Post Traumatic Stress Disorder is a mental disorder. I was first diagnosed with PTSD in 1994, but it wasn’t until a psychotic episode in 1999 that I finally had to admit … admit that I had a mental disorder.
The traumas that cause PTSD are as unique as the individuals suffering from the disorder. A friend of mine just recently survived a terrible auto accident. She currently complains about living in a fog, that nothing makes much sense to her right now, and that she has trouble concentrating. These are all symptoms of Post Traumatic Stress Disorder.
Any fearful trauma can produce symptoms of PTSD. I remember being in a tornado a few years back, and for the longest time, any wind, and I mean any wind, would send tremors through my body.
PTSD can be either acute or chronic; the acute phase occurring directly after the trauma, while the chronic phase can come along much later. In the acute phase, PTSD is said to be treatable and curable. In its chronic phase, it is only treatable. One must learn to live with it and to cope with it.
This paper is designed to demystify this newly named disease (it’s been around for centuries, but named and recognized by the American Psychiatric Association in 1978 as an official mental disorder, allowing patients to receive the treatment they needed), to list some of its symptoms, and to help you to help someone else, should you suspect they have a problem. This last part, helping someone, is not meant to be construed that you can help cure them, but rather you can direct them to caregivers who can help them. A person with a mental disorder is usually the last to know. Greater than one third of Vietnam Veterans suffering from PTSD were diagnosed after being released from jail.
Some of you will see yourself within these paragraphs. Enjoy the liberation.
This paper is also very personal. Some of what I’ve learned about this disorder pertains to all PTSD sufferers, but most of what I’ve learned pertains to the trauma of war. I am a Vietnam Veteran. I flew Cobra Gunships in Vietnam. My name is carved into the Wall of Honor at the Smithsonian’s National Air and Space Museum.
After a recent episode in which I had been turned into a babbling, stuttering idiot and locked up at the local Veterans Hospital, I spoke with my sister-in-law. She told me that I was the only returning Nam Vet she knew who laughed at it all; who made jokes of it. When I look back, it seems that that was how I dealt with it, how I’d stuffed it.
My family doesn’t know this, but on my first Thanksgiving in civilian life I attempted suicide. I had attended a party with some friends from high school. It hit me that evening that they were all still in high school while I felt a few generations older. On my way home, I had my first anniversary reaction (I will explain these later); while listening to the heavy marketing for Christmas on the radio, I couldn’t shake the thought of all those kids who were going to get “daddy in a box” for Christmas this year, and all those kids who got “daddy in a box” on previous Christmases, and I unlatched my seat belt, sped up to 60 miles an hour on a city street and aimed for a tree. The curb bounced me back onto the road, I spun around a g’zillion times in the thick new snow, jumped the curb, and hit a tree nearly one block away from my original target. I totaled my car and bumped my head. After that, figuring that I had survived that for some unknown reason, I went on with my life and “stuffed” it. Some twenty years later though, it slapped me upside the head, and now it’s here to stay. However, and this is a very important point, I have PTSD; PTSD does not have me.
So before we take a look at the symptoms, the results of this disorder, you might first like to view a few facts about war related PTSD that I’ve gleaned from the past five years (of therapy).
What is learned in combat is never, ever forgotten.
PTSD was once called Shell Shock, something soldiers got from battle, or from “being shelled.” It wasn’t until the eighties, when the name changed to Post Traumatic Stress Disorder, that others who had not been in battle, but had been the victims of car accidents, domestic abuse, rape, incest, or other traumas that these people finally got the help they needed and the disorder was clearly defined and studied. What is learned in trauma is never forgotten.
When a man goes to war, no one may follow.
Per capita, more Vietnam Veterans suffer from chronic PTSD than from any other war. [Editor’s Note: that is until the War in Iraq came along; these troops have been stretched beyond their breaking points repeatedly.] There are lots of theories as to why this is, including the simple fact that we fought an unpopular war and were never given the welcome home other soldiers received, at least not until recently. It was the first war America had lost, and many Vietnam era veterans received initial scorn from veterans of previous wars. However, there were fewer cases of acute PTSD in Vietnam, attributed to the fact that every soldier knew the day he was coming home, thus the countdown (“Short” meant the soldier had a short time left in country) to the day he’d return, and the subsequent “stuffing” of their trauma while counting down. Following a battle in WWII, 17% were afflicted with acute PTSD, while in Vietnam only one percent were afflicted, debilitated.
