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.

BRIGE THE GAP EXERCISE:

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)

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.

BRIDGE THE GAP EXERCISE

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)

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.

BRIDGE THE GAP EXERCISE:

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)

PTSD Diagnosis: 7 Tips for Telling Your Family

OK, so you’ve thought about how to choose which family member to speak to about your PTSD diagnosis and hopefully you've decided on someone. Now, you actually have to follow through with doing it. Problem is – let me guess: It’s hard to talk about it. Don’t I know it! One of the symptoms of PTSD no one ever, er, talks about is how tough it is to talk about.

The PTSD brain fog and chaos make thoughts, sentences, phrases and sometimes, even single words, tough to transfer from the mind through the mouth to the outside world. I always felt like there was a bottleneck; too many ideas and emotions crushing against each other in the narrow chute that would spit them out into language. This was frustrating. I didn’t have the energy for it. Plus, I didn’t have the focus to unjumble it all up. So, I stayed quiet. For a very, very long time.

Silence, though, isn’t helpful when you’re trying to heal PTSD. We have to find a way out of the language maze. New information can be tough to hold onto when we’re in the shadow of PTSD; having things in writing can make all the difference by making us grounded when we attempt to speak. If we surround ourselves with physical details and explanations that we can refer to rather than try to remember (because, let’s be serious, while our memory of traumatic events is impeccable our recall for the little things is not exactly up to par) it makes talking with others much easier. The key to having conversations is limiting – and as much as possible reducing – the amount of stress such communication engenders.

A few tips and tricks to help order your thoughts in a way that makes PTSD presentable to a family member:

1 – Make an outline of how you want the conversation to go. Make a numbered list of the points you want to make, the facts you want to share, any issues you want to discuss, plus information you want to quote. Use this as a guide and refer to it frequently during the conversation.

2 – Make a cheatsheet. Maybe you’re more of a conversational freestyler and don’t want to be hemmed in by the structure of an outline. Instead of an organized plan free associate a list of things you want to cover in the conversation and jot them down. During the conversation you can check off each point as you make it and continue on to something else.

3 – Make flashcards. Sometimes we’re not sure how we want to approach a subject. Often it’s difficult to decide in what order we want to say things. Write out each point, fact, piece of information on its own individual index card. Then, place the cards all over the floor or table and look them over. Choose an order and place the cards in a pile. Set it aside. Think about it for a while. Go back to the pile the next day and look through the order of the cards. Does it feel right? If not, dump the cards and start over. When you’ve got the order you like sit down with the cards and a family member and flip your way through the conversation.

4 – Write a letter. Often, it’s easier to say what we want to say when no one is listening; easier to write out our thoughts when we’re not watching for someone’s reaction or picking up the thread after they interrupt. Who says ‘talking’ to a family member about PTSD has to begin with speech? If you don’t want to risk the initial interaction, write a letter to a family member explaining everything about you and PTSD. Then, read the letter to him or her aloud, or give it to him or her to read and follow up with a conversation afterward.

5 – Make a voice recording. Don’t like to write but don’t want to do something face to face? Tape a cassette or burn a CD. Using your notes, say what you want to say in the privacy of your room or office. Then pass the tape/CD around the family to get the conversation going.

6 – Make a video. There’s something very immediately impactful about being able to watch someone speak. With the same impulses for making a recording, use a video camera or webcam to speak to your family in your own controlled environment and then share the video with them.

7 – Print information off the web. If you’re not ready to do the work that speaking involves, or you don’t want to try ordering your thoughts, you don’t have to. The net is full of good information you can print out and give to a family member to read. This blog, for example, has an entire PTSD Education series with several posts that outline PTSD symptoms, causes, effects, treatments and other pertinent information. Make a PTSD packet for your family and then ask them to read through it.

BRIDGE THE GAP EXERCISE:

Choose one of the methods above and use it to prepare yourself for a conversation.

How did you tell your family? Share your tips and tricks for approaching family members about PTSD. Leave a comment or shoot me an email.

(Photo: firoz shakir)

PTSD Diagnosis: Educating Family

When we think about educating our world about PTSD, the most logical place to begin is with family. Assuming you’re on speaking terms with them and they’re not the origin of your trauma, family is usually the first line of defense between a PTSDer and the outside world. Mothers, fathers, sisters, brothers and extended relations are usually the people we feel most comfortable being ourselves around, who we call when we admit we need help, who bail us out when we get ourselves in tricky situations, and are, in the best of circumstances, the people who love us and hurt the most when we’re unhappy. It’s critical then for this group to understand our condition.

Over the next few BRIDGE THE GAP posts I’ll outline different things to consider about approaching family with your PTSD diagnosis, plus how to communicate to them what you’re dealing with and how they can help.

Understanding PTSD Yourself

When I first discovered I had PTSD I kept the diagnosis to myself for a while. I wanted to fully understand it before I tried to explain it to someone else. I did a great deal of research and, because I would have been a professional student if that was a job description, I took notes, made outlines and highlighted the facts on tons Xeroxed, printed and downloaded pages. I studied PTSD which meant, really, I studied myself. In the things I read I recognized who I was, had become and was struggling so hard not to be. I spent a lot of time thinking, I’m not crazy after all! I walked around feeling like I had 2 new and very important secrets:

1 – a name for what was wrong with me

2 – the knowledge that, after all, there was nothing wrong with me but how my mind was processing memory

These two secrets meant that in explaining the situation to someone else I could highlight the fact that there was something bigger than my own temperament at fault. For many years I had just deemed myself ‘difficult’ and imagined that’s what others thought, too. With diagnosis came the chance to set the record straight.

Deciding Which Family Member to Talk To

After my own education my next task was choosing the first person to tell. We have two choices in making our announcement: we can tell the whole family all at once, or we can tell one person at a time. I chose the one person at a time option. While I’m very close to my entire nuclear family, my emotional state was fragile and fragmented enough without having to deal with the reactions, questions and suggestions of three people all at once.

Choosing with whom to first share my news was a no brainer. My mother has always been my best friend, champion and most trusted companion, so when it came time to share all of the new information I had, she was my natural choice. But if she hadn’t been, I would have had to develop a list of criteria to assess who would be the safest choice to begin sharing my story with. My list would have looked like this:

1 – who is the most compassionate?

