The Reality of PTSD

I received Karen's new article for the Returning Warriors Web site today, and thought it appropriate to post here in case anyone had questions or comments. The symptoms list at the end Karen also created is on the site as a checklist, as well.

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POST TRAUMATIC STRESS DISORDER...HOW REAL IS IT?

by Karen Hutchins, MALPC

The truth about our trauma/stress is stored up in our body; and although we can repress it, we can never alter it. Our intellect can be deceived, our feelings manipuated; our perceptions confused and our body tricked with medication. But someday our body will present its bill, for it is incorruptible as a child, who, still whole in spirit, will accept no compromises or excuses, and it will not stop tormenting us until we stop evading the truth. Alice Miller

Post Traumatic Stress Disorder is a condition where you bury what you don't want to live with, you cannot live with and continue to function in the real world; so you bury it, dissociate it and compartmentalize it until you are SAFE enough to live and work through it. And for many trauma/stress survivors, it may mean until you are away from your family of origin, your abusers, out of present day trauma/stress...whenever you feel safe. Stress/trauma is cumulative and continued stress/trauma adds up. It can be caused by trauma/abuse, extremely stressful situations, hospitalizations or natural disasters.

There are symptoms of PTSD...you may have all or several of them. In order for you to be diagnosed with PTSD, you must have several symptoms operating at the present time and the symptoms interfering with your daily functioning. I believe that PTSD is the umbrella for many of the coping skills that were normal/useful at the time of the trauma, but have outgrown their usefulness. These include addictions, compulsive behavior, depression, anxiety, etc. Studies have shown that soldiers with childhood trauma are more likely to have more severe PTSD symptoms; referring to the cumulative affect of stress.

People often function until their coping skills no longer work and the trauma/stress begins to surface. It may surface in feelings (depression or anxiety) or it may surface in flashbacks and flooding of memories (hallucinations and blips) or insonmia (nightmares of memories). Generally, the trauma will not surface until the person is able to look at it...not particularly WANTING to look at it, but CAPABLE of doing so.

What is necessary to know is that our past affects our present and our future and without knowledge of our past, we may continue repeating dysfunctional behavior and patterns without knowing why. The process of knowing our past is not to know every little detail of our trauma/stress, but important information that affects our present life and possibly our future health. The goal in therapy/healing process is for us to know enough about our history that we won't be REACTING, BUT HAVE ENOUGH KNOWLEDGE TO BEGIN PROACTING.

Working through memories will often make you feel worse before you feel better. You will often feel as you did while in the trauma/stressful events occurred and that may feel life threatening. You need to remind yourself that the trauma/stress is no longer occuring and you have lived through it once, you can live through the memory of the trauma/stress. From the soldiers view point, it was life threatening.

NO ONE DIES FROM FEELINGS...IT IS WHAT WE DO WITH THEM. A feeling is a feeling is a feeling is a feeling. We may not be comfortable with the feelings, but THEY JUST ARE.

The most common feelings that we have avoided are fear, aloneness, helplessness, sadness and hopelessness. We won't die from any of these feelings...again, what we do with them.

Some of the trauma/stress is so intense that you may feel that you are reliving it...we call those "flashbacks" or "abreactions." While they seem to be coming out of nowhere, there is usually a build up to the memory flashbacks or abreactions. There is generally a period of high unexplained anxiety, sleeplessness, anger, sadness, far or unexplained marks on the body. Actually the flashbacks or abreactions are not as random as they seem to appear. There is often a trigger for them and that is often accompanied by a period of dissociation, unreality, fear, terror or being out of the body.

We are blessed with a Higher Self or Spiritual Guide or our Divine Source or God that knows what is best for us and usually we are not given more than we can handle. The conflict within most of us, is that we do not want to believe that terrible things happened to us but it was a part of our job, protecting our country, etc. We do not have to like what we are remembering but the most difficulty is caused when we fight the memories or the information. Once we have embarked on the journey of self knowledge/healing, it is difficult to shut it off or to decide to censure what we want to know and what we are willing to accept. The whole unvarnished TRUTH is difficult, but freeing, and often helps us to make sense of things that haven't made sense in the past. So many people are relieved that the past makes sense of what is currently happening or the feelings that seemed to make no sense.