In WW2, soldiers fought a battle, on the average, twice a year. In Korea, our soldiers fought a battle, on the average, between two and three times a year. In Vietnam, our soldiers fought a battle every three weeks.
People with PTSD are famous for self-medicating (drugs, alcohol), however, ex-soldiers have an additional addiction that often lands them in trouble, or jail: an addiction to adrenaline. We love danger, even when trying to avoid it. Deep down inside, we love adrenaline. I remember an ex kissing me goodbye (the old last kiss) and sending me out into weather I wouldn’t send an enemy into: deep snow, I lived in the country, no chance of finding a plowed thruway. The average person would have gone to a motel, but not I; to me the entire ride home was the most exhilarating ride I’d taken in years (I had no cell phone, there was no other traffic on the roads, I didn’t even have a thick jacket, the storm had hit unexpectedly). I was so high from the adrenaline (knowing that every turn could be my last) that it took me 6 hours to come down after I had arrived at my home.
It has recently been learned that prolonged stress actually changes a person’s brain chemistry. PTSD is a physical disease. There is no escaping it. Even if most of the symptoms are suppressed, a person with PTSD will make all his/her decisions through the veil of this disorder, simply because one’s brain chemistry determines one’s thought patterns.
The Time Bomb
Inside every person with PTSD is a time bomb. It is merely a matter of time before symptoms begin to show up. One might exhibit all manner of symptoms in nearly everything s/he does, and still live what appears to be a normal life. However, it doesn’t take much to bring out full-blown symptoms of a full-blown case of PTSD.
Retirement: the kiss of death. Many World War II soldiers lived nearly normal lives, up until they retired. Within weeks of retiring, WWII vets suddenly started showing up at the VA hospitals exhibiting symptoms of PTSD. Keeping busy (like writing this paper) keeps the symptoms down. Free time (and worry) exacerbates PTSD symptoms.
Additional Stress: Stress kills; we know this. Additional stress in the life of a PTSD sufferer will bring out their PTSD symptoms. Even good stress can increase one’s symptoms; good stress such as a birth, or a new love, or a promotion at work. Anything that wobbles the apple cart—little changes, big changes, good changes, bad changes—will promote PTSD symptoms. Then there are the huge stressors; the larger the stressor, the more virulent the PTSD symptoms.
Reminders: anything that reminds the PTSD sufferer of the original trauma will pique symptoms. This includes odors, sounds, and sites. Additionally, the anniversary of a trauma will cause a rise in PTSD symptoms. Many soldiers dread holidays, for during their service, some of the days they remember most vividly were the holidays (sometimes, it was only on a holiday when a soldier knew what day it was). If a woman is assaulted near an elevator, elevators will trigger her symptoms. If she remembers the date of her assault, as the anniversary approaches, symptoms increase.
I arrived in Vietnam on Christmas morning. It took me years to have a good Christmas, or even wish to celebrate it.
Now, let’s take a look at the actual symptoms and results of PTSD.
PTSD is a normal response to an abnormal situation.
Dr. James Tuorila, PhD, St Cloud, Minnesota
I know of no more disagreeable situation than to be left feeling generally angry without anybody in particular to be angry at.
Frank Moore Colby
Persons with PTSD hold in a lot of anger. It is a free-floating anger with no real target and very subtle causes. It simmers below the surface and can jump out at inappropriate times, aimed at the wrong person for the wrong reasons (displaced anger).
Following a rape, the rape victim is filled with rage. The specific targets of this rage are quite obvious: the rapist, the system that puts the victim on trial, the doctors for their insensitivity, and the list can go on depending on the ordeal the rape victim endures. However, years later, this anger can still exist, simmering just below the surface. And though many argue that the cues to the anger have changed, that the original incident has softened in the mind of the sufferer, that this, that that—it’s all “neither here nor there” because there is no logic, no reasoning in a mental disorder: with chronic PTSD, everyone and everything is the cause, and the nearest person or object can be the target.