2 – who do I trust the most?

3 – who usually if not always seems to understand me?

4 – who has more often than anyone else worked to keep a relationship with me despite how difficult that has been?

5 – who is the most empathetic and willing to feel my emotions with me?

6 – who do I feel most comfortable talking to?

7 – who do I feel I can be myself around?

8 – who is the most stable so that I can count on their calm acceptance of this news?

9 – who do I think can support me the best on my road to recovery?

10 – who has the most patience?


Choosing to out ourselves and our struggle with PTSD is a very personal and brave action to take to further our PTSD healing. We need to move slowly and to carefully consider whom we bring into our inner circle of healing. Take your time, choose carefully.

BRIDGE THE GAP EXERCISE:

Two exercises today:

1 – Make your own criteria list. What qualities do you want in the first person you choose to share your diagnosis with? See if you can list 10 characteristics that are important to have in the person you talk to.

2 – Make a list of possible candidates in your family and score them against your list of criteria. Literally, make a chart and individually consider how each family member ranks on your list of criteria. One person may be a great listener, but has a tendency to interrupt; another may be empathetic but also demanding. Slowly working your way through a chart can help you put the facts into an easy to interpret form that allows you to clearly see who you think and feel would be the best person for you to approach. (For a free copy of a ‘PTSD Family Assessment’ chart email me at parasitesof.themind @ yahoo.com.)

How did you choose the first family (or adopted family) member to tell about your PTSD diagnosis? Leave a comment or shoot me an email.

(Photo: arcojedi)

PTSD Healing: What are the Causes of PTSD?

So, now that we know the definition and stats of PTSD, you can see how incredibly large the PTSD pool is. And, I’ve received more than one email from professional mental health colleagues who suggest that PTSD is underdiagnosed, which means the numbers are below the actual amount and they grow every day.

To add to our understanding of the PTSD experience – and to learn even more about the large group to which we belong – it helps to be aware of the many causes of PTSD.

Of course, PTSD as we know it was originally applied to the military experience, but in fact, there are many traumatic events that cause the disorder. According to Sidran Foundation (one of our leading trauma organizations) the anxiety disorder PTSD appears in “Anyone who has been victimized or has witnessed a violent act, or who has been repeatedly exposed to life-threatening situations.”

This includes survivors of:

-Domestic or intimate partner violence

-Rape or sexual assault or abuse

-Physical assault such as mugging or carjacking

-Other random acts of violence such as those that take place in public, in schools, or in the workplace

-Children who are neglected or sexually, physically, or verbally abused, or adults who were abused as children

-Survivors of unexpected events in everyday life such as:

-Car accidents or fires

-Natural disasters, such as tornadoes or earthquakes

-Major catastrophic events such as a plane crash or terrorist act

-Disasters caused by human error, such as industrial accidents, medical mistakes

-Combat veterans or civilian victims of war

-Those diagnosed with a life-threatening illness or who have undergone invasive
medical procedures

-Professionals who respond to victims in trauma situations, such as, emergency medical service workers, police, firefighters, military, and search and rescue workers

- People who learn of the sudden unexpected death of a close friend or relative

This is only a partial list. Can you think of causes not listed here?


BRIDGE THE GAP EXERCISE:

Time for you to dive in and learn some things. Two of the top sites for educating yourself about PTSD:

Sidran Institute

David Baldwin’s Trauma Page
(This is an award-winning site, but be careful; it is massive and easily overwhelming. Take your time. Go slowly.)

Discover some interesting new factoid about PTSD? Leave a comment or shoot me an email. The more we share our knowledge the quicker we all heal.

(Photo: Byabpryor)

PTSD Healing: PTSD U Has Officially Opened

Sometimes I wish someone would found PTSD U – a university for the study of Post-Traumatic Stress Disorder symptoms, causes, effects, treatments and everyting in between!

PTSD is so vast and diverse in the population it would take the equivalent of studying for a degree to learn about the biomolecular, anthropological, civic, statistical, psychological, physiological, historical, international, social, literary and educational aspects of it. Right there you’ve got an entirely well-rounded college course curriculum!

Until a big endowment opens the doors to such a program (and gives us all scholarships to attend), we’ll have to take on the course development ourselves. Let’s start with everyone’s favorite: statistics

So, you’ve been diagnosed with PTSD. Immediately you need to know your place in the universe. Statistics help your brain visualize, categorize, and understand the group to which you now belong, which can be summarized this way on Medicine.net:

Posttraumatic stress disorder (PTSD) is an emotional illness that develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal life experiences (hyperarousal).

Although this condition has likely existed since human beings have endured trauma, PTSD has only been recognized as a formal diagnosis since 1980. However, it was called by different names as early as the American Civil War, when combat veterans were referred to as suffering from "soldier's heart."

In World War I, symptoms that were generally consistent with PTSD were referred to as "combat fatigue." Soldiers who developed such symptoms in World War II were said to be suffering from "gross stress reaction," and many who fought in Vietnam who had symptoms of what is now called PTSD were assessed as having "post-Vietnam syndrome."

PTSD has also been called "battle fatigue" and "shell shock." Complex posttraumatic stress disorder (C-PTSD) usually results from prolonged exposure to a traumatic event or series thereof and is characterized by long-lasting problems with many aspects of emotional and social functioning.

I've pulled the following stats from a variety of articles, trauma organizations and trauma centers.

General Stats

- 70 percent of adults in the U.S. have experienced a traumatic event at least once in their lives.

- Up to 20% of these people go on to develop PTSD. (Since there’s always math in statistics, a little word problem: As of today the U.S. population count = 306,126,644. If you eliminate children and teens what’s the maximum number of people who will experience PTSD? Now, remember the number grows every day.)

- An estimated 5% of Americans – that’s 15 million people – has PTSD at any given time.

- An estimated 1 out of 10 women develops PTSD; women are about twice as likely as men.

- Among people who are victims of a severe traumatic experience 60 – 80% will develop PTSD.

- Almost 50% of all outpatient mental health patients have PTSD.