Flashbacks or abreactions are frightening until you know what they are. They are being in the past and present at the same time and being in the memory so that you can process it, in a safe place. It is the psyche's way of healing the memory. It may be condensed, selective to what you are supposed to know about how it still affects you. There are four parts to the memory ... feeling, body sensation/memory, knowledge of what happened or what was programmed and the behavior that it affects today.

Because you have lived through the memory/trauma/stress before, you will live through it again.

Although, you may feel that you will die from memories, you will not. They are, in fact, part of your history and your past. You will often feel you need to numb the feelings again, but you can facilitate the process by not numbing, as you did in the past. You can decrease the intensity of feelings by making collages, drawing, painting, journaling, talking to your support system and nurturing yourself. When you lived through the trauma/stress initially, you were emotionally alone; now you are not. That is why it is important to have a support system. Even being trained to kill/protect still makes it difficult to process in the psyche, because war wasn't something most of us grew up with. Even in countries where war is a fact of life, continued stress/trauma has taken large tolls on the health and well being of the citizens. Trauma is cummulative.

Going back to the original quote from Alice Miller, I have found that the body is often the part of you that will be present information to work on. It can begin with pain that isn't caused by a current event ... unexplained bruises, marks, etc. We call these body memories and the body will often pace the information. Another way that memories can be found is through dreams ... sometimes they are symbolic dreams and sometimes they are actual memory dreams. You will soon learn what type you are getting and probably will be getting both types of dreams, while you are doing this work. You will also be given hopeful, healing dreams to let you know that there is an end to the intensity of the process.

Recovery work is work and should be treated with the same respect and honor that we treat other work with. It is hard work and honorable work; to be working on your recovery and memories and recovering your history. That means that if you are working on other endeavors, you should make time for this work. It may mean an hour a day, but setting aside some time frame. Otherwise, it will interfere with your regular functioning. People often notice that on therapy day, the stuff becomes focused and they start feeling nauseated, tired, angry, sad or out of sorts; all of this is not unusual. Honoring that and knowing that, you will want to nurture yourself for that day; that is respecting the work, and, frankly, makes it easier on you.

Trauma keep us stuck in emotional states and we might call Ego states. We compartmentalize the Warrior, the Killer, the Stealthy One, and it is up to us to validate and nurture those wounded selves. Going out in Nature, finding a way to play as an adult, taking relaxing baths and exercising and other ways of nurturing yourself is absolutely necessary in this process.

If feelings of suicide and self abusive feelings and wanting to act out on them, we need to keep ourselves safe, but calling a support system or telling someone what is going on. We don't allow abusive behavior, but we provide alternative nurturing activities to be available. Again, it is a reminder that feelings are feelings and normal for the things that have happened to us; but it is what we do with those feelings. The intensity may be overwhelming but acknowledging them and not denying them and keeping ourselves safe is the best way to get through the process. The intensity is related to the fact that we had to turn off the feelings while we were doing our jobs in the war.

People who take advantage of their support system by talking, going to meetings, doing 12 Step work, finding a spiritual framework, all find doing this recovery process easier with less internal conflict. It is also recommended that you find someone to do bodywork with ... chiropractor, massage therapist, acupuncturist, Reiki healer, etc. helps the Mind, Body, Soul connections.

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PTSD SYMPTOMS

The trauma/stress creates symptoms that are normal for the abnormal situations that you were in. The symptom checklist might make it easier to understand what is going on with you. While you should not diagnose yourself without a professional, it may help you make sense of what is going on. If the symptoms are interfering with your daily life, it may be time, to go for support and get professional help.