Normal people get warm, then angry, then angrier, and progress to a state of rage if the stimulus to the anger is not abated. A PTSD sufferer can go from A to Z immediately, especially if s/he’s an ex-soldier. Soldiers are taught to react. They are not taught to think, deliberate, or discuss. They are taught to react, because during war, the distance between life and death is measured in milliseconds and centimeters. When anger strikes, it quickly turns to rage.
Anger Management classes are usually prescribed for PTSD patients, however, the patient might still never arrive at the cause of this anger, as the original cause has faded, leaving only the anger. Learning to deal with this anger is much more productive at this juncture than trying to discover its cause or causes. In a good Anger Management class, the PTSD sufferer can learn that one cannot control one’s initial feeling about something aggravating, however, s/he can control her/his reaction.
Being the target, displaced or not, of this anger is one of the major causes of “secondary PTSD,” the disorder suffered by those close to the PTSD sufferer. Oftentimes families walk on eggshells to avoid doing anything to upset the PTSD sufferer. Children, wives, and lovers tend to withdraw and avoid any and all possible confrontation. Ironically, simply talking about it; sitting down to have a family discussion and bringing their issues to light often relieves the tension PTSD has caused. Partners of PTSD patients must keep alert and note when the anger outbursts increase in intensity and the intervals between them shorten. This is a sure sign that there is something else occurring within the patient and a trip to the therapist is needed.
A hallucination is a fact, not an error; what is erroneous is a judgment based upon it.
Common to all PTSD sufferers are flashbacks. The longer the trauma lasted or the more powerful the trauma, the more intense the flashbacks. Hollywood flashbacks and real-life flashbacks are very different from each other. Whatever you see coming from Hollywood, is just that, a creation of Hollywood. In real life, it’s hard for someone suffering PTSD to explain their flashbacks, and since they do not conform to what is viewed in the movies, they are not easily identified as flashbacks. Personally, I oftentimes have auditory flashbacks: I hear the jet engine whistle. When I see helicopters, I smell the JP4, the fuel.
Hallucinations and flashbacks are related, though one can have hallucinations that go beyond flashbacks. When Christmas came around, my anniversary, I would see muzzle flashes off to the right in the periphery. Far off I heard screaming “Receiving fire! Receiving fire!” Being diagnosed did not stop these hallucinations. No diagnosis cures the illness. But you can, with work, heal the hallucinations.
After a while, one gets used to these flashbacks and hallucinations. Doctors put us on anti-psychotic drugs to eliminate them, however, the side effects of the drugs are horrible, and the actual hallucinations, after a time, really amount to nothing; in fact, we get used to them. At a class on Grief and Loss, I was once told that I might have to deal with loss one day when the hallucinations went away. It seems ludicrous, but we get used to them, and miss them when they are gone.
There is no terror in a bang, only in the anticipation of it.
For a long period of time after I had lived through a tornado that ran its course directly over my head, the slightest wind sent shivers through my blood stream. A rape victim suddenly has half the population to fear as every man becomes a potential rapist.
However, years after the trauma, the fear still exists, and like the anger, it has no specific cause. Fear of fear of fear of….
Having studied the martial arts and feeling sufficiently skilled to defend myself in any situation, I have conquered a specific fear. I fear no man. Once a fear is conquered, it never returns. However, a PTSD sufferer lives in constant fear and oftentimes this fear is diagnosed as paranoia; it is a general fear that never goes away and sits insidiously beneath the surface.
It can be argued that fear is the basis of one’s anger; that it is the basis of all other symptoms. Perhaps, but most important is knowing that every decision, every action of a person suffering from PTSD has some fear in its motivation, in its execution.
It is a time when one’s spirit is subdued and sad, one knows not why; when the past seems a storm-swept desolation, life a vanity and a burden, and the future but a way to death.
Once during a group session, one fellow said, “I have the feeling that I’m going to die in six months.” Eyes throughout the room widened; you could even hear the hard swallows. I spoke up: “My God, I’ve felt that way for years!”
Because soldiers know death intimately, we are consumed with death. A friend or a lover calls and says s/he’ll be over in fifteen minutes; when s/he is five minutes late, the PTSD sufferer is convinced s/he is dead on the highway.