- Somewhat higher rates of this disorder have been found to occur in African Americans, Hispanics, and Native Americans compared to Caucasians in the United States.


Combat PTSD

- Lifetime occurrence (prevalence) in combat veterans 10 – 30%.

- In the past year alone the number of diagnosed cases in the military jumped 50% – and that’s just diagnosed cases.

- Studies estimate that 1 in every 5 military personnel returning from Iraq and Afghanistan has PTSD.

- 19% of the soldiers who’ve been deployed in the past 6 years has PTSD. That’s over 300,00.

- Doing the breakdown by war:

Iraq = 12 – 20% returning vets have PTSD

Afghanistan = 6 – 11% returning vets have PTSD


Children & PTSD

- As many as 30 – 60% of children who have survived specific disasters have PTSD.

- Up to 100% of all children who see a parent killed will develop PTSD.

Adolescents & PTSD

- Up to more than 40% have experienced a traumatic event.

- Development of PTSD = 15% in girls, 6% in boys

- 3 – 6% of high school students in the U.S. who survive specific disaster develop PTSD.

- More than 33% of youths exposed to community violence with experience PTSD.

BRIDGE THE GAP EXERCISE:

The first class of any course is usually short – it gives an overview of the syllabus and then you’re supposed to read the first 4 chapters of the textbook before the next meeting.

Your homework is to dig up your own stats for the segment of the PTSD community in which you live. This can be done by a simple Google search – and then lots of reading!

When you discover statistical facts that are not listed here, leave a comment or shoot me an email. The more we pool our knowledge the more the entire PTSD community learns and heals.

(Photo: inju)

PTSD Healing: Why Every PTSDer Needs To Make Some New Friends

Congratulations! Today you are officially ¼ through the year long BRIDGE THE GAP healing workshop, which means you are three months closer to achieving your goal for healing PTSD. We are all individual in our healing paths, so you may have 3 months or 3 more years to go on your journey to becoming PTSD-free, but by using the BTG workshop to supplement your other therapeutic activities you are giving your healing journey a self-empowered foundation. Very cool. And also, very effective.

Part of healing means taking back the power that trauma and PTSD have stripped from us. No one can do this; we must do it for ourselves. The BTG series of posts is designed to help you construct a post-trauma identity that will confidently and with renewed strength and courage support your healing process.

This month we’ve been focused on Healing Resolution #3: I WILL REACH OUT.

This included:

1 – Learning to let your voice be heard

2 – Joining the survivor crowd

3 – How to choose a good online support group

4 – The 5Ws of reaching out

5 – Establishing emotional boundaries

6 – How to find a good offline support group

7 – How to reach out to family and friends

8 – The benefits of participating in a group activity


There is one more aspect of reaching out I’d like to cover before we leave this topic: The value of making new friends outside of the survivor community.

When I first began to construct my post-trauma identity I decided to pursue my joy of dance. I joined a local studio and went to classes every night of the week. At the studio I was My New Self. I did not speak about PTSD, trauma or my struggle to heal. I acted as I wanted and hoped to become. No one who met me knew anything about my past at all. To the other dancers I was just a woman who wanted to learn salsa, Argentine tango, West Coast swing, etc. People related to me only in the present moment, as if I was just another ‘normal’ person on the dance floor as if that were true, that’s exactly who I was. We learn things by repetition; we can relearn who we are this way, too. Every night in class I practiced dance steps and also: how to develop a self that had no PTSD strings attached. I was in the moment, of the moment, loving the moment.

This break from my PTSD identity was enormously liberating. I could be whomever I chose. I wasn’t a survivor, I was a dancer. I wasn’t struggling with PTSD, I was learning to cha-cha. I took these classes (and the socializing I did before, during and after them) as time to focus on the woman I wanted to become: a friendly, outgoing, in-the-moment person who was not constantly focused on my past.

Of course, this doesn’t mean I became that woman overnight. Nor does it mean that my past no longer existed. But by engaging in an activity that allowed me to feel joy and that distracted me from my pain – and one that allowed me to be perceived by others as something other than ‘survivor’ – I was able to take a short break every night from the overwhelming PTSD experience. This was good for me. I think it would be good for you, too. We focus on our pain a lot; we need to balance that with something other positive activity.

I hear you thinking I’ve lost my mind, grumbling that I don’t know your PTSD experience or I wouldn’t suggest this.

But that would be an incorrect assumption.

I do know. I was the biggest fan of ‘Leave me alone!’, ‘I don’t want to see anybody!’, and ‘I don’t want to talk to anyone!’ Unfortunately, these aren’t really healing attitudes.

It’s time to begin to break out of the PTSD mold. Inside of it we are not the most social animals, but we can develop that sort of behavior. It doesn’t have to be instinctual. We can condition ourselves to develop this sort of healing action. The benefits are too immense for us to overlook how getting outside of our PTSD selves:

1 – gives us a much-needed break from the rhetoric in our own heads

2 – allows us to discover what it feels like to be taken for face value

3 – puts us around other people whose energy is not struggling oriented

4 – reminds and shows us that we have not lost the ability to interact (even though PTSD can make us feel it is impossible and even though the first couple of interactions may not go perfectly)

5 – in the best case scenario puts us in contact with people whose presence is uplifting, energizing and inspirational (i.e. the dance community is full of people laughing, smiling and having a good time. Being around this – even on days my PTSD symptoms made me feel like crawling under the bed – it was impossible for it not to rub off on me in some way.)

We deserve to be happy, unhaunted, evolving, adventurous and experimenting people. It’s been 2 years since I entered the dance community. Since then I’ve constructed my post-trauma identity around the experience of joy, made some terrific friends, fallen in love with my dance partner, and become such an accomplished dancer I'm regularly asked to teach, perform and compete (which means I have a new marketable skill - always a plus in this economy! You never know where experimental healing can take you). Getting outside of my own head opened up a whole new world, one I could never have expected when, deep into my PTSD experience, I entered the studio for the first time.

Reaching out and making new friends can be like a breath of fresh air for PTSD healing. Get out there and breathe deeply. Who knows, you might just get a joy/normal/relaxation contact high. Now, wouldn’t that be nice?


