Sticky: Guide to the blog

Latest Post: An open letter to someone who is looking for help (9/6/2011),

New! Now you can subscribe to PTSD and Me to keep up with new posts and comments.

This is sort of the "best of" section where I'll link to the blog entries people seem to read the most. Perhaps I ought to have a page on "What is PTSD" but lots of others have already done that, so I'll just link to them here, here, here and here (pdf) [n.b.: New links, updated 12/8/08].

People in crisis often want to know where they can get help. Grounding exercises for PTSD can help get us through the short term. Here is a comprehensive list of US treatment centers that specialize in PTSD. That is of course assuming you are privileged enough to have access to these resources. Not everyone is. And in case I forget next winter, here are some tips on PTSD and the holidays.
One of the most disturbing symptoms of PTSD is flashbacks, especially when they result in "non-epilectic seizures" or what a doctor might have called "pseudo-seizures," though there is nothing "pseudo" about them.

Picking a therapist can be difficult for someone with PTSD, because often times the PTSD itself messes with our pickers. Through necessity and trial and error and generous borrowing of other people's wisdom, I've come up with a brief subjective guide on how to choose a therapist for ptsd. It contains links to some other, less subjective guides too.

Along with getting medical and psychological help, medication helped get me stabilized even though I was really resistant to it because of being a recovering addict. I wasn't resistant to trying Effexor, and kind of wish I had been (see Battle of the Effexor and Joy of Meds: Effexor withdrawal) I have quite a bit to say about PTSD and 12-step programs. While 12-step programs saved my life, I found that their one-size-fits-all model did more harm than good after the initial haze of the drugs and alcohol wore off. There is more than one type of addict (and some more on the subject here). And although it claims not to hew any one denominational line, it is based on Christianity in some ways that were harmful to my recovery. I finally decided to leave 12 step approaches, a difficult decision. In hindsight, however, some of the most exploitative folks I ever met were from the halls of twelve step rooms and the addictions recovery industry.

Betrayal bonds form a major part of PTSD as I have experienced it, so I've spent a lot of time writing about them. You might have heard of this as Stockholm syndrome. They take a number of different forms. Fully understanding the nature and effects of betrayal was key to beginning my recovery from PTSD. If you are interested, I can tell you more about my PTSD. Some days are still [rough] (skin-crawling, time-wasting, losing time, etc) but I have found a certain amount of recovery, and my life is once again bearable, even enjoyable on good days. Partly it depends on which dogs I feed. It also helps to have a loving and supportive network of friends. Oh, and to stay far away from toxic relationships.

neglect (hopefully not traumatically so this time)

eeep!  I have neglected the comments here and a whole bunch of really important onces came in.  I was backlogged since October.  Had a major death in the family and let things go.  They are all posted now.  I apologize to anyone who missed their post, and thank you all for writing.  The comments are often the most powerful part of the post!

An open letter to someone looking to help a loved one with ptsd

Hi,

Since you did not post anonymously and wanted to get a hold of me I won't publish your comment but will respond to your email.  If you want to repost anonymously, you might get some help that way too, so if it comes through again anonymously I'll publish the comment.  I never had Electro Convulsive Therapy (ECT), and have heard nightmarish stories about it, even in the new and improved version.  If it is not having a helpful effect, please reconsider it!

First off, sorry to hear you and your wife are having such a tough time.  When I went through the worst of the flashbacks and other stuff I was very difficult to deal with and a real burden.  I am fortunate my wife recognized what was going on as similar to what happens to battered women (she had done some work in the domestic violence field) and people who have been abused, but we had no idea when it went down what PTSD or flashbacks were.  It was incredibly frightening...I thought I had just gone crazy.  That is why I publish the blog, so that if people are hunting around they will know that what is happening is not unique and that there are ways through it.  The only way out, unfortunately, is through.

It put me out of work for 1 and 1/2 yrs, and I had to go to inpatient.  We basically maxed out credit cards and borrowed from friends and my wife's family.  Insurance would not cover anything.  I looked into but did not get social security for a disability, we were too busy with the symptoms to be able to go through with that when it actually could have helped.  My family of origin was in such denial they did not help and went on a sort of in-the-family PR campaign to discredit me and my wife.  I don't talk to them at all any more.  That whole things was weird, because the immediate causes of my ptsd were not directly anything to do with family other than raising me so I couldn't recognize psychopaths when I encountered them.  We had ok credit but not much income at the time and basically maxed out the 0% introductory offers and juggled them around for a couple of years before paying them off.  No fun, but it worked.