There is a French phrase: Partir c’est mourir un peu. “To part is to die a little.” Whenever I went away, I assumed I would never see my loved ones again. This wasn’t a conscious, active thought, just something packed away nicely down under the surface. I’m going to die, they’re going to die, we’re all going to die; we will never see each other again.
Every little pain is cancer. Heartburn is a heart attack. A skin rash is skin cancer. A sore throat is actually throat cancer, a burgeoning tumor about to cut off my air supply and viciously choke me to death. I will not make it six months. I’m going to die.
Having thoughts like these can cause some very dangerous behaviors. I am reminded of a sixties TV program called “Run For Your Life” starring Ben Gazara. He’s told by his doctor he has two years to live and so he vows to live every remaining moment of life to its fullest, risking everything; afraid of nothing: he races cars, climbs mountains, etc. Well, imagine, just imagine all the Vietnam Veterans out there with adrenaline addictions who believe they have six months left to live: check out your jails and prisons; that’s where they’ve landed. This is a very deadly combination, producing some very dangerous behaviors.
My apprehensions come in crowds;
I dread the rustling of the grass;
The very shadows of the clouds
Have power to shake me as they pass:
I question things and do not find
One that will answer to my mind;
And all the world appears unkind.
It is very hard to get some of my friends to go out in public with me. Veterans suffering from PTSD feel unsafe in crowds, especially Vietnam Veterans, since the enemy was all around. During the day they cut your hair; at night they cut your throat. At any moment, at any place, someone could walk up to you and drop a hot grenade in your lap. Those soldiers who’ve had to secure an area and watch for “Charlie” will never, ever stop watching for Charlie.
My situation is different from those who were in the infantry. I too am hyper-vigilant and somewhat paranoid (always checking out the window for intruders), but I’m not as security conscious. In my job as a gunship pilot, if I found something I didn’t like, I killed it. Infantry people sometimes never saw the enemy; never saw the muzzle flashes of the bullets whizzing over their heads. Their fears were ubiquitous and overwhelming at times, as all they saw were the bodies of their buddies ripped apart.
If you walk up behind an ex-infantry person and tap him on the shoulder, you’ll see him leave the ground. Most of my friends sit near a wall or right up against it. They sit near exits. They are constantly on guard; their “startle reflex” is heightened. Danger lurks everywhere.
In a world we find terrifying, we ratify that which doesn’t threaten us.
Add up the fear, dread, and uncertainty, mix in a few flashbacks and hallucinations, and you have yourself the groundwork for some full-blown anxiety attacks. However, on the positive side, one’s anxiety level can be a determination of what else is happening inside of the person suffering from PTSD.
We learn in Symptom Management classes our own individual symptoms—which ones to watch, and what to do if they increase. One chief symptom (common to everyone) is our overall anxiety level, for this can be a barometer of our PTSD in general. When anxiety attacks are frequent, all our PTSD symptoms are on the rise. Thus, being aware of one’s anxiety level is one good way to keep one’s PTSD in check, or know when to call a friend, call a therapist, or check into a hospital for help
It is impossible to go through life without trust: that is to be imprisoned in the worst cell of all, oneself.
Again I must repeat: What is learned in combat, is never, ever forgotten. Who can a soldier ever trust as much as he trusted his buddy with him in that foxhole? or that pilot overhead, who knows that the enemy is dangerously close, yet his deadly fire is accurate, on target, and he need not worry?
And who can I ever trust as much as I trusted my wingman, or my co-pilot, or the crew who kept my bird in the air?
In real life, if someone says they’ll be over in fifteen minutes, who cares if they’re a half-hour late? In combat, seconds count. No pilot is fifteen minutes late on target. No artillery is fifteen minutes late on target. And if a buddy doesn’t show up in fifteen minutes, you go after him.
Lacking trust places barriers between us and our partners, and there is still another barrier: we learned that we lose those we get close to.
There are two immutable rules to war:
So when we get home, we have trouble getting close again, because eventually the people we get close to will die.
Your wife will die; your kids will die; everyone eventually dies. Normal people accept this intellectually, but can never feel it as personally or as immediately as a combat veteran does.