BRIDGE THE GAP EXERCISE:

Make a list of 5 things you like to do. Play tennis? Like to quilt? Want to hone your drawing skills? Like to take photographs? Think about things you like to do that bring you a sense of pleasure and/or accomplishment.

Examine the list – which activity do you most want to do today?

Pick up the phone book, get online, look at your local paper: Where can you go to do this activity?

Make a plan to go to one thing at least one time in the next one week. Healing is about small steps, but we can travel great distances that way.

What outside-the-range of PTSD activities do you think allow PTSDers to get out of their heads for a little while? Leave a comment or shoot me an email.

(Photo: P Kinski)

PTSD Healing: Reaching Out To Family & Friends

Let’s think, for a moment, about what it’s like for those people who struggle to live, love, cope with and manage during our PTSD journey. I’ve written before about how difficult my PTSD experience was for my parents and brother. I was not nice. I was disconnected and removed. I was teary and depressed. I was furious and raging. I was starving myself in an effort to feel safe.

I was debilitated by extreme physical symptoms of psychological stress. I was in out and of doctor offices and hospitals for tests that led to erroneous and frightening diagnoses of maladies that we discovered later were purely caused by PTSD.

I was surviving but not thriving. I had lived through my trauma but was not even close to living a life that celebrated my survival. Instead, I descended down a black staircase and forced those who cared about me to watch me self-destruct.

Is this fair to those who stand by us? Is this the right way to honor those who don’t abandon us in our darkest hour? Is this the way to respect our own strength to survive, and the role our loved ones and friends are playing in helping us to get back on track?

If you had asked me this at the time I would have snarled, “This isn’t about them!”, or I would have dissolved in sobs about how I just couldn’t handle worrying about my family when I could barely hold myself together.

But we do need to think about them. They are the ones who did not have to survive trauma and whom we are now making slog through the muck anyway. We are traumatizing them with our behavior, and mostly they take it and defer to our pain and continue to walk the path with us despite how we treat them.

Survivors aren’t the only victims of trauma. Sure, we’re the main victims, but trauma is a big pond and the ripples are pretty strong.

In developing your ability to reach out this month, begin to think of those around you, and how your behavior impacts them. I never did this and I really should have because: If we think outside our own head for a moment and figure out how to better communicate with those who surround us, our healing can progress faster and our relationships can be maintained better. We want these people to stick around. We want to have friends and family when we are healed. We’d better think about that every once in a while.

It’s time, in your healing process, to begin reaching out to family and friends. To bridge the gap between themselves and you and your PTSD experience. One good way to do this is to explain to them what you feel and how you struggle.

The PTSD organization, Carrot of Hope, asked me to write an article that reaches out to friends and family of PTSDers. In response to their request I wrote ‘What I Wish My Family Had Known’ an article from the PTSD perspective that explains to those without PTSD what our internal struggle is and how they can help. In order to open the conversation with your friends and family, read this article together and relate your own experiences to my Top 10 things every family should understand about living with someone with PTSD.

BRIDGE THE GAP EXERCISE:

Make your own list of the top 5 things you wish your family understood about your PTSD experience and behavior. Choose one or two or even three people to explain this to. Reaching out means finding clarity and sharing it with those around us. The more we do this the more we heal. The more others understand us the more they can give us the room and support to move toward wellness. The more we reach out the more we pave the way to ease the struggle within.

(Photo: Andrew Orange)

PTSD Healing: Finding the Right Support Group

My brother and I are in Miami on business, which last night included meeting a client at Miami Fashion Week. We went with high hopes for an interesting evening. We’re New Yorkers, after all. We know that Fashion Week in New York means high glitz, high fashion and high expectations for an interesting crowd.

What we got was the surprising understanding that High Fashion is not how Miami conceives of Fashion Week. The event, held in a warehouse on the outskirts of downtown Miami, was mostly attended by what looked like high school students and friends and family of the presenting designer and models. The designs were uninspired and the catwalk crowded with women slumping up and down rather than professional models slinking, high-stepping and stalking down the runway. On the professional and entertainment scale, the event didn’t exactly live up to what we envisioned.

Same thing can happen when we reach out. Not every support group is going to be The One. Finding the right support environment is a little like shopping, you have to have an idea in mind, try on a garment, and then keep searching for that piece that makes you want to part with your money.

I’ve been trolling around lately looking for good resources for finding a PTSD support group in any geographical location. Finding groups online is easy, but I’m not having a lot of success with finding a live group resource. Unlike other illnesses and disorders, it seems PTSD hasn’t yet been organized. I’ve called my state and local health departments; when I ask about a PTSD support group they refer me to the substance abuse program. While it’s often true that addictions become wrapped up with the PTSD experience, that’s not the focus I’m looking for.

It really bothers me that we can’t find the outlet and support we need. This is why I’m in the process of launching Heal My PTSD, LLC, which will be an organization to advocate for PTSD awareness, education, treatment and healing. (You’ve probably noticed the new logo!) One of the projects I’m really looking forward to is collecting nationwide support group data and offering it on the site.

In the meantime, I’ve begun polling all the professional mental health people I know. What’s the best resource for finding a local PTSD support group? I ask. The answers have been varied, but they include references to sites and organizations that are searchable and so may offer information in your area. Today, I thought I’d list a few ideas to assist you in finding a way to get off the computer and into the world:

FACT SHEET: HOW DO I FIND A LOCAL SUPPORT GROUP? (Start here for a really terrific and comprehensive overview of resources.)

WAYS TO SNIFF OUT A SUPPORT GROUP NEAR YOU

NATIONAL ALLIANCE ON MENTAL HEALTH (NAMI): Call your local chapter and ask for guidance.

Each state has a list of its local NAMI resources. For example, Cindy Nelson, one of my NAMI friends, sent me this link to the info they have on the Massachusetts NAMI site. (Her email is included, so you can write her for more info – tell her you were referred by me; she’ll take good care of you!) Check out the NAMI site for information in your state.

HOW TO FIND A SUPPORT GROUP FOR POST-TRAUMATIC STRESS DISORDER

FINDGROUPTHERAPY.COM (Search the site specifically for Trauma/PTSD. The site is California-heavy in its information, but it is in the process of building a national database.)