If you can go that route, do careful research on the place.  I went to Life Healing Center in New Mexico.  Some people, like me, have gotten a lot out of it, others, not so much.  It did not cure me, but it did give me enough tools to manage the worst of the symptoms and set up a structure of recovery, which slowly happened (with lots of work from me) over the next five years.  I have not had a flashback in bout five years, but I know that seems like forever from the other side.  With help though, it can and does get better.  Without help it will not ever get better, and would have resulted in incapacitation, institutionalization, and death for me if left untreated any longer.  It kills lots of people through suicides and addictions, and the stigma prevents the experience from helping others.

About the careful research, look at the comprehensive list of treatment centers.   You might contact Life Healing Center and ask where to go or what you can do.  They were supportive when we called.  The Sidran Institute that is listed at the top of that page serves as a clearinghouse of info and advice on getting help with PTSD.  They have a great help desk.  I would also check "how to choose a therapist" on the blog.  While setting up longer term plans, try to get short term support in place.  If Kaiser will pay for therapy, try to get a referral for PTSD.  There are lots of positively harmful mental health professionals, I would say the majority of them, so if you get a bad vibe with one try another.  It is not you!  Other people I know on Kaiser have managed by trial and error to keep trying the therapist they assign and if that one does not work ask for another.  Make the first session an interview.  You may want to attend with your wife, because if she is now like I was a few years ago, I would pick abusive therapists!  Ultimately though it has to be someone she feels she can work with, so you can only support, not do it for her. But she has a right to get appropriate treatment specific to her case, and might need help to do that.

Kaiser may want to do an economy one-size fits all solution, but you have the right to get the help you guys need.  Especially be careful with psychiatrists prescribing meds.  If you get a sense they are just prescribing this week's pharmaceutical company offering and not listening to you either before during or after you start on meds, clear out fast!  I'd say psychiatrists approach closer to 90% incompetent.  I really had to hunt to get a good one that would actually listen.  My wife helped me find a good one, and the "how to pick a shrink" page is what we learned about how to find one and interview her or him.  Meds are an important part of my recovery today though.  But if one gets overmedicated, it is just zombifying, and if your wife gets on the wrong meds and the psychiatrist does not listen, it is horrible.

Also, check the laws in your state.  In my state, major depression, which I had from the PTSD, qualified for more intensive treatment and the insurance company had to pay for unlimited sessions, not just the usual 24/yr or whatever.  The insurance company of course will not tell you this, so check the laws and the fine print of your policy on it.  I went twice a week sometimes when things were just starting to get better.

If there is addictive behavior involved, tread very carefully around 12 step programs.  They have little to no understanding of trauma issues and even if it works for the addiction, like it did for me (I went to 12-step groups for 16 years), the cure can be worse than the ailment, and charlatans and @$$holes abound.  That is not to say don't use it as a resource if it works for halting the addictions, because the addiction, particularly to drugs or alcohol, will prevent any progress in recovering from the ptsd.  Just don't drink the kool-aid that says it is a cure-all and if you are not happy joyous and free in 6 months you are doing it wrong.  That is positively harmful and very prevalent.  Get help with the PTSD elsewhere.

With that said, a number of treatment centers are incorporating trauma work into their inpatient programs.  The meadows in Arizona and the Caron Foundation rehabs in PA are two examples.  Places that work with trauma primarily often won't take a person with substance abuse issues until they have come through a rehab for that.  When I went to Life Healing Center I was already 16 years sober and had to do a bit of convincing to get in without having to go through another drug and alcohol rehab!  Without the sobriety, the other work is impossible.

I am forever grateful that my wife and my friends I had made outside of 12 step groups came through and stuck with me.  I did get better over time and returned to being a more-or-less fully functioning adult again.  It was (and still is) a long slow process, but things do get better.  My wife was for me when I was not, when I was hopeless, she supplied the hope, and we came out the other side of it fine after some couples counseling.  Don't underestimate the strain on yourself and inequitability of what is happening.  It is not fair that you should be stuck cleaning up trauma that you had nothing to do with, and Christian strategies of turning the other cheek and repressing anger will backfire, coming out sideways and destructive.  It is a tremendous strain to live with someone going through PTSD, to the point they have a name for it, secondary PTSD.  So please, if you are going to support your wife, remember that you need to take care of yourself ultimately too.  That can get lost in the cycle of crisis, but it is crucial if you are to be supportive and if the relationship is going to come through in the long run.  It can and does happen, even if it seems hopeless now.  Having come out the other side, it was an awful expereince, but once we sorted things out, with a lot of emotional work from both of us and short term guidance from a good couples therapist when we got stuck, we are stronger in the relationship than ever, and I owe my recovery in large part to my wife's unstinting support.    I'm not advocating martyrdom though, please be clear.  I had to work hard at my recovery and do a lot of work in restoring the relationship.  If I had not done that work, even when I saw no point in it, nothing would have gotten better between us.