It is very difficult for combat veterans to be intimate again, very much like a victim of rape. Fearing intimacy and needing intimacy can lead to superficial relationships, one night stands, multiple partners, and extra-marital affairs.
It’s all very complicated, very ingrained, and very hurtful to someone who does not understand, someone who wants to throttle the PTSD patient and scream at them: “Hey! Get over it!”
We all wish it were that easy, believe me.
Addictions do come in handy sometimes: at least you have to get out of bed for them.
It seems much easier to deal with a problem when you’re stoned out your mind. At least it seems so. In reality, one’s PTSD symptoms are aggravated using drugs and alcohol. Your best psychologists cannot deal with or work with someone who’s been drunk or stoned for a month; the patient is unresponsive and unmotivated. Chemical Dependency classes are in order before any sort of talk therapy will do any good.
One unique facet to the war in Vietnam was the number of addicts and alcoholics who returned to the states only to have to deal with this problem. Most soldiers pick up an adrenaline addiction that can cause some very dangerous behaviors, however, a drug or alcohol problem is another slow and painful death, whose process exacerbates and stimulates all other PTSD symptoms. Alcohol, drugs, and adrenaline are the deadliest of combinations. Graveyards, jails, and prisons are full of Vietnam Veterans who’ve suffered these addictions.
Of all the…alternatives, running away is best.
Diagnosing PTSD means determining the patient’s attitude toward the original trauma.
A soldier with PTSD will do one of the following: he will either avoid everything that has anything to do with the military, the war, etc, or else he will immerse himself in those very same things.
I have an acquaintance who comes home every night and plays the video Platoon. Myself, after one visit to a VFW club and a less than warm reception, I never went to anything remotely associated with the military or the war until my diagnosis 5 years ago. However, it was certainly always on my mind, for someone once pointed out to me, not long before I was diagnosed, that I had issues with Vietnam because within five minutes of meeting me, people knew I was a Vietnam Veteran.
Of both behaviors, immersion is the least healthy. It can aggravate symptoms, cause flashbacks, and send one right back to the war (in their heads). Those who avoid those things reminding them of their experience are much healthier, even though this is a symptom of their PTSD; it is a healthy symptom.
Sleep is a reward for some, a punishment for others.
Psychologists working with wives and partners of combat veterans usually caution them about their method of waking the veteran. From across the room, is usually the best way. We don’t want to startle a sleeping combat veteran, especially since most veterans return to combat in their sleep.
Many combat veterans need to sleep in separate beds, sometimes in separate rooms. They fear they will hurt their loved ones during a terrible dream. Personally, I’ve been lucky here. Having been a pilot, I never slept in the bush, was always on a base with good security, and only once when I wasn’t, I was lucky enough to come down with a migraine headache and the corpsman administered a hypo that knocked me clear of reality (on a night we were expecting to be overrun). Personally, I sleep better with a partner in bed with me, or at least someone in the house making noise.
Infantry soldiers are acutely aware of security. Many combat veterans have trouble falling asleep or staying asleep when they do fall asleep. There are many sleep aids prescribed for these disorders, and since every drug affects every person differently, it is best not to self prescribe or use someone else’s medication.
Even when a PTSD sufferer gets to sleep, normal sleep is no guarantee; they suffer night terrors, nightmares, and night sweats. I have gone two weeks sleepless, only to grab a couple of hours when the housekeeper arrived and banged pots around in the kitchen. I guess I felt that someone was there to watch over me and I could at least grab a couple of hours.
Any possible night time disorder you can think of has occurred to a patient with PTSD. Though I was never an infantry soldier, escape and evasion was always in the back of my mind as a pilot, and twice in recent years have I awoke, naked, and crawling in the snow. I’ve been forced to lock my doors and take other measures to keep myself from freezing to death on a nighttime excursion.
Guilt always hurries towards its complement, punishment; only there does its satisfaction lie.
During war, we do things we are not proud of. Some soldiers have done things they can never mention, even to their therapists, because they seem so horrible. Guilt is an interesting emotion, for it even shows up in rape and incest victims, as if they were somehow the cause of their abuse. This fits into the frame of the above quotation; for many victims of abuse feel as if the abuse was their punishment for doing something (some unnamed thing) wrong.
