Sticky: Guide to the blog

Latest Post: alternatives to 12 step and why addiction recovery is crucial to PTSD recovery

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 my favorite, a glossary from the Sidhran Institute [link checked 7/12/20].

Two notes before we begin.  First, I am not a professional.  I have kept this blog to share my experience with PTSD, but I cannot help you directly if you are suffering from PTSD.  I only check in here intermittently and it breaks my heart to see someone plea for help and get no response.  Please, if you are in crisis, call 911.  If you are looking for treatment or direct help, please contact the Sidran Institute. They are an excellent resource and can help you find appropriate treatment.  If you are finding out about PTSD in yourself or another and want to know what my experience has been, read on.

Second, if you make comments that contain negative statements about people at various facilities by name, I will not publish them.  Stay general, and even say there are problematic people to avoid, but no names.  Probably best to leave out names of people you consider praiseworthy too.  Self-promoting comments or links to link farms or anything that is the least bit suspicious will be deleted.  I err on the side of caution.  That said, there is a wonderful compendium of knowledge and wisdom in the comments, so thank you to all who have shared there over the years, and please feel free to continue commenting as you see fit.  They are one of the great rewards of writing this blog!

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 way of finding US and global 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.

If you are looking to help a loved one diagnosed with PTSD, you might want to read my open letter to someone looking to help a loved one with PTSD. My partner, who is a key part of my loving and supportive network of friends, has been absolutely critical to my ongoing recovery, and I share some of the ways she has both helped me when I could not help myself and some of the unfortunate costs she has paid as a result of my PTSD.  It is a hard road, but we have come through stronger than ever, so there is hope.

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. Spiritual and psychological abuse are real and create huge barriers to recovery. Just to be sure, I tried a few alternatives to 12 step approaches that were promising but fizzled out, so I tried again, home group and everything,  The results were the same, but magnified in a way that really drove the point home.  For the past few years, I have found an Al-Anon home group that takes care to welcome everyone and not get caught up in "my way or the highway thinking.  It turns out that my main problem, as long as I don't pick up, is not with substances, but with addicted dysfunctional people, so this Al-Anon has turned into a real home group for me. Might not work for everyone, but it is working for me.

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. While the guy who wrote the book on betrayal bonds associates them with sexual addiction, I have found this ain't necessarily so.

 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. And I'm still here, yes still here, and even now, still here.  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.

One more try with AA. Swing and a miss

 I was looking for something in the way of fellowship for addiction recovery. I tried one of the Buddhist approaches and one of the secular approaches, but both fizzled out. I tried AA again, seeing if maybe that would work if I found the right group. I thought I did, right in my own neighborhood even. Things went well enough I declared it my home group and signed up to do coffee and setup.  A different person picks the speakers each month and unfortunately for me, my last month in this group was ledd by an AA Christian fundmentalist.  Here is my account of what happened in the form of the email I sent the group when I left. 

Hi all, just one last thing...Sorry it is a little long. You all never heard my story, so consider this that, and humor me by hearing me out if you wish.

I spoke with a few of you about leaving last night and I want to be clear so there is no misunderstanding...I’m not leaving because of the speaker, or even the Course of Miracles stuff about angels and whatever. And though I give both of those beliefs a wide berth, I have no problem with other people’s beliefs. My reason for leaving comes from the last speaker of the evening and the truth of what he said.

He said that agnostics like me maybe don’t drink but aren’t in recovery like “we” are by which he meant proper, god-fearing AA, which he called “the Truth” in affirmation of the speakers who preached Christianity prior to him that evening. OK, actually still no problem there, even when he wrapped up that little ball of intolerance and disingenuously labeled it “love.” Sorry dude, not feeling the love over here, but ok, principles before personalities. He also gave all of us, but especially me, since I was the person who identified as agnostic (I am pretty sure he has no idea what that word means), an assignment to read the chapter on the agnostic from the big book. So I re-read the chapter for the Nth time, and it is still an argument of the same type and thinking as that of the birther movement or Creationism, both of which I reject. Still no problem. Take what you want and leave the rest. OK, so let’s see what the google-god tells us about what the agnostics are up to in AA and what AA thinks of them.

It turns out that AA officially accepts agnostics and special interest meetings for agnostics, atheists and so forth (see the Oct. 2016 Grapevine for a whole issue on this). Cool, I’m in. Now where are those meetings? Pull up an Oahu schedule, and there you go, and right there at the top it is, an AG/AT symbol to mark the meetings where we are actually welcome, as opposed to the others, where I guess we are still not welcome. Well ok, ctrl-F, lets find all the AG/AT meetings. Zero. People like me are not welcome at any meetings on the Oahu schedule. OK, if I had infinite time and energy, I could go on a crusade and start one. Maybe I’m just copping out.

But here is the rub. AA has also declared that not a word of the first part of the big book can be changed, so that means that the chapter to the agnostic is considered divinely inspired and infallible in practice, which is what it means that AA declares as Gospel Truth a text written by a bunch of newly sober drunks flying blind in 1938 except for the guidance of a book on religion by William James and a Christian group called the Oxford Group (read Pass it on). The chapter on the agnostic does pretty much say I don’t have real recovery until I have a personal deity.

This, and the comically sexist chapters on “Wives” (stand by your Man) and employers (give Him some slack) are officially considered by AA infallible and unchangeable. It is a baked in principle and actually a dogma that my recovery is "less than," which is odd for a book that closes with the statement that it is “merely suggestive. We know only a little.” So it is a bedrock principle of the book, and the book is considered unchangeable truth, and it says I’m a second class citizen unless I have found God as We – not I – understand Him.

This is fundamentalism, which allows people to cherry pick from a text, do whatever hateful thing they want and call it love and God’s Will and “the Truth,” which is exactly what the last speaker did. And he was right to do so by the AA principle that the Big Book is a an unchanging, infallible, fundamentalist text.