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (search by state)

Finally, I really like this article on the Mayo Clinic web site – not only does it outline benefits of participating in a local support group, but it also provides info on evaluating, finding and maintaining your own approach to interacting.

(For all you international readers, check with your local hospitals, information directories, clergy and local mental health organizations for direction to the proper resources.)

Some of the resources in your area may offer everything except PTSD. If you can’t find a local PTSD support group (and if you are juggling more than one issue) think about joining a group that addresses one of the other topics/diagnoses you’re dealing with.

And then, go to the group with high expectations. Try to make it work for you. Bret and I found the fashion event to be far below what we expected, but we have a good time together; we made the night work instead of being frustrated by what didn’t work. We viewed the event as a night for us to hang out together, which we don’t often have time for.

Reaching out to a group goes two ways, 1) what it has to offer you, 2) how you engage in it. See if you can make the best of the experience. And if you don’t like one group, go back to the resources and plan to try something else. It feels good to get out of the house. More than that, it’s good for us (even if it doesn’t feel good initially) to force ourselves to engage in the world outside. Find a group. Give it a try. If it doesn’t work, keep looking until you find a community that feels right. We heal faster when we stop isolating ourselves.

BRIDGE THE GAP EXERCISE:

Troll the resources offered here. Make a list of groups that might be right for you. Pick up the phone and call 1 – 3 places to find information about where and when the appropriate support groups meet in your area. Take out your calendar; mark the next meeting date. Start preparing yourself mentally now to go to the next meeting.

If you come across a resource that offers good PTSD support group information in any geographic location, please leave a comment or shoot me an email so that we can offer it to everyone.

(Photo: Feeling Croppy)

PTSD Healing: Join the Crowd

Yesterday I received an email from a mother, we’ll call her L. Her son had been robbed at gunpoint and shot in the back in Los Angeles. L. was in Houston when she got the call. She jumped on a plane not knowing whether or not her son would be alive when she landed.

This was 6 months ago. Her son did live. In fact, he’s fully recuperated and returned to living his normal life. L., however, can’t get past the trauma. Her PTSD symptoms continue to persist.

She wrote asking me to cover these topics (which I will in future posts):

One, I feel ridiculous/guilty/whatever the word is for still having symptoms because a) my son is fine now, and b) people have been through a lot worse.

Two, my brain has been completely addled since then -- so much so that I have an appointment with a neurologist in case it is early dementia rather than PTSD. One of the most disconcerting symptoms is that I truly cannot remember what day of the week it is. Is it Sunday? Is it Thursday? I have to work my way back a few days to figure out what today is.

I’m struck by the isolation of L.’s experience. She's not the only one to feel ridiculous. She's not the only one whose brain isn't functioning optimally. Clearly, L. could benefit from reaching out to the PTSD community. She is feeling alone and frightened and unworthy. (As if your trauma has to be of a certain caliber to render your PTSD worthwhile!) I suggested she see a therapist to discuss her symptoms more in-depth; I wasn’t sure whether or not she was already doing this.

In the meantime, I also suggested L. join an online support group where she’d have the immediate advantage of a community of likeminded people to whom she could address her questions, and from whose viewpoints she could learn how common her feelings and symptoms are. If L. reached out to an online community she would discover we all struggle with various forms of the same thing. For example, do all of you know exactly what day it is? Do any of you feel ashamed about your symptoms? Brain fog is a common occurrence for PTSD experiencers. (I've written about this in my own PTSD experience.) L. might heal just a little bit by knowing she’s not alone. She might engage in healing more if she thought her healing was worthwhile. If we don’t feel our symptoms are worthy, how can we feel our healing is worthy?? The erroneous thoughts in our minds cannot continue if we let in the sound of other survivors' ideas and experiences.

L. ended her note to me saying, “I'll look forward to hearing from survivors.” But L. doesn’t have to wait for you all to leave a comment of solidarity or encouragement, she – and you – can immediately get answers and hear others’ voices in an online support group. Of all the online PTSD support groups I’ve researched and participated in, there’s one that I've found far surpasses all others: www.DailyStrength.org has a wonderful mix of intelligent, educated, proactive, struggling and healing PTSD experiencers. They are vocal and supportive, strong and thoughtprovoking. And the best part; you can be anonymous, so you can really get in there and say what you want to say, get answers to your darkest secrets and listen to your peers as they unravel the path of their own PTSD journey.

BRIDGE THE GAP exercise:

Today, join an online support group. Fill out your profile as much as you can (even if you're using an anonymous name) so that other survivors are able see who you are and identify with you and your experience.

Read the most recent discussions for the past few days.

Post answers to topics that have been posed.

Post your own ideas, thoughts, feelings, problems, issues, and questions.

DailyStrength.org is active 24 hours a day with people from all walks of life and all around the world. You will feel at home there. You could begin to exercise your voice. You could begin using the speaking tools we’ve been developing here to connect to a community; to bridge the gap between you and the outside world. Come on, you know you want to. Click here to reach out.

If, in your research of other online support groups, you come across additional sites you feel provide a great forum for PTSD experiencers, please post a link in the comments.

(Photo: Justin Ward)

PTSD Healing: Let Your Voice Be Heard

OK, so you read Monday’s post on reaching out and you thought, "Hell, no! I’m not ready to be a Chatty Cathy."

That’s cool. No need to rush into healing head first. You can sidle around the idea; circle it like a puppy before he chooses to lie down on a big fluffy pillow.

For now, reaching out can actually be done in private in the comfort of your own home. (This is just in the beginning – don’t get too comfortable with the fact that you can always reach out without personally interacting!)

The first step toward reaching out does not have to be a big one. Often I write and speak about the proactive things we need to do to heal. However, sometimes reaching out means sitting still and doing nothing at all but listening to the voices around us. In order to fully reach out and engage in healing and the world outside PTSD – which is where you eventually want to end up feeling comfortable and functional – it helps to hear that others are thinking the way you do, are as confused, troubled and stumped as you are, and are working as hard at figuring it all out, too. Do this more. Find a wide range of PTSD bloggers you can check in with every day. Learn from them. Educate them. Befriend them.

