A PTSD Survival Plan….

As I may have mentioned earlier in this blog, I have PTSD.  Coming to terms with this diagnosis has required me to develop a greater understand of the symptoms I’m experiencing.  I’ve also had to accept that I’ve had this disorder for much of my life.   My perception of “normal” is therefore skewed and I’m left wondering what it might feel like….

…The other concern which occupies my mind is the fact that this diagnosis has no cure.  Coming to terms with this fact has required me to fully develop a realistic understanding of healing means.  PTSD is managed and not cured.  This has been a bitter pill to swallow.  I mourn what could have been, and feel like a cumulative byproduct of others’ opinions about me.  I have to accept, regretfully, that I allowed the worst of my bully’s words throughout life, to become my truth.  Overcoming the cumulative byproduct of these early traumas has consumed much of my life.  On the alter of healing, a potential of “what could have been” has been sacrificed.  My own personal sense of self, has been consumed by external factors including a socially-relevant idea of my utilitarian value.  I feel like a man in a monkey suit with a scarlet letter sewn on front.  The fact that this perceived value has no basis in reality of my ultimate worth seems pointless.  I protest against the idea that anybody external to myself defines my ultimate worth.  However, by iterating this fact, I feel like that kid in story “The Emperor’s New Clothes”.  At times I speak the truth and yet get crucified for it.  It seems as if the rules of the game in life are set up to drive me mad.  Socially relevant “truths” carry the weight of a collective systems of belief in which the majority of us play by the rules unquestioningly.  Acting otherwise seems like a radical idea to some….

…..And as I read this stream-of-thought, I realize it reflects intrusive memories of recent events that have trigged painful memories, I had naively believed were buried in the past….

A Trigger & Reminder…

“The traumatic event can be re-experienced in various ways.  Commonly, the individual has recurrent, involuntary, and intrusive recollections of the event…depressive rumination…intrusive distressing memories….(American Psychiatric Association, 2013, p. 275).”

The above video, provides a good sampling of the rhetoric I’ve heard during this election.  I brought it up on the November 8th, as the election results began pouring in.  Its worth noting, that my husband and I have divergent political beliefs.  He is an ardent conservative and Trump supporter.  I am a progressive who voted for Hillary in the hopes of preventing a Trump presidency. As I expressed my concerns regarding this hateful rhetoric, memories of a time long ago rendered my brain.   Feelings of shame fell over me as memories of past abuse flashed through my mind.   I began crying uncontrollably, as my husband immediately dismissed my concern, iterating the what he heard that night on the Fox network.

Before I begin, I must admit I’m not a very politically-minded person and this post has nothing to do with who is president.  It is a personal recollection of an experience that points out vividly the lasting impact of PTSD on my daily life.  

Needless to day, shock & panic took over as this year’s election results began pouring in.   Panic & anxiety set in as I struggled to understand his appeal. The very idea that Donald Trump would be president horrified me.   My mind vacillated between shock and horror, panic, and numbness.   As this painful reality set in, I describe how hurtful Trumps words were for me to hear as a trauma survivor.   Rather than providing comfort and an empathic ear, he became defensive and angry.   Misperceiving my concerns as an attack of his own political beliefs began criticizing and attacking everything I said.   This sent me into an emotional tailspin.   I ran headlong into an interaction that was reminiscent of a child that involved a complete dismissal of my thoughts and feelings.

As I struggle to manage the effects of this election on our marriage, I came to realize my symptoms were evidence of a diagnosis and not an ardent political belief system.  I’m coming to the realization that I need to take this PTSD diagnosis seriously.  What is it that causes these emotional flashbacks and the painful distressing memories?  

A Survival Tool-Kit…

What follows is a quick list of steps I can take to manage trauma triggers and the emotional flashbacks that might ensue.  I need a plan of action, to endure the resulting PTSD symptoms should they flood my mind.  Mind you this is something I create for my own benefit.  I’m not an expert here, I’m a sufferer who is learning to cope.  Here’s what I’m doing now & what appears to be working.  In this respect, it is a quick reminder on how to survive emotional flashbacks, should they recur.

STEP ONE:  Find a Psychiatrist.

Currently I’m only seeing a therapist.  I am not taking any medications and don’t have a psychiatrist following my case, since the one who diagnosed me retired.  This first step is much more frustrating that I might have imagined.  However, I’m happy to admit I’ve finally find somebody.

STEP TWO:  Identifying Trauma Triggers.

“Trauma triggers are reminders of a traumatic experience that provoke continued trauma symptoms. Trauma triggers can be internal or external stimuli, (Trauma triggers, 2012).”  At myptsd.com, site owner Anthony, makes a point of arguing the semantics of what is and/or isn’t a trigger, according to his self-imposed expertise (myptsd.com, 2015).  As a sufferer I don’t feel these semantics are of any value.  Instead, for survival purposes, self-awareness is the ultimate goal.  What is it that has produces these painful reactions to reminders of past traumas?  The DSM-5 manual notes the foll0wing about trauma triggers:

“[they can be] events that resemble or symbolize an aspect of the traumatic event, (e.g. windy days after a hurricane, seeing someone who resembles one’s perpetrator”.  The triggering cue could be a physical sensation (dizziness….rapid heartbeat). (American Psychiatric Association, 2013, p. 275).”