I hope this is of some help.  I know PTSD is terrifying and awful, so please hang in there.  All the struggles and hardships paid off for us in the long run and I hope they do for you too.  I'll probably post this as an open letter on the blog without hooking it up to your comment.  Thank you for writing.

New Look

When I moderate comments, I often go back and review posts and comments for strength and sustenance (especially the comments!).  Today I realized that the bright white text on a black background was hard to read for any length of time, so I updated the look and feel.  I know a lot of people who come here go on extended readings of the info and your comments, so I made the text a little less bright, and switched from a sans serif font to a serif, Georgia, for the main text.  Serifs, the little horizontal guidelines at the tops and bottoms of letters, make it easier to read because the help the eye follow along horizontally instead of emphasizing the vertical.  I enlarged the font a notch too.  The background is from a stock theme.  I like it because it is bokeh, out of focus, so it gives the illusion of depth.  I also like that it stays in place while the text scrolls: it gives the illusion that there is a scene behind the writing.  And the rainy day seems to fit PTSD bouts with depression, even if the vista is inspirational.  The headings are in a felt marker-type font.  I wanted a sort of zen brush-stroke effect there.

The last real post is still the one about losing time, which I have been doing a lot of, and my updating the layout just goes to show you how desperately I am avoiding the real work I need to do!

Let me know whether you like the new look if  you got distracted enough to come over to this page and have read this far.  If you want to get back to reading the blog, here is the guide.

Sorry to those who have commented since May 8th. I've been traveling and working and got behind. Comments are all published now, and I hope if you are suffering from PTSD and maybe don't know what hit you, that you find something of use here!

losing time

This started out a comment, but became a post. The time-wasting thing is weird...partly, I've had to learn to give myself some space to waste some time on having fun and stuff like that that I used to think I did not deserve. But the losing time thing was a real problem for me for a long time -- still is in some ways.

I used to be in this weird form of denial about it. I would have dissociative, losing time, flashbacky stuff happen all the time, but as long as I was the only one who witnessed it I could pretend it was not happening, or I was just faking or being "dramatic." Denial runs very deep in my family!

Anyway, eventually, I started losing time so others noticed and I had to make up stories to cover (should sound familiar to anyone who has or had an addiction that is trauma-related), but ultimately, it spilled over, or I finally decided I could trust my partner of many years and what had been my own private nightmare was all of a sudden shared. Instead of leaving me in disgust, she said "oh my this is terrible." She recognized what was going on with me as similar to what another set of trauma survivors (women who have suffered domestic violence) whom she was familiar with go through. This set us off on the slow process of learning almost from scratch what PTSD is. I thought she would leave if she discovered how "bad" and "crazy" I was inside my head, but instead, sharing what was going on, even though it kind of spilled over rather than being a conscious decision on my part, began the process of recovery for me.

My ability to trust others was so damaged by the various traumas I have alluded to in this blog that it was nine years into our relationship before I trusted her with what was going on inside me. I really thought I was to blame for it all, and that I was just crazy or defective, and I had been burned so many times on trust issues I was extremely wary. And I was fortunate to find someone who saw things for what they really were instead of just being freaked out and leaving.

I guess the moral of the story for me is that when I am "losing time" it is a good idea to run it by someone I trust. That is hard for me, because I used to trust people who had not earned it and I got burned all the time.

god and stuff

Catherine wrote in a comment here, "Does this mean the steps don't work? Does this mean God does not exist?" I tried to answer briefly but it turned into a post.

"God is dead" - Nietzsche
"Nietzsche is dead" - God

I always liked that even if I disagree with the moral of it. I have come to more or less of a truce about spirituality. I have no way of telling whether or not any deity exists other than subjective guessing, which I have seen is often wrong when I do it and when others do it. In fact, the most harmful people in 12 step rooms for me were ones who were convinced they knew and were carrying out "God's will" saying things like "I like to think things happened for a reason" when the reason was that they did it: god as cop out in other words. So I have suspended judgment. If there is one (or more) or not is apparently not my business. My job is to do the best I can with what I have got, and belief in a deity has just not been sustainable for me, though I don't see disbelief as being any more supportable in my own case. In other words, I am not an atheist, I just don't know (which I think is the literal meaning of agnostic, though I am not keen on that label either). I am not one to substitute a faith that god does not exist for a faith that one does. Same goes for faith in science or AA or anything else as the answer to everything too. I don't think the whole world is reducible to the observable, but again, I don't know. I just don't know, and that is fine.

A higher power is a different story, I just don't need to deify it for it to work in my life...it is just the admission that I can't do it all, know it all, be it all, myself. I need others, their perspectives, their help sometimes, their human frailty at others, and mostly their love (that last one is hard to admit and write even now -- trauma has taught me so many times that I must be self-sufficient because I can't trust anyone). Finding a few people I can risk trusting in this regard has changed the everything for me and allowed me to get better even when faith and 12 steps failed me.