I have severe PTSD from fundamentalists (who come in every shape from followers of some brands of Jesus to New Age stuff to the Course of Miracles stuff artfully spouted at Tuesday’s meeting). It has put me out of work for over a year two times in sobriety, caused two trips to mental hospitals, and one for a residential treatment center for PTSD and addictions where they were amazed that I did not pick up after the stuff I have been through sober.  And, get this! Since meetings were triggering my PTSD, a rehab after verifying that I had no plans of picking up a drink or a drug, actually recommended I stop going to meetings! LOL, I still wonder how many times that has ever happened. Mind you, I had sixteen years under my belt at that time, and I wouldn’t actually take the advice for another year, being a stubborn alcoholic. Now like anyone, I may pick up a drink tonight or get struck with the drunken lightning for not going to meetings, but I’ll try not to do that today, since every good thing in my life depends on staying clean and sober and picking up would do absolutely nothing to make anything better, no matter how bad things seem. If you want to know how to get through a hard day without picking up a drink I can tell you a few things about it. Despite these challenges, I have carved out a good life, one that was beyond my wildest dreams when I came into the rooms.

I have PTSD from people in the program doing abominable things to me and calling it love and God’s will, because they had a personal God and they like to think everything happens according to His plan, so whatever hateful shit they spout and do is actually God’s Will, part of the Plan, and if you don’t get it, it must be because you are not special and chosen, poor soul. Because of how I was raised, in a generations’ deep swamp of alcoholic dysfunction, it has taken me years to figure out that this was their problems that they were dumping me with, not some flaw in me. And certain types of alcoholics from therapists to car salesmen to lovers to predators to sociopaths (not kidding) and to my family of birth look at me and, probably unconsciously except for a sociopath or two that has found me, see an awesome target for some reason I am still working on figuring out and that I am getting much better at avoiding.

So let me sum up here. AA endorses its own peculiar brand of fundamentalism. Some fundamentalists take shit that and run with it. Fundamentalists like this have caused tremendous harm in my life and I seem to have some kind of blind spot and they seem to be able to pick me out easily. Therefore, it does more harm than good for me to continue in AA.

Please be careful to note, I am not saying that everyone in AA or even AA as a whole, is fundamentalist. Only that it endorses its own peculiar brand of fundamentalism that is available to people who, like the last speaker, do take that and run with it. To me there is little in the world more dangerous than an alcoholic who is not drinking, has his or her wits about them, and Knows The Truth for sure. I saw this in the previous week’s meeting and its homogeneously uniformed and disciplined AA team following a charismatic leader, but I set it aside in the name of tolerance. This last meeting was not my cup of tea, but as I shared at that meeting, I actually think it is great that everyone from a follower of Jesus to someone like me who does not have the dubious luxury of such certainty, can all figure out a way to get sober together, which none of us could do on our own. I did have a major problem with the last speaker’s statement that without a personal deity you are not really sober, but I can do principles over personalities. The problem is that when I explored the principles, that brand of exclusive, intolerant faith is not only encouraged, but considered infallible. At that point, I’m done, and I have a better understanding of why I seem to run into so many people who see me as target practice rather than a fellow human.  I'm actually grateful for that last bit, as I understand it a little better now.

I have not met anyone in the group who has been anything other than lovely to me in my short time with the group. I seriously mean that. I think the last guy was a hateful ass, but I didn’t even see who it was. You’ll have that all over the world, not just in AA, so whatever, it is not really more than a passing bit of anger of the everyday sort one has to work through wherever they are anyway.

The principle is the problem. I am not up to fighting against it, and there are other things I can do in my life to be there for the still suffering alcoholic than try to make AA into my image of it. I found this out in my seventeen years away from AA but not recovery: there are plenty of people like me. I am one of the fortunate ones, who like you has been able to get in recovery and build a good life which completely depends on that recovery. Plenty of others – I think one in ten actually sticks around in AA and achieves sobriety that way – still struggle and many of them feel excluded for reasons similar to mine for leaving. Through the gift of anonymity, I have corresponded literally with hundreds of them with lots more behind each person I have been fortunate enough to talk to. They make me understand that I am not alone and that my recovery is just fine, and I am grateful for that, and them, and you all, and fortunate every day. Recovery, I have found out, is not a monopoly enterprise. We do “know only a little,” so it makes no sense to me to declare a solution with a ten-percent success rate to be infallible dogma. Especially when it does tremendous harm in my life and others. But AA does exactly that. That’s why I am leaving. But I am glad it works for you.  

So you guys never heard my story but there is a little of it. Anyway, like I said, I live in the neighborhood, so if you see me at the ABC store say hi please, and if a green Subaru sedan honks at you as I drive around the block to my place, it means, “Hi,” Not “get out of the road and quit smoking ya bums. What the hell kind of church is that anyway.” 

Anyone still read this?

Hello. I am wondering if anyone still reads this blog. when I checked stats, it seemed like a half million people have read parts of this blog over the course of its long active and dormant lifetime. I was shocked! A lot of bots and Estonian trolls must have PTSD! If you are a human, and are in recovery or seeking recovery or just suffering from post-traumatic stress reactions, please let me know in the comments if I should make an effort to say a few more things about my journey with PTSD and recovery. I could use the company right now!

When I started this blog many years ago to see if there was anyone else like me, I was blessed (and that is a pretty big deal for an agnostic:^) to find out that not only were you out there, but that what I thought, through shaming and isolation, was my own peculiar problem was actually something that many people could relate to, even if the details of our experiences vary from person to person. So if you find this and it touches you, let me know. If there is no response, I will know to let this rest and look for new avenues of support.

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.

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.

exploitative folks in 12 step programs and elsewhere

Once again, somebody's comments sparked a post from what started as a simple response. Anon, thanks for your comments on this page and and on the "type A&B" page. In a nutshell, she said thanks for the heads up as she tended to trust 12 step folks blindly and had not realized there were some exploitative types in the rooms.

I really need to tread a fine line...AA and 12 step programs saved my life at one time, but nearly cost it another. I managed to get sober there when I could not under my own steam no matter how hard I tried. I'm forever grateful for that, because it has made the rest of my life possible, painful as parts have been.

