Post-traumatic Stress

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Safety in Connections With Others

Nami 01

Marcy came in looking like a question mark.  Despite her gorgeous face and swank, she still looked uncertain.

Marcy was born into chaos.  Get this.  Her father who spent her whole childhood using drugs, alcohol and strange women, who was emotionally and mentally absent most of her life, who is possibly still using, is the one person in the whole world Marcy calls her confidante.  “He gets me.  I can really talk to him.  Even my husband doesn’t understand me like he does, you know, emotions.”

Marcy, despite years of fear, panic attacks, the survivor of abuse and neglect was clinging to her dad.

Marcy was lost in the headlights of the oncoming life.  She thought after having spent her entire life afraid, it was time to heal so she though she’d give medication therapy “a try.”

After initiating medications for Marcy’s post-traumatic stress disorder and after her panic-attacks stopped, Marcy started attending NAMI.  What a believer in NAMI she became!

They just make it easy for me to talk about myself, say things I can’t even tell my husband, and they know what I’m going through.

Listening to her talk about them was letting fresh air into our room.  Hope floated in.  Now Marci doesn’t believe that her dad is the only one in the world she can connect with at this level.  Now Marci does not feel as alone.  Why?  Because she went and got connected.  She whacked through the briar hedge of misperceptions, biases and insecurities between her and others.

Marci still thinks largely of her father, but he’s not the only one.  He has some competition to the throne which means, Marci has a better chance of being influenced by someone healthier.  Rather than attack Marci’s attachment with her Father, NAMI is giving her more to fill her heart with.

Self-Care Tip #285 – Find safety in healthy connections with others.

Questions:  When have the connections in your life saved you from warped views?  How do you think we could do better with this?  Please tell me your story.

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How To Be a Friend to Yourself When Thinking About Your Bully?

I love real life John Waters freeze-frames

Image by TheeErin via Flickr

Self-Care Tip #253 – Humanize and forgive your bully.

How to be a friend to yourself when thinking about your bully?

Have you noticed that when we think about our bully, we don’t feel so good.  Just thinking about him!  Sheeze!  In our last post on bullying, Nancy said,

Wow! This one brought up WAY too much pain. I’m feeling very vulnerable and uncomfortable and hurt and stupid at the moment. 

There are jumbled emotions that flood us, such as anger, shame, helplessness, anxiety or more.  Our autonomics may even trigger, making us hypervigilant as if we were being attacked.  We are in defense mode – all the while sitting alone in a chair at our desk, in the quiet of our bed while falling asleep, or any other place of our generally hum-drum lives.  These feelings and nervous system changes come in a time and place when we are not in danger.  They come without us realizing their approach, stealth feet and skilled hands; we are in their company before we know it.

Is there no hope?  What can we do so we don’t feel victimized all over again.

Humanize

1.  Do research on the bully.  Find out about him on the internet.  See what others have said about him.

This helps us:

  1. see him as a human, mortal, without superhuman powers.
  2. feel like we are less alone in this.
  3. realize that we are not chosen, so to speak, to suffer at his hands.  He is a bully and not just around “Me.”
  4. we didn’t cause his behaviors.  He chooses his behaviors because of the same biopsychosocial paradigm that we choose ours.
  5. realize that he hasn’t chosen to do his self-care, making him more vulnerable to his own negative feelings and behaviors.

Forgive

  1. Humanizing our bully helps us move towards empathy and forgiveness.
  2. Anger debts only hurt Me and that’s not friendly to Me.

Grow our self-confidence

  1. Such as doing our own thing.
  2. Grow our own natural genius.  Work hard at it and see how it is there for us, like a friend when we are feeling pushed down.  Our friend will be standing beside us, reminding us of our value when this remembering tries to beat us down.  Our friend will be there reminding us that this negative event in our life does not define us.

Now if they continue, these rememberings, and if these rememberings are frequent enough that we believe our quality of life is affected, we may be looking at something else.  There are other medical illnesses that can disable our abilities to cope.  In this scenario, I am thinking especially about Post-Traumatic Stress Disorder (PTSD.)