I know this is not everyone's path, and I hope I am not going to draw and evangelical types by my stating my lack of belief, but it has worked for me when all else failed and I have some peace of mind, whereas before, for me to believe at all, I would have had to have bought into the idea of a punishing (or very stupid and powerless) god that pretty much wanted me to suffer in order to test me. If so, I failed the test, or maybe I aced it, I don't know, which is the point. If the deity I used to believe in is in fact the case, nothing I can do about it, but I don't have any compelling reason to place my life in the hands of some invisible malevolent-for-my-own-good deity any more. Been there, tried real hard to make it work, results not so good. I have had to find my higher power in people around me, human and imperfect as they (including me) are. That has sometimes worked and sometimes not so much, but it is good enough for me right now.

What does it have to do with PTSD? Well for one thing, many of the tools that self-help have to offer rely on on putting your trust and faith in a deity of some sort, however contrived. Professionals rely on this to some extent too, especially ones who don't have proper training or better tools to offer. Some of the trauma I suffered had to do with spritual abuse of the first order, people invoking a spiritual higher power to gain trust and to then do extremely harmful things that truly f***ed up my life. And it was done as part of my seeking to recover from earlier trauma. So the tools I was supposed to use to get better were turned on me. Talk about having trust issues. Same sort of thing happened, in a related way, with therapists. And the end result was that "very spiritual" people put a big head trip on me, so that I was supposed to (and did for a time) believe that things happened the way they did because of my failures and shortcomings and god's will (constructed in the usual new agey fashion...I never got into church since being raised as a strict Catholic as a child).

This left me in the most forlorn place in my life, worse than the black hole of addiction because there was no addictive pain relief and no reason for any of it that made sense other than that I sucked. Nothing made sense anymore. Everything that I was taught would make me "happy joyous and free" made me miserable...I got the feeling of being some kind of alien, the butt of a joke I did not get, plopped down in a world meant for others that worked for them but not for me. That was the effect of spiritual and emotional abuse I now understand, but it led to a feeling of nearly complete abandonment and years of suicidal depression as I labored under the beliefs I had learned in early recovery.

I won't say too much about how I got through it, but after a suicide attempt that could have been successful, when I chose (a few moments away from not being able to come back), to go to the hospital, I made a very willful decision. They held me at the psyche ward until I promised to be good, that was about all, other than some horrible group work and an attempt to torture me physically in the name of an EEG by sticking an electrode on the end of a tube through my palate and into my nose. But while thereI basically made a decision that if I wanted to kill myself that I would have, that I had my chance and failed even at that, and that I just would not try killing myself to relieve pain any more, no matter what I had to do. This was not easy, because for the next nine years I suffered from ptsd without knowing what it was, getting (mis) treated for whatever this week's malady was with last week's pharmaceutical offering. I walked around suicidal for nine years, figuring that that is how I would live out my life. If I felt so bad I thought I would act out on it, I spoke up, not because I wanted to get better -- I had no such illusions by that point, but because I had promised myself not to and yelping for help was the only way I coulds see not acting out on the desire to stop hurting. The one thing I did right was I kept showing up as best I could. The other thing I did was change my friends and gradually, fitfully, and with much guilt and worry, clear out of 12 step rooms. Finding out about ptsd was like a cover being removed from my eyes. Things that made no sense finally did. That is why I write this blog, on the chance that someone else in the same state as I was might find out what the hell is going on in their life and skip some of the forlorn-ness of it all without checking out permanently.

As for the steps, they work for some people, though not nearly as many as 12 steppers claim, and I see value in them as a way to "clear the wreckage of the past" but they alone were not enough for me. I kept going over the same things, working the steps as well as anyone, and things kept getting worse. The reason was that I was taking responsibility for things that were not mine and stuffing anger because the literature said it was a "dubious luxury we can ill afford." One of the things I heard in 12 step rooms was that if you keep doing the same thing over and expect different results, that's insanity. I finally had to apply that to how the steps (did not) work in my life after a point. PTSD complicated matters and the steps did not and were not designed to help with it. I needed to do something different, but the only solution 12 steps had to offer was more step work. So my short answer to Catherine's question, "Does this mean the steps don't work?" is that they did not work on PTSD for me. A lot of the stuff was simply not my fault, and any attempt to take responsibilty for it just aggravated the problem. I needed to get good and angry, and I did not and still do not have any need to forgive or forget, much less make amends to these people. My life did not fall apart as dire warnings from the literature and the rooms said it would. In fact, getting angry and placing responsibility where it belonged was a true first step toward my ongoing recovery from PTSD and a return from the brink, or maybe over it, of insanity.

This turned into a way heavier post than I intended, but there it is for what it is worth; it is my experience and your mileage may vary.