That said, the most manipulative, scheming, two faced, fair weather friend type people I have ever met, straight or high, have been in 12 step programs or the addictions recovery field. I had the blind trust anon talks about -- after all, these people had literally saved my life and I knew it! And there are some great, decent, and honest people in AA. There are also used car salesmen (I bought a lemon from a guy who used 12-speak and AA "seniority" to get me to trust him when making a purchase I wished I hadn't), spiritual abusers ("when I f&%*ed you over it was God's will"), therapists ( did anyone ever notice that the word spells "the rapist?" -- just kidding sort of...while several of my therapists were akin to rapists, others I have learned to choose have been remarkably helpful) willing to rip up families to make a few thousand bucks, even to the point of driving the abandoned ones to suicide ("oh she was messed up...good thing he left her when he did!"), and this is before even getting to romantic relationships, where as I said, because of my tendency toward trauma repetition, and never having been around healthy people to know any better, and my blind trust in 12 step folk, I got involved with the sickest most twisted people I have ever met in my life. I'm still trying to sort it out 15-20 years later!

I would never tell anyone to avoid all relationships with recovering people...there are some healthy ones I am sure (plus I'm one!), but tread carefully! Trust slowly and cautiously if at all. Trust is earned and provisional, based on actions not words, and not granted eternally, just for now. Pay attention...don't disregard your common sense and intuition...a major part of my recovery has been to slowly reclaim those things...if it looks too good to be true, it probably is.

The thing is, I was so needy and vulnerable, even 5-6 years into recovery, that I ignored all this and rather than waiting and going slowly, I dove in and trusted blindly because I did not know how to develop earned trust over time rather than just give it or withhold it arbitrarily. As a result, I got in traumatic relationships again and again (twice in recovery, to be exact) that I am still struggling with much later. They very nearly cost me my life. They did cost hundreds of thousands of dollars in lost work time when I just could not function because of the results of them. They caused unbearable and completely unnecessary pain and a number of trips to psyche wards and a trauma treatment center. When I have told people the details, they have been amazed that I didn't pick up over this stuff...many just assumed I had. One person I respect a lot, an earth person (i.e., not in 12 step programs) said the last perpetrator was an emotional rapist.

But honestly, I don't know if I could have taken the advice I am giving now, because I was stubborn and thought if I did not get somebody *now* I'd be alone forever. Looking back, I would have been better off alone, but I needed to learn it the hard way I guess. And even today, knowing what I know, I don't know that if I were single and put in the same situation I wouldn't repeat my mistake again. I like to think I have learned better, but I don't know that. I am just glad I am in a healthy non-abusive relationship for a long time and don't have to face that particular weakness in myself.

It is a funny thing...the healthy relationship didn't come with all the drama, risk, and emotional highs -- or lows -- that the sick relationships did, so it took me literally years to figure out that all that drama and ball of hurt I was used to was not an intrinsic part of human relationships! I thought I was missing something and I guess I was. To be honest I missed the rush, just like a drug, but also to be honest, I have learned I certainly don't miss the consequences.

I just have to say, over the few years I have intermittently written this blog, I have been continuously gratified that there are other people who understand. One of the worst parts of my PTSD was thinking I was alone and hopeless and crazy. So thank you to all of you who have commented over the years. You keep me thinking and writing about this stuff, which helps me work stuff through, and I am grateful that something helpful to others has come out of something so insufferable.

PTSD and the holidays revisited...

Holidays have always been rough for me. A lot of trauma anniversary (pdf) stuff comes between Thanksgiving and New Years for me. I didn't even realize it but my partner pointed out that I always have a hard time with holidays and depression and PTSD symptoms. This year seems better so far. I am in a place I like. I won't be alone. People who traumatized me are far away and not in contact. So maybe things will be ok this year.

Another set of holidays has started, and I need to be aware of anniversary reactions. Awareness and talking about it to the people around me (I wouldn't recommend this unless they understand PTSD and are supportive) have helped reduce the worst of the reactions, as has staying away from my abusers, and unfortunately in my case, my family of origin, who are all mightily invested in not understanding my PTSD, which several of them find pretty threatening.

Why are holidays tough for people with PTSD? Well for one thing, getting in touch with positive feelings can be really difficult, and during the holidays there is a lot of pressure to do just that...be jolly in other words. For another, some holidays a reminders of anniversaries of traumatic events. Anniverseries are proven triggers for PTSD, and they sure were for me. I finally realized I needed to cut off contact with my family of origin -- a drastic step, not for everyone, BTW -- after calling on Thanksgiving and getting off the phone and having a severe flashback. I would have never put the two together because the content of the flashback was not my family, but my partner noticed that this happened regularly with contact with them and around holidays in particular. The "joke" in our family was "OK, we're going to have a good holiday or else, godammit" which was usually followed by some drunken craziness that turned ugly.

For me, controlling whom I am around, and scaling back expectations of jolliness both help a lot.
There is a bit more on how someone with PTSD can cope with the hiolidays in About.com's PTSD section.

toxic relationships

Well, this started as a response to a bunch of comments but turned int my first post in a while, so thanks to the anonymous poster who made the comments referenced below.

anonymous said:

My story was a string of "moderately traumatic" events that left me feeling constantly on edge, ready for betrayal or chaos at any moment, completely in physical and emotional pain for years.

Yes, I know that feeling well, that there is no safe place, the world might give way under foot at any moment. Finding ways of being and places, even imaginary ones, that are safe has been a big part of recovery for me. EMDR, which I have been thinking of writing a post on for a very long time but haven't gotten around to it, was helpful in doing this. I started out with an imaginary safe place, but also learned to trust that loving and supportive network of friends, which has been a challenge, but also tremendously rewarding as far as recovering goes.

anonymous wrote:
The supportive, loving people I have new relationships with don't deserve to deal with my insecurities from the manipulative, destructive people in my toxic past.

I think awareness is a crucial first step. All the toxic people who were in my life surely had their own unaddressed trauma issues, I know this for a fact. I think perpetrators of abuse are traumatized people who feel entitled to take out revenge for their trauma on the world around them. Its their way of dealing with it, but it creates more trauma, passing it along to new people. Most traumatized people won't turn into abusers, but I bet 99.9% of perpetrators come from traumatized backgrounds. Its important to reiterate that this is not a fait accompli.