• hypervigilence: hiding, sitting with back to walls, feeling watched, startle response, fear of being alone, constantly alert...fight or flight mode
  
  
• alienation from body: not at home in body, no sense of body image, avoidance of mirrors, layers of clothing, extremely private, manipulating body weight to avoid intimacy, often numb, detached in body
  
  
• dissociation: splitting from event, removing self from feelings/emotions/pain, feelings of viewing self, physical numbing, depersonalization of memory/pain, feeling like watching self on video, getting so focused on something can tune everything/everyone else out, inappropriate behavior (laughing at funeral/someone's pain), driving from one place to another and not remembering how got there, losing time
  
  
• anger issues: inability to recognize/express own anger, fear of someone's anger/rage, hostility towards certain people (reminder of other side in war), constant anger, fear of losing control, triggered into anger with various voices, colors, smells, etc.
  
  
• suicidal: ideation/attempt, obsessive thoughts about suicide, self mutilating behaviors, daring the fates with high risk behavior, accident prone
  
  
• sense of pervading fear: no sense of power, victimology, inability to set limits, fear of being left, phobias, compulsive behavior about locking doors, checking rooms, paranoid
  
  
• addictions: behaviors to cover pain/fear/anger/sadness/helplessness, driven compulsive behavior may be acceptable in workaholism, but still being used to numb out
  
  
• memory losses: blocks of any part of history, not explained by coma
  
  
• feeling of awful secret: feeling shame of having done something and can't share and others wouldn’t understand
  
  
• anxiety/panic attacks: heart speeds, chest feels pressure/squeezed, can't breathe, feeling dizzy/light headed, total debilitating fear/immobilization, feeling like dying, periodic or constant attacks
  
  
• sleeping disorders: night terrors, nightmares, awakening nightly at the same time, fear of dark, fear of falling asleep, doing things to avoid falling asleep, waking up screaming/yelling/ body jerks/movements while asleep, never getting REM sleep, sleep deprivation, waking up still feeling tired
  
  
• depression: periodic or constant sadness that feels bottomless, seeing only the negative in people/events, feeling helpless, worthless and not wanting to wake up, but no active plan of suicide, radical change in eating/sleeping habits, feeling hopeless, jaded, cynical, bored with no joy
  
  
• trust issues: mistrusting or trusting indiscriminately, feeling isolated an different
  
  
• self esteem: low self esteem, intense shame, need to be invisible, feeling bad for being alive, feeling useless, feelings others are more worthy and more important, behavior puts self second or last, arrogance and facade of feeling superior, feeling like a victim or perpetrator
  
  
• body memories: unexplained pains, bruises, marks, splotches. Body somatizes the trauma/stress ... Chronic Fatigue Syndrome, fibromyalgia and other autoimmune diseases may be escalated by intense stress/trauma
  
  
• feeling crazy/different: feeling like an outcast, unreal, create fantasy world/relationships, desire to change name or identity
  
  
• physical signs: gagging response, swallowing constantly, lower immune system, constantly sick, aches, headaches, having somatic symptoms that can't be explained by the doctor
  
  
• flashbacks/abreactions: reverting to other places, reliving a memory, being triggered to a past time frame of trauma, hallucinating which can be done visually, olfactory, auditorally, tactile or taste (metal, blood, etc.) Flashbacks can be done in blips ... pieces of feelings, pictures, sounds, tastes, etc. Finding self hiding under a table, closet, shaking uncontrollably, body jerking, falling into a trance state, agitated body movement, looking around and not recognizing where you are, feeling different in your body, feeling transported in time
  
  
• eating disorders: not wanting to eat, no joy in eating, bulimia or anorexia, overeating, binge eating

Again, you cannot diagnose yourself, but these symptoms may help you see that you are exhibiting behavior that is normal for abnormal past circumstances. If you had stress/trauma/abuse as a child, the current stress may be bringing up old trauma/stress. Again, remember that stress/trauma is cumulative.

Symptoms list author: Karen Hutchins, MALPC
Cicada Recovery Services
co-sponsor of the Returning Warriors program