Look, this is easy to do – you’re already doing it (you’re here on this blog, aren’t you?). I’m just asking you to do it a little more. There are plenty of us speaking out about PTSD. Are you listening to the others? Some bloggers chronicle their daily struggle; others approach things from the academic point of view. We're all in a similar boat.

If you take little time to find the other PTSD bloggers out there, you’ll expand your range of information, emotion and experience. This is good to do. It gives us perspective. Carefully choose who you follow so that you’re reading posts that benefit rather than depress or trigger you. There are several bloggers who are honest in their struggle but not self-destructive or self-indulgent. The quest is to find bloggers writing about PTSD in a proactive, self-aware voice.

When you’ve got a good list (this can be between 3 – 5 blogs) begin to engage in the conversations. Every blog post is an open invitation for someone to jump in. Are you leaving comments on the posts that resonate with you? Why not?? You are an expert in your experience. What you think, feel and understand is valid and might lead someone else to a new comprehension. It’s time to begin letting your thoughts out into the blogosphere.

BRDIGE THE GAP exercise:

Today, reach out in the smallest of ways: As you surf the net begin to leave comments on the blogs that strike a chord in you. Is there something I’ve written in an earlier post that you thought, “Oh, yeah! I feel that way, too!”? Go back to the post and leave a comment. You can do this anonymously. You can begin to flex your reach out muscle without any of us asking you for a bigger commitment.

When you find other PTSD bloggers who write clearly and with emotion, use all of our words to tap into your own experience, and then reach out to tap into the energy of the collective community. Make at least 5 comments on blog posts that ring a bell in your own self. This can be 5 comments on one blog, or spread the love around and meet some new bloggers. The point is to respond to what bloggers are saying by telling them you agree or disagree, that you feel that way or similarly, that you've discovered this has helped or that has hurt. As long as you’re respectful you can say whatever comes to mind so: Read and feel and then translate that into words that reach out and bridge the gap between you and the blogger and his/her community.

To get you started, I offer you these three PTSD bloggers:

Catatonic Kid has a great post today about fear and love. I already left a comment because her words so completely tapped into my own experience.

PTSD, A Soldier’s Perspective today has an in-depth exploration about why vets' patience, value structure and sense of self change in the post-combat environment.

Broken Brain – Brilliant Mind chronicles daily life with a mild TBI and PTSD.

Do some sleuthing and searching. Read with an ear for your own heart’s voice and an eye for appropriate opportunities to engage in the discussion, whether that means adding to one that’s ongoing or writing the first comment to kick off a conversation.

And then come back here and let us all benefit from your adventure! If you come across other PTSD oriented blogs that you feel have a great voice and focus on valid topics, post the links in the comments.

Reaching out means getting comfortable letting people know your PTSD self. That’s it. I’m not asking you to strip down to the whole you – yet. But stop being content to let the rest of us do all the work. You have thoughts, ideas and opinions that matter – let the world hear them!

(Photo: unfocused mike)

PTSD Healing: Preparing to Speak, Part 2

By now you’re thinking about with whom you’re going to take this next step in healing and share your story. How’s it going? Have you decided who it will be? What are you thinking as you mull over the choices?

One benefit of beginning the talking process is that it will help improve your relationships with friends and family. I know if I had talked earlier it would have really saved my family a lot of grief. They could see I was suffering, but they didn’t know what was wrong or how to help. (I could see I was suffering, but I didn’t know what was wrong either. Talking gave me a way to figure it out.)

Another point: my erratic and aggressive behavior often made my family feel like they were the problem and so a wide gulf was often created between us. Not a nice way for them to spend family dinners, vacations, and holidays. Especially vacations and holidays. I ruined many.

It’s hard to live with and love a person with PTSD – we are foreign to people who are not suffering and they are foreign to us. The only way to bridge the gap between them and us is with words.

[Note: Maybe your family is the problem. All the more reason to find someone outside of it with whom you can share and find support for healing. Later you can heal your family relationships if you choose. Even that will come down to words.]

You can prep people before you tell your story by showing them this article, 'What I Wish My Family Had Known About PTSD'. A guide for friends and family to understand us, this article explains the basics of our PTSD experience and how they might relate to every part of it.

Now that you’re imagining to whom you might share your story, take that thinking a few steps further and consider:

1 – The best time for this discussion. What would provide the right circumstances for this type of conversation? When will you have some private time you can invite someone to sit down and listen? Look at your calendar and choose a day that you will have time to prepare and center yourself (for example, by doing some breathing exercises or meditation). Speaking about our trauma can be stressful; choose a time you will not feel rushed, and a time your listener can give you his/her full attention. Also, choose a time you will not need to go or be anywhere afterward so that you can gently unwind from this conversation, perhaps with some more breathing and meditation techniques.

2 – The best place for this discussion. Do you think it will be easier to discuss this in the privacy of your home? Which room will make you feel most comfortable? Think of every room in the house and decide which one will make you feel most relaxed. Or, you might choose to have this conversation in a public space. Sometimes, when we’re out of our personal environments we are more able to view and act objectively and in a controlled emotional state. DO NOT ATTEMPT THIS CONVERSATION IN THE ENVIRONMENT IN WHICH YOUR TRAUMA TOOK/TAKES PLACE.

3 – The best way to tell the story. First, let’s say this: You do not need to be perfect in how you get the story out. The more you tell it, the easier it will become. I stuttered a lot when I first began relating the chronology of events. I couldn’t think of words, I lost my place; I wasn’t sure what I wanted to say or how to say it. You have a script – take it with you. Break it out into bulleted forms or put large spaces between paragraphs so you can refer to it if you get lost. Second, let’s say this: You do not need to be perfect in how you get the story out. Even with all of our preparation we can’t always tell the story without stopping and starting to gather our thoughts and control our emotions. That’s OK! There are no points or awards for perfection. Healing isn’t about being award-winning in our communication; it’s only about communicating so that we begin to find and receive the help we need so our struggling eventually ends.

In opening up we must be in a situation in which we feel safe, secure and believed. We must decide the level of detail we desire to share. In choosing the person, place and time, make sure that all factors will come together so that you are feeling comfortable and prepared for what you are trying to do.