It is a slippery and seductive slope though. Most traumatized people hold it in til it blows up, which I did, or find constructive ways of dealing with it, which is what I try to do now. But when things blew up, I hurt those around me, the closer and more supportive they were, the more so. I realized this and it was a major incentive to get better so that I would not continue to have the stuff come out sideways and hurt the ones I love and who love me. I can see though, that had I just felt entitled to what I was doing rather than being appalled at it, it would then be but a short drive to perp-dom. So I have understanding, but no tolerance or forgiveness for abusers.

I am grateful for being able to break the cycle in my own life but it has come at great cost. My tendency was to buy into the perpetrator's version of the story and see myself as defective or the source of whatever problems they blamed on me. I promised myself when I was a little kid that I would not do to my kids what was done to me. My latest greatest abuser played into all my fears and insecurities (and ignorance about boundaries!) and after I got totally screwed over, the person convinced me that I was the abusive one (I hesitate to even write this for fear that whoever reads it will side with my abuser too!) by invoking what I had recognized as lies a previous toxic person had accused me of.

The latest, greatest one knew my feelings and insecurities about this because I told her all about them. Rather than realizing "wow, what a sick person, trying to justify her abusive behavior by flinging that stuff at me," I thought "well that's twice in a row...maybe I'm as blind as my parents were to their abusive behavior and just cannot see it." As a result, I decided not to have kids, because I took my childhood promise to myself seriously, and until I could see how it was I was being abusive I would do what it took to make sure I didn't pass it on.

This was my backwards sense of boundaries, where I thought they were to keep me walled off from doing harm from others rather than to protect myself from toxic abusive people. Years later, the person admitted I had not been anything close to abusive and that she made it up to justify her actions, but by then it was too late to start a family and the harm had been done. Because a life of traumatic relationships with everyone from parents to siblings to strangers to lovers, my belief in myself and my own feelings was nil. This is perhaps the greatest thing I have recovered in getting better from PTSD, my trust in myself as a basically good human being. I had to learn what most people learn as children, how to tell what's mine from what's not, and that has made all the difference.

a loving and supportive network of friends

In a comment to this post, anonymous wrote:

also maybe you just haven't found the right support group yet. There's nothing like sharing with others who have endured similar experiences

This is true, sharing with others who have been there, or who have other ways of understanding, is a tremendous help. If you look through the rest of the blog, you will see that my recovery has come a long way. I do have a lot of support but it is not formalized in a "group" right now and that is fine with me. What I do have is a loving and supportive network of friends and family of choice. Groups have served their purpose in my recovery, and I have done them in several different forms and may do more if I see an opportunity to get better by doing so.

But groups have also been fraught experiences for me. I've said enough elsewhere on 12 step approaches, but even in therapeutic groups, the nature of a lot of my trauma and its manifestations is often threatening to other male group members' sense of their own masculinity and they have often gone out of their way to not identify with me, distancing themselves as much as possible. From what I gather this is their issue, not mine, but I'm not there to have them play out their idea of what a man is by being hostile to me or undermining my sense of who I am and what I have been through. Its counterproductive and whatever the opposite of affirming is.

Here is what I do have though, a loving and supportive network of friends and family of choice. Most untraumatized people grow up with the family part and develop the friends part as a matter of course. I had to spend decades to learn how to do it, and it had to be with a new family of my own creation, not my family of origin. I was able to manage this by reaching out to people as people, not as alcoholics, drug addicts, or trauma survivors.. Some had some of these issues mind you, but I reached a point in my life where that no longer needed to be the primary basis for a relationship.

When the PTSD came on hard, I involuntarily had to lean on this network for all it was worth, and these friends and family were there for me and came through for me in ways that my family of origin and my old frineds, both as an active addict and as a person recovering within the frame of the twelve steps, did not. What I like to think is that I had gotten well enough to operate in the world of "earth people" -- normal folks, in other words -- as one of them, instead of identifying as an addict or a victim or a survivor first and foremost. One of the goals of recovery is to reintegrate into society as a useful member, and over the course of many years that is what I have done. I'm just a person among people. Like everyone, I've got my own unique history, and I act in some particular ways...for example, not drinking or drugging. But I am more or less just a regular person, as long as I take care of myself.

So anyway, when doing EMDR, I was having difficulty facing some of the trauma yet it was intruding in my life in the form of flashbacks, seizure-like things, hypervigilance, and a host of other things. We did what is called installing resources, and the resource that I came up with was to think of my firends as a literal net, holding me up and protecting me from falling when I could not do so myself. This resource or whatever has helped me immensely, and my earth-friends have come through for me again and again to the point where I don't have to rely on that net anymore. It is good to know it is there though. Actually, it kind of reminds me of the end of Harry Potter (spoiler alert) where he goes and faces the evil Voldemort alone sort of, but with the sort of mental company of supportive and loving friends and family that carry him through things he did not believe himself capable of. Even when the are not there they are there.

Perhaps that image...a literal net made up of supportive and loving friends and family...is one that will help others get through the trying times of PTSD like it did me. It was not a cure, and it did not make it easier or less painful, but it did enable me to get better and to face some pretty horrific stuff to know I wasn't -- and still am not -- in it alone.

More on Type A & B addicts, 12 steps, and trauma

This was originally a response to some comments to "ptsd, AA, and different types of addicts" that grew too long, so it became a post. If you're curious, or want to try and convince me that my experience is wrong ;^), you can read more about my thoughts on PTSD and 12-step programs, the Christian basis of AA's "spirituality", and why I finally decided, after 17 years, to leave 12 step approaches, a difficult decision.

anonymous at 9:17 pm said:

I believe that AA can help anyone to sobriety and a life worth living.

Oh dear, the type A AAs have found us :)

...There ARE AA members experienced with PTSD. Value your own recovery enough to seek them out.

Indeed, during the seventeen years I attended AA I did find some people who knew personally what PTSD was and they were a tremendous help. I also met a lot of crazy people who thought because their way of doing things wasn't working for me that I was doing something wrong...kind of like you are here.

If it were easy, EVERYONE would be sober and sane.

a little condescension to help you endear yourself to us struggling misguided fools who don't do things your way....

... But sobriety and life are worth the effort. ...Find the people in AA who relate to who you are and where you've been. They are there.