“Even though it may sometimes feel like PTSD symptoms come out-of-the-blue, [they] rarely spontaneously occur….cued by something in our internal (thoughts or feelings) or external environment (…a stressful situation). (Tull, 2016a).”  It is for this reason, that the above description from the DSM-5 manual is useful as a jumping off point.   The following questions are posed in an article I found online titled: “How to Identify & Cope with your PTSD triggers?” (Tull, 2016a).

FIRSTLY, “what types of situations are you in (Tull, 2016a)?”

Utilizing the above example, I was in the middle of a conversation with my husband.   Throughout the election, the rhetoric (see video) has been hard for me to take in.  When I expressed my horror that a man with corrupt value system was in office, he became angry.  He began dismissing my perspective and refused to hear my concerns.  A critical aspect of this exchange reminded me of that bad relationship from long ago where my feelings were continually dismissed and belittled.   While not intended, my mind was thrown into a wellspring of negative emotions.  

SECONDLY, “What is happening around you (Tull, 2016a)?”

We were in the basement watching television together.  The kids were upstairs playing.  I remember feeling exhausted, still recovering after a three-day weekend night shift.   I drifted in and out of consciousness, taking cat naps throughout that evening.  Realizing our divergent political belief systems were problematic this election season, we’ve avoided the subject.  That evening we had agreed to not watch the results together.

With an f-d up sleep schedule, I found myself battling insomnia at 1 a.m.  I took out my iPad and decided to read a few blogs I like to follow.  The post I found announcing Trump’s win was unexpected, since this specific blog doesn’t cover the subject of politics.  As I started crying, my husband rolled over and asked me what I was reading.  This is when the conversation happened and things went downhill.

THIRDLY, “What kind of emotions are you feeling (Tull, 2016a)?”

A mixture of anxiety, fear, and depression overcame me.  They were to remain for the rest of the week as I began feeling I was left to “white knuckle it”.  Desperate for a magic “happy pill” to make the feelings go away, I was angry at myself for not finding a new psychiatrist since my last one retired.  Finally, I can’t help but compare my reaction to others’ I know who voted against Trump.  While my parents and sister were shock and worried about the nation’s future, somehow they remained more in control.  Like the above video, they found some ability to remain positive and keep things in perspective.  My mind, on the other hand, began spinning out of control…..

FOURTH, What thoughts are you experiencing (Tull, 2016a)?”

Intrusive and painful memories entered my mind.  I tried willing them to go away, but somehow found this impossible.  The most exquisitely painful memories that still haunt me, aren’t physical abuses, but simply harsh and abusive words.  Nothing can scar your soul more that emotional abuse and an endless barrage of hate and contempt.  The painful aspect of these experiences that still haunts me is that nobody acknowledged my feelings.  They did these mean things to me and let it known to me that it was my fault and I deserved what I got.  Somehow this fucked-up sentiment hurt the worst.

FIFTH, What does your body feel like (Tull, 2016a)?”

My body drifts back and fourth between a state of hyper-arousal and dissociative numbing. At a moments when the emotional pain is literally excruciating, I curse my family and their undying love for me.  If it wasn’t for this, I could just “off” myself and be done with it.  Enduring somehow has felt like a curse.  However, much I want to live and keep going, the struggle has been difficult.

STEP THREE:  Distract First…

When experiencing flashbacks or dissociative symptoms, first distract then challenge.  Distraction techniques involve “coping tools designed to ‘ground’ you in the present moment…so you can retain your connection with the present moment, (Tull, 2016b).”  The DBT distress tolerance and mindfulness skills described in this blog are useful as a jumping off point.  Distracting ourselves from a situation or trigger that can cause us pain, can ground us as we focus on the five senses (Tull, 2016b).  For example, one client I met recently has an aromatherapy glass roll-on bottle which she carries everywhere.  I, on the other hand, have utilized calming music, exercise or mandalas as a tool for distraction.

STEP FOUR:  Challenge Second….

Anthony at myptsd.com (2015), makes a useful point regarding ptsd triggers:

“Categorize your triggers as realistic or unrealistic. You may want outside opinions on this….Review your cognitive biases based on your immediate thoughts and reactions to the trigger, and have counter-statements prepared to confirm the unrealistic aspect of the trigger, (myptsd.com, 2015).”

This suggestion is useful in developing an awareness of how PTSD symptoms often reflect past events or unresolved cognitive biases, and not present situations.  Marsha Linehan’s emotional regulation skills a re useful in challenging our emotions and thoughts.  The ultimate goal here is thinking through them and not with them.

STEP FIVE:  Seek Support.

Tull (2016b), suggests finally, to utilize any support system we have in place.  “If you know that you may be at risk for a flashback or dissociation by going into a certain situation, bring along some trusted support.  Make sure that the person you bring with you is also aware of your triggers and knows how to tell and what to do when you are entering a flashback or dissociative state, (Tull, 2016b).”  My husband, sister, and parents have been a critical first line of defense here.

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
myptsd.com (2015, September, 2). PTSD Triggers.  What triggers PTSD symptoms?  Retrieved from:  https://www.myptsd.com/how-to-use-triggers-as-a-means-to-recovery/291/
TRAUMA TRIGGERS. Encyclopedia of Trauma. Jan. 1, 2012.
Tull, M., Phd. (2016a, May, 4)  How to identify and cope with your PTSD triggers.  Retrieved from:  https://www.verywell.com/ptsd-triggers-and-coping-strategies-2797557
Tull, M., Phd. (2016b, September, 6).  Coping With Flashback and Dissociation in PTSD.  Retrieved from:  https://www.verywell.com/coping-with-flashbacks-2797574

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