Lastly, remember this: I suffered in silence for 20 years. As you know from your own situation, those were not happy years and I missed a lot of life because I was not willing to dive into what was wrong and come out the other side. Don’t make the same mistake. Be brave. You can do this. Open your mouth and let the words and emotions and past come out. Let the past come out so that the future can come in.


(photo: revod)

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)

PTSD Healing: Learning To Say It Out Loud, Part 2, Or: Rehearse!

For many of my undiagnosed PTSD years my brother and I lived together on the Upper West Side of Manhattan. During some of that time I dabbled in playwriting. When my first play went into production I learned pretty quickly that what we put on the page sounds different on the stage.

As I rewrote and reworked the script, I added to the revision process by reading the characters’ lines out loud. This disturbed Bret. He’d come home from work and hear a few different voices speaking in my room, and then, when he stuck his head into say hello there would just be me sitting at my desk, pencil and script in hand, looking up at him as if he’d just interrupted a deeply fascinating conversation.

The first time this happened Bret carefully looked around the room and then back at me.

“Who are you talking to?” he asked cautiously.

He looked worried. I was, although we didn’t know it at the time, deep into PTSD, so he was used to me being a little off and needing some looking after, but having whole conversations with myself was something new.

“There’s no one here,” he said.

“I know.”

“But I heard voices.”

“Yes,” I said, “I’m revising.”

What I had discovered during rehearsals was that two things were happening: actors’ verbal interpretations of my writing gave different inflection and meaning to my words, and also: sometimes the words that sounded so right in my head sounded really awful when put together on the tongue.

I am not the Magellan of revision – for centuries poets, playwrights and other writers and orators have been revising their work by reading it out loud. For us writing our trauma scripts there are some great advantages to reading it aloud before we speak it to anyone else:

[For those of you who are already speaking with great ease, you are not exempt from today’s exercise! We all hold back. We all keep some details, images, or instances secret for ourselves. Sometimes it’s because we just can’t bear relating them, other times it’s because we don’t know how. Now is the time to figure out how to say what still haunts you.]

1 – You get used to hearing the story yourself. We can’t help it, we get emotional at the thought – much less the act – of relating what happened to us. If we don’t practice what it sounds like before we speak to someone else then we’re hearing it all for the first time at the same time we have an audience. This is not necessarily a recipe for success. We’re dealing with our own emotions about the past at the same time we’re feeling very emotional and vulnerable in the present. Not the best way to go.

2 – You get to hear how the words sound. When we’re writing, we can tend to overdo it a bit. Big fancy words and long explanations sound wonderful when we’re speaking to ourselves, but you’ll lose your audience this way. Likewise, if the phrasing is ambiguous and lacking detail the audience won’t get the whole picture which, in this case, is extremely important. By rehearsing out loud you can decide if there are better words to express what you mean, more succinct ways of telling it or more facts that should be conveyed.

3 – You get to practice the feeling of speaking and remembering at the same time.
We deal with enough unwanted flood of emotion without bringing it on ourselves. Let’s not take the positive step of beginning to tell the story and sabotage it by not being prepared for how it feels to hear it and feel it at the same time.

4 – You get used to how it sounds when the ideas, memories and emotions exit your head and enter the world. In our heads memories can loom so much larger than life we can’t imagine shrinking them down to world-sized pieces. But we can. When we put them on the page they shrink a little. When we speak them out loud we get to see that they are only memories, after all. They are not happening in the moment and, though we may be a little psychologically skewed, we are still strong enough to pull it all together and share the burden with someone else.

I could go on; this is just a starter list for the benefits of speaking. These items only relate to where you are in the process today of writing it out and getting it ready for public consumption, which is a topic we’ll tackle next week.

For today, to continue the BRIDGE THE GAP healing workshop your goal is to begin reading out loud the script you wrote a few days ago. Find a quiet place where you are isolated and alone. Block out at least 30 minutes when you can read your script out loud, revise it, and read it through again.

Look for phrases you stumble over, words that just don’t fit, ideas that don’t really get the point across when you hear them out loud, and gaps in the narrative that need to be fleshed out.

Trust your instincts. When something doesn’t sound right you’ll know. Stop, revise, start over again from the beginning. The goal is to be able to read through the entire script without feeling the need to revise anything.

Final tips:

Play with your voice. Experiment with how high or low, strong or weak, full or thin it is. Find a register that feels comfortable. Don’t fake it. Be real.

Control your breath. Read slowly. Do not be in a rush to get out the story. Take your time. Breathe. Speak slowly and clearly. This will help your audience take in and understand what you’re saying, and it will also help ground you. The breath is an extremely strong source of calm to the body. Use it to your advantage.

(photo: EmazingEm)

PTSD Healing: Learning to Say It Aloud, Part 1, Or: Crafting Your Story

An interesting study was released this weekend (conveniently in time for the biggest collective kissing day of the year) that indicates cortisol levels are reduced by locking lips. This is a tough nut to crack for PTSD application. I mean, here we are dealing with symptoms of emotional numbing, anger and the detachment of dissociation – and scientists are proving that if we did just the opposite, if we passionately smooched for a while – it would actually be very healing for us. A conundrum, yes?

Just like the rest of the PTSD riddle what we need to do to bridge the gap from PTSD to healing is a bit of a big jump. But I still think this info is good to know, so that when we’re having a bad day we can stop ourselves mid-stride, say to our partner, “Come over here and kiss me!” and feel a little better afterward. Sort of a new twist on cognitive behavior methodology. And not a bad one to get us thinking that maybe the isolation in which we cocoon ourselves is not the best way to go. Let me know what you think about this.

Getting back to the idea that TALKING is part of the healing process, today’s the day to look over what you wrote last week and get it into the shape of a script. That’s right, today you’re a playwright putting the finishing touches on a climactic monologue.

Using a highlighter, read back over the story you wrote out. Pull out the sentences and paragraphs that you feel tell the story in the best possible way. Rewrite the piece so that your favorites lines, explanations and descriptions are all in one place in one stream of information. Good. Now you’ve taken the burden of telling the story in the moment right off your shoulders.