Translation for type Bs: You are doing it wrong if you are not doing it my (anonymous's) way -- oops, I mean, the AA way, and you're not sober or sane unless you go through AA. Thanks, but no thanks. Been there done that. That is what the post explains if you could see through the haze a bit. If you go by the slogans, I might suggest "live and let live" to the anonymous poster here...Things only got saner and better for me after I left AA. That seems to be threatening somehow, and of course the type A response is that I didn't do it right. Well excuse my French, but fuck that. I've now been sober over 22 years, the last five without AA. I got a lot out of AA and gave a lot back, but it became more harm than help, to the point that my worst days sober were as bad or worse than the low points of my addiction, which included homelessness, hallucinations, lot's of "lucky to have lived through that"s, and lots of drug induced emotional and physical injury, so I left. Mind you, I wouldn't trade those awfullest sober days in for the druggy ones -- I learned a lot of hard-bought things about people and --I can't think of anything else to call it...sickness just doesn't capture the true extent -- evil from the hard times of my sobriety.

If I remember right, and I do, the definition of insanity I learned in AA was "to keep repeating the same things over and expect different results." Working things through the aa way became exactly this form of insanity. At a certain point the aa way...steps, spirituality, constant meetings, the whole thing that I was doing with the best of them...just wasn't working, again and again, no matter how hard I tried or how close I hewed to the big book and the rooms.

Maybe I'll drink tomorrow. I saw plenty of twenty and thirty year AA-ers go out and drink too. I plan on staying clean and sober, as I value the life it has granted me immensely now that I have been able to stay clear of the craziness and harm I encountered in AA. If it works for you, well bless you, go forth....I probably would have sided with you the first 5, 10, or 15 years I was sober. I was wrong, and I humbly submit that you are too if you think AA is a one stop shop with the answers for everyone's recovery. Open yer mind a little, please.

the next anonymous said:

But to say that the person with PTSD is .."almost exclusively harming themselves..." is denial at its greatest. It takes courage to ask for help.

Just for clarity sake, that quote within the quote is from another commentator, not something I said, though I said something similar. I agree with the wife of the PTSD sufferer, and I am sure my own partner would too, as she endured a lot of agony in supporting me through the worst of my PTSD. I am forever grateful for that...It has taught me what love really is in many ways, so if you are truly supporting the recovery -- and recovery can happen -- of a PTSD-er, well then props to you! Its a huge task and takes a lot of love and understanding.

I was referring, and I think the commentator was too, to the sort of perverse tendency Type Bs have of trying to make amends to their perpetrators. In my case that included members of my family. They are the ones who are in denial, not me. And to live as they would have me would kill me, quite literally, and they would rather see that than see what they did. I just stay far away now, which is sad, but I have developed a wonderful family of choice and made a life for myself with room for all of who I am.

When I was in the worst stages of my addiction, and my recovery, I isolated like the commentator, and any pain I caused my perpetrators was probably from pangs of guilt more than anything else. I managed to keep everyone else away from me. I didn't have anyone because I didn't think I was worth anything to anyone, and created a self-fulfilling prophecy. When I stopped drinking and drugging, this left me real vulnerable to a particular type of misanthropic, often charlatan, type of person who can be found in or around any AA anywhere (I had home groups in four different cities over the years). Mind you, I'm not saying all AA is like that, just that all AA attracts such people, and they prey on people like I was. I've seen it many times and experienced it more than once before I wised up. These types took some people's lives to get what they wanted and almost got mine. Maybe someday I'll tell that story here, but I try to keep things general so more people can relate and also so as to remain anonymous myself.

Anyway, there was no wife or partner or significant other in my addiction because I thought I was too fucked up to be with anyone -- and I mostly was. Type Bs tend to blame themselves and take on the violence and anger of others as their own. This has ...ummm....negative effects on one's social skills and attractiveness to others. This is what I had to learn to reject and get angry at in order to get better, that the guilt and shame I felt were not mine, but belonged to others, and I would imagine that the commentator was trying to express something similar. I am sure if he or she had people in his or her life, they were affected as you say, but some of us clear everyone out for their own good to protect them from what awful people we have been taught by our perpetrators to believe that we are. Realizing that was a lie, and dumping the evil others had dumped on me in a safe and non-abusive way were key to getting to a place where I could let people in and have real relationships. I could have gone to AA for eternity and I would never have learned what I needed there.

grounding exercises for ptsd symptoms

Today I'll go over a grounding exercise I learned that was very helpful in managing ptsd symptoms. Its not a cure. At best, it makes the unbearable manageable. Sometimes when things were really bad it did not work well at all, but I did it anyway. The goal is to bring the ptsd sufferer back to the present by way of the senses, out of a flashback or intrusive memory. Anytime the symptoms of ptsd come on, whatever they are for you, is a good time to practice this exercise.

First look around and see five things present where you are, naming them -- out loud if possible (the naming out loud is supposed to help, but sometimes I would cheat and do it under my breath, too). Anyway, name specific things, in detail, as you see them. For example, I see a picture of my old dog with a wet nose; I see a black computer speaker; and so on. Then name five things you can hear, like the humming of a fan, cars passing by, the dishwasher running, and so forth. Then name five things you can feel. I had a hard time with this first, because I thought it refered to emotions, feelings, but that's not what I was supposed to be after. Its the sense of touch, so I feel jeans against the skin of my left thigh; I feel the soles of my feet on the floor, and so on. If you get stumped, its ok to repeat things, just concentrate on actually sensing them in the present. Then repeat the whole process for sight, hearing and touch four times, then three, then two, then one. You get extra bonus points if you become so wrapped up in your senses that you lose count. Generally, this would bring me back a little. I would still be miserable most of the time and in pain, but the memory part would subside and sometimes the worst symptoms of a flashback would recede.

