light of your experience of them or your struggle to be free. You are doing the best you can (aren’t you??) given the circumstances. Always respect yourself, your battle to overcome, your intention to heal, your commitment to be well and your desire to be free. The attitude you project – one of strength, knowledge and strategy – is the one others will mirror. Plan wisely. Speak well.

Everyone’s situation is different; everyone’s family and friends more or less supportive than we’d like. But when it comes to educating those around us this list gives us a good starting point.

What would you add, clarify or define here? Leave a comment or shoot me an email.

(Photo: Shade Thinker)