If you’re anything the way I was, I could not tell the story. I could get out jagged bits of info in completely unrelated sentences one at a time. I could not look at the person to whom I was telling the story. I could not think straight while I was telling the story. And I usually couldn’t get out enough of the details for the other person to get the whole idea behind the story. Usually, I’d abruptly say, ‘That’s all’. By the time I was finished trying to formulate the throughline I’d be a black emotional mess and my thoughts were all over the place. I think the main reason for this was that bringing up the memories in the moment and sifting through them was too much of an emotional overload.

Having a script helps us lessen and get over these issues. With a prewritten script we no longer have to rely on our own clearheadedness to get the point across. We can memorize the script and then go on autopilot. We have a guide; we don’t have to do the guiding of the story. We know what to say without dipping into the past in the moment of the present to get there. Now that’s my kind of healing!

Today, sit down with your recollection. Think about it like a big lump of clay. You’re going to take that blob and transform it into a piece of art. You’re crafting the story. You’re choosing the words. You’re hand-picking the memories. You’re rising up just a little at a time to take back your power and control. You’re the artist of your healing journey. Create. Create. Create.

(photo: wacky_tom)

PTSD Healing: Wrestling With the Words

It’s great to organize all of the troubling thoughts and memories in our heads. That's the whole point of the work we’ve been doing with PTSD Healing Resolution No. 2. Gaining control over the things that swirl is the first step toward freedom. But that’s only the beginning.

Next, we need to pin down the memories on the mat. To conquer the past we must prove ourselves stronger that it is. And we are stronger – even if it doesn’t feel like it! We are in the present. The past only continues to affect us because … Well, the truth? Because we let it, subconsciously or otherwise. Creating your future means consciously choosing to move beyond trauma and build a new life. Learning to speak about the past is a major step toward that action.

Once you have a general idea and ability to conjure and organize the memories, it’s time to get them out of your head (that’s the ultimate goal anyway, right?). Step #2 in our I WILL TALK resolution is to begin putting it all down on paper. When people want to communicate clearly and effectively they don’t just ramble off the top of their heads; they write speeches so that in the moment their thoughts are focused and follow an explicit order. Today, that’s your task, too: begin getting the words out and down.

The key here is to solely focus on retelling the story of your trauma itself. Take some time today to sit down and write it out. Use details. Set the scene and then in plain language explain what happened. Utilize the flowing structure of the writing we’ve done in the past and just begin to write. Don’t worry about grammar, spelling or syntax. Begin writing and let the words flow and don’t edit yourself – we’ll do that later. Don’t set a timer for this exercise, but do give yourself a boundary. Say, 60 minutes. Know that you will have a completed draft by then and force yourself to stick within the limit. (Of course, if you get going and need to go beyond the time limit, keep it up! But know that within 60 minutes you must have put something of the whole story on the page. If your trauma lasted over a series of days or years you may need more than one writing session to get the whole overview done. Working in 60 minute intervals will control the amount of time you spend in the past.)

Plan ahead: When you’re finished writing, give yourself a reward. Go to the movies. Meet a friend. Call a buddy. Listen to your favorite music. Watch television. Read a book. As you would cool down your body from exercise, do this for your mind, too. Get close to the memories, and then put something between you and them. Writing out the story is not an easy task, but it is the beginning of regaining your power. Word by word you can take back yourself, your life and your future. Do it gently and pamper yourself.

If this exercise seems too difficult, trust me – you can do it. Sit down. Try it. If you can’t follow through the first time. Walk away. Think about it. Go back the next day and try again.

When I’m in pilates class the teacher always shows us the most difficult position, and then offers a modification of it. So, here’s a modification if you’re not ready for the advanced position yet:

Don’t write in the first person; write in the third person instead. Remove yourself from the event and it will be easier to look at and write about. Instead of saying, “I walked down the street,” say, “The young girl walked down the street.”

Changing to a distant pronoun is a way to ease into taking an objective look at yourself and your circumstances. My entire graduate school thesis – a book of poems dealing with my original trauma and PTSD – was originally written in the third person, about a man because I just simply could not get that close to myself. That’s okay. These things take time. Eventually, you’ll be able to write out the whole story.

Need an example to get started? Here’s an excerpt from my own:

The hospital staff remained woefully behind predicting or salving this rare illness’ progression. Ultimately, my parents became the primary managers of my care. They were the ones who ceaselessly researched and predicted; who turned my quarantined room into a burn unit through sheer instinct and will.

They worked as a team, my mother inside the room, my father in the domain beyond the door. My mother directed the staff and devised creative ways to get things done. To move me from one position to another, to avoid the insertion of a feeding tube, or to insert an IV when there was no unaffected skin in which to stick a needle – my mother was the presence in the room that figured out how to do the impossible with the least amount of pain. Meanwhile, my father corralled doctors, hired burn unit nurses, and tracked down leads and medications. My parents didn’t panic. They didn’t cry. They didn’t wail, moan, carry on or wring their hands. Instead, they got to work and became my advocates and nurses; the cheerleaders whose voices would guide my way.

The first two nights in the hospital were uneventful. My parents set up cots in my room so they could sleep beside my bed. We were waiting. I was taking massive doses of Prednisone and Benadryl in an attempt to stop the allergy from escalating. My parents met with doctors and hired nurses to care for me around the clock. Specialists examined me. Everyone prepared for what he or she thought might come.

Mostly, I lay in bed with my eyes closed. The headache had become so intense that the smallest noise was too much. The blisters on my lips and torso continued to develop, but they were small, still only the size of chicken pox, an illness of which I had fond memories since my brother and I had it together and spent most of our days at home driving my mother crazy by jumping on the beds and blowing up balloons that we let fly around the room while the air escaped and we doubled over with laughter.

The word bulla was never mentioned.

The words possibility of infection were not spoken.

I lay in my standard issue hospital bed thinking these little blisters and this big headache were as bad as things would be. And then things happened that made me understand otherwise.

See? Not so tough in the end. Focus on the details and let them guide your way. You’re a detective, remember? Writing about a scene. Just the facts, ma’am, just the facts. Just you, the facts, and a pen and paper. Nothing so scary about that. You are in a safe place. You are creating your future by exorcising the past. Think about that, and then get to work!

(Photo: CrotchSplay)