In PTSD, we relive experiences of trauma (which we perceived to have been life threatening to ourselves or observed by us in other(s).)  We may also feel hypervigilant, as if we are about to be attacked at times when our lives are not threatened.  We might have nightmares and avoid things that remind us of the trauma event as well.

PTSD is easily reactivated by other stressful situations – such as being bullied.  When we have a history of PTSD that has been quiet for a time, even years, we are more vulnerable to stressors reactivating it’s symptoms.  Then, although the said stressor may not have been a life-threatening stressor, we perceive similar feelings and neurologic changes we did when in the life-threatening situation.  Then, although the said stressor may be over and not recurring, those PTSD symptoms start happening all over again and may continue indeterminately – propagated by the disease process and not our bully event.

This might be endured and it may go away in time without treatment.  But it isn’t good for anyone while it is happening.  PTSD can improve with medical therapies.

Question:  How have you been able to humanize and forgive your bully?  Please tell me your story.

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You Are Enough.

Self-Care Tip #119 – Remember that you are enough.  Be a friend to yourself.

Forrest Gump (after watching his girl Jenny throw rocks at her childhood home of abuse,)

Sometimes, I guess there just aren’t enough rocks.

That movie grabbed almost everyone’s heart-strings.  And when I saw my patient Sarah, I kept thinking about Jenny throwing rocks.

Sarah started crying.  I’d never seen her do that in the 8 years we’d worked together.  She was one who talked in spurts.  Sometimes saying nothing for many visits, and then she’d start questioning me about foods, diet questions, or parenting.  Then quiet some more.  Today out of the blue came her tears and words.

When she started on her disclosure, I tensed up thinking, “What am I supposed to say?  She’s never done this before!”  I realized that being a psychiatrist, I should know the answer to that question and got even more insecure because nothing came to mind.

Her lovely face crumpled over the story of her “stupid” father.  He never let her go to school.  He was violent.  Sarah is now teaching herself how to read; and more tears, her lovely face trembling.  She is a mother and there are no books in her home for her children because she is ashamed of herself.  “My dad is an idiot man.”

Post traumatic stress disorder (PTSD) can last a lifetime.  The horrors that are relived by the survivor can be unspeakable for them.  We never know what people are going through really inside.  They could be a survivor like Sarah or Jenny.

So far, I hadn’t said other than a few “psychiatry-sounds” like “hmm,” and “Oh.”  Don’t be too impressed but I remembered someone somewhere wiser than me put it this way,

Sometimes it’s better not to say anything.

And I really didn’t.  She did.  And she did it wonderfully.  We ended up talking about authors she hoped to read eventually.  She’d heard of Isabelle Allende and wanted to get to her books some day.  We hadn’t even started talking about medications yet.  Sarah left after saying that when she stopped learning and growing, she would be dead.

What hit me was that Sarah wasn’t looking for more than me.  I searched, wanting to give her more and came up with what I hoped was an appropriate facial expression.  In a way, by not speaking much, I was able to receive and be blessed by her story.  I might have missed that.

My mentor, author of blog CreatingBrains.com, encouraged me when I was unsure about teaching others.  She said, “Look at your life and who you are.  You would be surprised.”

When we are insecure about something, it helps to remember that we are enough for the task at hand.  As individuals.  We have in us all the days that came before, the experiences, the generations that handed us down, the God who made us and as per my belief, never leaves us.  We have so much.  Considering all this, be still and know.

Question:  When have you been amazed at all that was inside you?  Please tell me your story.

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Escape Self-Loathing

happinessinthisworld.com

Self-Care Tip #91 – Put the fight down and take 2 steps back.  Be a friend to yourself.

He came in looking really good.  Chris had seen me for many years and he hasn’t always looked this way.  I said

You look great!

Chris shrugged and told me he had just had a long messy argument with his partner and somehow still felt alright.  In the past, after they fought and the self-loathing set in, he might have hurt himself – like using alcohol or cutting on himself to

…just feel something different.