[n.b.: updated 12/8/08 to replace broken links with new ones]
This isn't the only way to do it, just a very simple and easy to learn one that worked for me if you need it. About.com has some simple suggestions. The Mental Health Matters web site breaks it into three options: accept it and go through with it, learn to control it, or escape it. It is not always a matter of choice though. Their methods of coping are the same for whichever option you choose (or which chooese you!), including one that I tried during the worst of the flashbacks at the behest of counselors in the PTSD treatment center I was in. They had me hold two liter bottles of frozen water (ummm, I think they call it ice :), one in each hand to bring me back. I melted the ice in both and still didn't come back...they were about to send me off to the hospital, but I managed to get a handle on things after about a four hour flashback. Possibly the worst few hours of my life. Cold, the site explains, activates some reflexes that slow down the heart and exert a calming influence. Finally, you can read a more academic but still enlightening and useful treatment of coping techniques in the book Rebuilding Shattered Lives by James Chu.

ptsd, flashbacks, and "pseudo-seizures"

Just a quick post today. I have lots to write about. Working hard on recovery and finding out some new things from this experience of blogging about my ptsd. I'll share in little bits over the next few days. Plus, I just spent my blogging time commenting on another thought-provoking article on Holly's Fight to Stop the Violence on Internet Porn and Sexual Addictions.

BTW, grounding exercises can help a little with flashbacks, so if what I describe below is familiar try them out. They don't make the flashbacks tolerable or make them go away, but they helped bring me back to the present a little sooner when I could do them.

I just want to talk about what are called "pseudo-seizures." They are a particularly nasty kind of ptsd flashback. When I first came upon the name in therapy, I was relieved that there was even a name for what I was undergoing, namely half-hour to hours long episodes in which I would become a tautly curled up shaking sobbing mass of pain, followed by major disorientation...I often would not know what day it was or if and how long ago the thing had happened. I had hundreds of these over the space of a few months, utterly terrifying and exhausting, doubly so when I didn't know what they were. I just thought I was going crazy. So unlke ReallyNotImportant, who dismisses the labels as not very helpful, I found having a name for what I was experiencing comforting to some degree. At least I was not alone. This was within the range of human experience, even sane experience.

If you are having these things, which doctors are now starting to call "non-epileptic siezures" because sufferers have understandably negative and invalidated responses to the "pseudo" part of the label, I truly feel for you and hope you will get help however you can to get through it. There is another side, as far away and impossible as that may seem. I didn't think so either but there is, so plz hang in and get help. There is nothing pseudo about the experience at all. It is horrible.

I tried to think what I might have called them if I didn't know what they were...When I was able to contain them to when no one was around, I invalidated them as just me being dramatic -- though never with an audience. I just tried to minimize, hide, and wish them away. Ultimately, they outed me and that is when I got help from my wonderful family of choice. I thought they would think I was crazy and just discard me like my abusers had when they were done with me.

I guess "crazy" or "insane" were my descriptors once the cat was out of the bag. And they would have been correct I suppose if I hadn't been so fortunate as to be able to get help and support. I looked and felt battered and emptied out of all humanity, only able to feel pain and not able to get rid of it for a moment. No relief.

I still get shadows of them today. Sometimes I shake badly. Sometimes like today I feel like I am hitting the top of an elevator all day, an unsteadiness in the pit of my stomach. It serves as a reminder of worse times, but it is nowhere near the intensity of before...I have been "pseudo-seizure" free for a couple of years now. They slowly worked their way out of me. So if you have 'em, please don't let them get that last little bit of you that you hang on by, even if you have to fight tooth and nail and act all unseemly and cry alot. I needed medication as part of my solution...Geodon was the key one for me, though I know others who hate it.

So if you are having these sorts of intense, seizure-like flashbacks, or have had them in the past, leave a comment and let me know I am not the only one in the blogosphere to have had them!

crawling out of my own skin

PTSD sucks some days. The last few days fell into that category. At least its not constant like it used to be. Two days ago was crawling out of my own skin day. I just walked around with this ripping burning nauseous feeling centering on my solar plexus like I wanted to puke my guts literally out...just get whatever it was out of my body. It makes me kind of understand bulimia, which I never fortunately had. My partner gave me a massage which helped a little, but it didn't go away until I went to sleep. I suspect it had something to do with stuff brought up in therapy that day.

Then the next day I was revisited by another of the joys of ptsd, intrusive thinking. Any moment of down time, thoughts of my abuser would come flooding in and I would try to make sense of the senseless, over and over. This lasted until I went to sleep, maybe longer, as I tossed and turned a lot and had nightmares. All in all it kind of sucks. My partner thinks it might be because of the onset of the holidays, which is a tough time for me. Anyway, at least now it is not constant. Before the intrusive thinking and the ripping feeling, along with a lump in my throat were my ennervating constant reality.

Comprehensive list of US Treatment Centers for PTSD and Trauma

Updated 4/2/19
This is one of the most read pages on the site, so I guess there must be a need for more information of this sort. The Sidran Institute gave me the original list, which I have now removed because it was outdated.  Sidran keeps a comprehensive list of U.S. treatment centers but this list is static and may not be updated regularly.  Sidran has an excellent help desk. If you need help locating a treatment facility, contact them. If you have concerns about contacting a place over the net, they have a page explaining how the help desk works. If you want to help out, their help desk is currently without funding and run all by volunteers, so make a donation or volunteer once you are better. They will use it to make sure someone is there when you need them and to update their resources to make it easier for volunteers to find the information you need. They are doing great work.

Sidran is US-based.  If you are not in the US, you might find help at the International Society for Traumatic Stress Studies database. Along with Sidran, ISTSS has a lot of helpful materials available and is worth a look. GoodTherapy.org also has an international database. 

Before contacting any of the centers (unless you are in immediate crisis!) it would be a good idea to look at the post on how to choose a therapist for PTSD.

If you are considering one of these places, make sure you check for references to it in the comments below the main post too, as many readers have offered their very valuable personal experiences at a number of these places. If you have had good or bad experiences, feel free to share. I reserve the right to not publish if it seems there is disrespect or slander going on. Please avoid naming particular people, but saying the" director," "my therapist" and so forth is fine. Otherwise, keep it real and I'll approve the post no problem. There are some names in here right now because I did not put this policy into place until 4/29/2010, but I'll leave them unless I get complaints from the person named as the comments are still valuable and I cannot edit them, just publish them or not.

ptsd and meds

[2/2010: one reader asked for people to share what has and has not worked for them concerning meds. If you have had good or bad experience with any particular prescribed meds, share it in the comments please.]