The question is this: Can a person kill someone and walk away guilt free? Sure, we can rationalize our actions: we were only doing our duties (doesn’t seem to work for war criminals); we were actually saving American lives; it was him or me; etc. etc. etc.
What if we enjoyed killing, much like the quarterback enjoys the game, that feeling of success when he puts that pigskin on the numbers? As soldiers, we were highly trained killing machines. We performed like well oiled machines, proud of our expertise, proud of our skills. The war demanded results and we each kept track of how many confirmed kills we could rack up. Can a person kill 50 enemy, come home, sit at a desk, and go on working as if nothing ever happened? (For an essay on this subject, read It’s Only a Game.)
In the movie “The Meaning of Life” by the Monty Python group, one soldier, lying across the barrel of a cannon, slightly wounded, but having just killed 15 Zulus states: “Back home they’d hang me, but here they gim’me a fuckin’ medal!”
Another form of guilt, one which I denied for the past 5 years, that is until some 30 year old repressed memories came back is Survivor’s Guilt (Survivor Guilt). “Why did I, with no wife, no kids, make it out alive when my friends who had wives and kids didn’t?”
Or what about those who, out of 30 or 60 men, were the only ones standing after the battle? Why were they singled out to survive?
When something lousy happens to a combat veteran, a car accident, a job demotion, a failed marriage, it all fits into the big picture; the veteran feels he deserves such lousy luck, such lousy outcomes, because he feels guilty.
The effectiveness of our memory banks is determined not by the total number of facts we take in, but the number we wish to reject.
Memory loss, the inability to “think straight,” the feeling that one is lost in a fog: these are the most salient features of PTSD, the most common complaints. Right after the trauma, the fog rolls in and it is at this time that the patient must seek immediate help, because it can only get worse.
In group [group therapy], one common thread, one common expression is: “Did it really happen, or did I dream it.” The war is far away now. What we all did there is far away. Did it really happen? Pieces, huge chunks are missing. There isn’t a one in my group who doesn’t complain of CRS (Can’t Remember Stuff) on a regular basis.
Additionally, should one of us lose it, go off and have a psychotic episode, memory loss is a given and subsequent cognitive losses can also occur.
This was brought home recently to your author, who, after having a particularly bad anniversary reaction, wound up in the VA hospital, a babbling, stuttering idiot. While there, I’d forgotten I’d had a fiancée, the woman who a month earlier, I had intended on marrying. I’d forgotten nearly everything associated with her. I’d forgotten my own phone number, and when prompted for my Military Signature, I had to ask, “What’s that?” I was told that it was my signature with a middle initial (yes, I remembered when told). I began writing my signature, and stopped. I looked up, shaking, “What’s my middle name?” I pulled out my wallet and looked at my driver’s license; the nurse asked, “Well, what’s your middle name?” to which I responded, “Apparently, it’s Bruce.”
A few days later, in the computer lab, I found an IQ test. I took it, answered all the questions to the best of my ability, summed her up, and whammo, a kick to the groin: my temperature was a half a point higher.
In a recent test, my IQ has risen somewhat. I expect to get most of it back, most of my cognitive ability back, but there will always be some loss, I am told. (A very good book to read on this subject is Does Stress Damage the Brain?: understanding trauma-related disorders from a mind-body perspective By J. Douglas Bremner, M.D. Bremner shows that upwards of 30% dysfunction to the hippocampus appear in veterans with PTSD. The hippocampus is responsible for memory and new learning.)
Though memory loss and cognitive dysfunction are common to sufferers of PTSD, how it affects us, when it affects us, and to what degree it affects us varies from person to person. I brought up in group once that I’d sat down to pay my phone bill at 9:00 o’clock in the morning. At 5:00 o’clock in the afternoon I’d stuffed it in the mailbox. The entire day was spent trying to pay the bill because I had gotten off on a tangent. I had MCI (5 Cent Sundays) as my long distance carrier. I’d made one call to Virginia, under a minute, and the total bill was $5.96. I spent the day contacting long distance carriers, talking to friends about long distance carriers, and at one point, totally exhausted, I had to take a nap. After relating this story to the group, the psychologist who ran the group stated that this is a common theme in PTSD. We often spend more time on the periphery of a problem than on the problem itself. This is one reason many of us are unemployable.