I was ready to move past the story as he sounded like he was ok with it.  We talked past each other.  Me asking about his sleep, and Chris telling me clips and phrases from the argument.

But amazingly I’m fine!  If he wanted me out today, I’d be out of there, no problem.  He just needs to say the word!

Chris was sitting back in his chair, relaxed until then.  His hands came up and took control of his space, thrusting as he spoke.

Being a psychiatrist, my expertise kicked in and I realized I should turn back.  Chris wasn’t ready to talk about sleep.  You see what all those years of school can do.  Not everyone knows how to pick up on such subtleties.

Chris, maybe you aren’t so happy you argued.

We talked more about his energy, appetite and motivation.  Then we came back to his argument.

It’s none of his f—— business where I am during the day!  I’m not his child.  I’m his partner!  I told him…!

And so on.  Chris still looked better than when he was in the grip of post-traumatic stress disorder symptoms, or when he was catatonic.  But he didn’t sit comfortably with himself.  And I thought, Chris has fought so hard for himself, why can’t he handle what I want to say?  And I did.  And he did.  Beautifully.  He was a brave knight on a black steed holding his wounded sides.  Life had been a battle for him, but he was making choices to fight less and live more.

“Ok.  Yes.  You’re right.  I will next time.  That makes sense.”

When you’re about to engage in something that in the end will make you loath yourself, choose not to.  That’s friendly to you and your other.  Say something like,

When I was gone you felt jealous?

Give over stage and anger and open windows and breath.  Just choose not to hurt yourself.  Winning or losing the argument, in the end, you hurt by your own choice.

Biologically and probably spiritually Chris wouldn’t have known what to do with that years ago.  But he did now.  I saw him relax again and put his hands away.  I knew Chris had a love for Love and this clicked for him.

I can’t describe how happy I was/am.  Being a part of his journey is a great honor.

Question:  How have you escaped self-loathing and your mean self in the heat of the moment?  Please tell me your story.

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Scare Yourself If You Must, With Caution

A patient came in depressed and anxious.  After our initial interview he disclosed that he and his girlfriend were playing around with sadomasochism and it was scaring him.  We discussed that to help him get healthy, he would need to do healthy things for himself.  Anything directly harmful or potentially life-threatening doesn’t fit in to that.  We agreed not to formally engage in therapy until he had thought this through and what he was going to do with his sex-practices.  He came back wanting treatment, and spoke like this whole S&M thing was old history.  “Oh that!  I talked it over with my girlfriend and she understands.”  Ok.

Why do we scare ourselves on purpose?  Like watching horror movies, or even movies that are more mainstream but have suicide scenes, abuse, car accidents or other freaky things.  Some are thrill-seekers through extreme sports like sky diving.  Others cut themselves or do other forms of self-injury.  This may seem like an odd bundle but they all share volitional fear experiences.  Even as do team sports like tag or football when getting happy from being chased like a rabbit from a fox.

When we scare ourselves on purpose, our bodies release a number of wonderfully feeling chemical messengers.  There is adrenaline, dopamine, cortisol and more that give us a rush, a lift.  It is positive feedback.  (Dopamine is the main pleasure molecule that all addictive drugs target as does food or even a back scratch.)

Psychoanalytically one might say, like Boston College professor Peter Gray, PhD

…our greatest real fear becomes, in play, our greatest joy.

When this goes wrong is when we hurt ourselves in the process.  “Look out!” is what I say.
Other examples that are more common are film, television and video games.  We now have data that supports evidence of primary emotional illness induced and driven by watching violence – such as post traumatic stress disorder.  Post traumatic stress disorder is a bummer.  It is the only primary emotional illness that has no clear genetic origin but comes after a life threatening event either experienced by yourself or observed by you.  Just don’t get it on purpose for crying out loud!

When I am hankering for a good thriller movie, I try to use this understanding to steer me.  I try to remember that I am extremely valuable.  Along with the obvious but not so obvious good advice,

…whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.

Self Care Tip #48 – Scare yourself if you must, with caution.  Be a friend to yourself.

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