I've been some sort of human guinea pig for the better part of a decade. After one trip to the mental hospital I went on Prozac when that first came out. I didn't like it and quit after a few months. At the time I had no insurance to speak of and didn't trust the mental health profession at all. A few years later, I was trying to get things under control and got diagnosed with Obsessive Compulsive Disorder (OCD). They put me on a clinical trial for a drug that was used for something else altogether. I got markedly suicidal, and when I reported that, the doctor would interpret his questionaire number scores and say I was improving, completely ignoring what I was saying! I discontued the drug and the trial. A year or so later, I went to a shrink. The shrink sent me to a psychiatrist, who was this guy who smoked in his office. He barely even met with me and put me on Zoloft. I took it and got suicidal. He upped the dosage, things got worse, so he upped the dosage again and things got worse again. He wanted to up it some more. At this point I quit...He wasn't paying any attention to what was going on with me, just following some formula with the drug being pitched by the pharmaceutical companies that week.

A few years later, right before the ptsd got really bad I decided to go back into therapy, this time with a psychiatrist so he would actually listen to what I was saying. The guy wanted to put me on Celexa and pulled out this tinker toy model of a neurotransmitter reaction (serotonin reuptake inhibition, to be exact) that was right out of the Parke Davis sales kit. It was like Amway or a tupperware party or something. He turned out to be a real jackass and I cursed him out and left mid-session after he did something really unethical concerning my privacy.

After that the ptsd kicked in with the flashbacks and all the other stuff I described yesterday. I didn't want to take any drugs at this point, but we were desperate. My wife did some research and found out some stuff about picking psychiatrists and psychologists and called around, interviewing some people. We finally found a good psychiatrist and therapist. The psychiatrist actually listened to what I said about the previous drugs and tried one that acts on something other than serotonin. So we started with effexor. No side effects from this, but not much in the way of front effects either. I had done some research and suggested we try Naltrexone, a drug used to stop cravings in addicts, thinking that some of my problems (picking and ripping out skin, compulsive masturbation) were maybe related to addiction problems) It helped with those things a little, but not with the main problems.

Then I went to the treatment center I mentioned yesterday, and there they slowly got me on a total cocktail: Effexor, Naltrexone, Wellbutrin, Trazadone to sleep, and zyprexa, an anti-psychotic that finally helped with the flashbacks. Later, we switched the zyprexa to geodon, a related anti-psychotic without some of the side effects. Then a year or so ago, we added seroquel to the mix at night and I worked my way off the trazadone. That helped with the intrusive thinking. So until recently my drug cocktail looked like this: 450mg Welbutrin, 300mg Effexor , 100mg Naltrexone, 140mg Geodon, and 100mg Seroquel. I finally started to get some stability.

My favorite discussion of the drugs is the two anti-psychotics, because the doctors always said it like one word: It is an anti-psychoticbutyournotpsychotic. The flyers for these (the seroquel and the geodon) are kinda scary, because the FDA hasn't approved them for anything but schizophrenia, so that is all they talk about. A little searching around on the web showed anti-psychotics were being tried for ptsd as a "second line" if serotonin-reuptake inhibitors like Prozac and Zoloft didn't work.

Lately I have been trying to cut down some of the dosages. We started with the Geodon, because that made me dopey and gave me a real flat affect. Got that down to 20mg, but the ptsd, depression, and anxiety started to come back so the dose went back up to 40mg. That seems ok. Now We are trying reducing the Seroquel, the other real powerful one. I am down to 50mg on that and so far so good.

[update...Feb. 2010. I am off the Seroquel, but had to reintroduce the Trazodon...I know split the lowest dosage pill (5MG?) in half and take one of those to sleep. Just can't seem to sleep otherwise. I take Seroquel about once every three months or so if I have a really bad day and I'm having intrusive thoughts that won't stop through non-chemical means. Most recently, I phased out the Naltrexone, which seemed to make no difference. Earlier, when I tried to get off Effexor, it was a disaster, so that is staying for the foreseeable future. You should read the two posts on Effexor (Battle of the Effexor and Joy of Meds: Effexor withdrawal) BEFORE going on it, though, so you know what you are in for. So now the cocktail is 40mg Geodon, 150mg Effexor, 300mg Wellbutrin, and 2.5mg Trazodone.] Mazeltof!

What is it like taking so many drugs? My sex drive changed a lot...It kind of went to hell for the most part, but the compulsive parts stopped too, so its a mixed bag. It takes me a year to pee -- no water pressure, -- and I am constantly mildly constipated (sorry for the details). People have noticed I am a lot livelier since cutting down on the geodon, so that is good. Ultimately I'd love to be off them all, but that might not work, and at this point I am willing to face that rather than facing a return to the worst of the ptsd symptoms.

It kind of sucks to have gotten sober for so long and then be reliant on drugs to be able to function, but that is the way it goes. Anyway, any 12-stepper who actually reads the literature knows that if a doctor tells you to take a medicine that you take it, as directed, which is what I do. Some 12 step folks think it is cheating or a cop out, but they don't have to scrape me up off the floor after a flashback either so they can go s....well never mind.

For me, the point of all this is that it paid off to be persistent in finding good people to help me and to have some really supportive people around. I have been really lucky that way. 12 step people talked about being there, but weren't. I was sober for a long time and it freaked people out that I was having problems. Some of them were nice and understanding, but the people that took care of me for real had nothing to do with 12 step programs. They just talked the talk with me and seldom came through. I don't want to get too down on the program, because it did save my life earlier, but it also really screwed me up in terms of trauma and recovery from it. Maybe I'll go into that some other time.

Also, I am privileged. I am at a point in life where not only do I have people that care about me enough to give me the support I need (a lot less these days), but I have insurance to cover the therapy and the real expensive drugs, and found the financial wherewithal to go to treatment even when it wasn't covered by insurance (even though we went into lots of credit card and family debt...my wife's family...my family wouldn't acknowledge that there was a problem). If I hadn't gotten those things, I'd probably be dead, locked up, or homeless. So I am pretty privileged to be walking around and functioning like a regular human being, and I think about that when I see people who are homeless or down and out. That's something I'll have more to say on at some point.