Memory loss is sometimes a good thing, especially when the memories are painful. However, they don’t always last forever. Repressed memories can eventually come back, though they don’t hurt as much as we’d expect and oftentimes help us clarify our experience. It has been said that God never gives us more than we can handle. This is a good thing, I am sure.
Sometimes it is hard to understand why this memory or that memory is lost. Especially when the incident is not significantly harmful and sometimes it is absolutely benign. I recently met with a woman I’d dated during my first large anniversary reaction, the one preceding a trip to the VA and a subsequent diagnosis of PTSD. We had lunch together. I had to tell her that I did not remember her at all. She told me how we’d spent the New Years; watching a movie and playing the guitar. I just do not recall a single second of our time together and perhaps never will.
Because we tend to “stuff” our feelings about something, a common masculine trait (though women under stress will do the same), we also, eventually, forget what it is we stuffed and why we stuffed it. There are techniques used by psychologists to pull these memories back to consciousness, however, this isn’t always as productive as it would seem. Some things are just better left forgotten, or left to return in their own time. But as my ex-fiancée’s coffee mug states: Of all the things I’ve lost, I miss my mind the most.
Once upon a midnight dreary, while I pondered, weak and weary,
Over many a quaint and curious volume of forgotten lore,
While I nodded, nearly napping, suddenly there came a tapping,
As of some one gently rapping, rapping at my chamber door.
“‘Tis some visitor,” I muttered, “tapping at my chamber door-
Only this, and nothing more.”
Edgar Allen Poe
This symptom of PTSD really belongs above under Cognitive Dysfunction, for intrusive thoughts are an underlying cause of cognitive dysfunction: How can a person maintain a line of thought when constantly being bombarded with unwanted, intrusive thoughts?
The frequency and intensity of intrusive thoughts can be a barometer of a PTSD sufferer’s overall mental health, and the patient (and those around him) should be aware of any changes as this might call for a trip to the doctor. The frequency of intrusive thoughts can increase during anniversary periods, after watching a movie that brings back memories, after a flashback, or after anything that revives unwanted memories in the patient’s mind.
Interestingly enough, the content of the intrusive thought need not be from the original trauma, though most of the time it is. Like the ex-smoker who takes up chewing gum and is suddenly a gum addict, a patient with PTSD can substitute, at a subconscious level, a whole slew of ideas, imaginings, or obsessions aimed at keeping away those original traumatic thoughts. This has caused the PTSD patient to oftentimes get an early diagnosis of Obsessive/Compulsive Disorder or OCD; the substituted thoughts have completely taken over; masking the original thoughts and tricking even the patient into thinking they are no longer the problem, but that these new intrusive thoughts are. If these new obsessions are delusional, the patient is teetering.
Patients with solid families and healthy therapeutic techniques picked up from classes such as Symptom Management, when hit with these thoughts can usually pull themselves out (with a little help), by merely changing what they were doing when the thoughts came on. A wife can suggest a walk, or working with a stress ball, or a trip to the Mall or, a night out together. The patient might suggest a trip to the park with the kids to play in the sun, or slide down some slopes in winter time. The secret here is to find something else to focus on, something else to do. Keeping busy is very healthy.
My depression is the most faithful mistress I have known—no wonder, then, that I return the love.
Given all of the above, is it any wonder that most people suffering from PTSD also suffer from depression?
Luckily, depression is very treatable, and can be controlled with nutrition, drug therapy, talk therapy, and a loving, safe environment.
Additionally, you want to get out and exercise and then there is this happy fact: You cannot be depressed when you are helping another. So, get out and volunteer and help others.
Chronic Post Traumatic Stress Disorder is treatable but not curable (though this is debatable). One learns to cope with it, learns what stimulates and exacerbates the symptoms, and learns what to do when the symptoms get out of check, hopefully before they get out of check.