Anyway, if you have read this far, thanks! Let me know that you read it, ok?

ptsd and me

OK, the description by the title says a lot about what I want to do here, but let me tell you a little about me. I'm a white guy (but a bit of a race traitor), mid-40s, good job that I'll never get rich from but pays the bills and is fun. I'm happily married, live in a beautiful place, and life is pretty good -- when I can be present for it.

I also have severe, chronic, complex, delayed onset ptsd. It makes my life challenging, but now that I know what it is, I at least have a handle on what was and is happening to me. PTSD is of course, post-traumatic stress disorder. Let me go through the other parts.

Severe? The last major run-in with it put me out of work for over a year. I had about 120 flashbacks over the course of about seven weeks, what get called pseudo-seizures -- they look like regular seizures but I remained somewhat conscious and aware of my surroundings, though sometimes delusional about that. When I came out of them I wouldn't know what day it was or be able to remember how long ago they happened. Maybe I'll go into more detail about them sometime, but they totally freaked us (my wife and me) out. We had no idea what these were or what to do about them at first.

There was more: intense crying jags, incredible bodily pain (I had an operation for hemorrhoids, which is supposed to be about the most painful recovery you can imagine, and ptsd was worse -- though I wouldn't want to repeat either), and something called intrusive thinking...memories of traumatic events triggered by anything, everything, and nothing; lost forty pounds, couldn't sleep, sex life totally fucked up (part of my trauma is sexual abuse, something I'm still trying to deal with), couldn't focus enough to read, self harm (ripping chunks of flesh out for example), and there was probably more I cannot remember. Ummm, no fun.

We (actually, mostly my partner) did a lot of research when the flashbacks started and I ended up in a treatment center for ptsd (Here's another good one, and a comprehensive list for the US). It didn't cure me, but it gave me some tools to help manage things. Slowly, with lots of medication (which I struggled against), therapy, and lifestyle changes, some of the harsher symptoms have gotten better over the past few years.

Chronic? I have come to realize that I have had some version of ptsd for most of my life, but it has been treated and mistreated and outright abused under a bunch of different names.

Complex? Well, let's see...It starts with childhood sexual abuse (which I still struggle with identifying because as a kid I normalized it and my family of origin is in complete denial -- so much so that I am no longer in touch with them -- too crazy-making), neglect, emotional and verbal abuse, depression, and substance abuse. I left home at a young age and added physical abuse and more sexual abuse onto that from street life. I developed a nasty drug and alcohol addiction, something pretty common for ptsd sufferers (I've been clean now for more than twenty years, but other addictive behaviors have haunted me) and became occasionally homeless. The depression continued, I was suicidal. Substance addictions, sexual acting out (nothing violent, but stuff that I'm ashamed of) combined with intense isolation and loneliness contributed to having a really miserable existence.

After getting clean in 12 step programs, my attraction to sick, twisted people (also part of my ptsd) caused more trauma, some of it worse than the substance abuse addiction. Cult abuse, some serious, life changing betrayals by people I trusted and opened up to, suicide attempts, two three-week stays in the loony bin: I wasn't getting the "happy, joyous, and free" promised by 12 step programs. For their part, 12-steppers (and I guess my own internalized twelve step training) often blamed me when things didn't work, saying I was just not doing things right somehow rather than seeing something was wrong that the program couldn't -- and wasn't designed to -- fix.

Severe spiritual and therapist abuse compounded the traumas rather than treating them. This has been a major challenge in my recovery from ptsd. Trust is a problem. A lot of times I don't even trust that the world is not going to disappear beneath my feet. On bad days, every step is an adventure, like walking on a rotted out rooftop or thin ice.

So yeah, its complex.

Delayed onset? The flashbacks started nine years after the events that caused them, long after I was supposedly "over it." In hindsight, I was displaying symptoms of ptsd the whole time, but no one recognized them as such. I got diagnosed with depression, obsessive-compulsive disorder, and a few other things and got put on whatever drugs the pharmaceutical companies were plugging that week with awful results.

I thought I was a sex addict and went to those meetings for a while, but they all had sex with other people. My problem was with porn and compulsive masturbation. I used this as a painkiller because nothing else worked and I was not about to give up sobriety -- too scared of people to act out any other way. Sometimes internet porn would eat up whole days every day. It is something I still struggle with and will write about more, but I didn't feel safe or supported in the twelve step rooms for sex addicts. My sponsor there was hitting on me under the guise of male intimacy and spirituality and others were perpetrators of stuff that I had been a victim of and were having a hard time seeing it as a problem. Not a safe place for me.

I'm actually pretty fed up with twelve step programs even though at the time I got sober they no doubt saved my life. Here's what one study (.pdf file) has to say about it:

Messages in substance abuse treatment such as Dont work on the PTSD until youve been clean for a year or Substance abuse is the only problem you need to focus on, while well-intentioned, can be perceived as invalidating of clients trauma history. . . clients and clinicians report that when a client has PTSD, getting clean and sober is a bigger hurdle and such traditional methods may not work as well. For example, the tendency for PTSD memories and feelings to worsen as clients get clean is a common phenomenon. . . . Sadly, clients with the dual diagnosis of PTSD and substance abuse have worse outcomes than those with either disorder alone, and may internalize a sense of failure when they do not succeed in standard treatment programs that work for others. Feeling crazy, lazy, or bad is common-- a sense of demoralization, self-blame, and a feeling of something being terribly wrong with them. . . . initial evidence suggests that working on PTSD and substance abuse in an integrated fashion results in positive outcomes in both of these disorders, as well as related areas. Contrary to older views, treating both PTSD and substance abuse at the same time appears to help clients with their substance abuse recovery, rather than derailing them from attaining abstinence.

I got sober under the "older" model. Against the odds, I didn't pick up. When people at the treatment center heard my story, they were amazed that I stayed sober through it. But drugs and alcohol were a hell I didn't want to go back to.

Anyway, that's a little of my "war story." One last thing for now: I have talked to people who have combat ptsd, and the symptoms don't seem a whole lot different, even if the causes seem different. My ptsd is pretty un-macho, though, so if that offends or you can't deal or you think I just need to get over it, maybe you need to look elsewhere or start your own blog. I have no desire to play the ptsd version of what Elizabeth Martinez calls the "oppression olympics."

I guess the next thing I'll do is post some links. Leave a comment if you read this, let me know someone is there.