There are many ways of learning to cope with PTSD whether you suffer from it or your partner/spouse suffers from it. As a spouse or partner of a PTSD patient, learning love and patience is the first step to helping your partner: you didn’t cause it nor can you cure it, but you can support your partner and lead your partner on the right path to healing.
Partners should attend everything associated with PTSD they can. There are not as many classes available to the partners of patients as there are for the patients themselves, but if you look around you will find them.
For the patient, taking classes in Symptom Management, Anger Management, and attending rap groups is a way of keeping one’s symptoms at bay. Knowing when to reach out for help, is a second strategy; one to fall back on when the others don’t work.
Practicing Bio-Feedback, relaxation, Tai Chi, meditation have an enormous healing power for the PTSD sufferer. I’ve often told people that if it wasn’t for Tai Chi and meditation, I’d have off’d myself long long ago.
EMDR is showing some promise; studies are currently being conducted at the VA hospitals and as soon as the findings are released, we will post them here along with an article explaining/discussing EMDR.
Emotional Freedom Technique (EFT) is a form of acupressure or tapping, which was tested at the VA and passed muster. I learned it from a friend by the name of Valerie Lis, and here is her website: Courses for Life. You can actually learn the techniques there because she has her videos to help you along. I know that to many, it seems a bit “hokey,” but I’ve seen it work some wonders.
Many new treatments are being studied as I write this. But the simplest and most straight forward means of dealing with PTSD is to be aware of one’s own mental condition, have a place to go, and have a friend to call when everything seems to go wrong.
We’ve finally completed a page on Healing PTSD. I’m sure you’ll want to check it out: Healing PTSD.
All quotations: The Columbia Dictionary of Quotations is licensed from Columbia University Press. Copyright © 1993, 1995, 1997, 1998 by Columbia University Press. All rights reserved.
If you have any questions regarding PTSD, please send them. If I cannot answer them, I certainly will find someone who can: [email protected]
When I’ve spoken of combat veterans, I’ve not tried to imply that all combat veterans are male, and if that came across, I apologize to all those women who’ve experienced combat; I have in no way meant to overlook you, as so many, historically, have overlooked your contributions. When a soldier throws his body over another to protect him and loses his life doing so, we award him (posthumously) the Congressional Medal of Honor; however, many nurses placed their bodies between their patient and harms way in Vietnam and they received no recognition. This is a wrong that must someday be corrected.
Finally, we can honor the brave women who served us so selflessly in Nam. Bless them all: A Nurse’s Story.
And here is a tribute to the first nurse killed in action in Vietnam: Sharon Lane.
Facing the Wall: A Mission, a book by Mary S King. Read Our Review.
Because vets of conflicts in the Middle East are coming home in droves, all having witnessed some of the most horrible atrocities imaginable, we are going to list two sites especially for them; the first is for women vets and the second is for the men. BringMeHome.org
National Center for PTSD: http://www.dartmouth.edu/dms/ptsd/
Soldiers For The Truth: http://www.sftt.org/
Patience Mason’s newsletters on PTSD: www.patiencepress.com
For information about an online degree in psycholgy with a focus on PTSD: Maryville University.
Gift from Within (a private, nonprofit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals. Our philosophy is to rekindle hope and restore dignity to trauma survivors): http://www.giftfromwithin.org
The following links are to articles found at Gift from Within:
Post Traumatic Therapy by Frank Ochberg is
Understanding the Victims of Spousal Abuse by Frank Ochberg is
The Counting Method for Ameliorating Traumatic Memories by Frank Ochberg
Bound by a Trauma Called Columbine by Frank Ochberg
Article by Dr. Kathi Nader and Dr. Robert Pynoos: School Disaster: Planning and Initial Interventions
Article by Erwin Randolph Parson Inner City Children of Trauma: UrbanViolence Traumatic Stress Response Syndrome (U-VTS) and Therapists’ Responses
CULTIVATING RESILIENCY by Carl C. Bell, M.D.
Our Videos: http://www.giftfromwithin.org/html/video.html
PTSD 101 for Journalists by Frank Ochberg, M.D.
Survivors and The Media by Elaine Silvestrini
Surviving the Crash: Stress Reactions of Motor Vehicle Accident Victims
Tara E. Galovski, Ph.D. & Connie Veazey, M.A.
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